XIX International AIDS Conference


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WEPE291 Poster Exhibition

Reasons for methamphetamine use and type of drug-use administration and associatiopns with sexual risk behaviour by HIV-status among high-risk MSM in the United States

Presented by Gordon Mansergh (United States).

G. Mansergh1, D. Purcell1, S. Flores1, B. Koblin2, G. Colfax3

1Centers for Disease Control and Prevention, Atlanta, United States, 2New York Blood Center, New York, United States, 3San Francisco Department of Public Health, San Francisco, United States

Background: MSM continue to be disproportionately affected by HIV, and methamphetamine (meth) use is associated with MSM risk behavior. Better understanding of the associations of reasons for and type of meth use administration with HIV risk behavior is needed to develop more effective programs to reduce meth-linked sexual risk.
Methods: A convenience sample of substance-using MSM (N=600 HIV-negative and n=608 HIV-positive) was enrolled in a randomized intervention trial in Chicago, Los Angeles, New York City, and San Francisco (2005-08). Multivariate (stepwise) logistic regression analyses were stratified by HIV status and tested the association of nine reasons for most of the respondent's meth use in the prior 6 months (e.g., more sex, better sex); their most common type of meth use administration (snort, smoke, inject); whether they ever rectally inserted meth (“booty bump”); and the association of those variables with meth use and sexual risk behavior during their most recent anal sex encounter with a non-primary partner.
Results: For HIV-negatives, better sex (OR=2.3, 95% CI=1.3-4.4), injection meth use (OR=9.7, CI=2.5-38), and booty bumping (OR=4.1, CI=1.1-15) were associated with meth use during last sex. Not wanting to feel left out (OR=4.1, CI=1.7-10) and booty bumping (OR=3.5, CI=1.1-11) were associated with HIV-discordant unprotected anal sex. For HIV-positives, wanting to feel more connected (OR=4.1, CI=1.4-12) and to forget problems (OR=2.8, CI=1.4-5.6) were associated with meth use; not wanting to feel left out reduced the odds of meth use (OR=0.2, CI=0.1-0.5). Taking meth to feel better reduced the odds of reporting HIV-discordant unprotected insertive anal sex (OR=0.2, CI=0.1-0.8).
Conclusions: The differential reasons for using meth and meth use administration by HIV status can provide opportunities for targeted messages to reduce sexual risk. This includes addressing booty bumping and wanting better sex among HIV-negative MSM, and wanting to feel more connected and to avoid problems among HIV-positive MSM.

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