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Understanding Patterns and Correlates of Use and the Association With HIV-Related Sexual Risk

Robert Garofalo, MD, MPH; Brian S. Mustanski, PhD; David J. McKirnan, PhD; Amy Herrick, MA; Geri R. Donenberg, PhD

Arch Pediatr Adolesc Med. 2007;161(6):591-596.

Objective  To examine patterns, consequences, and correlates of methamphetamine use among adolescent and young adult men who have sex with men (YMSM).

Design  Descriptive, bivariate, and hierarchical regression analyses of cross-sectional data.

Setting  Howard Brown Health Center, a community-based facility in Chicago, Ill, from August 2004 to September 2005.

Participants  Three hundred ten YMSM who completed an anonymous, computer-assisted survey.

Main Outcome Measure  Methamphetamine use in the past year.

Results  Participants ranged in age from 16 to 24 years (mean age, 20.3 years); 30% were white and 70% were of other race/ethnicity (African American, 33%; Hispanic, 26%; Asian or Pacific Islander, 3%; and other, 8%). Participants reported many high-risk sexual and substance use behaviors. Thirteen percent used methamphetamine in the past year. Methamphetamine use was more common among human immunodeficiency virus–infected participants (odds ratio, 2.8; 95% confidence interval, 1.3-5.3) and varied by age and race/ethnicity; substantially higher prevalence was reported by older and non–African American YMSM (P<.001). Compared with other illicit substance users, methamphetamine users reported more memory difficulties, impairments in daily activities, and unintended risky sex resulting from substance use (all P<.01). Hierarchical regression identified sexual risk (unprotected intercourse and multiple partners), sexualized social context (eg, Internet sex, sex in a bathhouse or sex club, sex with older partners, and commercial sex), lower self-esteem, and psychological distress as correlated with methamphetamine use among participants (P<.05).

Conclusions  A substantial percentage of YMSM in this sample used methamphetamine. Methamphetamine use is a public health problem with significant implications for the health and well-being of YMSM. Methamphetamine use was associated with human immunodeficiency virus–related risk, and patterns of use were predicted by demographic data, sexualized social contexts, and psychological variables.

Author Affiliations: Department of Pediatrics, Children's Memorial Hospital/Northwestern University (Dr Garofalo), Department of Research, Howard Brown Health Center (Drs Garofalo and McKirnan and Ms Herrick), Department of Psychiatry, Institute for Juvenile Research (Drs Mustanski and Donenberg), and Department of Psychology (Dr McKirnan), University of Illinois at Chicago.