The impact of age, HIV serostatus and seroconversion on methamphetamine use

ABSTRACT

Background: Characterizing methamphetamine use in relation to age, HIV serostatus and seroconversion is pertinent given the increasingly older age of the population with HIV and the intertwined epidemics of methamphetamine use and HIV. Objectives: Study aims were to investigate whether (i) methamphetamine use differs by age and HIV serostatus, and (ii) receiving an HIV diagnosis impacts methamphetamine use among younger and older persons with HIV. Methods: This study examined methamphetamine use characteristics among 217 individuals with a lifetime methamphetamine dependence diagnosis who completed an in-person study assessment. Results: Multivariable regressions revealed that HIV serostatus uniquely attenuates methamphetamine use, such that persons with HIV report a smaller cumulative quantity (β = −0.16, p = 0.01) and a fewer number of days (β = −0.18, p = 0.004) of methamphetamine use than persons without HIV. Among the HIV+ sample, all participants persisted in methamphetamine use after receiving an HIV diagnosis, with about 20% initiating use after seroconversion. Repeated measures analysis of variance indicated that density of methamphetamine use (i.e. grams per day used) was greater among the younger, relative to the older, HIV+ group (p = 0.02), and increased for both age groups following seroconversion (p < 0.001). Conclusion: These analyses indicate that although HIV serostatus may attenuate methamphetamine use behaviors, many people with HIV initiate, or persist in, methamphetamine use after receiving an HIV diagnosis. These findings raise the question of whether tailoring of prevention and intervention strategies might reduce the impact of methamphetamine and HIV across the age continuum.

KEYWORDS:

• Methamphetamine
• stimulant
• HIV/AIDS
• age
• HIV risk behavior

Acknowledgements

The Translational Methamphetamine AIDS Research Center (TMARC) group is affiliated with the University of California, San Diego (UCSD) and the Sanford-Burnham Medical Research Institute (SBMRI). The TMARC is comprised of: Director – Igor Grant, MD; Co-Directors – Ronald J. Ellis, MD, PhD, Scott L. Letendre, MD, and Cristian L. Achim, MD, PhD; Center Manager – Steven Paul Woods, PsyD; Assistant Center Manager – Aaron M. Carr, BA; Clinical Assessment and Laboratory (CAL) Core: Scott L. Letendre, MD (Core Director), Ronald J. Ellis, MD, PhD, Rachel Schrier, PhD; Neuropsychiatric (NP) Core: Robert K. Heaton, PhD (Core Director), J. Hampton Atkinson, MD, Mariana Cherner, PhD, Thomas D. Marcotte, PhD, Erin E. Morgan, PhD; Neuroimaging (NI) Core: Gregory Brown, PhD (Core Director), Terry Jernigan, PhD, Anders Dale, PhD, Thomas Liu, PhD, Miriam Scadeng, PhD, Christine Fennema-Notestine, PhD, Sarah L. Archibald, MA; Neurosciences and Animal Models (NAM) Core: Cristian L. Achim, MD, PhD (Core Director), Eliezer Masliah, MD, Stuart Lipton, MD, PhD, Virawudh Soontornniyomkij, MD; Administrative Coordinating Core (ACC) – Data Management and Information Systems (DMIS) Unit: Anthony C. Gamst, PhD (Unit Chief), Clint Cushman, BA (Unit Manager); ACC – Statistics Unit: Ian Abramson, PhD (Unit Chief), Florin Vaida, PhD, Reena Deutsch, PhD, Anya Umlauf, MS; ACC – Participant Unit: J. Hampton Atkinson, MD (Unit Chief), Jennifer Marquie-Beck, MPH (Unit Manager); Project 1: Arpi Minassian, PhD (Project Director), William Perry, PhD, Mark Geyer, PhD, Brook Henry, PhD, Jared Young, PhD; Project 2: Amanda B. Grethe, PhD (Project Director), Martin Paulus MD, Ronald J. Ellis, MD, PhD; Project 3: Sheldon Morris, MD, MPH (Project Director), David M. Smith, MD, MAS, Igor Grant, MD; Project 4: Svetlana Semenova, PhD (Project Director), Athina Markou, PhD, James Kesby, PhD; Project 5: Marcus Kaul, PhD (Project Director).

Funding

This research was supported by NIH grants R01 MH099987-02S1 and P50-DA026306; the NIH had no further role in study design, in the collection, analysis and interpretation of data, in the writing of this report, or in the decision to submit the paper for publication.

Declaration of interest

The authors report no conflicts of interest. The views expressed in this article are those of the authors and do not reflect the official policy or position of the United States Government.

Additional information

Funding

This research was supported by NIH grants R01 MH099987-02S1 and P50-DA026306; the NIH had no further role in study design, in the collection, analysis and interpretation of data, in the writing of this report, or in the decision to submit the paper for publication.