New findings that one in 20 North Carolina men who have sex with men (MSM) reported using crystal methamphetamine during the previous month suggests increased risk for spreading HIV and other sexually transmitted diseases (STD), according to researchers from Wake Forest University School of Medicine and colleagues.
The rate of methamphetamine use among 1,189 MSM was 30 times higher than levels reported in the general U.S. population over the same period. Methampehtamine, or "meth," is a highly addictive stimulant that has been found to impair judgment, decrease inhibition, increase impulsivity and enhance sexual sensitivity -- which can all increase the potential for transmitting HIV.
The study's authors found that participants who reported using methamphetamines were more likely to report inconsistent condom use during anal sex within the past three months, a history of STD infection, being HIV-positive and using medications designed to treat erectile dysfunction.
"Until now, there has been little data on meth use in the Southeast," said lead author Scott D. Rhodes, Ph.D. M.P.H., associate professor in the Department of Social Sciences and Health Policy. "Our findings, including that meth users were more likely to be HIV-positive, suggest that prevention, intervention and treatment efforts are urgently needed."
Rhodes noted that some of the men reported having sex with both men and women, which means the risk of HIV extends to both sexes.
The study's results will be published on Aug. 20 in AIDS Patient Care and STDs, a leading AIDS journal that provides the latest research for clinicians and researchers. It is among the first to document meth use among MSM in the South, which carries a disproportionate HIV, AIDS, and STD burden, with 46 percent of newly identified cases.
"The findings underscore the need for further research and intervention," said Rhodes. "The HIV/AIDS epidemic is clearly not over. We must develop innovative intervention approaches designed to reach communities at highest risk. Men who have sex with men, whether or not they identify themselves as gay, who use drugs like methamphetamines are clearly at higher risk. Yet currently nothing is being done in the Southeast."
Participants were recruited in 2005 in five gay bars and in five geographically defined internet chat rooms in central North Carolina (primarily rural/suburban areas) and were asked to complete a brief assessment of drug use and other risk behaviors. Of the 1,189 MSM, two-thirds self-identified as black or other minorities, and 25 percent as bisexual. The mean age was 29 years.
In addition to being more inclined to risky sexual behaviors, the study participants who said they used methamphetamines were also more likely to report having higher education and health insurance coverage.
"Because users of methamphetamines were more likely to have higher educational levels and report having health insurance, we must change the way we think about meth users and develop sophisticated prevention strategies that are appropriate for these types of users," noted Rhodes. "In addition, the link between meth use and the use of drugs for sexual dysfunction among a young population deserves attention. Meth use in combination with one of these medications may be having an even more profound impact on the HIV and STD disease epidemics in the South."
Rhodes is also affiliated with the Maya Angelou Research Center on Minority Health at Wake Forest. In 2006, Rhodes won the New Investigator Award in Clinical Sciences at Wake Forest.
The study's co-authors include Emily Knipper and Aimee M. Wilkin, M.D., M.P.H., both with Wake Forest, Kenneth C. Hergenrather, Ph.D., M.S.Ed., M.R.C., of George Washington University, Leland J. Yee, Ph.D., M.P.H., of the University of Pittsburgh, and Morrow R. Omli, M.A.Ed., of the University of Florida.
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