Amphetamine-group substances and HIV.
Amphetamine-group substances are used worldwide and are more prevalent than either cocaine or opioids. We reviewed published reports about amphetamine-group substances and did a meta-analysis of randomised controlled trials of behavioural interventions for their use. Most research was done in developed countries. Many, but not all, studies show an association between amphetamine-group substance use and risk of HIV infection. Much use of amphetamine-group substances is non-injection and is associated with increased HIV risk, particularly in men who have sex with men. The structural, social, interpersonal, and personal factors that link to amphetamine-group substance use and HIV risk are poorly understood. 13 studies, with a cumulative sample size of 1997 individuals, qualified for the meta-analysis. Overall, high-intensity behavioural interventions were moderately effective in reducing use of amphetamine-group substances (effect size 0.28, 95% CI 0.13-0.44). We did not find conclusive evidence that behavioural interventions as a group are more effective than are passive or minium treatment for reduction of amphetamine-group substance use or sexual risk behaviours. The search for effective, scalable, and sustainable interventions for amphetamine-group substance use, including pharmacotherapies, should be supported and encouraged.
Colfax
Grant
G
HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA. grant.colfax@sfdph.org
Santos
Glenn-Milo
GM
Chu
Priscilla
P
Vittinghoff
Eric
E
Pluddemann
Andreas
A
Kumar
Suresh
S
Hart
Carl
C
D019969:Amphetamine-Related Disorders / Q000150:complications* / Q000453:epidemiology / Q000534:rehabilitation; D001521:Behavior Therapy; D015658:HIV Infections / Q000175:diagnosis / Q000517:prevention & control / Q000635:transmission*; D006801:Humans; D018671:Needle-Exchange Programs; D015995:Prevalence; D016032:Randomized Controlled Trials as Topic; D012309:Risk-Taking; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000150:complications