Treating Methamphetamine Dependence Reduces Risk for HIV

The use of methamphetamines is associated with injection drug use, increased sexual activity, unprotected sex, and HIV transmission. Behavioral treatments may be effective in reducing methamphetamine use and decreasing HIV risk behaviors among those using illicit drugs. The current study was conducted in 787 methamphetamine-dependent individuals who received 1 of 2 counseling strategies (either 16 weeks of a standardized psychosocial protocol or 8–16 weeks of treatment-as-usual representing 8 diverse treatment approaches). Both approaches focused on drug use, not HIV risk.

• The proportion of the sample who injected methamphetamine within the previous 30 days significantly declined from baseline to treatment discharge (14.6% to 5.4%).

• High-risk sexual activity also decreased from baseline to treatment discharge:

• mean times participants reported having sex without a condom, 14.7 versus 13.2;
• mean times participants reported having sex without a condom with an injection drug user, 2.3 versus 1.4;
• mean times participants reported having sex without a condom with a methamphetamine user, 6.5 versus 1.4;
• mean times participants reported having sex while high, 9.1 versus 4.9.
• There were significant associations between treatment retention and HIV risk outcomes.

Comments:

This study demonstrates the benefit of psychosocial counseling for patients with methampheta-mine dependence. Treatment was associated with decreased methamphetamine use and decreased risk for HIV infection. The association between treatment retention and reduced HIV risk outcomes supports the implementation of programs that reduce barriers for treatment entry and retention.

David A. Fiellin, MD

Reference:

Rawson RA, Gonzales R, Pearce V, et al. Methamphetamine dependence and human immunodeficiency virus risk behavior. J Subst Abuse Treat. 2008;35(3):279–284.