Attitudes Toward Methamphetamine Use and HIV Risk Behavior in Men Who Have Sex with Men (original) (raw)
Archives of Sexual Behavior, 2011
This study examined attitudes about condoms as a moderator of the relationship between methamphetamine use and sexual risk behavior in a sample of 297 HIV-positive, methamphetamine-using men who have sex with men (MSM). To test for a moderating effect of attitudes towards condoms, an interaction term was included in multiple regression analysis along with age, income, negative condom attitudes, frequency of methamphetamine use, and Beck depression score. A post hoc analysis was conducted to determine the relations between methamphetamine use and unprotected sex for persons with more vs. less negative attitudes toward condoms. These analyses indicated that when individuals had more negative attitudes toward condoms, the relation between methamphetamine frequency and unprotected sex was significant, while among participants with less negative attitudes toward condoms, no significant association was found. Addressing methamphetamine-using MSM's attitudes about condoms can serve as a form of harm reduction for those who are not yet ready or willing to discontinue methamphetamine use.
Journal of Urban Health, 2006
Among men who have sex with men (MSM) in Los Angeles County, methamphetamine use is associated with high rates of HIV prevalence and sexual risk behaviors. In four separate samples of MSM who differed in the range of their intensity of methamphetamine use, from levels of recreational use to chronic use to those for MSM seeking drug abuse treatment, the association between methamphetamine use and HIV infection increased as the intensity of use increased. The lowest HIV prevalence rate (23%) was observed among MSM contacted through street outreach who mentioned recent methamphetamine use, followed by MSM who used at least once a month for six months (42%), followed by MSM seeking intensive outpatient treatment (61%). The highest rate (86%) was observed among MSM seeking residential treatment for methamphetamine dependence. The interleaving nature of these epidemics calls for comprehensive strategies that address methamphetamine use and concomitant sexual behaviors that increase risk of HIV transmission in this group already at high risk. These and other data suggest that MSM who infrequently use methamphetamine may respond to lower intensity/lower cost prevention and early intervention programs while those who use the drug at dependence levels may benefit from high intensity treatment to achieve goals of reduced drug use and HIV-risk sexual behaviors.
Sexually Transmitted Diseases, 2009
This study compared associations between methamphetamine use, drug use other than methamphetamine, and HIV transmission factors among men who have sex with men, attending an sexually transmitted disease clinic. Of 6435 participants, newly recognized HIV status (OR: 3.02 95% CI: 2.30, 3.99) was associated with methamphetamine use compared with nondrug users, an association not found among other club drug users. The HIV epidemic in the United States continues to predominantly affect men who have sex with men (MSM). 1 Among MSM, stimulant drug use, and in particular methamphetamine, is associated with concomitant high-risk sexual behaviors 2,3 and complicates efforts toward prevention of new HIV infections. Surveillance at HIV testing sites in San Francisco found a 3-fold increase in HIV incidence among MSM who reported methamphetamine use compared to those who did not report its use (methamphetamine users: 6.3% vs. nonmethamphetamine users: 2.1%). 4 At follow-up visits in the Multisite AIDS Cohort Study sample, MSM who reported methamphetamine use were approximately three times more likely to seroconvert than those who did not report such use. 5 Wong et al reported strong correlations between methamphetamine use and early syphilis infection among gay and bisexual men attending the San Francisco City Clinic. 6
Biomedical HIV Protection Among Gay and Bisexual Men Who Use Crystal Methamphetamine
Aids and Behavior, 2019
Use of crystal methamphetamine (crystal) among gay and bisexual men (GBM) has been associated with condomless anal intercourse with casual partners (CLAIC) and HIV infection. Pre-exposure prophylaxis (PrEP) and undetectable viral load (UVL) are important biomedical HIV prevention strategies. We investigate the relationship between crystal use and HIV sexual risk behaviours in the context of PrEP and UVL. In 2018, 1367 GBM provided details about crystal use and HIV prevention strategies. Binary logistic regression was used to estimate associations between crystal use and behaviour. Recent crystal use was independently associated with greater social engagement with gay men and having more sexual partners. Crystal use was also independently associated with use of PrEP and UVL among GBM who engaged in CLAIC. Although GBM who used crystal were more likely to have engaged in CLAIC, they were also more likely to use biomedical HIV prevention which mitigates against the risks of HIV infection.
Drug and Alcohol Dependence, 2018
Background: Methamphetamine use is common among some populations of gay, bisexual and other men who have sex with men (gbMSM). This study reviewed the status of research on the efficacy of interventions that address harms among gbMSM who use methamphetamine. Methods: We searched MEDLINE, PsycINFO, CINAHL, Embase, Cochrane Central Register of Controlled Trials, Web of Science, and Google Scholar to identify publications from inception to October 23, 2017, that assessed an intervention addressing methamphetamine use among gbMSM. Results: Of 1896 potential studies and 935 unique articles screened for inclusion, 28 eligible studies assessed 26 different interventions in the following categories: pharmacological (n = 5); psychosocial (n = 20); harm reduction (n = 1). Given that outcome variables were measured in highly variable ways, we were unable to conduct a meta-analysis of intervention effects. However, 22 studies reported a statistically significant effect on one or more methamphetamine-related outcomes. Among 21 studies that included measures of sexual healthrelated outcomes, 18 reported a significant effect on one or more sexual health-related outcomes, and 15 of those reported a concurrent effect on both drug-and sexual health-related outcomes. Conclusions: This is the first review to provide compelling evidence that integrating interventions to address both drug-and sexual-related harms for gbMSM who use methamphetamine can be efficacious. Future research should focus on identifying differential effects of various intervention approaches by social positioning, as well as prioritize future evaluations of integrated harm reduction interventions (e.g., the distribution of harm reduction kits within sexual health care settings). 1. Introduction Across global settings, including North America, Europe, East and SouthEast Asia, and Australia (United Nations Office on Drugs and Crime, 2017), methamphetamine (MA) use manifests within many gay, bisexual and other men who have sex with men's (gbMSM) sexual and social lives (Ciketic et al., 2012). A growing body of research also indicates that the use of MA, used alone or in combination with other substances, is among the primary contemporary drivers of high-risk sexual behavior among gbMSM (e.g., unprotected anal intercourse with multiple concurrent partners), significantly contributing to the elevated rates of HIV and other sexually transmitted and blood-borne infections (STBBIs) that gbMSM experience today (Bradshaw et al., 2003; Celentano et al., 2006; Colfax et al., 2004; Ferlatte et al., 2014; Marshall et al., 2011). As such, epidemiological data now clearly indicate an association between MA use and high viral loads among HIV-positive men and an increased risk of HIV/STBBIs transmission or acquisition among gbMSM more broadly (Carey et al., 2009; Cunningham et al., 2015; Plankey et al., 2017). This growing body of evidence also now indicates that the elevated rates of HIV/STBBIs among gbMSM is highly associated with the sexualized use of MA, i.e., intensive use of MA and other substances (e.g., gamma-hydroxybutyrate-GHB) to maximize
Sexual HIV risk among gay and bisexual male methamphetamine abusers
Journal of Substance Abuse Treatment, 1996
The current report examined HIV-related high risk sexual behaviors among a small sample of gay and bisexual male methamphetamine abusers in Los Angeles. Participants were 16 methamphetamine-abusing or -dependent gay or bisexual males who participated in a treatment demonstration project between 1989 and 1993. All participants completed the NIDA/WA VE survey, a detailed inventory of HIVrelated risk behaviors. Findings indicate a strong connection between methamphetamine abuse and highrisk sexual behavior. For the 12 months prior to treatment 62.5% of participants reported having anal insertive sex without a condom, and 56.3% reported having sex with someone who had HIV. Drug use before or during sex, measured on a 5-point Likert scale, was frequent (M = 4.27, SD = 0.7). Implications for treatment of gay and bisexual male methamphetamine abusers and prevention of HIV among this population are discussed.
Initiation into methamphetamine use for young gay and bisexual men
Drug and Alcohol Dependence, 2007
Research over the past 10 years has suggested that methamphetamine use has become a significant problem and is associated with risky sexual behaviors among gay and bisexual men. In order to better understand initiation into methamphetamine use among gay and bisexual men, qualitative analyses were performed on a sample of young gay and bisexual men (ages 18-29) in New York City. Participants were recruited as part of a larger study which used time-space sampling to enroll club-going young adults who indicated recent club drug (ecstasy, ketamine, GHB, methamphetamine, cocaine, and/or LSD) use. The data for this paper are derived from the qualitative interviews of 54 gay and bisexual male methamphetamine users. At initiation (1) methamphetamine was used in a social, non-sexual setting for a majority of the participants; (2) participants expressed limited knowledge of methamphetamine; and (3) many participants used cocaine as a basis for comparison when describing various effects of the drug. The understanding that at initiation methamphetamine was not solely used as a sexual enhancement for members of this community may enable health workers to more accurately target potential users when putting forth intervention efforts. Future research should aim to gain a better understanding into the role that methamphetamine plays in non-sexual contexts, particularly among gay and bisexual men who may not be part of the club "scene." The relationship between attitudes towards methamphetamine and other drugs, particularly cocaine, among gay and bisexual men should be explored.
AIDS and Behavior, 2000
Methamphetamine is widely used among gay and bisexual men in the West Coast of the United States, and is often used in combination with high-risk sexual activities. This study combined quantitative and qualitative research methodologies to examine sexual risk behaviors among gay and bisexual male methamphetamine abusers as they entered treatment and at 1-year follow-up evaluations. Findings from the quantitative follow-up data demonstrate that gay and bisexual men reduce sexual risk behaviors and sustain those reductions following substance abuse treatment, and qualitative data reveal the meaning of these behavior changes from the perspective of the participant. At 1-year evaluations, associated behaviors of methamphetamine use and sexual risk behaviors were lessened. Although condom use decreased slightly, participants reported fewer anonymous sexual partners, reductions in episodes of both receptive and insertive anal intercourse, and an increased sense of responsibility to disclose their HIV status. This study further demonstrates the value of coupling quantitative with qualitative data in understanding the meanings behind reductions in high-risk behaviors.
Public Health Reports
In January 2005, the U.S. Centers for Disease Control and Prevention hosted a national consultation of scientists, public health officials, and community service providers to address growing concerns about the association of methamphetamine use and sexual risk behavior for HIV/STD infection, which is well documented among men who have sex with men. The purpose of the consultation was to review a representation of the current state of the science and practice on the topic in order to reduce the situational link of methamphetamine use and sexual risk. A set of suggestions for future research and programs were developed by the participants. This article provides a summary of content and recommendations from the consultation, and not an exhaustive review of the literature.