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Methamphetamine prevention programs may overlook many patients at risk for HIV
Experts say these programs are worthwhile, but the majority of patients who report unsafe sex are not methamphetamine users.
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ATLANTA — Methamphetamine prevention programs aimed at helping to decrease HIV risk are useful, but may only be addressing a limited percentage of patients at risk.
Methamphetamine use has been associated with increased risk for transmission of HIV and STDs because the drug decreases users’ inhibitions while sexual drive is increased. To address the issue, numerous programs to raise methamphetamine awareness have been established. But findings from a recent study suggest that other club drugs – such as cocaine, ecstasy and gamma-hydroxybutyric acid (GHB) – may be associated with an equal or higher risk for unsafe sexual behaviors.
“We are not saying that methamphetamine awareness programs should be stopped, but if we channel all our HIV prevention funds to methamphetamine, we are not going to catch a huge amount of people,” Christian Grov, PhD, MPH, project director and researcher at Hunter College’s Center for HIV Educational Studies and Training (CHEST) in New York City, told Infectious Disease News. “The antimethamphetamine campaigns are definitely not a catchall.”
Grov presented results from the study at the 2007 National HIV Prevention Conference, held here recently. Participants in the study reported using other drugs, such as cocaine, more frequently than methamphetamine.
“One participant told us that cocaine is crystal methamphetamine’s weaker stepsister because cocaine is perceived to be less harmful,” Grov said. “We have noted that cocaine use rates are now on the rise.”
Methamphetamine use
Methamphetamine is a stimulant that can be manufactured at home, is less expensive than cocaine, and has longer-lasting effects of eight to 24 hours.
In the 2002 National Survey on Drug Use and Health, 5.3% of Americans aged 12 and older reported using methamphetamine at least once. Most participants who reported methamphetamine use were aged between 18 and 34 years. Researchers estimated methamphetamine use among men who have sex with men could be 10 times higher than the general population.
Although methamphetamine use and increased risk for unsafe sex among MSM has been undisputed in numerous studies, researchers at CHEST sought to identify other variables that could predict sexual risk behavior while controlling for methamphetamine use.
Surveys administered
A cross-sectional, street intercept survey called the Sex and Love Study was administered to men who identified themselves as gay or bisexual (n=738) at The Gay Life Expo and The Gay Erotic Expo in New York City in 2004. The survey included questions about sexual behavior and substance abuse.
Ninety-two percent of study participants identified themselves as gay; the remainder identified themselves as bisexual. More than a third of participants were blacks; 62% were white and 17% were Latino. Mean age was 37 years; participants ages ranged from 18 to 78 years. Approximately 15.2% of participants (n=112) reported being HIV positive. About 10% of the participants identified themselves as “barebackers,” or men who seek unprotected sex.
Unsafe sex
A majority (81.1%) of the participants who reported unsafe sex did not report recent use of methamphetamines. About 10% reported methamphetamine use within the past 90 days and 29.9% of participants reported recent unprotected anal intercourse.
Only 20.7% (n=153) of the participants reported having ever used methamphetamine; 5.1% reported both unsafe sexual behavior and recent methamphetamine use. No racial or ethnic correlation was detected in either recent or lifetime methamphetamine use. Recent users of GHB were 4.6 times more likely to report recent unprotected sex; 72.7% (n=16) of recent GHB users reported recent unprotected sex.
Other variables, including GHB use, sex addiction, younger age, and identification as barebackers, were found to be greater indicators of high risk behavior than methamphetamine use. – by Kirsten H. Ellis
For more information:
- Grov C, Parsons JT, Bimbi DS. Getting clear about crystal: unsafe sex, crystal methamphetamine and the (dis)connection between the two. #E06-1. Presented at: the 2007 National HIV Prevention Conference; Dec. 2-5, 2007; Atlanta.