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Meth and HIV

Jun 27, 2006

Dr. Bob,

I'm a grateful, recovering Crystal Meth Addict. I have just passed my 8 month mark of being clean. At my partner's prompting, he suggested I use my gift of voice somehow. I have decided and am in the process of making a documentary of my addiction and my recovery. I asked my Infectious Disease Specialist if he would let me interview him specifically on how Meth has affected my health only. I was always very honest with him about my injecting meth and we would often discuss what meth was doing to my health. 2 years ago when I tested Positive my CD4 was 914, VL was 4000. CD4 is now 241, VL 72000. I have started HIV Meds on my 2 year anniversary of being Positive. My doctor said he would not be part of my film since he can not prove meth had any connection to the degeneration of my health. I have read the research and understand the effects meth has on one's body so I know he is full of you know what. So, for others who may not understand meth's affects; Dr. Bob, what effects does meth have on a Positive person's health and if there are affects, what are they? I respect your words tremendously. Former Meth Man in FL

Response from Dr. Frascino

Hello Former Meth Man,

Congratulations on your eight months of sobriety!

Regarding meth effects on HIV pozatoids, I'll reprint an article from the archives that addresses that issue.

Stay well! Good luck with your film!

Dr. Bob

Scientists Explore Meth's Role in Immune System

February 25, 2005

Crystal methamphetamine's effect on the immune system, HIV's progression and the overall AIDS epidemic is receiving fresh scrutiny after New York City health officials reported that a meth-using resident acquired multiple drug-resistant HIV and quickly progressed to AIDS. Experts fear more people, especially gay men, are using the drug -- in many cases, with Viagra -- to engage in unprotected sex with multiple partners.

In the Explore Project -- a long-term study of more than 4,000 gay men sexually active with more than one partner -- researchers found a quarter of the men had tried crystal methamphetamine in the previous six months. All the meth users were HIV-negative at the study's start, but by the end, about 2.1 percent had seroconverted. Independent of behaviors such as unprotected sex with multiple partners -- which was strongly associated with infection -- and injection drug use, men reporting crystal use were twice as likely to contract HIV.

While research is limited, studies in animals and on cell cultures have found that methamphetamine suppresses killer T cells. That, combined with the drug's propensity to dry out mucous membranes, could cause abrasions in the mouth and rectum and slightly increase a person's vulnerability to the virus, said Dr. Antonio Urbina, lead author of a study on crystal meth and HIV published last year in Clinical Infectious Diseases.

In a Journal of Infectious Diseases study of 230 HIV-positive people, two-thirds were either current or former crystal users. Those on antiretroviral medication who used crystal had much higher viral loads than other subjects. One explanation is that meth users, like many drug users, failed to adhere to their drug regimens, said Dr. Igor Grant, a study author. Such irregular adherence can also allow drug-resistant HIV to emerge, according to experts. Nevertheless, it is meth's role on behavior that most alarms experts. "Being in a sex club for 36 hours on crystal meth and engaging in unprotected anal sex is really the most profound effect," said Dr. Steve Shoptaw, a research psychologist at University of California-Los Angeles' Integrated Substance Abuse programs.

The studies cited include "Crystal Methamphetamine, Its Analogues, and HIV Infection: Medical and Psychiatric Aspects of a New Epidemic," published in Journal of Infectious Diseases (2004;38:890-894) and "Increased Human Immunodeficiency Virus Loads in Active Methamphetamine Users Are Explained by Reduced Effectiveness of Antiretroviral Therapy," published in Journal of Infectious Diseases (2003;188:1820-1826).

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