A growing body of research supports the relationship between methamphetamine use by MSM and heterosexual populations and an increase in behaviors (sexual and those related to injection drug use) that can put the user at risk for HIV infection.
A survey of users of noninjection drugs, conducted in California during the mid-1990s, showed that heterosexual persons and MSM who reported using methamphetamine also had more sex partners, were less likely to use a condom, and were more likely to exchange sex for money or drugs, have sex with an injection drug user, or to have a history of STD―all risk factors for HIV transmission 14.
A qualitative study of gay and bisexual men in Seattle (Washington) and San Jose (California), conducted during 1997–2001, revealed a high prevalence of club drugs (methamphetamine, ecstasy, ketamine, and GHB [gamma hydroxyl butyrate]) in tandem with unsafe sex practices. Many of the respondents reported that they already had HIV infection or AIDS and that they “medicated” their symptoms through their drug use. Respondents reported engaging in unprotected sex as well as trading sex for drugs 15.
A 2001 study conducted among gay and bisexual men in the San Francisco Bay Area showed that of MSM who participated in circuit party weekends, those who used methamphetamine were more than twice as likely to have unprotected anal sex during that weekend with a partner whose HIV status was unknown or different from theirs 16.
According to a 1998 study conducted at publicly funded HIV testing sites in California, HIV-positive MSM may be more likely than HIV-negative MSM to use methamphetamine, and some MSM methamphetamine users may be more likely than other methamphetamine users to use it during sex 16.
An analysis of data of heterosexual men, performed by the California Department of Health Services during 2001–2003 determined that recent methamphetamine use was associated with high-risk sexual behaviors, including anal intercourse, sex with an injection drug user, and sex with a casual or an anonymous female partner 17.
In California, 9.5% of primary and secondary syphilis cases in heterosexual men during 2004 were cases in men with a history of methamphetamine use, continuing a trend of increases in syphilis cases, from 3.1% in 2001, 6.4% in 2002, and 7.3% in 2003 18. Syphilis infection is a marker for unprotected sex, a risk factor for HIV infection.
During a gonorrhea outbreak in 6 central California counties in 2004, substantial proportions of heterosexual men (38%) and women (28%) reported methamphetamine use, particularly when compared with MSM (8%) 17. Like syphilis, gonorrhea infection is a marker for unprotected sex, a risk factor for HIV infection.
Some evidence suggests that the use of methamphetamine (not injected) by heterosexual men and women is associated with unprotected vaginal sex and with a higher number of sex partners during the past 12 months. Full Methamphetamine Use and HIV Risk Behaviors story from CDCHIV Risk Behaviors and Methamphetamine Use