A study by researchers at Johns Hopkins Children’s Center and elsewhere shows that methamphetamine use can fuel HIV infection risk among teenage boys and young men who have sex with men (MSM), a group that includes openly gay and bisexual men as well as those who have sex with men but do not identify themselves as gay or bisexual.
The researchers said that nearly one-third (20) of the 64 participants who reported recent meth use also reported sex with an HIV-infected person, while half reported sex with an injection drug user. More than half (34) said they have had unprotected sex.
Although previous research has linked risky sexual behaviors to drug use in MSM, the new study, conducted in eight big U.S. cities, is the first analysis of its kind to also include teenagers, a group made especially vulnerable by lack of experience, the investigators say.
The team’s findings, published in the Aug. 1 issue of the Archives of Pediatrics & Adolescent Medicine, underscore the need for HIV prevention programs to factor in the role of substance abuse, the investigators say.
“Drug use is closely linked to risk-taking behaviors, including sexually risky behaviors, so any HIV prevention efforts must, by definition, include drug use prevention and treatment of those with known drug problems,” said senior investigator Jonathan Ellen, M.D., a pediatrician and adolescent health specialist at Hopkins Children’s.
Methamphetamine — a popular and relatively cheap street drug — heightens sexual response and lowers inhibitions, the researchers note.
“Add meth and you have a formula that leads to increased sexual risk in a group that already has higher prevalence of HIV,” says study co-investigator Nancy Willard, M.S., a researcher at Johns Hopkins.
Researchers asked 595 males, aged 12 to 24, from eight U.S. cities, including New York City, Baltimore and Washington, D.C., to describe their use of methamphetamine, other hard drugs and their sexual behavior.
Overall, recent meth users were more likely than those with no recent drug use to have had sex with an HIV-positive person (33 percent vs. 11 percent), to have a history of sexually transmitted infections (52 percent vs. 21 percent), to have had sex with an injection drug user (52 percent vs. 11 percent) and to have had sex with multiple partners in the past three months (86 percent vs. 63 percent). Meth users were also more likely to report having unprotected sex than those without recent drug use (67 percent vs. 46 percent). And recent meth users were also more likely than those with no recent drug use to be or have been homeless (72 percent vs. 28 percent) and less likely to be enrolled in school (36 vs. 60 percent).
The researchers caution that any drug abuse — not just methamphetamine — can push up the rates of risky behavior. Indeed, participants who reported having used other hard drugs such as cocaine, crack, heroin and ecstasy, were more likely than non-drug users to have sex with HIV-infected partners (24 percent vs. 11 percent) and more likely to have sex with injection drug users (20 percent vs. 10 percent)
The study was funded by the National Institutes of Health.
Bendu Walker, M.P.H., also of Hopkins, was co-author on the paper.
Researchers from other institutions included Peter Freeman, M.P.H., and Robert Garofalo, M.D., of Children’s Memorial Hospital at Northwestern University, and Robert Harris, Ph.D., of Westat, Inc.
Founded in 1912 as the children’s hospital of the Johns Hopkins Medical Institutions, the Johns Hopkins Children’s Center offers one of the most comprehensive pediatric medical programs in the country, with more than 92,000 patient visits and nearly 9,000 admissions each year. Hopkins Children’s is consistently ranked among the top children’s hospitals in the nation. Hopkins Children’s is Maryland’s largest children’s hospital and the only state-designated Trauma Service and Burn Unit for pediatric patients. It has recognized Centers of Excellence in dozens of pediatric subspecialties, including allergy, cardiology, cystic fibrosis, gastroenterology, nephrology, neurology, neurosurgery, oncology, pulmonary, and transplant. Hopkins Children’s will celebrate its 100th anniversary and move to a new home in 2012. For more information, please visit www.hopkinschildrens.org
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