A study by researchers at Johns Hopkins Children's Center and elsewhere shows that methamphetamine use can fuel HIV infection risk among teenage boys and young men who have sex with men (MSM), a group that includes openly gay and bisexual men, as well as those who have sex with men but do not identify themselves as gay or bisexual.
The researchers said that nearly one-third (20) of the 64 participants who reported recent meth use also reported sex with an HIV-infected person, while half reported sex with an injection drug user. More than half, 34, said they have had unprotected sex.
While previous research has linked risky sexual behaviors to drug use in MSM, the new study is the first multi-city analysis to also include teenagers, a group made especially vulnerable by lack of experience, the investigators say.
The team's findings, published in the Aug. 1 issue of the Archives of Pediatrics & Adolescent Medicine, underscore the need for HIV prevention programs to factor in the role of substance abuse, the investigators say.
"Drug use is closely linked to risk-taking behaviors, including sexually risky behaviors, so any HIV prevention efforts must, by definition, include drug use prevention and treatment of those with known drug problems," said senior investigator Jonathan Ellen, M.D., a pediatrician and adolescent health specialist at Johns Hopkins Children's Center.
Methamphetamine ¬ a popular and relatively cheap street drug ¬ heightens sexual response and lowers inhibitions, the researchers note.
"Add meth and you have a formula that leads to increased sexual risk in a group that already has higher prevalence of HIV," says study co-investigator Nancy Willard, M.S., a researcher at Johns Hopkins.
The NIH-funded asked 595 males, ages 12 to 24, from eight major U.S. cities, including New York City, Baltimore and Washington, D.C., to describe their use of methamphetamine, other hard drugs and their sexual behavior.
Overall, recent meth users were more likely than those with no recent drug use to have had sex with an HIV-positive person (33 percent vs. 11 percent), to have history of sexually transmitted infections (52 percent vs. 21 percent), to have had sex with an injection drug user (52 percent vs. 11 percent) and to have sex with multiple partners in the past three months (86 percent vs. 63 percent). Meth users were also more likely to report having unprotected sex than those without recent drug use (67 percent vs. 46 percent). And recent meth users were also more likely than those with no recent drug use to be or have been homeless (72 percent vs. 28 percent) and less likely to be enrolled in school (36 vs. 60 percent).
The researchers caution that any drug abuse ¬ not just methamphetamine ¬ can push up the rates of risky behavior. Indeed, participants who reported having used other hard drugs such as cocaine, crack, heroin and ecstasy, were more likely than non-drug users to have sex with HIV-infected partners (24 vs. 11 percent) and more likely to have sex with injection drug users (20 percent vs. 10 percent)
Researchers from other institutions included Peter Freeman, M.P.H., and Robert Garofalo, M.D., of Children's Memorial Hospital at Northwestern University, and Robert Harris, Ph.D., of Westat Inc.
Bendu Walker, M.P.H., also of Johns Hopkins, was co-author on the paper.
Related on the Web:
Higher HIV Risk in Black Gay Men Linked to Partner Choice, Risk Perception http://www.hopkinschildrens.org/Higher-HIV-Risk-in-Black-Gay-Men.aspx
STI, HIV Counseling Inadequate in Male Teens http://www.hopkinschildrens.org/newsDetail.aspx?id=8302&terms=Arik+Marcell
Archives of Pediatrics and Adolescent Medicine