Post-Exposure Prophylaxis and Methamphetamine Use among Young Sexual Minority Men: The P18 Cohort Study.

Elizabeth Kaplun,Michael Briganti,Paul D’Avanzo,Kristen Krause,Perry Halkitis,Richard Martino

doi:10.3390/ijerph19020712

Abstract

Methamphetamine use is associated with increased risk of HIV infection among young sexual minority men (SMM). Post-exposure prophylaxis (PEP) is an effective strategy for individuals who are exposed to HIV, but there is limited research about PEP use among young SMM and its relationship with methamphetamine use. This study analyzes the association between ever PEP use and recent methamphetamine use among young SMM in New York City, using cross-sectional data from the P18 Cohort Study (n = 429). Multivariable logistic regression models were used to assess the association between methamphetamine use and ever PEP use. Compared with those who had not used methamphetamine in the last 6 months, young SMM who did use methamphetamine were significantly more likely to have ever used PEP (AOR = 6.07, 95% CI: 2.10–16.86). Young SMM who had ever used PrEP had 16 times higher odds of ever using PEP (AOR = 16, 95% CI: 7.41–35.95). Those who completed bachelor’s degrees were 61% less likely to have ever used PEP (AOR = 0.39, 95% CI: 0.17–0.88). These data suggest that methamphetamine use could increase the risk of HIV infection, highlighting the critical need to target interventions for young SMM who use methamphetamine and are more likely to engage in unprotected intercourse.

Highlights

Rates of HIV infection have declined significantly over the last decade, but disparities persist among vulnerable populations
The aim of this study was to evaluate the association of ever Post-exposure prophylaxis (PEP) use and methamphetamine use among young young sexual minority men (YSMM) living in the New York City metropolitan area (NYC)
The data for this cross-sectional analysis were drawn from the baseline of the second wave of the P18 Cohort Study, a prospective cohort study that surveyed young sexual minority men (YSMM) in NYC to assess the syndemic of substance use, mental health burden and HIV

Summary

Introduction

Rates of HIV infection have declined significantly over the last decade, but disparities persist among vulnerable populations. The Center for Disease Control and Prevention (CDC) reports that approximately 36,400 people were newly infected with HIV in the United States in 2018 [1]. Of these new diagnoses, 69% were men who have sex with men (MSM) or sexual minority men (SMM), with young SMM aged 13–24 compromising 80% of new diagnoses in their age group, and 25% of all SMM [2]. In the last few decades, HIV has become a chronic condition that is highly manageable through antiretroviral therapy [3], and in 2012, the U.S Food and Drug

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