Adolescent boys and young men who have sex with men and use methamphetamines appear to be at an increased risk for human immunodeficiency virus (HIV) exposure, according to a report in the August issue of Archives of Pediatrics and Adolescent Medicine, one of the JAMA/Archives journals.
Among adult men who have sex with men (MSM), methamphetamine use has an estimated prevalence of 43 percent and an association with HIV risk and infection. "Research focuses on older MSM, and little is known about methamphetamine use and sexual behavior among younger MSM (YMSM)," write the authors. They add that the most recent data in this population date back more than 15 years: "Behavior, mortality, and treatment have changed dramatically in 15 years."
Peter Freeman, M.P.H., from Children's Memorial Hospital, Chicago, and colleagues conducted a cross-sectional observational analysis of data from the Adolescent Trials Network for HIV/AIDS Interventions. Between January 2005 and August 2006, a total of 595 adolescent boys and young men ages 12 years to 24 years -- all of whom reported having sex with men -- were recruited from social venues in eight U.S. cities. The study participants completed a survey that included questions about methamphetamine use, other hard drug use and sexual risk behavior.
Of the 595 participants, 64 reported they had used methamphetamines in the last 90 days. The YMSM in this group were more likely than those who had not used hard drugs to have a history of sexually transmitted diseases (51.6 percent vs. 21.1 percent), two or more sex partners in the past 90 days (85.7 percent vs. 63.1 percent), sex with an injection drug user ([IDU]; 51.6 percent vs. 10.7 percent) and sex with someone who has HIV (32.8 percent vs. 11.1 percent). These participants were also less likely to use condoms during every sexual encounter (33.3 percent vs. 54.3 percent). Recent methamphetamine use was associated with a lower likelihood of current school attendance and a history of homelessness, compared with YMSM who reported no recent hard drug use.
"Adolescent boys and young men who have sex with men and use methamphetamine seem to be at high risk for human immunodeficiency virus," conclude the authors. "The findings of our study suggest that there is a need to develop substance abuse prevention and treatment programs as part of HIV prevention for YMSM." They add, "To be most effective among YMSM who use methamphetamine, prevention programs should address issues such as housing, polydrug use, and educational needs. ... Prevention efforts targeting YMSM who use methamphetamine should also ensure that partner selection is addressed, as they showed higher rates of having sex with IDUs and individuals with HIV."
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