Viagra, Methamphetamine, and HIV Risk: Results From a Probability Sample of MSM, San Francisco

Spindler, Hilary; Scheer, Susan; Chen, Sanny Y.; Klausner, Jeffrey D.; Katz, Mitchell H.; Valleroy, Linda A.; Schwarcz, Sandra

doi:10.1097/01.olq.0000258339.17325.93

Cited by 60 publications

(46 citation statements)

References 14 publications

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“…6,21 Moreover, among HIV-infected MSM with a serodiscordant (HIV-uninfected or unknown HIV status) sexual partner, crystal meth use is significantly associated with UAI (insertive: odds ratio [OR] 1.9, 95% confidence interval [CI] 1.1-3.3; receptive: OR 1.6, 95% CI 0.9-3.1). 22 This has been corroborated by multiple studies. [23][24][25] There are subgroups within this community with variable patterns of crystal meth use that engage in behaviors that are at particularly high risk for HIV transmission and STI acquisition.…”

Section: Hiv Risk Behaviorsupporting

confidence: 65%

A Systematic Review of Behavioral and Treatment Outcome Studies Among HIV-Infected Men Who Have Sex with Men Who Abuse Crystal Methamphetamine

Rajasingham

Mimiaga

White

et al. 2012

AIDS Patient Care and STDs

123

101

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Men who have sex with men (MSM) have the highest incidence of HIV infection in the United States. One of the contributing factors to HIV spread among this group is the use of crystal methamphetamine ("meth"). The objective was to review the behavioral impact of crystal meth use in HIV-infected MSM and potential treatment options. A systematic review of MEDLINE identified studies that evaluated the clinical effects of crystal meth on the HIV-infected MSM population. Search terms included HIV, methamphetamine, MSM, antiretroviral therapy, adherence, resistance, and treatment. U.S. citations in the English language in peer-reviewed journals until December 2010 were included. The primary author reviewed eligible articles, and relevant data including study design, sample, and outcomes were entered into an electronic data table. The 61 included studies highlight that HIV-infected MSM who use crystal meth are more likely to report high-risk sexual behaviors, incident sexually transmitted infections, and serodiscordant unprotected anal intercourse, compared to HIV-infected MSM who do not use crystal meth. Medication adherence in this population is notably low, which may contribute to transmission of resistant virus. No medications have proven effective in the treatment of crystal meth addiction, and the role of behavioral therapies, such as contingency management are still in question. HIV-infected MSM who abuse crystal meth have worse HIV-related health outcomes. Behavioral interventions have shown variable results in treating crystal meth addiction, and more investigation into rehabilitation options are needed. The results presented support efforts to develop and implement novel interventions to reduce crystal meth use in HIV-infected MSM.

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Section: Hiv Risk Behaviorsupporting

confidence: 65%

A Systematic Review of Behavioral and Treatment Outcome Studies Among HIV-Infected Men Who Have Sex with Men Who Abuse Crystal Methamphetamine

Rajasingham

Mimiaga

White

et al. 2012

AIDS Patient Care and STDs

123

101

View full text Add to dashboard Cite

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“…There is an extensive literature on non-injection drug use and HIV risk behavior in MSM populations elsewhere in the world. Many studies have found associations between sexual risk behavior and consumption of recreational drugs including crystal methamphetamine, ecstasy, cocaine, gamma hydroxybutyrate (GHB), and amyl nitrate (''poppers'') in a variety of social contexts (Choi et al 2005;Colfax et al 2001;Darrow et al 2005;Hirshfield et al 2004;Koblin et al 2006;Operario et al 2006;Rawstorne et al 2007;Spindler et al 2007;Stueve et al 2002). One study has described sexual risk behavior among members of drug-using sub-populations of urban South African MSM (Parry et al 2008).…”

Section: Introductionmentioning

confidence: 97%

Alcohol and Sexual Risk Behavior Among Men Who Have Sex with Men in South African Township Communities

et al. 2008

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There are few studies of HIV risk behavior among men who have sex with men (MSM) in sub-Saharan Africa. We conducted a behavioral survey of MSM in peri-urban "township" communities in Gauteng province, South Africa. Between October 2004 and March 2005, 199 MSM completed an interviewer administered pen-and-paper standardized questionnaire. The sample was 94% black, 83% identified as gay, and 12% as bisexual. Among those reporting sex with other men in the prior six months (n = 147), 59% reported unprotected anal intercourse (UAI). Increased risk of UAI was associated with both regular drinking (adjusted odds ratio (OR) 4.1, 95% confidence interval (CI) 1.4, 12.6) regular drinking to intoxication (OR 2.6, 95% CI 1.0, 6.8), and reporting symptoms of rectal trauma resulting from anal intercourse (AI; OR 4.3, 95% CI 1.8, 10.4). Decreased risk of UAI was associated with the exclusive use of lubricants that are latex-compatible for AI (OR 0.3, 95% CI 0.1, 0.7). Township MSM in South Africa are at high risk of HIV infection. Targeted sexual health and risk reduction interventions that address the link between alcohol use and HIV risk are urgently needed.

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“…These findings differ from the majority of previous studies on this topic. One of the most plausible reasons for the varying conclusions is that the focus of our study is on men who received EDD as part of clinical practice, whereas nearly all of the previous reports linking EDD to risky sexual behavior were conducted in non-clinical samples in high risk groups, including MSM [4][5][6][7][8][9][10][11][12]16,25 , substance abusers 11,26 , and HIV-infected men outside of clinical settings. [13][14][15] In nearly all of these studies, the association of EDD and risky sexual behavior was consistently the strongest in men who also used stimulant drugs such as methamphetamines, ecstasy, or gamma-hydroxybutyrate (GHB), which were rare in our study sample.…”

Section: Discussionmentioning

confidence: 64%

“…3 EDDs have also been linked to high-risk sexual behavior in some groups of men at increased risk for HIV transmission, in particular men who have sex with men (MSM), men who use recreational or illicit drugs, and HIV-infected men. [4][5][6][7][8][9][10][11][12][13][14][15][16] Because of their association with risky behavior, some have argued that EDD medications should be classified as controlled substances.…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction Drug Receipt, Risky Sexual Behavior and Sexually Transmitted Diseases in HIV-infected and HIV-uninfected Men

et al. 2009

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BACKGROUND: Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior.OBJECTIVES: To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. DESIGN:Cross-sectional study. PARTICIPANTS:Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data.MEASURES: EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. RESULTS:Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P< 0.001). Compared to men who did not receive EDD, men who received EDD were equally likely to report risky sexual behavior (11% vs. 10%, p=0.9) and STDs (7% vs 7%, p=0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men.CONCLUSION: EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIVinfected men, indicating ongoing need for prevention interventions.KEY WORDS: HIV infection; risky sexual behavior; STDs; men; phosphodiesterase inhibitors.

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Viagra, Methamphetamine, and HIV Risk: Results From a Probability Sample of MSM, San Francisco

Abstract: MSM who use Viagra with crystal methamphetamine have high prevalence rates of HIV and engage in HIV risk behaviors.

Cited by 60 publications

References 14 publications

A Systematic Review of Behavioral and Treatment Outcome Studies Among HIV-Infected Men Who Have Sex with Men Who Abuse Crystal Methamphetamine

A Systematic Review of Behavioral and Treatment Outcome Studies Among HIV-Infected Men Who Have Sex with Men Who Abuse Crystal Methamphetamine

Alcohol and Sexual Risk Behavior Among Men Who Have Sex with Men in South African Township Communities

Erectile Dysfunction Drug Receipt, Risky Sexual Behavior and Sexually Transmitted Diseases in HIV-infected and HIV-uninfected Men

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