Antiretroviral Drug Resistance and Risk Behavior Among Recently HIV-Infected Men Who Have Sex With Men

In the current study of recently HIV-infected men who have sex with men (MSM), researchers examined associations among behaviors and HIV drug resistance.

The study enrolled 117 newly HIV-infected MSM between 2002 and 2006 who completed questionnaires about their three most recent sexual partners. Participants' serum samples were tested for phenotypic and genotypic HIV drug resistance. The authors used logistic regression analysis to assess relationships among substance use, behaviors, and resistance to at least one class of HIV therapy.

Among participants, the mean age was 35 years; 71 percent were white and 19 percent Hispanic. During the previous 12 months, 51 percent (60/117) reported substance use during sex. In serum testing, 12.5 percent of MSM had genotypic resistance and 14 percent had phenotypic resistance.

Substance use during sexual activity was associated with phenotypic resistance in multivariate analysis, including any substance use (adjusted odds ratio [aOR]=4.21, 95 percent confidence interval [CI]: 1.13-15.68), polysubstance use (aOR=5.64, 95 percent CI: 1.62-19.60), methamphetamine (aOR=4.00, 95 CI: 1.19-13.38), 3,4-methylenedioxy-N-methylamphetamine (MDMA)/ecstasy (aOR=7.16, 95 CI: 1.40-36.59) and gamma-hydroxyl butyrate (GHB) use (aOR=6.98, 95 CI: 1.82-26.80). Similar results were seen for genotypic resistance.

"Among these recently HIV-infected MSM, methamphetamine use during sexual activity and use of other substances, such as MDMA and GHB, was associated with acquired drug-resistant virus," the authors concluded. "No other behaviors associated with acquisition of drug-resistant HIV."

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