HIV This Week

Shoptaw S, Reback CJ. Methamphetamine use and infectious disease-related behaviors in men who have sex with men: implications for interventions. Addiction 2007;102 Suppl 1:130-5.

Shoptaw and Reback aimed to review the current evidence regarding the prevalence of methamphetamine use among men who have sex with men (MSM) and to evaluate the factors that contribute to methamphetamine use and potential for sexual transmission of HIV and other infectious diseases. The authors used data based reports to address (1) epidemiology of methamphetamine use in MSM; (2) methamphetamine use and risk behaviours for sexually transmitted infections; and (3) interventions. Their findings showed that methamphetamine use is highly prevalent in MSM. Strong associations between methamphetamine use and HIV-related sexual transmission behaviours are noted across studies of MSM and correspond to increased incidence for HIV and syphilis compared to MSM who do not use the drug. Behavioural treatments produce sustained reductions in methamphetamine use and concomitant sexual risk behaviours among methamphetamine-dependent MSM. In conclusion, brief screening of methamphetamine use for MSM who seek physical, mental health and substance abuse services is recommended. Behavioural interventions that address methamphetamine use may range from brief interventions to intensive out-patient treatments.

Editors’ note: If you don’t ask, you’ll never know. Methamphetamine use can increase the likelihood of sexual risk-taking and therefore of sexually transmitted infections and of HIV acquisition and transmission. Behavioural treatments can work to reduce risk but can’t even be offered if providers don’t become comfortable asking about drug use and sexual behaviour patterns.