HIV Risk Behavior Among Methamphetamine Users Entering Substance Abuse Treatment in Cape Town, South Africa

Abstract

South Africa is experiencing a growing methamphetamine problem, and there is concern that methamphetamine use may accelerate HIV transmission. There has been little research on the HIV prevention needs of methamphetamine users receiving substance abuse treatment in South Africa. This study assessed the prevalence and correlates of HIV risk behaviors among 269 methamphetamine users entering substance abuse treatment in two clinics in Cape Town. The prevalence of sexual risk behaviors was high among sexually active participants: 34% multiple partners, 26% unprotected intercourse with a casual partner, and 24% sex trading for money/methamphetamine. The strongest predictor of all sexual risk behaviors was concurrent other drug use. Over half had not been HIV tested in the past year, and 25% had never been tested, although attitudes toward HIV testing were overwhelmingly positive. This population of primarily heterosexual, non-injecting methamphetamine users is a high-risk group in need of targeted HIV prevention interventions. Substance abuse treatment is an ideal setting in which to reach methamphetamine users for HIV services.

Understanding HIV Risk Behaviors Among Young Men in South Africa: A Syndemic Approach

“…Yet, in another study, Meade at al. (2016) found no significant relationship between depression symptoms and unprotected sex, multiple sex partners and sex trading (50). Therefore, additional investigation on the relationship between depression symptoms and HIV risk behavior among young men in South Africa is warranted.…”

“…This finding contrasts with the majority of studies from North America that find depressive symptoms to be predictive of greater likelihood of reporting HIV risk behaviors (48,49). Among men in South Africa, the relationship between depressive symptoms and HIV risk behavior has been mixed (33,50,51). For example in a study among young men aged 15 to 26 years in the Eastern Cape region of South Africa, young men with depressive symptoms were more likely to report ever engaging in transactional sex (51).…”

Methamphetamine use, health and criminal justice system outcomes: A systematic review

“…Amphetamine-related hospitalisations are also associated with higher in-hospital mortality, and greater length of stay, compared with non-amphetamine-related hospitalisations [10]. There have also been recent increases in methamphetamine use in lower-income country settings including South Africa [11] and Iran [12], which pose ongoing public health concerns such as increased risk of HIV transmission [13]. These findings illustrate the substantial burden that methamphetamine use is currently having on health systems across different countries.…”

Recreational Drugs and Antiretrovirals: Is It Worth the World or Trivial?

“…Ayrıca metamfetamin kullanan kişilerin viral yükleri, kullanmayanlara göre daha yüksektir [55] . Metamfetamin kullanımı hem enfeksiyon kazanılma riskini arttırmakta hem de viral yük artışı ile kullanan kişileri daha bulaştırıcı hale getirmektedir [56,57] . Metamfetamin CYP3A4 ve CYP2D6 ile metabolize olur ve CYP3A4'ü indükleyebilir ve ART ilaçlara yanıtta azalmaya neden olabilir [16] .…”