HIV Treatment Optimism and Crystal Methamphetamine Use and Initiation Among HIV-Negative Men Who Have Sex With Men in Vancouver, Canada: A Longitudinal Analysis
Date
2018
Authors
Colyer, Sean P.
Lachowsky, Nathan J.
Cui, Zishan
Zhu, Julia
Armstrong, Heather L.
Taylor, Matthew
Edward, Joshua
Olarewaju, Gbolahan
Hogg, Robert S.
Roth, Eric A.
Journal Title
Journal ISSN
Volume Title
Publisher
Drug and Alcohol Dependence
Abstract
Background: Treatment as Prevention (TasP) leading to increased HIV treatment optimism
among men who have sex with men (MSM) has been previously associated with behavioural risk
compensation, though not yet via crystal methamphetamine (CM) use. Among HIV-negative
MSM in a TasP environment, this study aimed to investigate the prevalence of recent CM use
over time, examine the association between HIV treatment optimism and CM use and initiation,
and identify correlates of recent CM use and predictors of CM initiation.
Methods: Using data from a prospective behavioural cohort study of sexually-active MSM in
the Vancouver area, we used multi-level generalized mixed effect models to evaluate temporal
trends in CM use, univariable and multivariable logistic regression to identify covariates of
recent CM use, and univariable and multivariable survival analysis to identify predictors of CM
initiation.
Results: Of 497 HIV-negative cohort participants, 10.3% reported any recent CM use at
enrollment. From 2012-2016, there were no statistically significant temporal trends in overall
CM use or with routes of administration. In multivariable logistic regression analyses, HIV
treatment optimism was not associated with recent CM use (not retained in final model) or CM
initiation (aHR=1.06, 95% CI:0.98-1.15). Significant correlates of CM use include recent
gamma-hydroxybutyrate (GHB) and ecstasy use, and having received/given drugs for sex.
Conclusions: Among HIV-negative MSM in Vancouver, HIV treatment optimism does not
appear to be independently associated with CM use or initiation of use, though use of CM was
both prevalent and stable over time.
Description
We would like to thank the Momentum Health Study participants, office staff, community advisory board, and our community agency partners: Health Initiative for Men, YouthCO HIV & Hep C Society, and Positive Living Society of BC.
Keywords
HIV/AIDS, methamphetamine, men who have sex with men (MSM), gay and bisexual men, HIV treatment optimism, treatment as prevention (TasP)
Citation
Colyer, S. P., Lachowsky, N. J., Cui, Z., Zhu, J., Armstrong, H. L., Taylor, M., Edward, J., Olarewaju, G., Hogg, R. S., Roth, E. A., & Moore, D. M. (2018). “HIV Treatment Optimism and Crystal Methamphetamine Use and Initiation Among HIVNegative Men Who Have Sex With Men in Vancouver, Canada: A Longitudinal Analysis.” Drug and Alcohol Dependence, 185, 67-74. https://doi.org/10.1016/j.drugalcdep.2017.12.004