Crystal methamphetamine use, sexual risk behaviours and harm reduction among men who have sex with men

Key take-home messages

• Use of crystal methamphetamine among men who have sex with men has been linked to unprotected sex, sex with multiple partners, sex with partners of unknown serostatus, and a number of other risky sexual behaviours that may facilitate transmission of sexually transmitted and bloodborne infections.
• Amphetamine-using men who have sex with men have a 2.9 times greater risk of acquiring HIV infection through unprotected receptive anal intercourse than men who do not use amphetamines. Use of methamphetamine even once has been linked to a 2.3 times greater likelihood of seroconversion.
• The use of makeshift pipes made from hazardous materials such as glass fragments and aluminum cans often results in chronic cuts, burns, blisters and open sores inside the mouth and on the lips and gums of crystal methamphetamine smokers. Evidence suggests that these injuries promote the transmission of HCV and HIV through blood-to-blood contact when these devices are shared.
• For HIV-positive men who have sex with men who are being treated with protease inhibitors, the use of antiretroviral medication has been shown to affect methamphetamine absorption rates. The effect of methamphetamine is two or three times greater for individuals on combination therapy. A variety of harm reduction techniques can be employed to promote the safer use of crystal methamphetamine, including the provision of safer drug use supplies and related harm reduction education and counseling.
• Pilot testing of safer smoking kits to initiate discussion and education about the risks associated with sharing pipes and unprotected sex for men who have sex with men is worth pursuing. Future studies should be conducted to thoroughly examine whether harm reduction services could actually reduce the risk of transmission of sexually transmitted and bloodborne infections in this population.

• Population(s)
  • Men who have sex with men
  • General HIV+ population
  • General HIV- population
• Prevention
  • Sexual risk behaviour
  • Drug use behaviours/harm reduction
• Substance Use
  • Nonmedicinal drugs