HIV, STD Exposure Risk Increases With Methamphetamine Use

August 1, 2011 - Methamphetamine use among younger men who report having sex with older men significantly increases the risk for exposure to sexually transmitted diseases (STDs) and HIV, according to a study published in the August issue of the Archives of Pediatrics and Adolescent Medicine.

As part of the Adolescent Trials Network for HIV/AIDS Interventions, Peter Freeman, MPH, from the Children’s Memorial Hospital, Northwestern University, Chicago, Illinois, and colleagues conducted a cross-sectional observational study, surveying 595 adolescent boys and young men who have sex with men, aged 12 to 24 years, recruited from social venues (eg, clubs, parks, and street corners) in 8 US cities. Recruitment took place between January 3, 2005 and August 21, 2006. Among the participants, 64 respondents reported having used methamphetamines in the past 90 days. The methamphetamine users were found to have higher STD rates than those who did not use methamphetamine or other hard drugs in the preceding 90 days (51.6% vs 21.1%), higher rates of 2 or more sex partners in the past 90 days (85.7% vs 63.1%), much higher rates of sex with an injection-drug user (51.6% vs 10.7%), and sex with someone who has HIV (32.8% vs 11.1%). Each of these comparisons was statistically significant (P < .05).

The methamphetamine users were also less likely to use condoms during every sexual encounter compared with non-hard drug users (33.3% vs 54.3%; P < .001), and recent methamphetamine use was associated with a lower likelihood of current school attendance and a history of homelessness compared with non-drug users.

"Adolescent boys and young men who have sex with men and use methamphetamine seem to be at high risk for human immunodeficiency virus," the authors concluded.

Previous studies have shown similar risks among men over age 18 who have sex with other men and use methamphetamine; however, less is known about risks among teens and younger men. In addition, most existing data were collected more than 15 years ago; as the authors write, "ehavior, mortality, and treatment [in relation to HIV] have changed dramatically in 15 years."
The results indicated that among the methamphetamine users, all were older than 18 years except 1, and 18 (28.1%) reported a history of injecting nonprescription drugs; 14 reported the injection of drugs 1 or more times in the past 90 days.

"The reported high rates of sex with [injection drug users] in this sample of [young men who have sex with men] suggest that more research is needed to distinguish the extent of risk associated with sexual behavior vs risk that may be a result of sharing injection drug paraphernalia," the authors noted.

Limitations of the study include the following: (1) the sample may not have represented all young men who have sex with men in the United States because participants were recruited from venues where high-risk behaviors may have been more prevalent, such as parks, clubs, and street corners; (2) participants who may not have disclosed sexual behavior were not represented in the study; and (3) methamphetamine use was based on self-report and may have been underreported.

The findings nevertheless underscore the need for HIV prevention programs to include substance abuse prevention components that target younger men, the authors said.

"To be most effective among [young men who have sex with men] who use methamphetamine, prevention programs should address issues such as housing, polydrug use, and educational needs," they said.

"Prevention efforts targeting [young men who have sex with men] who use methamphetamine should also ensure that partner selection is addressed, as they showed higher rates of having sex with [injection drug users] and individuals with HIV."

The study was supported by grants from the National Institute of Child Health and Human Development, with supplemental funding from the National Institute on Drug Abuse and the National Institute of Mental Health. The authors have disclosed no relevant financial relationships.