Wednesday, August 3, 2011

Meth / HIV Public Health Crisis (new study)

According to a new study conducted by Peter Freeman, MPH; Bendu C. Walker, MPH; D. Robert Harris, PhD; Robert Garofalo, MD; Nancy Willard, MS; Jonathan M. Ellen, MD; for the Adolescent Trials Network for HIV/AIDS Interventions 016b Team with the Pediatrics & Adolescent Medicine, young gay and bisexual men who use methamphetamine are more likely to take sexual risks that boost their chances of contracting HIV.

Kentucky Equality Federation's Board of Directors passed a resolution on March 18, 2010 which stated:

Kentucky Equality Federation is committed to securing peace, liberty, and equality for all Kentuckians, which by de facto must include their health and well-being.

Kentucky Equality Federation also and declared a community health crisis and urged people to get tested for HIV immediately. (view in .pdf) or (view in .xps)

Kentucky Equality Federation held several meeting with Representatives in the Health and Welfare Committee of the Kentucky House of Representatives in 2009, 2010, and 2011.

Researchers say the findings underscore the fact that meth, and its associated HIV risk, is not just a problem of middle-aged white men.

Methamphetamine triggers a massive release of the feel-good chemical dopamine in the brain, making users feel disinhibited, energized -- and prone to sexual risk-taking.

Studies of gay and bisexual men have found that roughly 43 percent have ever used meth, and that the habit is strongly linked to their risk of contracting HIV, the virus that causes AIDS.

But much less has been known about meth use and HIV risk among teenagers and young men.

So for the new study, researchers surveyed 595 12- to 24-year-old gay and bisexual males from eight U.S. cities. They found that 31 percent had ever used hard drugs -- one-third of whom had used methamphetamine.

And young men who'd used meth were more likely to report a range of risk factors for HIV.

Nearly 86 percent said they'd had sex with at least two different partners in the past 90 days (versus 63 percent of non-drug users). Almost 52 percent had ever had sex with an injection-drug user (versus 11 percent), and one-third had had sex with someone who was HIV-positive (against 11 percent).

Despite all of that, meth users were less consistent with condoms: one-third said they used them every time they had sex, compared with 54 percent of young men who'd never used hard drugs.

"In many ways, these findings mirror what's been seen in older MSM (men who have sex with men)," said Dr. Robert Garofalo of Children's Memorial Hospital in Chicago.

That's concerning, he told Reuters Health in an interview, and it also points to a large public health need.

"There are not a lot of proven HIV prevention programs for this age group," Garofalo said. More programs, including ones that target meth abuse, need to be piloted, according to Garofalo and his colleagues.

"We shouldn't wait," he said. "This is a real public health crisis."

The findings, which appear in the Archives of Pediatrics & Adolescent Medicine, are not representative of all young gay and bisexual men in the U.S. The researchers recruited their participants from clubs, bars, parks and other urban venues where they might find higher-risk young men.

But the researchers also consider that a strong point of the study.

"It tells us something about where to find these young men, and where we might be able to run some type of intervention," said lead researcher Peter Freeman, who is also with Children's Memorial.

For parents and teenagers, he said, the findings highlight the importance of having open conversations about both drug use and risky sexual behavior.

Garofalo said there still may be many parents who do not know that methamphetamine is something they need to worry about. So the current findings may be something of an eye-opener for some, he added.

Finding effective ways to curb HIV risk among young gay and bisexual men will only become increasingly important, according to Garofalo and Freeman.

In 2004, Americans between the ages of 13 and 24 accounted for 13 percent of new HIV diagnoses.

And gay and bisexual males, especially minorities, have been particularly vulnerable. A study of seven cities by the U.S. Centers for Disease Control and Prevention found that 14 percent of African-American gay and bisexual males ages 15 to 22 had HIV. The same was true of 7 percent of Hispanics.

SOURCE: Archives of Pediatrics & Adolescent Medicine, August 2011.

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