Prevalence and correlates of methamphetamine/amphetamine use among young adult injection drug users (IDUs) in five U.S. cities

Background: A growing body of literature suggests an expansion of methamphetamine/amphetamine (M/A) markets in many U.S. cities and an association between M/A use increased HIV infection risk.

Methods: In a cross-sectional study, we assessed correlates of recent (last three month) M/A use, irrespective of administration route, among 3243 15-30 year-old IDUs in cities with low (Baltimore, Chicago, New York) and high (Los Angeles, Seattle) prevalence of M/A use. Low and high prevalence cities were analyzed separately.

Results: Overall, the sample was predominantly male (69.3%), White non-Hispanic (64.0%), and heterosexual (72.6%). Prevalence of recent M/A use was 17.4% and 75.8% in low and high prevalence cities, respectively. In multivariate logistic regression analysis, models from both low and high prevalence cities revealed that when compared to non-M/A users, recent M/A users were less likely to be Black non-Hispanic and more likely to be homeless and have recently used cocaine, inhalants, or PCP. In low prevalence cities, compared with non-M/A users, recent M/A users were also less likely to be Hispanic and more likely to be heterosexual women and women-who-have-sex-with-women (WSW) (reference: heterosexual men), use crack and club drugs, and report five or more recent injection partners. In high prevalence cities, recent M/A users were also more likely to be MSM and share injection paraphernalia (e.g., cookers, cottons, water).

Conclusions: These findings highlight the importance of considering the local context of M/A use as well as emerging subpopulations (i.e., WSW and heterosexual women) of users when designing methamphetamine education, prevention, and treatment programs.