Crystal Methamphetamine Use and Initiation among Gay, Bisexual, and Other Men Who Have Sex with Men Living with HIV in a Treatment as Prevention Environment

Colyer, Sean P; Moore, David; Cui, Zishan; Zhu, Julia; Armstrong, Heather; Taylor, Maureen; Edward, Joshua; Howard, Terry Lee; Dickie, Chad; Olarewaju, Gbolahan; Montaner, Julio S. G.; Hogg, Robert S.; Roth, Eric Abella; Lachowsky, Nathan J.

doi:10.1080/10826084.2020.1833925

Cited by 15 publications

(9 citation statements)

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“…These included a study of transgender women in Cambodia [12], a Canadian study of HIV‐positive gay, bisexual and other men who have sex with men [7], another Canadian study of lesbian, gay, bisexual and transgendered people [15], and a US cohort of HIV‐positive and negative men [17]. These studies were consistent in reporting significant higher risks of depression associated with methamphetamine use, including in analyses that adjusted for polydrug use [7], a range of individual, social and structural HIV‐related vulnerabilities [15], and adjusting for prior levels of depression, unemployment, antidepressant medication use, depressive symptoms at prior visit and HIV‐status [17]. Findings from these studies of high‐risk subpopulations may not be generalisable to the broader general population.…”

Section: Discussionmentioning

confidence: 99%

“…Of the included studies, 11 (78.6%) were cross-sectional data [5][6][7][8][9][10][11][12][13][14][15] and 3 (21.4%) were longitudinal estimates [16][17][18]. Twelve studies reported any methamphetamine use, the other two studies examined methamphetamine use disorders [6,11].…”

Section: Study Characteristicsmentioning

confidence: 99%

“…We included nine cross-sectional studies [5,[7][8][9][10][12][13][14][15] that reported on the association between any methamphetamine use and depression (see Table 1). There were mixed findings with some studies reporting a positive association [9,12,14,15] and others reporting no association [5,7,8,10,13].…”

Section: Any Methamphetamine Use-cross-sectional Estimatesmentioning

confidence: 99%

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Methamphetamine exposure and depression—A systematic review and meta‐analysis

Leung

Mekonen

Wang

et al. 2023

Drug and Alcohol Review

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IssuesMethamphetamine use is a public health concern that has been associated with comorbid mental health problems. We aim to better understand the relationship between methamphetamine use and depression by: (i) systematically reviewing and meta‐analysing the risks of depression by methamphetamine use; and (ii) investigating the risk of unmeasured confounding.ApproachA systematic review and meta‐analysis were conducted following PRISMA guidelines. EMBASE, PsycINFO and PubMed were searched to identify human studies reporting on the association between methamphetamine or amphetamine use and depressive outcomes. The data were summarised narratively and meta‐analysed, stratified by cross‐sectional and longitudinal estimates. Unmeasured confounding was assessed by E‐values analyses.Key FindingsFrom the 6606 studies that came up from the search, 14 eligible studies were included in the narrative review and had data for meta‐analysis. A significant association was found between any use of methamphetamine and any depression outcomes in cross‐sectional (odds ratio [OR] = 1.66 [95% confidence interval [CI] 1.34, 2.05]) and longitudinal estimates (OR = 1.18 [95% CI 1.08, 1.28]). People with a methamphetamine use disorder had significantly higher odds of depression than those without (OR = 2.80 [95% CI 1.40, 5.90]). The E‐values ranged from 1.28 to 6.30 for cross‐sectional studies and from 2.37 to 3.21 for longitudinal studies.ConclusionBased on limited data, people who used methamphetamine have higher odds of depression than people who do not. There were mostly a low to moderate risk of unmeasured confounding in the longitudinal study results. Future longitudinal studies conducted using causal framework methods are warranted.

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Section: Discussionmentioning

confidence: 99%

Section: Study Characteristicsmentioning

confidence: 99%

Section: Any Methamphetamine Use-cross-sectional Estimatesmentioning

confidence: 99%

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Methamphetamine exposure and depression—A systematic review and meta‐analysis

Leung

Mekonen

Wang

et al. 2023

Drug and Alcohol Review

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“…This is concerning as crystal methamphetamine and ecstasy are often used in sexualised contexts (e.g., party and play (PnP), chemsex) [33] and crystal methamphetamine in particular has been associated with greater likelihood of engaging in higher-risk sexual behaviours and STI diagnosis [34][35][36]. In a recent analysis of crystal methamphetamine use among gbMSM living with HIV in the Momentum cohort, 44.3% reported any crystal methamphetamine use at enrolment and this was stable across time; most who used reported using at least monthly [37]. Further, crystal methamphetamine use was associated with more recent anal sex partners, more condomless sex with seroconcordant partners, trading sex for drugs, recent STI diagnosis, and greater use of poppers, GHB, and ecstasy [37].…”

Section: Plos Onementioning

confidence: 99%

“…In a recent analysis of crystal methamphetamine use among gbMSM living with HIV in the Momentum cohort, 44.3% reported any crystal methamphetamine use at enrolment and this was stable across time; most who used reported using at least monthly [37]. Further, crystal methamphetamine use was associated with more recent anal sex partners, more condomless sex with seroconcordant partners, trading sex for drugs, recent STI diagnosis, and greater use of poppers, GHB, and ecstasy [37]. As individuals who use stimulants are more likely to experience episodes of elevated viremia and are more likely to participate in higher risk sexual behaviour, there is an increased likelihood that onward transmission may occur.…”

Section: Plos Onementioning

confidence: 99%

Virological suppression among gay, bisexual, and other men who have sex with men living with HIV in Vancouver, Canada: A longitudinal cohort study from 2012–2017

et al. 2022

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Introduction In 2010, British Columbia (BC) implemented HIV Treatment as Prevention (TasP) as policy. We examined trends in virologic suppression and determinants of significant viremia among a prospective biobehavioural cohort of men who have sex with men (gbMSM) in Vancouver from 2012–2017. Methods Respondent-driven sampling was used to recruit sexually active gbMSM (≥16 years) who completed biannual study visits with a computer-assisted self-interview and clinical CD4 and viral load (VL) testing. We linked participant data with the BC HIV Drug Treatment Program to obtain antiretroviral dispensing and VL data. We conducted a trend analysis of VL suppression using univariable generalized estimating equation (GEE) multi-level modelling and multivariable GEE to identify factors associated with episodes of VL ≥200 copies/mL. Results Of 774 participants, 223 were living with HIV at baseline and 16 were diagnosed during follow-up (n = 239). We observed a significant trend towards reduced levels of unsuppressed VL (>200 copies/mL) from 22% (07/2012-12/2012) to 12% (07/2016-12/2016) (OR:0.87; 95%CI:0.83–0.91 for each 6-month period). Among those with at least one follow-up visit, (n = 178, median follow-up = 3.2 years, median age = 46.9 years), younger age (aOR:0.97; 95%CI:0.94–0.99, per year), ecstasy use (aOR:1.69; 95%CI:1.13–2.53), crystal methamphetamine use (aOR:1.71; 95%CI:1.18–2.48), seeking sex via websites (aOR:1.46; 95%CI:1.01–2.12), and lower HIV treatment optimism (aOR:0.94; 95%CI:0.90–0.97) were associated with episodes of elevated viremia. Conclusions During a period when TasP policy was actively promoted, we observed a significant trend towards reduced levels of unsuppressed VL. Continued efforts should promote HIV treatment optimism and engagement, especially among younger gbMSM and those who use ecstasy and crystal methamphetamine.

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