Crystal methamphetamine use increases HIV risk

The use of crystal methamphetamine by men who have sex with men (MSM) increases the risk of HIV transmission and can cause complications in those who are already HIV-positive, according to an article in the March 15 issue of Clinical Infectious Diseases, now available online.

Highly popular with young people who frequent dance clubs, crystal meth and its cousin “Ecstasy” both induce a feeling of elation and alertness. This sense of well-being is dangerous, though, as it lessens inhibitions and can lead to unprotected sex with multiple partners. HIV rates are high among methamphetamine users, putting younger MSM at an increased risk for infection.

Meth-induced lapses in judgment leading to promiscuous sexual behavior make users more likely to contract HIV, but the drug itself could also increase the risk “because it may suppress a part of your immune system that’s important in fighting off HIV,” said Dr. Antonio Urbina, lead author of the study. Furthermore, he said, meth and its analogs, such as “Ecstasy,” can be fatal when mixed with certain antiretroviral treatment (ART). In addition, HIV-positive meth users on HIV medications are missing more doses and are likely contributing to the spread of drug-resistant strains of HIV, said Dr. Urbina.

Among HIV-positive patients not receiving ART, meth use may increase the risk of developing HIV dementia, a condition associated with reduced motor and verbal skills. Methamphetamine decreases dopamine transporter levels, causing symptoms akin to those of Parkinson’s disease, and when combined with HIV’s toxic effects on the brain, “there’s an overlap in neurotoxicity between methamphetamine and HIV,” said Dr. Urbina. “That’s potentially the most serious side effect.”

Getting the word out to young people about the risks of meth use may be difficult. “I really think there’s a lack of information about the catastrophic risks of methamphetamine use, particularly in young MSMs,” said Dr. Urbina, especially since adolescents and young adults “tend to be risk-takers.” The risk of having unsafe sex, and thus the risk of contracting HIV “is far greater [with methamphetamine use] than with marijuana or alcohol,” Dr. Urbina added. “We need to create an environment of awareness that this drug is not one to experiment with.”

Founded in 1979, Clinical Infectious Diseases publishes clinical articles twice monthly in a variety of areas of infectious disease, and is one of the most highly regarded journals in this specialty. It is published under the auspices of IDSA. Based in Alexandria, Virginia, IDSA is a professional society representing more than 7,500 physicians and scientists who specialize in infectious diseases. The Society’s affiliate organization, the HIV Medicine Association (HIVMA), is the professional home for more than 2,500 physicians, scientists, and other health professionals dedicated to HIV/AIDS.