Meth and HIV
What is the association between methamphetamine and HIV?
The association between methamphetamine and HIV transmission is related to:
1) the tendency of users to engage in unprotected and uninhibited sex while under the influence of methamphetamine among gay, bisexual and other men who have sex with men (G/B/MSM) and
2) the risks associated with injection drug use for those who inject methamphetamine.
Many G/B/MSM who are methamphetamine users may not use condoms and may have sex with many different partners while experiencing the effects of the drug. Sex while under the influence of methamphetamine can be rougher and often lasts longer. This increases the likelihood that a condom may break or a sexual partner experiences injury during intercourse, which in turn increases the risk of HIV infection.
Different studies have found that gay men who use methamphetamine are two to four times more likely to be infected with HIV. For those infected with HIV, methamphetamine use can lead to a lapse in HIV medication regimens, weight loss and vitamin depletion. Use also decreases the sleep essential to maintaining the immune system and causes a drop in T cells and NK cells.
In direct response to the rising tide of evidence linking methamphetamine to increasing HIV infection rates in MSM, OAPP conducted a situational assessment in the spring of 2005 to gather information on current strategies and interventions in Los Angeles County. The objectives included identifying existing gaps in HIV prevention and substance abuse education among MSM. OAPP wanted to glean this information from the perspective of the experts in the field. We were also trying to gain a deeper understanding of the myriad of issues surrounding methamphetamine use in LA (link to situational analysis).
Methamphetamine is a highly addictive drug being used by growing numbers of adolescents and adults in the United States. In Los Angeles County, methamphetamine has emerged as the leading cause of admissions for substance abuse treatment, accounting for nearly 30% of all treatment admissions in 2005.
MA use has a pronounced impact on certain populations, including adolescents, women, and men who have sex with men (MSM) but ultimately impacts our entire population.
o Approximately 1 out of every 10 MSM in Los Angeles County reported methamphetamine use within the past 6 months, a frequency 20 times greater than the reported MA use among the general population (Shoptaw et al., 2005). This is consistent with other studies that have found high rates of methamphetamine use among MSM, an important contributor to the HIV epidemic in this population because of its association with increased sexual risk behavior.
o In addition, data from our counseling and testing sites suggest that MSM who use methamphetamine are almost 2.5 times more likely to test positive for HIV than MSM who do not use MA.
In response to these frightening odds, in Jan 2005, the Department’s Office of AIDS Programs and Policy (OAPP) funded 3 new HIV and Crystal Meth prevention programs specifically targeting MSM.
These contracted providers offer prevention services
including outreach, individual level interventions and
group level interventions (risk reduction):
o LA Gay and Lesbian Center
o
Center for Behavioral Research and Services, Long
Beach
o
Friends La Brea
• Additional activities include increasing funding to expand the services of
two HIV and Crystal Meth prevention programs
o
APLA (Group level intervention for users and social affiliates of users, Community level interventions – Forums)
o
California Drug Consultants
(Outreach, Group level Intervention)
