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Moradi S, Moradi Y, Rahmani K, Nouri B, Moradi G. The association between methamphetamine use and number of sexual partners in men who have sex with men: a systematic review and meta-analysis. Subst Abuse Treat Prev Policy 2022; 17:27. [PMID: 35397571 PMCID: PMC8994254 DOI: 10.1186/s13011-022-00453-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2022] [Indexed: 11/21/2022] Open
Abstract
Background Methamphetamine use in men who have sex with men population is significantly higher than that in the general population. Meth use can cause high-risk sexual behaviors, such as having sex with a variety of sexual partners. The aim of this study was to determine the association between meth use and the number of sexual partners in MSM. Methods Searching international databases (PubMed (Medline), Scopus, Web of Sciences, Embase (Elsevier), PsycInfo (Ovid), Cochrane CENTRAL (Ovid)) until March 2021 was performed in this meta-analysis using appropriate keywords terms to identify related articles. After retrieving articles in these databases, screening was performed based on the title, abstract and full text of the articles, and the final related studies were selected and evaluated using the Newcastle Ottawa scale checklist. Results The sample size consisted 18,455 people in this study, including four cohort studies with a sample size of 15,026 MSM and four case–control studies with a sample size of 3429 MSM. The results of meta-analysis showed that meth use increased the number of sexual partners in MSM (RR: 3.70; % 95 CI: 2.04—6.70). The results of subgroup analyze based on the number of sexual partners showed that in MSM taking meth, the risks of having one to three, four to five, and six or more than six sexual partners were respectively 2.82, 2.98 and 5.89 times higher than those in MSM who did not take meth. Conclusion The results showed that meth uses in MSM increased the number of their sexual partners. Due to the fact that increasing the number of sexual partners and high-risk sexual behaviors increase the risk of contracting sexually transmitted diseases such as HIV, it is necessary to adopt control programs to prevent meth use by this group, or to implement programs of reduction in the risk of STIs for this group.
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Petrova M, Miller-Perusse M, Hirshfield S, Carrico A, Horvath K. The Beat Goes On: Stimulant Use and HIV in the Era of COVID-19. JMIR Form Res 2021; 6:e30897. [PMID: 35275839 PMCID: PMC9159464 DOI: 10.2196/30897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 11/01/2021] [Accepted: 11/23/2021] [Indexed: 11/27/2022] Open
Abstract
Background Evidence suggests that economic, social, and psychological circumstances brought about by the COVID-19 pandemic may have a serious impact on behavioral health. Men who have sex with men (MSM) are disproportionally impacted by HIV and stimulant use, the co-occurrence of which heightens HIV transmission risk and undermines nationwide treatment strategies as prevention efforts for ending the HIV epidemic. There is a paucity of information regarding the potential impact of the COVID-19 pandemic on the substance use and HIV medication adherence in this key vulnerable population—MSM who use stimulants and are living with HIV. Objective The aim of this qualitative study was to identify ways in which the COVID-19 pandemic has affected stimulant use and antiretroviral therapy (ART) adherence among a sample of MSM living with HIV. Methods Two focus groups were conducted in August 2020 via videoconferencing technology compliant with the Health Insurance Portability and Accountability Act. Potential participants from an established research participant registry at State University of New York Downstate Health Sciences University were invited and screened for study participation on the basis of inclusion criteria. A semistructured interview guide was followed. A general inductive approach was used to analyze the data. Findings in two general areas of interest, the impact of the COVID-19 pandemic on stimulant use and ART adherence, emerged directly from the raw data. Results A total of 12 ethnically diverse participants over the age of 25 years took part in the study. Results were heterogeneous in terms of the effects of the pandemic on both stimulant use and ART adherence among MSM living with HIV. Some men indicated increased or sustained stimulant use and ART adherence, and others reported decreased stimulant use and ART adherence. Reasons for these behavioral changes ranged from concerns about their own health and that of their loved ones to challenges brought about by the lack of daily structure during the lockdown phase of the pandemic and emotion regulation difficulties. Conclusions The COVID-19 pandemic has had a differential impact on stimulant use and ART medication adherence among MSM living with HIV. The reasons for behavioral change identified in this study may be salient intervention targets to support ART medication adherence and lower stimulant use among MSM in the aftermath of the of the COVID-19 pandemic, as well as beyond.
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Affiliation(s)
- Mariya Petrova
- Miller School of Medicine, University of Miami, 1120 N.W. 14th StreetOffice 1085, Miami, US
| | | | | | - Adam Carrico
- Miller School of Medicine, University of Miami, 1120 N.W. 14th StreetOffice 1085, Miami, US
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Garcia A, Rowe C, Turner C, Santos GM. Correlates of Alcohol-Using Network Size Among Men Who Have Sex with Men in San Francisco, CA. Am J Mens Health 2021; 15:15579883211007005. [PMID: 33899602 PMCID: PMC8076769 DOI: 10.1177/15579883211007005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 02/16/2021] [Accepted: 02/23/2021] [Indexed: 12/02/2022] Open
Abstract
Men who have sex with men (MSM) have a high prevalence of hazardous alcohol consumption. While network-level characteristics such as social network size have been indicated as upstream determinants of alcohol use in general population samples, no studies have examined factors associated with alcohol using network size (ANS), among MSM.This secondary analysis examined demographic, substance use, and sexual behavior correlates of ANS using data from a diverse sample of alcohol-using MSM in San Francisco (N = 252). Associations were calculated using multivariable negative binomial regression, adjusting for age, race, education, and employment.The median ANS was 10. Factors associated with larger ANS in multivariable analyses included identifying as Hispanic/Latino, having completed a college education or higher, having a higher Alcohol Use Disorders Identification Test (AUDIT) score, having a greater number of sexual partners, polysubstance use, and being unaware of one's own HIV status. Factors associated with smaller ANS included being between 18 and 24 years of age, reporting a low income, and having any lifetime history of injection drug use.For MSM, ANS was associated with increased likelihood of hazardous alcohol use, as well specific individual-level substance use and sexual risk behaviors. These results highlight the role of ANS in hazardous alcohol consumption and sexually transmitted infection transmission among MSM. These results also indicate ways that research and intervention programs aimed at reducing alcohol use among MSM might be improved through network-based recruitment or engagement. Finally, these results suggest the need for further research on HIV-unknown MSM.
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Affiliation(s)
- Alex Garcia
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA, United States
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Chris Rowe
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA, United States
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Caitlin Turner
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA, United States
| | - Glenn-Milo Santos
- Center for Public Health Research, San Francisco Department of Public Health, 25 Van Ness Avenue, San Francisco, CA, United States
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Francisco, CA, USA
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4
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Miller M, Lee JY, Fulcher JA, Roach ME, Dilworth SE, Chahine A, Pallikkuth S, Fuchs D, Pahwa S, Carrico AW. Getting to the point: Methamphetamine injection is associated with biomarkers relevant to HIV pathogenesis. Drug Alcohol Depend 2020; 213:108133. [PMID: 32580112 DOI: 10.1016/j.drugalcdep.2020.108133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/01/2020] [Accepted: 06/09/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND People living with HIV who use stimulants, such as methamphetamine, display greater immune dysregulation and experience faster clinical HIV progression. However, it remains unclear if the extent of immune dysregulation differs between methamphetamine users who engage in injection drug use (Meth IDU) and methamphetamine users who do not. METHODS This cross-sectional study enrolled 86 sexual minority men living with HIV who had an undetectable viral load (< 40 copies/mL) and recent, biologically confirmed methamphetamine use. Meth IDU participants were compared to methamphetamine users who did not report IDU with respect to microbial translocation, immune activation, and inflammation plasma biomarkers. Multiple linear regression models were adjusted for age, antiretroviral therapy regimen, CD4 + T-cell count, and reactive urine toxicology results (Tox+) for stimulants. RESULTS The Meth IDU participants were significantly more likely to be homeless and Tox + for stimulants. In adjusted analyses, those reporting Meth IDU displayed elevated plasma levels of lipopolysaccharide binding protein (LBP), soluble CD163 (sCD163), interleukin-6 (IL-6), and soluble tumor necrosis factor - alpha receptor I (sTNF-αRI). DISCUSSION Even among methamphetamine users with treated HIV, those who engage in Meth IDU display exacerbations in key pathophysiologic processes that are linked to faster clinical HIV progression. These findings highlight the importance of screening for Meth IDU, discussing safer injection practices, and providing linkages to needle exchanges to reduce the harms of Meth IDU. Those who are not ready, willing, or able to abstain from methamphetamine use could also derive important health benefits from avoiding Meth IDU.
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Affiliation(s)
| | - Ji-Young Lee
- University of Miami School of Medicine, United States
| | | | | | - Samantha E Dilworth
- University of California, San Francisco Center for AIDS Prevention Studies, United States
| | | | | | | | - Savita Pahwa
- University of Miami School of Medicine, United States
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Loza O, Curiel ZV, Beltran O, Ramos R. Methamphetamine Use and Sexual Risk Behaviors among Men Who Have Sex With Men in a Mexico-US Border City. Am J Addict 2020; 29:111-119. [PMID: 31908109 PMCID: PMC7895453 DOI: 10.1111/ajad.12985] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 11/06/2019] [Accepted: 12/15/2019] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Methamphetamine (meth) use and its related risk behaviors for HIV among men who have sex with men (MSM) are a public health concern across the Mexico-US border. This study aims to contribute to the limited literature of meth use and sexual risk behaviors among Latino MSM on the Mexico-US border. METHODS Data were drawn from the Meth Pilot Study (2014-2015) among men who use meth (n = 100). Descriptive statistics and bivariate analysis comparing MSM to non-MSM were conducted using Pearson's χ2 test, Fisher's exact tests, and Mann-Whitney U test; all tests were conducted using SPSS v.25. RESULTS Most participants obtained meth in El Paso, Texas (87.2%), used meth orally (65.2%) or smoked (78.3%), and the most common reason for initiation was curiosity. Significant differences (P < .05) in meth use behaviors and sexual risk behaviors between MSM and non-MSM who used meth included: median number of sex partners (7 vs 3), being penetrated anally by last sexual partner (31.6% vs 1.4%), and engaging in transactional sex ever (63.2% vs 9.6%) and past 12 months (52.6% vs 6.8%). Finally, rates of HIV positivity were higher among MSM than non-MSM (10.5% vs 1.4%). DISCUSSION AND CONCLUSIONS Among men who use meth, MSM are engaging in higher HIV risk behaviors compared with non-MSM. Understanding these risks could help identify candidates for pre-exposure prophylaxis (PrEP) and evidence-based substance use disorder treatment options. SCIENTIFIC SIGNIFICANCE This study reveals that Latino MSM who use meth is a high-risk group for HIV and a need for tailored interventions. (Am J Addict 2020;29:111-119).
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Affiliation(s)
- Oralia Loza
- Department of Public Health Sciences, The University of Texas at El Paso, El Paso, Texas
| | - Zuleika V. Curiel
- Texas Tech University Health Sciences Center El Paso, El Paso, Texas
| | | | - Rebeca Ramos
- Alliance of Border Collaboratives, El Paso, Texas
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6
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Abstract
We examined factors associated with reporting sex with men among men who inject drugs in Vancouver, Canada. Data were drawn from three open prospective cohorts of people who use drugs between 2005 and 2014. Generalized estimating equations were used to identify factors associated with reporting non-transactional sex with men (MSM) in the previous 6 months. Of 1663 men who used injection drugs, 225 (13.5%) were MSM over the study period. Sex with men was independently associated with younger age [Adjusted Odds Ratio (AOR) = 0.96], childhood sexual abuse (AOR = 2.65), sex work (AOR = 3.33), crystal methamphetamine use (AOR = 1.30), borrowing used syringes (AOR = 1.39), inconsistent condom use (AOR = 1.76), and HIV seropositivity (AOR = 3.82). MSM were less likely to be Hepatitis C-positive (AOR = 0.43) and to have accessed addiction treatment in the previous 6 months (AOR = 0.83) (all p < 0.05). Findings highlight vulnerabilities and resiliencies among MSM-PWID and indicate a need for trauma-informed and affirming harm reduction and substance use treatment services for MSM-PWID.
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7
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Deldar Z, Ekhtiari H, Pouretemad HR, Khatibi A. Bias Toward Drug-Related Stimuli Is Affected by Loading Working Memory in Abstinent Ex-Methamphetamine Users. Front Psychiatry 2019; 10:776. [PMID: 31695630 PMCID: PMC6817911 DOI: 10.3389/fpsyt.2019.00776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 09/26/2019] [Indexed: 01/24/2023] Open
Abstract
Background: There is a trade-off between drug-related impulsive process and cognitive reflective process among ex-drug abusers. The present study aimed to investigate the impulsive effects of methamphetamine-related stimuli on working memory (WM) performance by manipulating WM load in abstinent ex-methamphetamine users. Methods: Thirty abstinent ex-methamphetamine users and 30 nonaddict matched control participants were recruited in this study. We used a modified Sternberg task in which participants were instructed to memorize three different sets of methamphetamine-related and non-drug-related words (three, five, or seven words) while performing a secondary attention-demanding task as an interference. Results: Repeated-measures ANOVA revealed that reaction times of abstinent ex-methamphetamine users increased during low WM load (three words) compared to the control group (p = 0.01). No significant differences were observed during high WM loads (five or seven words) (both p's > 0.1). Besides, reaction times of the experimental group during trials with high interference (three, five, or seven words) were not significantly different compared to the control group (p > 0.2). Conclusion: These findings imply that increasing WM load may provide an efficient buffer against attentional capture by salient stimuli (i.e., methamphetamine-related words). This buffer might modify the effect of interference bias. Besides, presenting methamphetamine-related stimuli might facilitate the encoding phase due to bias toward task-relevant stimuli. This finding has an important implication, suggesting that performing concurrent demanding tasks may reduce the power of salient stimuli and thus improve the efficiency of emotional regulation strategies.
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Affiliation(s)
- Zoha Deldar
- Institute for Cognitive Science Studies, Tehran, Iran
| | - Hamed Ekhtiari
- Institute for Cognitive Science Studies, Tehran, Iran.,Iranian National Center for Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Pouretemad
- Institute for Cognitive and Brain Sciences (ICBS), Shahid Beheshti University, Tehran, Iran
| | - Ali Khatibi
- Department of Neurology and Neurosurgery, McGill University, Montreal, QC, Canada.,Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, AL, United States
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8
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Kuiper LB, Coolen LM. Compulsive Sexual Behavior in Humans and Preclinical Models. CURRENT SEXUAL HEALTH REPORTS 2018. [DOI: 10.1007/s11930-018-0157-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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9
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Luo YL, Bian JW, Zheng ZJ, Zhao L, Han S, Sun XH, Li JF, Ni GX. Effects of methamphetamine abuse on spatial cognitive function. Sci Rep 2018; 8:5502. [PMID: 29615755 PMCID: PMC5882954 DOI: 10.1038/s41598-018-23828-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 03/20/2018] [Indexed: 02/08/2023] Open
Abstract
Methamphetamine (MA) abuse has been rising rapidly over the past decade, however, its impact in spatial cognitive function remains unknown. To understand its effect on visuospatial ability and spatial orientation ability, 40 MA users and 40 non-MA users conducted the Simple Reaction Task (Task 1), the Spatial Orientation Task (Task 2), and the Mental Rotation Task (Task 3), respectively. There was no significant difference in either accuracy or reaction time (RT) between 2 groups in Task 1. During Task 2, in comparison with non-MA users, MA users performed poorer on RT, but not in accuracy for foot and hand stimuli. In addition, both non-MA and MA users responded much more quickly to upward stimuli than downward stimuli on vertical surface, however, only non-MA users exhibited leftward visual field advantage in horizontal orientation processing. As for Task 3, MA users exhibited poorer performance and more errors than their healthy counterparts. For each group, linear relationship was revealed between RT and orientation angle, whereas MA abuse led to longer intercept for all stimuli involved. Our findings suggested that MA abuse may lead to a general deficit in the visuospatial ability and the spatial orientation ability with more serious impact in the former.
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Affiliation(s)
- Yan-Lin Luo
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Jing-Wei Bian
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Zhi-Jun Zheng
- Shanghai Compulsory Isolation Detox Center, Shanghai, China
| | - Li Zhao
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Song Han
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Xiao-Hong Sun
- Department of Neurobiology, Capital Medical University, Beijing, China
| | - Jun-Fa Li
- Department of Neurobiology, Capital Medical University, Beijing, China.
| | - Guo-Xin Ni
- Department of Rehabilitation Medicine, First Affiliated Hospital, Fujian Medical University, Fuzhou, China.
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10
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Anderson-Carpenter KD, Fletcher JB, Reback CJ. Associations between Methamphetamine Use, Housing Status, and Incarceration Rates among Men Who Have Sex with Men and Transgender Women. JOURNAL OF DRUG ISSUES 2017; 47:383-395. [PMID: 28670005 DOI: 10.1177/0022042617696917] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study examined associations between methamphetamine use and social factors among men who have sex with men (MSM) and transgender women. Over a four-year period, 7,419 HIV outreach encounters were conducted with MSM (n=6,243) and transgender women (n=1,176). Logistic and negative binomial regressions estimated associations between sociodemographics, incarceration history, housing status, and methamphetamine use. Incarceration history was associated with marginal housing or homelessness (AOR=3.4) and with increased likelihood (AOR = 6.00) and rate (AIRR = 3.57) of methamphetamine use. African American/Black MSM and transgender women were more likely to report a recent incarceration history compared to non-African American/Black participants (AOR=2.18). Incarceration history was associated with a HIV-positive status (AOR=1.69), and transgender women were 5.2 times more likely to report recent incarceration relative to MSM. Understanding these associations may provide a basis for developing interventions that account for the social factors influencing health outcomes among these high-risk populations.
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Affiliation(s)
| | | | - Cathy J Reback
- University of California, Los Angeles, Friends Research Institute, Inc
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11
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Stigma, sexual risks, and the war on drugs: Examining drug policy and HIV/AIDS inequities among African Americans using the Drug War HIV/AIDS Inequities Model. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 37:31-41. [PMID: 27565526 DOI: 10.1016/j.drugpo.2016.07.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 06/27/2016] [Accepted: 07/21/2016] [Indexed: 11/23/2022]
Abstract
The relationship between drug policy and HIV vulnerability is well documented. However, little research examines the links between racial/ethnic HIV disparities via the Drug War, sexual risk, and stigma. The Drug War HIV/AIDS Inequities Model has been developed to address this dearth. This model contends that inequitable policing and sentencing promotes sexual risks, resource deprivation, and ultimately greater HIV risk for African-Americans. The Drug War also socially marginalizes African Americans and compounds stigma for incarcerated and formerly incarcerated persons living with HIV/AIDS. This marginalization has implications for sexual risk-taking, access to health-promoting resources, and continuum of care participation. The Drug War HIV/AIDS Inequities Model may help illuminate mechanisms that promote increased HIV vulnerability as well as inform structural intervention development and targeting to address racial/ethnic disparities.
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12
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Dolatshahi B, Farhoudian A, Falahatdoost M, Tavakoli M, Rezaie Dogahe E. A Qualitative Study of the Relationship Between Methamphetamine Abuse and Sexual Dysfunction in Male Substance Abusers. INTERNATIONAL JOURNAL OF HIGH RISK BEHAVIORS & ADDICTION 2016; 5:e29640. [PMID: 27803891 PMCID: PMC5086781 DOI: 10.5812/ijhrba.29640] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/14/2015] [Accepted: 07/27/2015] [Indexed: 11/20/2022]
Abstract
Background Increased prevalent use of methamphetamine is a global public challenge. Information on drug use can be helpful in preventing high-risk behavior related to drug abuse. Objectives This study aims to investigate the sexual function changes related to methamphetamine use in the male clients of public and private addiction treatment centers. Patients and Methods In this qualitative study, 45 men (35 methamphetamine users, 5 family members of the users, and 5 psychiatrists or physicians who were famous for treating or researching addiction) are involved. An in-depth interview was done with therapists and key individuals. Results The results show that the effects of methamphetamine on sexual function are not identical. The first usage is concomitant with the increased duration of sex, an increase in the quality and quantity of sexual pleasure, a delighted orgasm, and feeling more control of the sex act. These effects gradually decrease. A decreased libido and various sexual dysfunctions such as erectile dysfunction, premature ejaculation, and losing control during the sex act will appear over time. Conclusions There are differences in the libido and sexual functions of methamphetamine users. Personal perceptions of one’s sexual function may be affected by cognitive changes resultant from the drug. Drug-use prevention, addiction treatments, appropriate sexual behavior education, and harm reduction are priorities.
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Affiliation(s)
- Behrouz Dolatshahi
- Substance Abuse and Dependence Research Center, Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Ali Farhoudian
- Substance Abuse and Dependence Research Center, Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
- Corresponding author: Ali Farhoudian, Substance Abuse and Dependence Research Center, Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran. Tel: +98-9111517707, E-mail:
| | - Mozhgan Falahatdoost
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Mahmoud Tavakoli
- Substance Abuse and Dependence Research Center, Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
| | - Ebrahim Rezaie Dogahe
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, IR Iran
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13
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Can G, Tanrıverdi D. Social functioning and internalized stigma in individuals diagnosed with substance use disorder. Arch Psychiatr Nurs 2015; 29:441-6. [PMID: 26577560 DOI: 10.1016/j.apnu.2015.07.008] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Revised: 07/09/2015] [Accepted: 07/15/2015] [Indexed: 11/28/2022]
Abstract
The aim of this descriptive study was to determine social functioning and internalized stigma in individuals with substance use disorder. The study sample consisted of 105 patients diagnosed with substance use disorder according to the DSM-IV-TR diagnostic criteria. A Descriptive Information Form, Internalized Stigma of Mental Illness Scale (ISMI) and Social Functioning Scale (SFS) were used for data collection. Average total SFS score of the patients was 103.25±25.09 points, indicating an intermediate level of social functioning. Average total ISMI score of patients was 2.92±0.48 points, reflecting a high level of internalized stigma. A negative significant association was observed between the internalized stigma levels and social functioning of patients. These results suggest that rehabilitation of substance users should include counseling services in order to reduce internal perception of stigma and improve their social functioning.
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Affiliation(s)
- Ganime Can
- University of Atatürk, Faculty of Health Science, Department of Psychiatric Nursing, Erzurum, Turkey.
| | - Derya Tanrıverdi
- Gaziantep University, Faculty of Health Science, Department of Psychiatric Nursing, Gaziantep, Turkey.
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14
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Surgical Intervention for Penile Methamphetamine Injections. Case Rep Urol 2015; 2015:467683. [PMID: 26451272 PMCID: PMC4586958 DOI: 10.1155/2015/467683] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/03/2015] [Indexed: 11/17/2022] Open
Abstract
Methamphetamine is a central nervous system stimulant and is the second most commonly used illicit drug after cannabis. Methamphetamine use for sexual pleasure is well documented. In this case report, we describe two cases presenting to our urban county hospital associated with complications related to penile injection of methamphetamine. Both patients developed penile abscesses and required urgent surgical incision and drainage. Penile abscesses represent a rare complication associated with IV drug administration into the penile corpora. Resultant penile abscesses require broad-spectrum antibiotics and surgical drainage. Further understanding of methamphetamine abuse along with the role it plays in sexual enhancement would be an invaluable addition to understanding of the rationale behind this self-administered stimulant. Drainage of penile abscesses associated with IV drug users may be hazardous to healthcare providers who are at risk from a needle stick injury.
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15
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Quinn B, Stoové M, Dietze P. One-year changes in methamphetamine use, dependence and remission in a community-recruited cohort. JOURNAL OF SUBSTANCE USE 2015. [DOI: 10.3109/14659891.2015.1018972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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16
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Kapitány-Fövény M, Mervó B, Kertész M, Corazza O, Farkas J, Kökönyei G, Urbán R, Demetrovics Z. Is there any difference in patterns of use and psychiatric symptom status between injectors and non-injectors of mephedrone? Hum Psychopharmacol 2015. [PMID: 26216556 DOI: 10.1002/hup.2490] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE In recent years, increasing intravenous mephedrone use was reported in several countries. The aim of this study was to describe the characteristics of such a form of mephedrone use, while identifying the differences between injectors and non-injectors in patterns of mephedrone use and psychiatric symptom status. METHODS One hundred and forty-five mephedrone users were surveyed on patterns of mephedrone use using a structured questionnaire as well as the Brief Symptom Inventory. RESULTS Majority of users received mephedrone from acquaintances and used it in discos/parties settings regarding both first and current mephedrone use. Intranasal use was the most typical route of administration (84.4%). Injectors (11%) used the drug more frequently and in higher dosages. This group included a greater proportion of opiate users (37.5%) and showed more diffuse psychiatric symptoms. Regarding the predictors of being an injector, heroin use showed the highest odds ratio. CONCLUSIONS Intravenous mephedrone use is associated with a higher risk of harmful drug use, elevated psychiatric symptom profile and increased possibility of mephedrone being considered as an addictive substance. These findings might be important in efficient treatment planning.
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Affiliation(s)
- Máté Kapitány-Fövény
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Nyírő Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary.,Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
| | - Barbara Mervó
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Máté Kertész
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Judit Farkas
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary.,Doctoral School of Psychology, Eötvös Loránd University, Budapest, Hungary.,Nyírő Gyula Hospital Drug Outpatient and Prevention Center, Budapest, Hungary
| | - Gyöngyi Kökönyei
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Róbert Urbán
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
| | - Zsolt Demetrovics
- Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
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17
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Latent class analysis of substance use among men who have sex with men in Malaysia: Findings from the Asian Internet MSM Sex Survey. Drug Alcohol Depend 2015; 151:31-7. [PMID: 25865907 DOI: 10.1016/j.drugalcdep.2015.02.040] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Revised: 02/16/2015] [Accepted: 02/16/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND High prevalence of substance use among men who have sex with men (MSM) may drive the HIV epidemic in Malaysia but patterns of substance use among Malaysian MSM have not been examined. Our study investigated specific Malaysian MSM risk groups to determine the association between their substance use and sexual risk behaviors. METHODS Data from Malaysian respondents (n=1235) in a large, multinational online survey of Asian MSM in 2010 were used to identify latent classes of substance use. Subsequent covariates were included in a joint model to predict class membership. RESULTS The 3-class model was identified as the best fitting model, which included: (1) 'negligible substance use' for those reporting none or using any substance sparingly; (2) 'soft substance use' for those using poppers, ecstasy and drinking before sex; and (3) 'amphetamine-type stimulant (ATS) use' for those using stimulants (methamphetamine, ecstasy), erectile dysfunction drugs and recreational drug use before sex. Men in the 'ATS use' category were significantly less likely to not know their HIV status (AOR: 0.30, 95%CI: 0.14,0.66), more likely to have had more than 6 male sex partners (AOR: 4.83, 95% CI: 1.92-12.2), to have group sex (AOR:4.07, 95% CI: 2.31-7.15), to report inconsistent condom use (AOR:2.01, 95% CI: 1.12-3.60), to be HIV-infected (AOR:3.92, 95% CI: 1.63-8.42) and to have had any sexually transmitted infections (AOR:3.92, 95% CI:1.70, 9.08), compared to men in the 'negligible substance use' category. CONCLUSIONS Our study identified subgroups of Malaysian MSM with distinct substance use patterns and HIV-related risk profiles, which provides implication for targeting HIV prevention in this subpopulation.
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Mata MM, Napier TC, Graves SM, Mahmood F, Raeisi S, Baum LL. Methamphetamine decreases CD4 T cell frequency and alters pro-inflammatory cytokine production in a model of drug abuse. Eur J Pharmacol 2015; 752:26-33. [PMID: 25678251 DOI: 10.1016/j.ejphar.2015.02.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 01/28/2015] [Accepted: 02/03/2015] [Indexed: 01/10/2023]
Abstract
The reason co-morbid methamphetamine use and HIV infection lead to more rapid progression to AIDS is unclear. We used a model of methamphetamine self-administration to measure the effect of methamphetamine on the systemic immune system to better understand the co-morbidity of methamphetamine and HIV. Catheters were implanted into the jugular veins of male, Sprague Dawley rats so they could self-administer methamphetamine (n=18) or be given saline (control; n=16) for 14 days. One day after the last operant session, blood and spleens were collected. We measured serum levels of pro-inflammatory cytokines, intracellular IFN-γ and TNF-α, and frequencies of CD4(+), CD8(+), CD200(+) and CD11b/c(+) lymphocytes in the spleen. Rats that self-administered methamphetamine had a lower frequency of CD4(+) T cells, but more of these cells produced IFN-γ. Methamphetamine did not alter the frequency of TNF-α-producing CD4(+) T cells. Methamphetamine using rats had a higher frequency of CD8(+) T cells, but fewer of them produced TNF-α. CD11b/c and CD200 expression were unchanged. Serum cytokine levels of IFN-γ, TNF-α and IL-6 in methamphetamine rats were unchanged. Methamphetamine lifetime dose inversely correlated with serum TNF-α levels. Our data suggest that methamphetamine abuse may exacerbate HIV disease progression by activating CD4 T cells, making them more susceptible to HIV infection, and contributing to their premature demise. Methamphetamine may also increase susceptibility to HIV infection, explaining why men who have sex with men (MSM) and frequently use methamphetamine are at the highest risk of HIV infection.
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Affiliation(s)
- Mariana M Mata
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612, United States
| | - T Celeste Napier
- Department of Pharmacology and Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL 60612, United States
| | - Steven M Graves
- Department of Pharmacology and Center for Compulsive Behavior and Addiction, Rush University Medical Center, Chicago, IL 60612, United States
| | - Fareeha Mahmood
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612, United States
| | - Shohreh Raeisi
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612, United States
| | - Linda L Baum
- Department of Immunology/Microbiology, Rush University Medical Center, Chicago, IL 60612, United States.
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19
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Cadet JL, Bisagno V. Neuropsychological Consequences of Chronic Drug Use: Relevance to Treatment Approaches. Front Psychiatry 2015; 6:189. [PMID: 26834649 PMCID: PMC4713863 DOI: 10.3389/fpsyt.2015.00189] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 12/27/2015] [Indexed: 11/21/2022] Open
Abstract
Heavy use of drugs impacts of the daily activities of individuals in these activities. Several groups of investigators have indeed documented changes in cognitive performance by individuals who have a long history of chronic drug use. In the case of marijuana, a wealth of information suggests that heavy long-term use of the drug may have neurobehavioral consequences in some individuals. In humans, heavy cocaine use is accompanied by neuropathological changes that might serve as substrates for cognitive dysfunctions. Similarly, methamphetamine users suffer from cognitive abnormalities that may be consequent to alterations in structures and functions. Here, we detail the evidence for these neuropsychological consequences. The review suggests that improving the care of our patients will necessarily depend on the better characterization of drug-induced cognitive phenotypes because they might inform the development of better pharmacological and behavioral interventions, with the goal of improving cognitive functions in these subsets of drug users.
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Affiliation(s)
- Jean Lud Cadet
- National Institute on Drug Abuse Intramural Program, Molecular Neuropsychiatry Research Branch , Baltimore, MD , USA
| | - Veronica Bisagno
- Instituto de Investigaciones Farmacológicas (ININFA), Universidad de Buenos Aires-CONICET , Buenos Aires , Argentina
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20
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Ho HT, Le GM, Dinh TT. Female sex workers who use amphetamine-type stimulants (ATS) in three cities of Vietnam: Use and sexual risks related to HIV/AIDS. Glob Public Health 2013; 8:552-69. [DOI: 10.1080/17441692.2013.790459] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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21
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Injecting drug use among gay and bisexual men in Sydney: prevalence and associations with sexual risk practices and HIV and hepatitis C infection. AIDS Behav 2013; 17:1344-51. [PMID: 23321949 DOI: 10.1007/s10461-013-0409-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Injecting drug use is commonly reported among gay and bisexual men in Australia. We examined the prevalence and covariates of injecting drug use among men participating in the Sydney Gay Community Periodic Survey between 2004-06 and 2011. In 2004-06, data was collected about which drugs were injected, while in 2011, data was collected about hepatitis C (HCV) and esoteric sexual practices. In 2004-06, 5.6 % of men reported injecting drugs in the previous 6 months; 3.4 % reported methamphetamine injection and 0.4 % heroin injection. In 2011, men who injected drugs were less likely to be employed full-time, and more likely to be HCV-positive, HIV-positive, to have used party drugs for sex, and to have engaged in esoteric sexual practices. The strong associations between injecting drug use, sexual risk practices and blood-borne virus infection suggests the need for combined sexual health and harm reduction services for gay and bisexual men who inject drugs.
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22
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Kipke MD, Kubicek K, Supan J, Weiss G, Schrager S. Laying the groundwork for an HIV prevention intervention: a descriptive profile of the Los Angeles House and Ball communities. AIDS Behav 2013; 17:1068-81. [PMID: 22699855 PMCID: PMC3492531 DOI: 10.1007/s10461-012-0227-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
African American young men who have sex with men (AAYMSM) represent the largest proportion of new HIV infections among MSM. While evidence-based interventions are lacking, all too often HIV interventions are implemented in a community without thoroughly understanding its needs, risks and assets. AAYMSM are not homogenous; subgroups exist that may require different approaches to be effective. The House and Ball communities represent one such subgroup. A community-engaged, mixed-methods approach was used. Participant observations, qualitative interviews (N = 26), and a survey at House/Ball events (N = 252) were completed. Survey data broadly describe the community. For example: 69 % of survey respondents identify as gay; 25 % as bisexual; 13 % reported recent use of ecstasy and 11 % recently participated in sex exchange. The depth of qualitative data is key for intervention development. For example, while the survey provides broad descriptions of respondents' involvement in the House and Ball communities, leaders provided in-depth descriptions of the structure of the House and Ball scene-something vital to the development of HIV prevention programs within these communities. This kind of rigorous study is recommended prior to implementing an intervention. Findings are discussed in relation to leveraging the communities' supportive aspects to design culturally relevant HIV prevention programs.
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Affiliation(s)
- Michele D. Kipke
- Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Katrina Kubicek
- Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Jocelyn Supan
- Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA
| | - George Weiss
- Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Sheree Schrager
- Community, Health Outcomes and Intervention Research Program, The Saban Research Institute, Children’s Hospital Los Angeles, Los Angeles, CA
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23
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Prevalence of HIV/STIs and Associated Factors Among Men Who Have Sex With Men in An Giang, Vietnam. Sex Transm Dis 2012; 39:799-806. [DOI: 10.1097/olq.0b013e318265b180] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Weber E, Blackstone K, Iudicello JE, Morgan EE, Grant I, Moore DJ, Woods SP. Neurocognitive deficits are associated with unemployment in chronic methamphetamine users. Drug Alcohol Depend 2012; 125:146-53. [PMID: 22560676 PMCID: PMC3735422 DOI: 10.1016/j.drugalcdep.2012.04.002] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2012] [Revised: 03/31/2012] [Accepted: 04/06/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND Unemployment rates are high among chronic methamphetamine (MA) users and carry a significant economic burden, yet little is known about the neurocognitive and psychiatric predictors of employment in this vulnerable population. METHODS The present study examined this issue in 63 participants with recent MA dependence and 47 comparison subjects without histories of MA use disorders. All participants completed a comprehensive neurocognitive, psychiatric and neuromedical evaluation. Individuals with HIV infection, severe neuropsychological or psychiatric conditions that might affect cognition (e.g., seizure disorder, schizophrenia), or a positive Breathalyzer or urine toxicology screen on the day of testing were excluded. RESULTS Consistent with previous research, a logistic regression revealed MA dependence as a significant, independent predictor of full-time unemployment status. Within the MA-dependent sample, greater impairment in global neurocognitive functioning and history of injection drug use emerged as significant independent predictors of unemployment status. The association between worse global cognitive functioning and unemployment was primarily driven by deficits in executive functions, learning, verbal fluency, and working memory. CONCLUSION These findings indicate that neurocognitive deficits play a significant role in the higher unemployment rates of MA-dependent individuals, and highlight the need for vocational rehabilitation and supported employment programs that assess and bolster cognitive skills in this population.
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Affiliation(s)
- Erica Weber
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, United States
| | - Kaitlin Blackstone
- Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, San Diego, CA, United States
| | - Jennfer E. Iudicello
- Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, United States
| | - Erin E. Morgan
- Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, United States
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, United States
| | - David J. Moore
- Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, United States
| | - Steven Paul Woods
- Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, United States,Corresponding author at: HIV Neurobehavioral Research Program, 220 Dickinson Street, Suite B, Mail Code 8231, San Diego, CA 92103-8231, United States. Tel.: +1 619 543 5004; fax: +1 619 543 1235. (S.P. Woods)
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25
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Semple SJ, Strathdee SA, Zians J, Patterson TL. Factors associated with experiences of stigma in a sample of HIV-positive, methamphetamine-using men who have sex with men. Drug Alcohol Depend 2012; 125:154-9. [PMID: 22572209 PMCID: PMC3419298 DOI: 10.1016/j.drugalcdep.2012.04.007] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2012] [Revised: 04/05/2012] [Accepted: 04/10/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND While methamphetamine users report high rates of internalized or self-stigma, few studies have examined experiences of stigma (i.e., stigmatization by others) and its correlates. METHODS This study identified correlates of stigma experiences in a sample of 438 HIV-positive men who have sex with men (MSM) who were enrolled in a sexual risk reduction intervention in San Diego, CA. RESULTS Approximately 96% of the sample reported experiences of stigma related to their use of methamphetamine. In multiple regression analysis, experiences of stigma were associated with binge use of methamphetamine, injection drug use, increased anger symptoms, reduced emotional support, and lifetime treatment for methamphetamine use. CONCLUSIONS These findings suggest that experiences of stigma are common among methamphetamine users and that interventions to address this type of stigma and its correlates may offer social, psychological, and health benefits to HIV-positive methamphetamine-using MSM.
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Affiliation(s)
- Shirley J. Semple
- Department of Psychiatry, University of California, San Diego, La Jolla, California, U.S.A
| | - Steffanie A. Strathdee
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, U.S.A
| | - Jim Zians
- Department of Psychiatry, University of California, San Diego, La Jolla, California, U.S.A
| | - Thomas L. Patterson
- Department of Psychiatry, University of California, San Diego, La Jolla, California, U.S.A.,Correspondence: Thomas L. Patterson, Department of Psychiatry (0680), University of California, San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680 U.S.A. Tel. 858-534-3354;
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26
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Lea T, Prestage G, Mao L, Zablotska I, de Wit J, Holt M. Trends in drug use among gay and bisexual men in Sydney, Melbourne and Queensland, Australia. Drug Alcohol Rev 2012; 32:39-46. [DOI: 10.1111/j.1465-3362.2012.00494.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 07/10/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Toby Lea
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
| | - Garrett Prestage
- The Kirby Institute; The University of New South Wales; Sydney; Australia
| | - Limin Mao
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
| | - Iryna Zablotska
- The Kirby Institute; The University of New South Wales; Sydney; Australia
| | - John de Wit
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
| | - Martin Holt
- National Centre in HIV Social Research; The University of New South Wales; Sydney; Australia
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27
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Vearrier D, Greenberg MI, Miller SN, Okaneku JT, Haggerty DA. Methamphetamine: history, pathophysiology, adverse health effects, current trends, and hazards associated with the clandestine manufacture of methamphetamine. Dis Mon 2012; 58:38-89. [PMID: 22251899 DOI: 10.1016/j.disamonth.2011.09.004] [Citation(s) in RCA: 103] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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28
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Morgan EE, Woods SP, Poquette AJ, Vigil O, Heaton RK, Grant I. Visual Memory in Methamphetamine Dependent Individuals: Deficient Strategic Control of Encoding and Retrieval. Aust N Z J Psychiatry 2012; 46:141-52. [PMID: 22311530 PMCID: PMC3278859 DOI: 10.1177/0004867411433212] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Chronic use of methamphetamine (MA) has moderate effects on neurocognitive functions associated with frontal systems, including the executive aspects of verbal episodic memory. Extending this literature, the current study examined the effects of MA on visual episodic memory with the hypothesis that a profile of deficient strategic encoding and retrieval processes would be revealed for visuospatial information (i.e., simple geometric designs), including possible differential effects on source versus item recall. METHOD The sample comprised 114 MA-dependent (MA+) and 110 demographically-matched MA-nondependent comparison participants (MA-) who completed the Brief Visuospatial Memory Test-Revised (BVMT-R), which was scored for standard learning and memory indices, as well as novel item (i.e., figure) and source (i.e., location) memory indices. RESULTS Results revealed a profile of impaired immediate and delayed free recall (p<0.05) in the context of preserved learning slope, retention, and recognition discriminability in the MA+ group. The MA+ group also performed more poorly than MA- participants on Item visual memory (p<0.05) but not Source visual memory (p>0.05), and no group by task-type interaction was observed (p>0.05). Item visual memory demonstrated significant associations with executive dysfunction, deficits in working memory, and shorter length of abstinence from MA use (p<0.05). CONCLUSIONS These visual memory findings are commensurate with studies reporting deficient strategic verbal encoding and retrieval in MA users that are posited to reflect the vulnerability of frontostriatal circuits to the neurotoxic effects of MA. Potential clinical implications of these visual memory deficits are discussed.
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Affiliation(s)
- Erin E. Morgan
- Department of Psychiatry, University of California, San Diego (UCSD), San Diego, USA
| | - Steven Paul Woods
- Department of Psychiatry, University of California, San Diego (UCSD), San Diego, USA
| | - Amelia J. Poquette
- Department of Psychiatry, University of California, San Diego (UCSD), San Diego, USA
| | - Ofilio Vigil
- Department of Psychiatry, University of California, San Diego (UCSD), San Diego, USA
| | - Robert K. Heaton
- Department of Psychiatry, University of California, San Diego (UCSD), San Diego, USA
| | - Igor Grant
- Department of Psychiatry, University of California, San Diego (UCSD), San Diego, USA
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29
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Injection methamphetamine use is associated with an increased risk of attempted suicide: a prospective cohort study. Drug Alcohol Depend 2011; 119:134-7. [PMID: 21676557 PMCID: PMC3179553 DOI: 10.1016/j.drugalcdep.2011.05.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Revised: 05/05/2011] [Accepted: 05/09/2011] [Indexed: 11/24/2022]
Abstract
BACKGROUND Methamphetamine (MA) use is a growing public health concern in many settings around the world. While some physical and mental health effects associated with injection MA use have been well described, little is known about the relationship between injecting MA and suicidal behavior. We sought to determine whether MA injection was associated with an increased risk of attempting suicide among a prospective cohort of injection drug users (IDUs) in Vancouver, Canada. METHODS Between 2001 and 2008, eligible participants enrolled in the Vancouver Injection Drug Users Study (VIDUS) completed semi-annual questionnaires that elicited information regarding sociodemographics, drug use patterns, and mental health problems including suicidal behavior. We used Cox proportional hazards models with time-dependent covariates to determine whether self-reported MA injection was an independent predictor of attempting suicide at subsequent time points. RESULTS Of 1873 eligible participants, 149 (8.0%) reported a suicide attempt, resulting in an incidence density of 2.5 per 100 person-years. Participants who attempted suicide were more likely to be younger (median: 35 vs. 40, p<0.01), female (48.3% vs. 35.1%, p<0.01), and of Aboriginal ancestry (43.6% vs. 31.3%, p<0.01). In a Cox proportional hazards model, MA injection was associated with an 80% increase in the risk of attempting suicide (adjusted hazard ratio=1.80, 95% CI: 1.08-2.99, p=0.02). CONCLUSIONS These findings suggest that IDUs who inject MA should be monitored for suicidal behavior. Improved integration of mental health and suicide prevention interventions within harm reduction and drug treatment programs may be fruitful.
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High-risk behaviors associated with injection drug use among recently HIV-infected men who have sex with men in San Diego, CA. AIDS Behav 2011; 15:1561-9. [PMID: 21607643 DOI: 10.1007/s10461-011-9970-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The contribution of injection drug use to HIV risk among men who have sex with men (MSM) is understudied. MSM infected with HIV within the prior 12 months completed a questionnaire assessing sociodemographic, sexual, drug use, and social factors. Analyses were performed to identify factors associated with lifetime history of injection drug use. Among 212 participants, the mean age was 33.8 years, 72% were White, 89% had attended college, and 9.4% reported ever injecting drugs. In multivariable logistic regression analysis, ever trading sex and using methamphetamine during sex with at least one of their last three partners were associated with injection drug use. Adjusting for these variables, in separate models, ever perpetrating violence against others (Adjusted Odds Ratio [AOR] = 3.16), having physically abusive sexual partners (AOR = 3.08), or physically abusing sexual partners (AOR = 10.17) were significantly (P < 0.05) associated with injection drug use. These findings suggest that violence is more common among MSM who inject drugs, which should be considered in HIV prevention efforts.
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31
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Individual, social, and environmental factors associated with initiating methamphetamine injection: implications for drug use and HIV prevention strategies. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2011; 12:173-80. [PMID: 21274628 DOI: 10.1007/s11121-010-0197-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of this study was to determine the incidence and predictors of initiating methamphetamine injection among a cohort of injection drug users (IDU). We conducted a longitudinal analysis of IDU participating in a prospective study between June 2001 and May 2008 in Vancouver, Canada. IDU who had never reported injecting methamphetamine at the study's commencement were eligible. We used Cox proportional hazards models to identify the predictors of initiating methamphetamine injection. The outcome was time to first report of methamphetamine injection. Time-updated independent variables of interest included sociodemographic characteristics, drug use patterns, and social, economic and environmental factors. Of 1317 eligible individuals, the median age was 39.9 and 522 (39.6%) were female. At the study's conclusion, 200 (15.2%) participants had initiated injecting methamphetamine (incidence density: 4.3 per 100 person-years). In multivariate analysis, age (adjusted hazard ratio [aHR]: 0.96 per year older, 95%CI: 0.95-0.98), female sex (aHR: 0.58, 95%CI: 0.41-0.82), sexual abuse (aHR: 1.63, 95%CI: 1.18-2.23), using drugs in Vancouver's drug scene epicentre (aHR: 2.15 95%CI: 1.49-3.10), homelessness (aHR: 1.43, 95%CI: 1.01-2.04), non-injection crack cocaine use (aHR: 2.06, 95%CI: 1.36-3.14), and non-injection methamphetamine use (aHR: 3.69, 95%CI: 2.03-6.70) were associated with initiating methamphetamine injection. We observed a high incidence of methamphetamine initiation, particularly among young IDU, stimulant users, homeless individuals, and those involved in the city's open drug scene. These data should be useful for the development of a broad set of interventions aimed at reducing initiation into methamphetamine injection among IDU.
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Strathdee SA, Lozada R, Martinez G, Vera A, Rusch M, Nguyen L, Pollini RA, Uribe-Salas F, Beletsky L, Patterson TL. Social and structural factors associated with HIV infection among female sex workers who inject drugs in the Mexico-US border region. PLoS One 2011; 6:e19048. [PMID: 21541349 PMCID: PMC3081836 DOI: 10.1371/journal.pone.0019048] [Citation(s) in RCA: 145] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 03/19/2011] [Indexed: 11/19/2022] Open
Abstract
Background FSWs who inject drugs (FSW-IDUs) can acquire HIV through high risk sexual and injection behaviors. We studied correlates of HIV infection among FSW-IDUs in northern Mexico, where sex work is quasi-legal and syringes can be legally obtained without a prescription. Methods FSW-IDUs>18 years old who reported injecting drugs and recent unprotected sex with clients in Tijuana and Ciudad Juarez underwent surveys and HIV/STI testing. Logistic regression identified correlates of HIV infection. Results Of 620 FSW-IDUs, prevalence of HIV, gonorrhea, Chlamydia, trichomonas, syphilis titers ≥1∶8, or any of these infections was 5.3%, 4%, 13%, 35%, 10% and 72%, respectively. Compared to other FSW-IDUs, HIV-positive women were more likely to: have syphilis titers ≥1∶8 (36% vs. 9%, p<0.001), often/always inject drugs with clients (55% vs. 32%, p = 0.01), and experience confiscation of syringes by police (49% vs. 28%, p = 0.02). Factors independently associated with HIV infection were syphilis titers ≥1∶8, often/always injecting with clients and police confiscation of syringes. Women who obtained syringes from NEPs (needle exchange programs) within the last month had lower odds of HIV infection associated with active syphilis, but among non-NEP attenders, the odds of HIV infection associated with active syphilis was significantly elevated. Conclusions Factors operating in both the micro-social environment (i.e., injecting drugs with clients) and policy environment (i.e., having syringes confiscated by police, attending NEPs) predominated as factors associated with risk of HIV infection, rather than individual-level risk behaviors. Interventions should target unjustified policing practices, clients' risk behaviors and HIV/STI prevention through NEPs.
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Affiliation(s)
- Steffanie A Strathdee
- Department of Medicine, School of Medicine, University of California San Diego, La Jolla, California, United States of America.
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Marshall BDL, Wood E, Shoveller JA, Patterson TL, Montaner JSG, Kerr T. Pathways to HIV risk and vulnerability among lesbian, gay, bisexual, and transgendered methamphetamine users: a multi-cohort gender-based analysis. BMC Public Health 2011; 11:20. [PMID: 21214930 PMCID: PMC3022697 DOI: 10.1186/1471-2458-11-20] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 01/07/2011] [Indexed: 11/13/2022] Open
Abstract
Background Methamphetamine (MA) use continues to be a major public health concern in many urban settings. We sought to assess potential relationships between MA use and individual, social, and structural HIV vulnerabilities among sexual minority (lesbian, gay, bisexual or transgendered) drug users. Methods Beginning in 2005 and ending in 2008, 2109 drug users were enroled into one of three cohort studies in Vancouver, Canada. We analysed longitudinal data from all self-identified sexual minority participants (n = 248). Logistic regression using generalized estimating equations (GEE) was used to examine the independent correlates of MA use over time. All analyses were stratified by biological sex at birth. Results At baseline, 104 (7.5%) males and 144 (20.4%) females reported sexual minority status, among whom 64 (62.1%) and 58 (40.3%) reported MA use in the past six months, respectively. Compared to heterosexual participants, sexual minority males (odds ratio [OR] = 3.74, p < 0.001) and females (OR = 1.80, p = 0.003) were more likely to report recent MA use. In multivariate analysis, MA use among sexual minority males was associated with younger age (adjusted odds ratio [AOR] = 0.93 per year older, p = 0.011), Aboriginal ancestry (AOR = 2.59, p = 0.019), injection drug use (AOR = 3.98, p < 0.001), having a legal order or area restriction (i.e., "no-go zone") impact access to services or influence where drugs are used or purchased (AOR = 4.18, p = 0.008), unprotected intercourse (AOR = 1.62, p = 0.048), and increased depressive symptoms (AOR = 1.67, p = 0.044). Among females, MA use was associated with injection drug use (AOR = 2.49, p = 0.002), Downtown South residency (i.e., an area known for drug use) (AOR = 1.60, p = 0.047), and unprotected intercourse with sex trade clients (AOR = 2.62, p = 0.027). Conclusions Methamphetamine use was more prevalent among sexual minority males and females and was associated with different sets of HIV risks and vulnerabilities. Our findings suggest that interventions addressing MA-related harms may need to be informed by more nuanced understandings of the intersection between drug use patterns, social and structural HIV vulnerabilities, and gender/sexual identities. In particular, MA-focused prevention and treatment programs tailored to disenfranchised male and female sexual minority youth are recommended.
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Affiliation(s)
- Brandon D L Marshall
- British Columbia Centre for Excellence in HIV/AIDS, St, Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC, Canada
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Shannon K, Strathdee SA, Shoveller J, Zhang R, Montaner JS, Tyndall MW. Crystal methamphetamine use among female street-based sex workers: Moving beyond individual-focused interventions. Drug Alcohol Depend 2011; 113:76-81. [PMID: 20810223 PMCID: PMC3392206 DOI: 10.1016/j.drugalcdep.2010.07.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2010] [Revised: 07/21/2010] [Accepted: 07/26/2010] [Indexed: 11/16/2022]
Abstract
Given growing concern of the sexual risks associated with crystal methamphetamine use and the dearth of research characterizing the use of methamphetamine among street-based sex workers (FSWs), this study aimed to characterize the prevalence and individual, social, and structural contexts of crystal methamphetamine use among FSWs in a Canadian setting. Drawing on data from a prospective cohort, we constructed multivariate logistic models to examine independent correlates of crystal methamphetamine among FSWs over a two-year follow-up period using generalized estimating equations. Of a total of 255 street-based FSWs, 78 (32%) reported lifetime crystal methamphetamine use and 24% used crystal methamphetamine during the two-year follow-up period, with no significant associations between methamphetamine use and sexual risk patterns. In a final multivariate GEE model, FSWs who used crystal methamphetamine had a higher proportional odds of dual heroin injection (adjOR=2.98, 95%CI: 1.35-5.22), having a primary male sex partner who procures drugs for them (adjOR=1.79, 95%CI: 1.02-3.14), and working (adjOR=1.62, 95%CI: 1.04-2.65) and living (adjOR=1.41, 95%CI: 1.07-1.99) in marginalized public spaces. The findings highlight the crucial need to move beyond the individual to gender-focused safer environment interventions that mediate the physical and social risk environment of crystal methamphetamine use among FSWs.
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Affiliation(s)
- K Shannon
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6,School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, CANADA, V6T 1Z3
| | - SA Strathdee
- Centre for Global Public Health, University of California San Diego School of Medicine, La Jolla, CA 92093-0507, United States
| | - J Shoveller
- School of Population and Public Health, University of British Columbia, 5804 Fairview Avenue, Vancouver, BC, CANADA, V6T 1Z3
| | - R Zhang
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
| | - JS Montaner
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
| | - MW Tyndall
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul’s Hospital, 608-1081 Burrard Street, Vancouver, BC, CANADA, V6Z 1Y6
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Stockman JK, Strathdee SA. HIV among people who use drugs: a global perspective of populations at risk. J Acquir Immune Defic Syndr 2010; 55 Suppl 1:S17-22. [PMID: 21045594 PMCID: PMC3059238 DOI: 10.1097/qai.0b013e3181f9c04c] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article examines the epidemiology of HIV among selected subgroups of drug users around the world who are "most at risk"--men who have sex with men, female sex workers, prisoners, and mobile populations. The underlying determinants of HIV infection among these populations include stigma, physical and sexual violence, mental illness, social marginalization, and economic vulnerability. HIV interventions must reach beyond specific risk groups and individuals to address the micro-level and macro-level determinants that shape their risk environments. Public health interventions that focus on the physical, social, and health policy environments that influence HIV risk-taking in various settings are significantly more likely to impact the incidence of HIV and other blood-borne and sexually transmitted infections across larger population groups.
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Affiliation(s)
- Jamila K Stockman
- Department of Medicine, Division of Global Public Health, University of California San Diego, La Jolla, CA 92093-0507, USA
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Hoffman R, Al'Absi M. Khat use and neurobehavioral functions: suggestions for future studies. JOURNAL OF ETHNOPHARMACOLOGY 2010; 132:554-563. [PMID: 20553832 PMCID: PMC2976806 DOI: 10.1016/j.jep.2010.05.033] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2009] [Revised: 03/05/2010] [Accepted: 05/16/2010] [Indexed: 05/29/2023]
Abstract
Although there is a rich body of research available regarding the effect of acute and chronic khat dosing in animal models, research on the behavioral and cognitive effects of khat in human subjects is not extensive and several of the available studies have been done only in the context of observational and single-case studies. In light of the absence of a substantial literature on the neurobehavioral deficits associated with khat use and to provide a context that could be used to identify themes for future research we review previous research that has focused on other stimulant drugs. This review highlights multiple areas of neurocognitive deficit that have been identified in previous studies of individuals who have been chronic users of stimulants, such as amphetamines and methamphetamines. The review highlights a substantial body of evidence demonstrating a wide range of learning and memory impairments including deficits that persist during abstinence from active drug use. This review does not imply a similar khat effect, but due to some similarities pharmacologically between the active components of khat (cathinone and cathine) and amphetamines, future studies examining these same domains of cognitive functioning in chronic khat users and abstinent khat users appears to be warranted, if possible using some of the same or similar laboratory measures.
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Affiliation(s)
- Richard Hoffman
- Department of Behavioral Sciences, University of Minnesota Medical School Duluth, 1035 University Avenue, Duluth, MN 55812-3031, USA.
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Abstract
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.
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Affiliation(s)
- Grant Colfax
- HIV Prevention Section, San Francisco Department of Public Health, San Francisco, CA 94102, USA.
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Cheng WS, Garfein RS, Semple SJ, Strathdee SA, Zians JK, Patterson TL. Increased drug use and STI risk with injection drug use among HIV-seronegative heterosexual methamphetamine users. J Psychoactive Drugs 2010; 42:11-8. [PMID: 20464802 DOI: 10.1080/02791072.2010.10399781] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Methamphetamine (MA) use has been found to be associated with increased risk of HIV and sexually transmitted infections (STI) among men having sex with men, but it is unknown whether those who inject MA are at greater risk for these infections than those who administer MA by other routes. Furthermore, comparable data from heterosexual MA users are lacking. We investigated whether the HIV and STI risks of male and female heterosexual MA users who inject MA differ from those of comparable users who do not inject. Between 2001 and 2005, we interviewed 452 HIV-negative men and women aged 18 and older who had recently used MA and engaged in unprotected sex. Their mean age was 36.6 years; 68% were male; ethnicity was 49.4% Caucasian, 26.8% African-American, and 12.8% Hispanic. Logistic regression identified factors associated with injecting MA. Compared to non-IDU, IDU were more likely to: be Caucasian; be homeless; have used MA for a longer period and used more grams of MA in the last 30 days; have a history of felony conviction; and report a recent STI. HIV and STI prevention interventions should be tailored according to MA users' method of administration.
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Affiliation(s)
- W Susan Cheng
- Native American Alliance for Emergency Preparedness (NAAEP), California Department of Health Care Services, Davis, CA, USA
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Hatfield LA, Horvath KJ, Jacoby SM, Simon Rosser BR. Comparison of substance use and risky sexual behavior among a diverse sample of urban, HIV-positive men who have sex with men. J Addict Dis 2010; 28:208-18. [PMID: 20155589 DOI: 10.1080/10550880903014726] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The purpose of this study was to examine substance use among a racially and ethnically diverse group of HIV-positive men who have sex with men (MSM) living in six U.S. cities, model associations between drug use and serodiscordant unprotected anal intercourse (SDUAI), and characterize users of the substances strongly associated with risky sexual behavior. Baseline questionnaire data from 675 participants of the Positive Connections intervention trial were analyzed. Overall, substance use was common; however, the highest percentage of stimulant (30%), methamphetamine (27%), and popper (i.e., amyl nitrite) (46%) use was reported among white MSM and crack/cocaine (38%) use was highest among African American MSM. Popper use versus non-use (odds ratio = 2.46; 95% confidence interval = 1.55-3.94) and condom self-efficacy (1 standard deviation (sd) increase on scale; odds ratio = .58; 95% confidence interval = .46-.73) were significantly associated with SDUAI after adjusting for key demographic and psychosocial factors. These results highlight the importance of addressing drug use in the context of sex for possible HIV transmission risk.
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Affiliation(s)
- Laura A Hatfield
- School of Public Health, University of Minnesota, Minneapolis, MN, USA.
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Garfein RS, Metzner M, Cuevas J, Bousman CA, Patterson T. Formative Assessment of ARM-U: A Modular Intervention for Decreasing Risk Behaviors Among HIV-Positive and HIV-Negative Methamphetamine-Using MSM. Open AIDS J 2010; 4:105-15. [PMID: 20657829 PMCID: PMC2905777 DOI: 10.2174/1874613601004030105] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 11/15/2009] [Accepted: 11/25/2009] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Methamphetamine is a major contributor to HIV transmission among men who have sex with men (MSM). Recent studies show that up to one-third of methamphetamine-using MSM (MUMSM) inject the drug. We developed a behavioral intervention for MUMSM to decrease unprotected anal intercourse and increase awareness of parenteral HIV transmission risk. This 6-session (3 in-person, 3 by telephone) modular intervention was designed to be tailored to participants' HIV (+/-) and injection drug user ([IDU] yes/no) status. We present results of formative research used to evaluate the content and to assess feasibility and acceptability of this individual-level HIV risk-reduction intervention. SETTING HIV research clinic in a high MSM and methamphetamine prevalence neighborhood. PROJECT Avoiding Risks from Methamphetamine-Use (ARM-U) is a brief toolbox intervention that allows counselors to select modules that suit a client's individual risk profile and intervention needs employing motivational interviewing and cognitive behavioral theory. We evaluated the format and content of the intervention through focus groups and pre-testing of the entire intervention using volunteers from the target population stratified into four groups (HIV+/IDU, HIV-/IDU, HIV+/non-IDU, HIV-/non-IDU). Four individuals in each stratum were recruited to undergo the intervention and complete a satisfaction survey at the end of each in-person session. RESULTS In total, 25 MUMSM attended one of five focus groups. Participants thought all proposed intervention topics were important and could aid in reducing sexual risk behaviors among MUMSM. However, the neurocognitive effects of methamphetamine were reported to be a barrier to practicing safer sex, condom use negotiation or HIV status disclosure. Fifteen (94%) of 16 participants completed all 6 sessions and the satisfaction survey. On average, participants felt the intervention was useful for MUMSM, made them contemplate and move toward behavior change, and would recommend the program to their peers. LESSONS LEARNED Based on our formative research, we revised the ARM-U intervention to emphasize pre-planning to avoid combining methamphetamine use and sex or develop strategies to avoid sex risk following methamphetamine use. We also increased emphasis on referrals for care and other requested services. Future efficacy trials are needed to evaluate the intervention's ability to reduce HIV-associated risk behaviors.
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Affiliation(s)
- Richard S Garfein
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, California, USA
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41
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Nakamura N, Semple SJ, Strathdee SA, Patterson TL. Methamphetamine initiation among HIV-positive gay and bisexual men. AIDS Care 2010; 21:1176-84. [PMID: 20024778 DOI: 10.1080/09540120902729999] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study describes factors associated with methamphetamine initiation in a racially diverse sample of 340 methamphetamine-using, HIV-positive gay and bisexual men. A factor analysis was conducted on reasons for initiation, and four factors were identified: to party, to cope, for energy, and to improve self-esteem. Methamphetamine to party accounted for more than one-third of the variance in the factor analysis. Methamphetamine to cope captured almost 9% of the variance, methamphetamine for energy accounted for approximately 8% of the variance, and methamphetamine for self-esteem accounted for approximately 7% of the variance. Regression analyses revealed differential associations between methamphetamine-initiation factors and HIV-risk behaviors. Methamphetamine for self-esteem predicted binge methamphetamine use, while methamphetamine to cope was associated with injecting methamphetamine. Using methamphetamine for energy was associated with number of illicit drugs-used and using methamphetamine to party was associated with having a greater number of sexually transmitted infections. These findings suggest that methamphetamine initiation among gay and bisexual men is multifaceted, which could have implications for intervention development.
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Affiliation(s)
- Nadine Nakamura
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
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Cheng WS, Garfein RS, Semple SJ, Strathdee SA, Zians JK, Patterson TL. Binge use and sex and drug use behaviors among HIV(-), heterosexual methamphetamine users in San Diego. Subst Use Misuse 2010; 45:116-33. [PMID: 20025442 PMCID: PMC2861916 DOI: 10.3109/10826080902869620] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
UNLABELLED This study identified sociodemographic factors, drug using practices, sexual behaviors, and motivational factors associated with binge (a period of uninterrupted) methamphetamine (MA) use among heterosexual MA users. SAMPLE AND METHOD The FASTLANE study provided cross-sectional data collected by audio computer-assisted self-interview (ACASI) between June 2001 and August 2004 from 451 HIV-negative MA users in San Diego, California, USA who had engaged in unprotected sex and used MA in the previous two months. RESULTS The study sample was 67.8% male, 49.4% Caucasian, 26.8% African-American, and 12.8% Hispanic with a mean age of 36.6 years; 183 (40.5%) reported binge use in the past 2 months. Compared with non-binge users, binge users of MA were more likely to report risky drug use and sex behaviors and differed in motivations to initiate and currently use MA. The final logistic regression model for binge use included more days of MA use in the last month, ever treated for MA use, injection drug use, higher Beck Depression Inventory score, "experimentation" as a motivation for initiating MA use, and engaging in sex marathons while high on MA. HIV prevention efforts should differentiate and address these differences in motivations for MA use and the associated HIV-risk sex and drug use behaviors as key targets for effective intervention.
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Affiliation(s)
- W Susan Cheng
- Division of Global Public Health, Department of Medicine, University of California, San Diego, La Jolla, CA 92093-0680, USA
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Wohl AR, Frye DM, Johnson DF. Demographic characteristics and sexual behaviors associated with methamphetamine use among MSM and non-MSM diagnosed with AIDS in Los Angeles County. AIDS Behav 2008; 12:705-12. [PMID: 17968649 DOI: 10.1007/s10461-007-9315-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2005] [Accepted: 10/15/2007] [Indexed: 11/28/2022]
Abstract
Demographic and behavioral factors associated with methamphetamine use are presented for 455 men who have sex with men (MSM) and 228 non-MSM diagnosed with AIDS in Los Angeles County (LAC) from 2000 to 2004, as there are limited population-based data for these subgroups. Lifetime methamphetamine use was 35% for MSM, 14% for non-MSM, 50% for white MSM, and 35% for black MSM. Methamphetamine use in the previous 12 months among MSM (11%) and non-MSM (0.4%) was less than lifetime use. Compared to MSM with no history of methamphetamine use in a multivariate analysis, MSM methamphetamine users were more likely to be non-Latino (white or black) (OR = 2.8, 95% CI: 1.6, 4.9) compared to Latino and reported > or = 10 sexual partners in the previous 12 months (OR = 3.1, 95% CI: 1.7, 5.6). These data indicate that methamphetamine has been widely used by both MSM and non-MSM with AIDS in LAC and that lifetime use is associated with sexual risk behaviors among MSM.
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Affiliation(s)
- Amy Rock Wohl
- HIV Epidemiology Program, Los Angeles County Department of Public Health, 600 S. Commonwealth Avenue, Suite 1920, Los Angeles, CA 90005, USA.
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Willner-Reid J, Belendiuk KA, Epstein DH, Schmittner J, Preston KL. Hepatitis C and human immunodeficiency virus risk behaviors in polydrug users on methadone maintenance. J Subst Abuse Treat 2008; 35:78-86. [PMID: 17931826 PMCID: PMC2600879 DOI: 10.1016/j.jsat.2007.08.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2007] [Revised: 07/11/2007] [Accepted: 08/08/2007] [Indexed: 11/22/2022]
Abstract
We examined the impact of methadone maintenance treatment (MMT) on risk behaviors for transmission of blood-borne diseases in polydrug users who had tested positive or negative for hepatitis C virus (HCV). At intake, HCV-positive participants (n=362) engaged in more human immunodeficiency virus (HIV) risk behaviors (as measured by the HIV Risk-Taking Behavior Scale) than HCV-negative participants (n=297; p< .001). This difference was specific to injection-related behaviors and decreased significantly within the first few weeks of MMT (p< .0001). Where needles continued to be used, HCV-positive participants became more likely over time to engage in safer injecting practices. Furthermore, HCV-positive participants became more likely to use condoms than HCV-negative participants. These findings demonstrate that both drug- and sex-related risk behaviors decrease during MMT and emphasize the benefits of methadone programs for public health and HIV/HCV prevention.
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Patricia C, Ramos R, Brouwer KC, Firestone-Cruz M, Pollini RA, Strathdee SA, Fraga MA, Patterson TL. At the borders, on the edge: use of injected methamphetamine in Tijuana and Ciudad Juarez, Mexico. J Immigr Minor Health 2008; 10:23-33. [PMID: 17516170 PMCID: PMC2716800 DOI: 10.1007/s10903-007-9051-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Injection drug use is of increasing concern along the US-Mexico border where Tijuana and Ciudad (Cd.) Juarez are located. Methamphetamine has long been manufactured and trafficked through Mexico, with low rates of use within Mexico. With methamphetamine use now considered epidemic in the United States, and with associated individual and community harms such as HIV, STDs, domestic violence and crime, there is concern that rates of methamphetamine in the Northwestern border regions of Mexico may be rising. We conducted a qualitative study to explore the context of injection drug use in Tijuana and Cd. Juarez and included questions about methamphetamine. Guided in-depth interviews were conducted with 10 male and 10 female injection drug users (IDUs) in Tijuana and 15 male and 8 female IDUs in Cd. Juarez (total N = 43). Topics included types of drug used, injection settings, access to sterile needles and environmental influences. Interviews were taped, transcribed verbatim and translated. Content analysis was conducted to identify themes. The median age of injectors in both cities was 30. Methamphetamine was injected, either alone or in combination with other drugs by injectors in both Tijuana (85%) and Cd. Juarez (17%) in the 6 months previous to interview. Several important themes emerged with respect to methamphetamine use in both cities. IDUs in both cities considered methamphetamine to be widely used in Tijuana and infrequently used in Cd. Juarez, while the converse was true for cocaine. In both cities, stimulant (either cocaine or methamphetamine) use was widespread, with 85% in Tijuana and 83% in Cd. Juarez reporting current use of a stimulant, most often used in combination with heroin. Some injectors reported knowledge of local manufacturing and one had direct experience in making methamphetamine; some cross-border use and trafficking was reported. Injectors reported concerns or experience with serious health effects of methamphetamine such as abscesses or tuberculosis. Our study suggests that injected methamphetamine is entrenched in Tijuana and that Cd. Juarez may experience a methamphetamine outbreak in the future. Robust targeted interventions for both injected and non-injected methamphetamine should be a public health priority in both cities.
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Affiliation(s)
- Case Patricia
- The Fenway Institute, Fenway Community Health, 7 Haviland Street, Boston, MA 02115−2683 e-mail:
| | - Rebeca Ramos
- Mexico Border Health Association, El Paso, Texas, USA e-mail:
| | - Kimberly C. Brouwer
- Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, UCSD School of Medicine, 9500 Gilman Drive, mailcode 0622, San Diego, CA 92093, USA e-mail:
| | - Michelle Firestone-Cruz
- Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, UCSD School of Medicine, 9500 Gilman Drive, mailcode 0622, San Diego, CA 92093, USA
| | - Robin A. Pollini
- Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, UCSD School of Medicine, 9500 Gilman Drive, mailcode 0622, San Diego, CA 92093, USA e-mail:
| | - Steffanie A. Strathdee
- Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, UCSD School of Medicine, 9500 Gilman Drive, mailcode 0622, San Diego, CA 92093, USA e-mail:
| | - Miguel A. Fraga
- Tijuana School of Medicine, Universidad Autónoma de Baja California, Tijuana, Baja California, México e-mail:
| | - Thomas L. Patterson
- Department of Psychiatry, UCSD School of Medicine, San Diego, CA, USA e-mail:
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McKetin R, Ross J, Kelly E, Baker A, Lee N, Lubman DI, Mattick R. Characteristics and harms associated with injecting versus smoking methamphetamine among methamphetamine treatment entrants. Drug Alcohol Rev 2008; 27:277-85. [PMID: 18368609 DOI: 10.1080/09595230801919486] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION AND AIMS To compare the characteristics and harms associated with injecting and smoking methamphetamine among methamphetamine treatment entrants. METHOD AND DESIGN A structured face-to-face interview was used to assess demographics, drug use patterns and harms [physical and mental health, psychological distress, psychotic symptoms, crime and human immunodeficiency virus (HIV) risk behaviour] among 400 methamphetamine treatment entrants in Sydney and Brisbane, Australia. Participants who had injected but not smoked methamphetamine in the month before treatment (n = 195, injectors) were compared to participants who had either: (a) injected and smoked (n = 90, injectors who smoke), or (b) smoked but not injected (n = 73, smokers), during this time. RESULTS In comparison with injectors, smokers were primarily non-injecting drug users, who were younger, more likely to be female and use ecstasy rather than heroin. After adjusting for these differences smokers were less dependent on methamphetamine than injectors, but they took the drug as often and had similarly high levels of psychological distress, poor physical and mental health, psychotic symptoms, sexual risk behaviour and criminal involvement. Injectors who smoked had a similar demographic and clinical profile to injectors, including comparable levels of needle sharing, but they used methamphetamine more often and had greater criminal involvement. CONCLUSION Within this treatment sample, smoking methamphetamine occurred among both long-standing injecting drug users and a comparatively younger group of non-injecting drug users. It was associated with less severe methamphetamine dependence than injecting, but more intense use patterns and similar levels of other harms.
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Affiliation(s)
- Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Australia.
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Das-Douglas M, Colfax G, Moss AR, Bangsberg DR, Hahn JA. Tripling of methamphetamine/amphetamine use among homeless and marginally housed persons, 1996-2003. J Urban Health 2008; 85:239-49. [PMID: 18163214 PMCID: PMC2430118 DOI: 10.1007/s11524-007-9249-4] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2007] [Accepted: 11/29/2007] [Indexed: 11/26/2022]
Abstract
Methamphetamine/amphetamine (MA)-related morbidity and mortality has been increasing in the United States. MA use is associated with high-risk sexual behavior and syringe-sharing practices. Homeless and marginalized housed persons (H/M) have high rates of substance use and mental health disorders. Little is known about trends of MA use among the H/M. The objective of this study was to quantify increases in MA use among H/M in San Francisco and to determine which demographic and behavioral subgroups have experienced the greatest increases in MA use. We conducted serial cross-sectional population-based studies in three waves: 1996-1997, 1999-2000, and 2003 and studied 2,348 H/M recruited at shelters and lunch lines. The main outcome was self-reported current (30-day) MA use. We found a tripling of current MA use among H/M persons from 1996 to 2003, with a sevenfold increase in smoked MA use. MA use doubled to tripled in most demographic and behavioral subgroups, whereas it quadrupled in those under age 35, and there was a fivefold increase among HIV-infected persons. The increase in MA use among H/M places a vulnerable population at additional increased risk for HIV infection and MA-use related morbidity and mortality. Among HIV-infected H/M, the increase in MA use has important public health implications for the development and secondary transmission of drug-resistant HIV caused by synergistic neurocognitive decline, poor adherence to HIV medications, and increased sexual risk behavior. Clinicians caring for H/M persons should inquire about MA use, refer interested MA users to MA dependence treatment programs and provide targeted HIV sexual risk reduction counseling. For HIV-infected H/M MA users, clinicians should closely monitor adherence to HIV or other chronic medications, to avoid unnecessary morbidity and mortality. Further research is needed to elucidate the most effective prevention and treatment for MA use and dependence among the H/M.
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Affiliation(s)
- Moupali Das-Douglas
- Department of Medicine, Division of Infectious Diseases, University of California, San Francisco, CA 94143, USA.
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Cadet JL, Krasnova IN. Interactions of HIV and methamphetamine: cellular and molecular mechanisms of toxicity potentiation. Neurotox Res 2008; 12:181-204. [PMID: 17967742 DOI: 10.1007/bf03033915] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Methamphetamine (METH) is a highly addictive psychostimulant drug, whose abuse has reached epidemic proportions worldwide. METH use is disproportionally represented among populations at high risks for developing HIV infection or who are already infected with the virus. Psychostimulant abuse has been reported to exacerbate the cognitive deficits and neurodegenerative abnormalities observed in HIV-positive patients. Thus, the purpose of the present paper is to review the clinical and basic observations that METH potentiates the adverse effects of HIV infection. An additional purpose is to provide a synthesis of the cellular and molecular mechanisms that might be responsible for the increased toxicity observed in co-morbid patients. The reviewed data indicate that METH and HIV proteins, including gp120, gp41, Tat, Vpr and Nef, converge on various caspase-dependent death pathways to cause neuronal apoptosis. The role of reactive microgliosis in METH- and in HIV-induced toxicity is also discussed.
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Affiliation(s)
- J L Cadet
- Molecular Neuropsychiatry Branch, NIH/NIDA Intramural Research Program, Baltimore, MD 21224, USA.
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Brecht ML, Stein J, Evans E, Murphy DA, Longshore D. Predictors of intention to change HIV sexual and injection risk behaviors among heterosexual methamphetamine-using offenders in drug treatment: a test of the AIDS Risk Reduction Model. J Behav Health Serv Res 2008; 36:247-66. [PMID: 18214688 DOI: 10.1007/s11414-007-9106-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2007] [Accepted: 12/17/2007] [Indexed: 11/29/2022]
Abstract
This study tested components of the acquired immunodeficiency syndrome (AIDS) Risk Reduction Model (ARRM) for a sample of methamphetamine-using offenders in drug treatment. Analyses included the first two stages of the ARRM, problem recognition and intention to reduce risk (potential precursors to later possible behavior change), assessing predictors of intentions to increase condom use, reduce other sexual risk, and disinfect needles. Path analysis results showed potential applicability of the ARRM as a basis for intervention development for this population. There was a consistent effect of self-efficacy for risk reduction strategies, as well as direct or indirect effects of problem recognition factors (AIDS knowledge, peer norms), on the three intention indicators. Prior sex risk behavior (condom use) was directly negatively related to intention to use condoms; prior needle use was indirectly negatively related to intention to disinfect. Intention to use condoms was lower for women. Results can help identify areas for intervention development.
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Affiliation(s)
- Mary-Lynn Brecht
- Integrated Substance Abuse Programs, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, University of California-Los Angeles, 1640 S. Sepulveda Blvd., Suite 200, Los Angeles, CA 90025, USA.
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