Methamphetamine Use, Sexual Activity, Patient-Provider Communication, and Medication Adherence Among HIV-Infected Patients in Care, San Francisco, 2004-2006

"While numerous studies examine methamphetamine use and associated risky sexual behaviors in HIV-uninfected individuals, few studies have surveyed HIV-infected individuals in the health care setting," the authors wrote. To assess the frequency and trends of methamphetamine use, sexual activity, injection drug use, patient-provider communication and medication adherence among HIV-infected persons in care, the researchers administered a one-page anonymous survey in 2004 and 2006. The setting was two University of California-San Francisco outpatient HIV clinics: Moffitt Hospital (Moffitt), serving primarily privately insured patients, and San Francisco General Hospital (SFGH), a county hospital serving primarily patients who are uninsured or publicly insured.

In 2006, 39 percent of men who have sex with men (MSM), 33 percent of heterosexual men, and 11 percent of women reported methamphetamine use in the previous 12 months. Use of the drug was significantly associated with an increased number of sex partners among MSM and heterosexual men, as well as poor adherence to antiretroviral treatment.

Among MSM, methamphetamine use was more common at SFGH. From 2004 to 2006, reported use in the prior 12 months decreased among MSM at Moffitt (38 to 20 percent, p<0.01), but rose at SFGH (40 to 50 percent, p<0.05). A higher frequency of injection among methamphetamine users was noted, increasing at SFGH from 38 to 55 percent (p<0.05).

While patient-provider communication regarding methamphetamine use increased during the study period, no significant change was found for providers asking patients about sexual activity.

"Overall, we found methamphetamine use to be common among HIV-infected patients in care, and associated with an increased number of sex partners, a high frequency of injection drug use, and poor adherence to antiretroviral medications," the researchers concluded. "These findings support the need for improved screening and clinic-based interventions to reduce and treat methamphetamine abuse and associated high-risk sexual behaviors."

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