Crystal Meth, HIV, Gays and Lesbians
Methamphetamine Treatment as HIV Prevention
For about a decade in California, the drug most tightly linked with HIV infection in Gay Bisexual Men has been crystal methamphetamine. The drug conveys a sense of heightened sexuality in the short term and is associated with risky sexual behaviors and extremely high rates of HIV infection in those seeking treatment. Sixty percent of the participants in Dr. Shoptaw’s study reported HIV-positive status, a prevalence much higher than his group has observed among GBM seeking treatment for cocaine (30 percent), alcohol (15 percent), or heroin (5 percent) abuse.
“The reductions in risky sexual behavior in this study exceeded those observed in HIV prevention trials among Gay BBisexual Men. We conclude that treatment for crystal meth abuse fits into a comprehensive HIV prevention strategy,” says Dr. Shoptaw. The findings have already made an impact: These data helped policymakers at the California Office of AIDS decide to allocate $3 million for programs that address methamphetamine abuse among GBM.
Methamphetamine and the Blues
The researchers were not surprised by the high percentage of their study participants who reported depression symptoms at the beginning of the study. Gay Bisexual Men are three times as likely as heterosexual men to have clinical depression.
Crystal Methamphetamine abusers often say they take the drug to kick the blues, but results from the current study suggest that continuing abuse may serve to relieve low moods related to stimulant withdrawal rather than alleviate underlying chronic depression.
When they analyzed the temporal link between crystal methamphetamine abuse and depression, Dr. Shoptaw and his colleagues found that a urine sample indicating abuse of the drug within the past 5 days strongly predicted high BDI scores and abstinence strongly predicted low scores. In contrast, BDI scores did not predict episodes of future methamphetamine abuse, which is what would be expected if the men were abusing the drug to alleviate depression. “Meth abusers probably remember feeling better after taking the drug, but this perception may not match the physiology of long-term stimulant abuse,” says Dr. James Peck, a member of the research team who led the analysis of the depression data.
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