title: Crystal Clear? The Relationship Between Methamphetamine Use and Sexually Transmitted Infections.
abstract: Public health officials have cited methamphetamine control as a tool with which to decrease HIV and other sexually transmitted infections, based on previous research that finds a strong positive correlation between methamphetamine use and risky sexual behavior. However, the observed correlation may not be causal, as both methamphetamine use and risky sexual behavior could be driven by a third factor, such as a preference for risky behavior. We estimate the effect of methamphetamine use on risky sexual behavior using monthly data on syphilis diagnoses in California and quarterly data on syphilis, gonorrhea, and chlamydia diagnoses across all states. To circumvent possible endogeneity, we use a large exogenous supply shock in the US methamphetamine market that occurred in May 1995 and a later shock stemming from the Methamphetamine Control Act, which went into effect in October 1997. While the supply shocks had large negative effects on methamphetamine use, we find no evidence that they decreased syphilis, gonorrhea, or chlamydia rates. Our results have broad implications for public policies designed to decrease sexually transmitted infection rates.
authors.affiliation: Department of Economics, Emory University, Atlanta, GA, USA.
authors.forename: Hugo M
authors.initials: HM
authors.lastname: Mialon
authors.affiliation: Department of Economics, Ball State University, Muncie, IN, USA.
authors.forename: Erik T
authors.initials: ET
authors.lastname: Nesson
authors.affiliation: Surveillance and Epidemiology Section, STD Control Branch, California Department of Public Health, Richmond, CA, USA.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Samuel
mesh_terms: D019969:Amphetamine-Related Disorders / Q000453:epidemiology*; D002140:California / Q000453:epidemiology; D002690:Chlamydia Infections / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D008297:Male; D008694:Methamphetamine; D012309:Risk-Taking; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology
chemical_list: D008694:Methamphetamine
keywords: chlamydia; ephedrine; gonorrhea; methamphetamine; risky sexual behavior; sexually transmitted infections; substance use; supply shock; syphilis