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P107 Crystal Meth: Still Speeding Out of Control with Sexual Partners Along for the Ride

Tuesday, March 13, 2012
Hyatt Exhibit Hall
Robert Bolan, MD1, Matthew Beymer, MPH1, Risa Flynn2, Everardo Mejia, PA3 and Mike Rizzo, CSAC4, 1Health & Mental Health Services, L.A. Gay & Lesbian Center, Los Angeles, CA, 2Clinical Research Department, L.A. Gay & Lesbian Center, Los Angeles, CA, 3Sexual Health Program, L.A. Gay & Lesbian Center, Los Angeles, CA, 4Crystal Meth Recovery Services, L.A. Gay & Lesbian Center, Los Angeles, CA

  

Background: Crystal methamphetamine use (CMU) is associated with new HIV infections and other STIs among urban men who have sex with men (MSM) and has not decreased despite numerous and novel interventions. Crystal Methamphetamine Users (CMUs), estimated at 8-15% of urban MSM, are especially risky sexual partners. More should be done to educate non-CM users about the risks for exposure to HIV and STIs when choosing partners who use CM.

Objectives: 1. Define odds ratios for CMU-associated HIV and STI infection using local epidemiological data. 2. Describe CMU frequency among this population 3. Develop practical messages to enable more informed sexual partner choices.

Methods: This retrospective analysis classified CMUs as individuals who reported methamphetamine use within the past calendar year, measured by electronic medical record variables. From January 2011 through October 2011, 8,610 unique clients visited the Los Angeles Gay and Lesbian Center for testing; 7.7% (N=663) were CMUs. CMUs were compared to non-users on incident HIV, Gonorrhea (GC), Chlamydia (CT), and Syphilis infections. Frequency estimates for CMU, odds ratios and Mantel-Haenszel Chi-squared tests were computed using SAS software (Version 9.2).

Results: CMUs had significantly higher odds of contracting HIV (OR: 4.18, CI 3.07-5.69, p-value: <0.0001), GC (OR: 2.23, CI 1.81-2.74, p-value: <0.0001), CT (OR: 1.63, CI: 1.30-2.04, p-value: <0.0001), and Syphilis (OR: 2.83, CI: 2.27-3.53, p-value: <0.0001). Among CMUs with incident HIV, GC, CT and Syphilis infections, 60.34%, 60.8%, 61.89%, 63.30% had used within the past month, respectively. CMU frequency was missing for 15.52% of incident HIV, 20% of GC, 16.49% of CT and 12.84% of Syphilis infections.

Conclusions: 60-63% of each of the incident infections among this especially high risk group is associated with CMU within the previous month.

Implications for Programs, Policy, and Research: Asking potential partners about CMU during the past month is one useful risk reduction strategy for MSM to avoid excess exposure to these infections.

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