Crystal methamphetamine use and initiation among gay, bisexual, and other men who have sex with men living with HIV in a Treatment as Prevention environment
Crystal methamphetamine use and initiation among gay, bisexual, and other men who have sex with men living with HIV in a Treatment as Prevention environment
Background: Risk compensation in an HIV Treatment as Prevention (TasP) environment may increase high-risk sexual and substance use behaviors among people living with HIV. Objective: To examine recent crystal methamphetamine (CM) use/initiation in a longitudinal cohort of gay, bisexual, and other men who have sex with men (GBMSM) living with HIV in Metro Vancouver, Canada. Methods: Eligible participants were GBMSM aged >15years who reported sex with another man in the past six months. Participants were recruited using respondent-driven sampling and self-completed a computer questionnaire every six months. We used multi-level generalized mixed-effect models to evaluate trends in recent CM use (past six months), multivariable logistic regression to identify covariates of recent CM use, and multivariable survival analysis to identify predictors of CM initiation. Results: Of 207 GBMSM living with HIV at enrollment, 44.3% reported recent CM use; there was a statistically non-significant decrease over the study period (41% in first period to 25% in final period, p=0.087). HIV treatment optimism was not associated with CM use/initiation. CM use was positively associated with depressive symptomology, sexual escape motivation, transactional sex, number of anal sex partners, condomless anal sex with seroconcordant partners, STIs, and other substance use. Recent CM use was negatively associated with viral load sorting. CM initiation was predicted by escape motivation, transactional sex, and group sex participation. Conclusion: Results suggest that CM use among GBMSM living with HIV is prevalent and increased CM use/initiation is not a consequence of TasP public policy.
HIV/AIDS, Methamphetamine, men who have sex with men (MSM), prospective cohort study, stimulant, treatment as prevention
2428-2437
Colyer, Sean P.
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Moore, David M.
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Cui, Zishan
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Zhu, Julia
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Armstrong, Heather
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Taylor, Matthew
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Edward, Joshua
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Howard, Terry
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Dickie, Chad
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Olarewaju, Gbolahan
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Montaner, Julio S.G.
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Hogg, Robert S.
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Roth, Eric A.
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Lachowsky, Nathan J.
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23 October 2020
Colyer, Sean P.
07c512fe-0d3f-4a20-a13c-f9a3a5e52850
Moore, David M.
5f5c705c-70f2-4d1f-9135-6c560f7d82c3
Cui, Zishan
298721d1-0246-4602-9120-c626eec8b142
Zhu, Julia
ace0838d-a3a1-4594-a8ed-9ee5d94dfb26
Armstrong, Heather
3dc9c223-1a61-47ad-ab0b-50d06cddf4f2
Taylor, Matthew
f13c3f40-e2d7-423b-91cc-00621f04df00
Edward, Joshua
6bed5e0a-a382-4b01-aad8-e2a6df68fd47
Howard, Terry
3a2a59d2-d72a-4d90-b69d-3e2155a1e410
Dickie, Chad
095d8641-3ba8-4353-bebf-4856be6c5547
Olarewaju, Gbolahan
2c3cfb4b-af61-480f-8cd2-84b981cb0b33
Montaner, Julio S.G.
8732d65e-cae2-408e-bf60-580f8298547a
Hogg, Robert S.
3f71ad69-9c8a-4732-bb86-4aa0652e1f3f
Roth, Eric A.
4900d79c-ac00-475b-8bb9-e96243905ca7
Lachowsky, Nathan J.
87634bac-759c-4e7b-9f16-22fb37e87cf6
Colyer, Sean P., Moore, David M., Cui, Zishan, Zhu, Julia, Armstrong, Heather, Taylor, Matthew, Edward, Joshua, Howard, Terry, Dickie, Chad, Olarewaju, Gbolahan, Montaner, Julio S.G., Hogg, Robert S., Roth, Eric A. and Lachowsky, Nathan J.
(2020)
Crystal methamphetamine use and initiation among gay, bisexual, and other men who have sex with men living with HIV in a Treatment as Prevention environment.
Substance Use & Misuse, 55 (14), .
(doi:10.1080/10826084.2020.1833925).
Abstract
Background: Risk compensation in an HIV Treatment as Prevention (TasP) environment may increase high-risk sexual and substance use behaviors among people living with HIV. Objective: To examine recent crystal methamphetamine (CM) use/initiation in a longitudinal cohort of gay, bisexual, and other men who have sex with men (GBMSM) living with HIV in Metro Vancouver, Canada. Methods: Eligible participants were GBMSM aged >15years who reported sex with another man in the past six months. Participants were recruited using respondent-driven sampling and self-completed a computer questionnaire every six months. We used multi-level generalized mixed-effect models to evaluate trends in recent CM use (past six months), multivariable logistic regression to identify covariates of recent CM use, and multivariable survival analysis to identify predictors of CM initiation. Results: Of 207 GBMSM living with HIV at enrollment, 44.3% reported recent CM use; there was a statistically non-significant decrease over the study period (41% in first period to 25% in final period, p=0.087). HIV treatment optimism was not associated with CM use/initiation. CM use was positively associated with depressive symptomology, sexual escape motivation, transactional sex, number of anal sex partners, condomless anal sex with seroconcordant partners, STIs, and other substance use. Recent CM use was negatively associated with viral load sorting. CM initiation was predicted by escape motivation, transactional sex, and group sex participation. Conclusion: Results suggest that CM use among GBMSM living with HIV is prevalent and increased CM use/initiation is not a consequence of TasP public policy.
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Crystal Methamphetamine Use and Initiation among Gay Bisexual and Other Men Who Have Sex with Men Living with HIV in a Treatment as Prevention
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Accepted/In Press date: 5 October 2020
e-pub ahead of print date: 15 October 2020
Published date: 23 October 2020
Additional Information:
Funding Information:
Momentum is funded through the National Institute on Drug Abuse under grant R01DA031055-01A1 and the Canadian Institutes for Health Research under grants MOP-107544, FND-143342, and PJT-153139. NJL was supported by a CANFAR/CTN Postdoctoral Fellowship Award. DMM and NJL are supported by Scholar Awards from the Michael Smith Foundation for Health Research (#5209, #16863). HLA was supported by a Postdoctoral Fellowship Award from the Canadian Institutes of Health Research (Grant # MFE-152443). JSGM is supported with grants paid to his institution by the British Columbia Ministry of Health and by the US National Institutes of Health under grant R01DA036307; he has also received limited unrestricted funding, paid to his institution, from Abbvie, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck, and ViiV Healthcare. The authors report no other conflict of interest. The authors would like to thank the Momentum Health Study participants, office staff and community advisory board, as well as our community partner agencies, Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC.
Publisher Copyright:
© 2020 Taylor & Francis Group, LLC.
Keywords:
HIV/AIDS, Methamphetamine, men who have sex with men (MSM), prospective cohort study, stimulant, treatment as prevention
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Local EPrints ID: 444469
URI: http://eprints.soton.ac.uk/id/eprint/444469
ISSN: 1082-6084
PURE UUID: a70d1d33-b1b1-444b-93d6-7b5e58f3b735
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Date deposited: 20 Oct 2020 16:33
Last modified: 17 Mar 2024 05:59
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Contributors
Author:
Sean P. Colyer
Author:
David M. Moore
Author:
Zishan Cui
Author:
Julia Zhu
Author:
Matthew Taylor
Author:
Joshua Edward
Author:
Terry Howard
Author:
Chad Dickie
Author:
Gbolahan Olarewaju
Author:
Julio S.G. Montaner
Author:
Robert S. Hogg
Author:
Eric A. Roth
Author:
Nathan J. Lachowsky
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