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SUMMARY
Methamphetamine use has been closely linked to sexual risk taking in the gay and bisexual population. While previous studies have noted this relationship, few empirical investigations have quantified this association. As part of a larger, longitudinal study of club drug use among gay and bisexual men in New York City, the authors assessed the sexual risk taking of those who identified as methamphetamine users. A subset of these men, who reported either a seronegative or unknown HIV status, was confirmed to be HIV-positive. Comparisons of this group to confirmed HIV-negative methamphetamine using men in this study's sample indicated that these not known to be HIV positive individuals differed in their reasons for methamphetamine use and in terms of their sexual risk taking. In particular, those who had seroconverted reported higher levels of unprotected receptive anal intercourse while high. Our study confirms that methamphetamine may play a causal role in HIV infection and may fuel the HIV epidemic at large.