Abstract
BackgroundMethamphetamine (MA) use is a significant public health concern due to its negative effects on health. However, to date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. This topic is particularly important in Myanmar, which is recognized as one of the key MA production countries in the Southeast Asia region. Therefore, this study examined factors associated with high-risk sexual behaviors among MA users in Muse city, Myanmar.MethodsA community-based cross-sectional study was conducted from January to March 2013 in Muse city, Northern Shan State, Myanmar. In total, 1183 MA users (772 male; 411 female) were recruited using respondent-driven sampling and a computer assisted self-interviewing method. Generalized estimating equation models were used to examine factors associated with high-risk sexual behaviors.ResultsA large proportion of MA users engaged in high-risk sexual behaviors (inconsistent condom use: males, 90.7%, females, 85.2%; multiple sexual partners: males, 94.2%, females, 47.2%; and history of STIs: males, 55.7%, females, 56.0%). Among males, being a multiple stimulants drug user (adjusted odds ratio [AOR] =1.77; 95% confidence interval [CI] =1.30–2.41) and being a client of sex workers (AOR = 1.41; 95% CI = 1.08–1.83) were risk factors for engaging in high-risk sexual behaviors. Among females, being a migrant worker (AOR = 2.70; 95% CI = 1.86–3.93) and being employed (AOR = 1.57; 95% CI = 1.13–2.18) were risk factors for engaging in high-risk sexual behaviors as well.ConclusionsHigh-risk sexual behaviors were particularly pronounced among both male and female MA users. MA prevention programs that reflect gender considerations should be developed to pay more attention to vulnerable populations such as migrants, clients of sex workers, and less educated female MA users.
Highlights
Methamphetamine (MA) use is a significant public health concern due to its negative effects on health
A statistically significant difference was observed between males and females regarding their age (p < 0.001; Table 1), with 35.2% of males and 32.8% of females being aged between 21 and 24 years (Table 1)
39.4% of males and 47.7% of females had at least a secondary level of education (p < 0.001), and 24.2% of males and 38.4% of females were unemployed (p < 0.001)
Summary
Methamphetamine (MA) use is a significant public health concern due to its negative effects on health. To date, no epidemiological research has examined high-risk sexual behaviors (inconsistent condom use, having multiple sexual partners and having a history of sexually transmitted infections) among MA users. MA use has been associated with the transmission of sexually transmitted infections (STIs) including human immunodeficiency virus (HIV), [9] and with unprotected anal sex among men who have sex with men (MSM). MSM who take MA may be more likely to engage in receptive anal sex [15, 16] As such types of sexual intercourse are inherently more risky, MA users are more likely to be at risk of STI transmission [13]. The positive correlation observed between MA use and high-risk sexual behaviors leading to STI transmission may be due to a higher preference for high-risk behaviors characteristic of those who use MA [18]
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