Indicators of use of methamphetamine and other substances among men who have sex with men, San Francisco, 2003-2006

San Francisco Department of Public Health, San Francisco, CA 94102, USA.
Drug and Alcohol Dependence (Impact Factor: 3.42). 10/2007; 90(1):97-100. DOI: 10.1016/j.drugalcdep.2007.02.020
Source: PubMed


Substance use has been associated with high-risk sexual behavior among men who have sex with men (MSM) both in the U.S. and around the world. Recent efforts by local organizations in San Francisco have specifically targeted methamphetamine use in this population.
We tracked methamphetamine and other substance use among men who have sex with men (MSM) in San Francisco from 2003 to 2006 using an indicator available in community outreach surveys of a prevention education program targeting MSM (n=4602).
Overall, use of diverse substances tended to decrease from 2003 to 2006, many significantly so. Reported use of methamphetamine significantly decreased among HIV-negative MSM. However, methamphetamine and alcohol use during sex was associated with unprotected potentially HIV serodiscordant sex.
Intensified prevention efforts to reduce methamphetamine use in San Francisco may be having some impact; however, strong associations of substance use and high-risk sex persist.

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Available from: Katherine A. Ahrens, Mar 17, 2014
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    • "Methamphetamine has been implicated as being highly associated with risky sexual behavior among MSM in numerous studies (Colfax & Shoptaw, 2005; Drumright et al., 2006; Fernández et al., 2007; Plankey et al., 2007; Purcell, Moss, Remien, Woods, & Parsons, 2005; Vaudrey et al., 2007). For example, Drumright et al. reported a five-fold increase in unprotected sex in those HIV-positive MSM who had used methamphetamine. "
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    ABSTRACT: This study examined demographic characteristics, sexual risk behaviors, sexual beliefs, and substance use patterns in HIV-positive, methamphetamine-using men who have sex with both men and women (MSMW) (n = 50) as compared to men who have sex with men only (MSM) (n = 150). Separate logistic regressions were conducted to predict group membership. In the final model, of 12 variables, eight were independently associated with group membership. Factors independently associated with MSMW were acquiring HIV through injection drug use, being an injection drug user, using hallucinogens, using crack, being less likely to have sex at a bathhouse, being less likely to be the receptive partner when high on methamphetamine, having greater intentions to use condoms for oral sex, and having more negative attitudes about HIV disclosure. These results suggest that, among HIV-positive methamphetamine users, MSMW differ significantly from MSM in terms of their HIV risk behaviors. Studies of gay men and HIV often also include bisexual men, grouping them all together as MSM, which may obscure important differences between MSMW and MSM. It is important that future studies consider MSM and MSMW separately in order to expand our knowledge about differential HIV prevention needs for both groups. This study showed that there were important differences in primary and secondary prevention needs of MSM and MSMW. These findings have implications for both primary and secondary HIV prevention among these high-risk populations.
    Archives of Sexual Behavior 08/2011; 40(4):793-801. DOI:10.1007/s10508-010-9713-1 · 3.53 Impact Factor
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    • "The frequency of methamphetamine use in the past year among our study population in 2008 (31%) was similar to the frequency found among similar samples in 2004 (35%) and 2006 (33%), and was substantially higher than the reported frequency of methamphetamine use in the past year nationwide (0.6% in 2005) [1] and in community samples of MSM in San Francisco (i.e. 9.0% of HIV-uninfected MSM and 19.9% of HIV-infected MSM in 2006) [28]. We found that 11% of women and 26% of transgender participants reported methamphetamine use in the past 12 months. "
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    ABSTRACT: Methamphetamine use is associated with adverse health outcomes and HIV incidence. Few studies have assessed methamphetamine use, sexual behavior and Internet use among HIV-infected patients. Surveys were administered to a sample of HIV-infected patients seeking medical care in a San Francisco county hospital and university-based clinic. In 2008, 35% of homosexual participants, 26% of heterosexual participants and 11% of female participants reported methamphetamine use in the past year. Of participants, 29% reported using the Internet to find sex partners; Internet-users versus non-Internet-users reported a higher median number of sex partners in 6 months (4 vs. 1), were more likely to report unprotected sex (32 vs. 10%), and higher rates of methamphetamine use in the past 12 months (48 vs. 24%). Given the association among methamphetamine use, increased sex partners and Internet use, the Internet may present a new and effective medium for interventions to reduce methamphetamine-associated sexual risk behavior.
    AIDS and Behavior 12/2010; 16(2):396-403. DOI:10.1007/s10461-010-9869-7 · 3.49 Impact Factor
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    • "We repeated the study in 2006 to track changes in methamphetamine use and sexual behavior between 2004 and 2006 in the setting of intensified HIV prevention programs in San Francisco targeting methamphetamine use among MSM (Vaudrey et al., 2007). This current study provided the opportunity to assess changes in patientÁprovider communication and changes in methamphetamine use among subgroups of patients by gender, sexual orientation, and socio-economic status all within the health care setting. "
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    ABSTRACT: While numerous studies examine methamphetamine use and associated risky sexual behaviors in HIV-uninfected individuals, few studies have surveyed HIV-infected individuals in the health care setting. To assess the frequency and trends of methamphetamine use, sexual activity, injection drug use, patient-provider communication, and medication adherence among HIV-infected persons in care, we administered a one-page anonymous survey in 2004 and 2006. The survey was conducted at the two University of California, San Francisco outpatient HIV clinics: at Moffitt Hospital (Moffitt), serving primarily privately insured patients, and at San Francisco General Hospital (SFGH), a county hospital serving primarily patients who are uninsured or publicly insured. In 2006, 39% of men who have sex with men (MSM), 33% of heterosexual men, and 11% of women reported methamphetamine use in the prior 12 months. Methamphetamine use was significantly associated with an increased number of sex partners among MSM and heterosexual men, and poor anti-retroviral medication adherence. Among MSM, methamphetamine use was more common at the SFGH clinic. Between 2004 and 2006, reported methamphetamine use in the last 12 months decreased among MSM at Moffitt (38 to 20%, p<0.01), but increased at SFGH (40 to 50%, p<0.05). Among methamphetamine users we found a high frequency of injection of methamphetamine, which increased at SFGH from 38 to 55%, p<0.05. Patient-provider communication regarding methamphetamine use has increased from 2004 to 2006 but no significant change has been found for providers asking patients about sexual activity. Overall, we found methamphetamine use to be common among HIV-infected patients in care, and associated with an increased number of sex partners, a high frequency of injection drug use, and poor adherence to anti-retroviral medications. These findings support the need for improved screening and clinic-based interventions to reduce and treat methamphetamine abuse and associated high risk sexual behaviors.
    AIDS Care 06/2009; 21(5):575-82. DOI:10.1080/09540120802385579 · 1.60 Impact Factor
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