Methamphetamine and young men who have sex with men: Understanding patterns and correlates of use, and the association with HIV-related sexual risk

Background: A strong association has emerged between methamphetamine use, high-risk sex and HIV acquisition among adult MSM. A paucity of research has explored these issues among adolescent and young adult MSM (YMSM) despite their high-risk for both HIV infection and substance use. Therefore, this study examines methamphetamine use and its association with HIV-related sexual risk in a community-based sample of YMSM age 16-24. Methods: 310 urban, ethnically-diverse participants were recruited from multiple community-based sources. A computer-assisted, confidential survey was administered in private at a community-based health center providing medical care and social services to the LGBT community. Factors associated with methamphetamine use and HIV-related sexual risk were assessed with Χ² and hierarchical logistic regression. Results: Participants ranged in age from 16-24 years (M=20.3, SD=2.4); 70% from communities of color. Thirteen percent used methamphetamine in the past year. Methamphetamine use was more common among HIV-infected participants, odds ratio (OR) = 2.8; 95% confidence interval (CI) = 1.3-5.3, and varied by age and race/ethnicity; substantially higher prevalence was reported by older and non-Black YMSM (p<0.001). Hierarchical regression modeling identified sexual risk (unprotected anal intercourse and multiple anal sex partners), sexualized social context (e.g. internet sex, sex in a bathhouse/sex club, sex with older partners, and commercial sex), lower self-esteem and psychological distress as correlated with methamphetamine use (p<0.05) among participants. Conclusions: A substantial proportion of YMSM in this sample use methamphetamine. Methamphetamine use was associated with HIV-related risk and patterns of use were correlated with demographics, sexualized social contexts, and psychological variables.