Differences in HIV/STI-risk behavior among male and female HIV(-), heterosexual methamphetamine users in San Diego

Objective: We examined gender differences in sociodemographic characteristics, drug use practices, sexual behaviors, and consequences of and motivations for methamphetamine (MA) use among HIV-negative heterosexuals in San Diego, CA. Methods: Baseline interviews conducted between June 2001 and February 2005 for the FASTLANE intervention trial provided cross-sectional data from 452 HIV-negative MA users who had engaged in unprotected sex and used MA in the previous two months. Results: Of 306 men and 146 women, 49.4% Caucasian, 26.8% African-American, and 12.8% Hispanic and median age was 38 years. Compared to male MA users, females were more likely to use MA on more days per month (OR=1.03,95%CI=1.01,1.06), and experience more adverse consequences including weight loss (OR=1.31,95%CI=1.05,1.64), relationship loss (OR=1.47,95%CI=1.19,1.82), dental (OR=1.25,95%CI=1.05,1.50), skin (OR=1.41,95%CI=1.15,1.73), and stomach problems (OR=1.46,95%CI=1.17,1.82), facial lesions (OR=1.37,95%CI=1.03,1.82), and depressive symptoms (OR=1.07,95%CI=1.05,1.09); women also reported the desire to use MA “to lose weight” (OR=6.43,95%CI=3.49,11.83) or “to escape” (OR=2.90,95%CI=1.86,4.53). Women were also more likely to be in steady relationships (OR=4.80,95%CI=1.43,16.01), but reported higher STI-risk behaviors in these relationships including unprotected sex (OR=2.39,95%CI=1.24,4.63) and a self-reported STI (OR=2.63,95%CI=1.63,4.23) or that their steady sex partner had an STI in the last 60 days (OR=2.86,95%CI=1.02,8.04). Conclusions: Overall, female MA users experienced greater consequences, STI-risks, and signs of negative self-esteem in their motivations for using MA compared to their male counterparts. These results suggest that gender differences in attitudes and negative self-perceptions should inform prevention and intervention programs in terms of treatment efficacy, retention, and completion.