title: Experiences and sexual behaviors of HIV-infected MSM who acquired HIV in the context of crystal methamphetamine use.
abstract: The prevalence of crystal methamphetamine "meth" use among men who have sex with men (MSM) has been shown to be 20 times that of the general population, and it has been linked to increased sexual risk taking in MSM and others. Although previously seen as a "West Coast" phenomenon, clinical and other reports indicate that it is problematic among MSM regardless of geographic location. To assist in future intervention development, we interviewed 20 HIV-infected MSM who believe they seroconverted in the context of using crystal meth. Topics included factors related to continued and previous meth use, HIV risk behavior prior to and after HIV infection, and the consequences of sustained use. Generally, participants openly discussed the highly destructive effects of using crystal meth. Almost every (95%) participant spoke of chronic depression and anxiety following cycles of discontinued use, and participants often claimed an inability to enjoy activities that used to be pleasurable. Almost all (90%) respondents also reported that their social relationships were compromised by their crystal addictions. Many had lost friends, and in some cases, non-drug-using friends distanced themselves because of the addiction. A striking number of participants felt strongly that MSM sexual partner-meeting Web sites represented a major starting point for crystal-influenced sexual "hookups," and that they should likewise be a starting point for interventions. Corroborating previous research in this arena, this study exhibits support for a link between crystal meth use and high-risk sexual behavior among East Coast MSM. The study also draws attention to the need for associated mental health, functional and quality-of life impairments that seem to accompany continued use in individuals with HIV.
authors.affiliation: Fenway Institute, Fenway Community Health, Boston, MA 02119, USA. mmimiaga@partners.org
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Mimiaga
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Fair
authors.forename: Kenneth H
authors.initials: KH
authors.lastname: Mayer
authors.forename: Karestan
authors.initials: K
authors.lastname: Koenen
authors.forename: Steven
authors.initials: S
authors.lastname: Gortmaker
authors.forename: Ashley M
authors.initials: AM
authors.lastname: Tetu
authors.forename: Jeremy
authors.initials: J
authors.lastname: Hobson
authors.forename: Steven A
authors.initials: SA
authors.lastname: Safren
mesh_terms: D000328:Adult; D001007:Anxiety / Q000150:complications; D000697:Central Nervous System Stimulants / Q000009:adverse effects*; D003863:Depression / Q000150:complications; D015658:HIV Infections / Q000635:transmission*; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D020407:Internet; D007407:Interviews as Topic; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008694:Methamphetamine / Q000009:adverse effects*; D008875:Middle Aged; D010565:Persuasive Communication; D012307:Risk Factors; D012309:Risk-Taking; D012650:Self Disclosure; D019966:Substance-Related Disorders / Q000150:complications / Q000453:epidemiology / Q000523:psychology*
chemical_list: D000697:Central Nervous System Stimulants; D008694:Methamphetamine