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High rates of co-occurring mental health and other substance abuse problems in men who have sex with men (MSM) screening for a behavioral intervention to reduce crystal methamphetamine use and HIV risk behaviors
Amaya Perez-Brumer, BA,
Harvard University School of Public Health and the Fenway Institute, Fenway Health, Boston, MA
Jaclyn White, MPH,
Epidemiology Department, The Fenway Institute, Fenway Health, Boston, MA
David Pantalone, PhD,
Department of Psychology, University of Massachusetts, Boston and the Fenway Institute, Fenway Health, Boston, MA
Matthew J. Mimiaga, ScD, MPH,
Psychiatry, Harvard Medical School/Massachusetts General Hospital, Harvard School of Public Health and the Fenway Institute, Fenway Health, Boston, MA
Background: Crystal methamphetamine (meth) use remains a treatment-resistant problem and a significant driver of high-risk sexual behavior among MSM. Little research has examined the characteristics of MSM interested in participating in a novel combination behavioral intervention to reduce meth use and sexual risk. Methods: Using venue-based recruitment and purposive sampling, 57 MSM were recruited and screened. Data collected included demographics, sexual risk behavior, and substance use and mental health history. Fisher's exact tests examined associations between sexual risk and mental health variables. Results: Mean age was 39 (SD=10), 86% were unstably housed, and 63% unemployed. In the past 3-months, 92% reported unprotected anal intercourse (UAI) while high on meth. Modes of use in the past 3-months (98%) included, smoking (86%), injecting (46%), snorting (32%), and rectal use (19%). Concurrent drug use was common (84%) and included cocaine (53%), poppers (49%), crack (44%), and GHB (30%). Prior substance abuse treatment (68%) and mental health histories were common: 75% endorsed a past mental health diagnosis, 47% a prior psychiatric hospitalization, and 30% reported antidepressant use. Additionally, a diagnosis of depression/anxiety was associated with UAI in the past 3-months (p = 0.04). Overall, 5% self-reported as HIV-infected and 12% were unaware their status. Conclusion: MSM interested in participating in a meth abuse and risk reduction study are at high-risk for HIV infection and transmission, with high rates of co-occurring mental health problems. Behavioral interventions that simultaneously target substance abuse treatment, HIV risk reduction, and co-morbid mental health problems are needed among this group.
Learning Areas:
Public health or related research
Learning Objectives:
Discuss the key characteristics, including co-occurring mental health and other substance abuse problems, among MSM screening for a behavioral intervention to reduce crystal methamphetamine use and HIV risk behaviors.
Identify the need for behavioral interventions to simultaneously target substance abuse treatment, HIV risk reduction, and co-morbid mental health problems among MSM interested in participating in combination behavioral interventions to reduce meth use and sexual risk.
Keyword(s): Substance Abuse Treatment, Sexual Risk Behavior
Presenting author's disclosure statement:Qualified on the content I am responsible for because: I am a current Masters of Science candidate at the Harvard School of Public Health with more than 5 years experience working on behavioral HIV/STI prevention interventions among have men who have sex with men (MSM) and transgender women. Among my scientific interests has been the development of multidisciplinary strategies for the prevention of HIV/STI and mixed-methods evaluation of current HIV/STI interventions.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines,
and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed
in my presentation.
