Antiretroviral drug resistance and risk behavior among recently HIV-infected men who have sex with men.
OBJECTIVE
Examine associations among behaviors including substance use during sexual encounters, and transmitted HIV drug resistance in recently HIV-infected men who have sex with men (MSM).


METHODS
Between 2002 and 2006, 117 recently HIV-infected MSM completed questionnaires regarding their 3 most recent sexual partners. Serum samples were tested for the presence of genotypic and phenotypic HIV drug resistance. Logistic regression analysis was used to assess the association of substance use, behaviors, and resistance to at least 1 class of HIV drugs.


RESULTS
The mean age of participants was 35 years; 71% identified as white and 19% as Hispanic. Sixty (51%) reported substance use during sexual activity in the past 12 months. A total of 12.5% of 112 had genotypic drug resistance to at least 1 class of antiretroviral medications, and 14% of 117 had phenotypic drug resistance. Substances used during sexual activity associated with phenotypic drug resistance in multivariate models included any substance use (adjusted odds ratio [aOR] = 4.21, 95% confidence interval [CI]: 1.13 to 15.68), polysubstance use (aOR = 5.64, 95% CI: 1.62 to 19.60), methamphetamine (aOR = 4.00, 95% CI: 1.19 to 13.38), 3,4-methylenedioxy-N-methylamphetamine (MDMA)/Ecstasy (aOR = 7.16, 95% CI: 1.40 to 36.59), and gamma-hydroxyl butyrate (GHB) (aOR = 6.98, 95% CI: 1.82 to 26.80). The genotype analysis was similar.


CONCLUSIONS
Among these recently HIV-infected MSM, methamphetamine use during sexual activity and use of other substances, such as MDMA and GHB, was associated with acquired drug-resistant virus. No other behaviors associated with acquisition of drug-resistant HIV.
Gorbach
Pamina M
PM
Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095-7353, USA. pgorbach@ucla.edu
Drumright
Lydia N
LN
Javanbakht
Marjan
M
Pond
Sergei L
SL
Woelk
Christopher H
CH
Daar
Eric S
ES
Little
Susan J
SJ
D000328:Adult; D024882:Drug Resistance, Viral; D006678:HIV / Q000187:drug effects*; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008694:Methamphetamine; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000821:virology; D019966:Substance-Related Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires
D008694:Methamphetamine