Meth Users More Likely to Contract HIV

If a drug user smoked some meth in a room, all alone, without any possibility to see or be around anyone else, then meth would be the only problem. But that doesn't happen, and the effects are harsh on the LGBT community, according to a new study headed by Robert Bolan, M.D.

"My interests have always been driven by what the problems are that threaten our community," said Bolan, who's been the medical director of the Los Angeles Gay & Lesbian Center since 1996. "For the past 5 to 10 years or so, I think that crystal methamphetamine use is a scourge in our community that is helping to fuel the HIV epidemic."

The study looked at more than 9,000 people. Those who admitted using meth in the preceding year were almost four times as likely to contract HIV, more than four times as likely to contract syphilis, more than twice as likely to contract gonorrhea, and almost twice as likely to contract chlamydia. They were compared with those who hadn't used in the preceding year. Of all the diseases 60 percent of those newly infected had admitted to using meth in the preceding month.

In South Florida, Bolan noted, this is especially pertinent. In a 2010 study by the Centers of Disease Control and Prevention, Men Who Have Sex With Men (MSM) in South Florida showed an 18 percent increase in use of meth.

"This is a much higher rate than is usually reported in other populations," Bolan said. "The prevalence in our Los Angeles STD clinic is 8 percent."

So how does meth affect the spread of disease? The answer is simple: Sex.

"Because crystal meth can increase sexual arousal while reducing inhibition and judgment," the study read, "Its use is associated with high-risk behaviors that increase the likelihood of acquiring a new STD or HIV."

In other words, users tend to have risky sex, both in terms of the who and the how. In rats, Bolan said, amphetamines cause obsessive and prolonged sexual behaviors - it appears like it does the same thing to humans.

"The effects of a given dose of [meth] last for hours and this can result in so-called sex marathons where an individual can engage in continuous or repetitive sexual activities with the same or multiple individuals," Bolan said, adding that the drug also tends to dry out mucous membranes, like the rectum, adding potential to injury. "All of these things - prolonged intercourse, multiple partners, dried mucous membranes - promote transmission of HIV and STIs... One effect of [meth] is that it can inhibit erections, but with erectile dysfunction drugs that side effect is no longer a limiting factor."

The researchers looked at various educational resources and found that all of them are directed at meth users, or at trying to persuade people not to start. This study attacks from a different angle.

"Our message is not that 'if you have sex with someone who uses [meth], you will become infected with something,'" Bolan said, adding that his study in no way suggests that having unprotected sex with a non-user is a definite shield against STIs. "Our message aims at a more real world way that gay men appear to be looking at sexual partner choices. We just want everyone to think about this a bit differently... My intent is to arm gay men with real statistics that can help them make informed sexual choices."

Bolan, who's been involved with gay men's health issues and moved had moved to L.A. in the 80s during the height of the HIV epidemic, released and presented this study at the CDC's 2012 National STD Prevention Conference. The March conference began in 1998, according to a CDC spokesperson, "to provide an avenue... to learn, grow and share about STD prevention."

Visit www.cdc.gov/stdconference for more information.