IAS: Use of crystal methamphetamine boosts risk of transmitting drug-resistant HIV

Using crystal methamphetamine increases the risk of transmission of drug-resistant HIV as a result of unsafe sex practices by infected users with uninfected partners, according to results of a San Francisco survey detailed at the Third International AIDS Society Conference on HIV Pathogenesis and Treatment held July 24-27^th 2005, in Rio de Janeiro, Brazil.

The survey study, presented by Peter Chin-Hong from the University of California, San Francisco (UCSF), determined that crystal methamphetamine use in HIV-infected persons with drug-resistant virus quadrupled the risk of unprotected anal or vaginal sex with an HIV-negative person or a person with unknown HIV status. Using the erectile dysfunction drug sildenafil (Viagra) also raised the risk of having had unsafe sex with a partner of unknown status in the preceding four months.

Chin-Hong and colleagues interviewed 168 men and 21 women with detectable viral loads and resistance-related mutations while receiving antiretroviral treatment. At one or more clinic visits, more than a quarter of these individuals reported having had unsafe sex with an HIV-negative person or a person of unknown HIV status.

Statistical analysis that controlled for several variables found that of five independent predictors of unsafe sex in the past four months with a person who was HIV-negative or of unknown status, crystal methamphetamine use had a strong effect as did sildenafil use and younger age: younger age (p

A total of 38% of the survey respondents had virus resistant to the three oral antiretroviral classes, while 26% had virus resistant to protease inhibitors and NNRTIs and another 15% carried mutations conferring resistance to NRTIs and NNRTIs.

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