Increased Drug Use and STI Risk with Injection Drug Use Among Hiv-Seronegative Heterosexual Methamphetamine Users (Report‪)‬

A highly addictive and potent stimulant, methamphetamine (MA) was used by an estimated 529,000 individuals aged 12 and older in the US in 2007 (SAMHSA 2007). Although the drug has become common throughout the US, in many western US cities use of MA by injection is on the rise (NIDA 2008; Case et al. 2008; SAMHSA 2007; Pollini & Strathdee 2007; Brouwer et al. 2006; Bucardo et al. 2005; Banken 2004; Gibson, Leamon & Flynn 2002). Although MA use has been associated in the literature with risk behaviors for the acquisition of HIV and sexually transmitted infections (STI), few studies have examined injection use of MA among heterosexuals. Two studies, one conducted in San Bernardino, California, and the other in Yokohama City, Kanagawa, Japan, examined MA injection among heterosexual MA users entering treatment for MA abuse, and found that MA injection was associated with increased years of MA use, concurrent use of other drugs, and a history of felony convictions. The authors also reported multiple negative consequences of MA use, including depression, psychological manifestations (e.g., auditory hallucinations), and such physical effects as impaired sexual functioning, HIV infection, and loss of consciousness (Matsumoto et al. 2002; Domier et al. 2000). Neither study examined HIV sex risk behaviors or motivations for MA use. A different study, which to our knowledge is the only one to have examined motivations for MA use, focused on a sample of men who have sex with men (MSM). That study reported injection of MA to be associated with being Caucasian, homeless, and unmarried, and with having lower educational attainment (Semple, Patterson & Grant 2004). Injection drug use in this population was also associated with greater number of years of MA use, greater amount and frequency of MA use, and greater consequences from MA use; in addition, injection drug users (IDU) reported more HIV-seropositive partners, more incident STIs, and trading sex for money. Compared to noninjection drug users (NIDU), IDU were more likely to have initiated MA use in order to get high, to escape, and to cope with mood. IDU were also more likely to report the desire "to cope with mood" and "to feel self-confident" as reasons for their current MA use.