Methamphetamine use by New York gay men risks epidemic of resistant HIV warns opinion piece

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Use of the recreational drug methamphetamine by gay men is leading to an increase in unsafe sex and many new cases of HIV, warn HIV prevention workers from New York in an opinion piece in Newsweek. The New York prevention workers also warn that as HIV-positive gay men using methamphetamine are more likely to miss doses of their anti-HIV treatment, use of the drug could lead to the transmission of drug-resistant strains of HIV.

The potential implications for methamphetamine use on the HIV epidemic were recently reviewed in detail in an article in Clinical Infectious Diseases (see link to aidsmap news story below). Earlier studies have suggested that the reason why HIV-positive methamphetamine users experience faster HIV disease progression could be that they are less likely to adhere to their treatment regimens.

According to research conducted by the Center for HIV/AIDS Education Studies and Training (CHEST) in New York, gay men in the city who use methamphetamine are 2.9 times more likely to contract HIV through unprotected receptive anal sex than gay men who do not use the drug.

Glossary

strain

A variant characterised by a specific genotype.

 

epidemiology

The study of the causes of a disease, its distribution within a population, and measures for control and prevention. Epidemiology focuses on groups rather than individuals.

disease progression

The worsening of a disease.

receptive

Receptive anal intercourse refers to the act of being penetrated during anal intercourse. The receptive partner is the ‘bottom’.

The Newsweek opinion piece warns that “a cascade of disasters is accompanying the rise in …meth use”, adding that HIV-positive users of the drug are neglecting to take doses of their anti-HIV medication and are therefore at risk of transmitting drug-resistant HIV. The combined effects of methamphetamine use and passing on of drug-resistant HIV “may be setting the stage for a far greater epidemiological disaster by creating novel, super-spreading varieties of HIV,” warn the CHEST researchers.

There are only limited data that methamphetamine users are less likely to adhere to their treatments. However, the CHEST workers state in their opinion piece that "[we] must not wait for unequivocal proof showing the association between crystal use and new HIV infections before mounting a decisive and intelligent response." They call on health officials to mount an aggressive response to methamphetamine use by gay men, which is as “creative and compassionate” as its other sexual health education programmes targeted at gay men.

Further information on this website

Methamphetamine is a 'new challenge in HIV treatment and prevention' concludes review article - news story

Does methamphetamine affect HIV viral load? - news story