HIV Treatment Adherence Among Crystal Meth-Using gbMSM: The Impact of Stigma and Substance Use

Crystal meth use and HIV are serious public health concerns, particularly among gay, bisexual, and other men who have sex with men (gbMSM). This blog post explores a study that examined factors associated with non-adherence to HIV treatment among gbMSM who use crystal meth.

The study found that HIV-related stigma is a significant barrier to treatment adherence. Additionally, substance use, particularly cocaine, was associated with non-adherence. Conversely, educational attainment and health insurance were protective factors.

This blog post summarizes the key findings of the study and highlights the importance of addressing stigma and substance use to improve HIV treatment outcomes among gbMSM who use crystal meth.

Sample and Demographics

The study involved a sample of 89 gbMSM who had used crystal meth within the past 3 months. The median age of the participants was 34 years old, and a majority reported high levels of education, employment, and health insurance coverage.

HIV Status and Treatment Adherence

Most participants in the study were living with HIV and reported adhering to their HIV treatment regimen. However, factors such as lower educational attainment and lack of health insurance were associated with non-adherence.

HIV-Related Stigma

Participants who reported non-adherence to treatment also indicated experiencing higher levels of total, enacted, internalized, and anticipated HIV-related stigma. This suggests that stigma can be a significant barrier to effective HIV treatment.

Substance Use and Sexual Behavior

The study found high rates of condomless sex among participants, particularly with other people living with HIV (PLWHIV). Crystal meth use was prevalent, and some participants reported exchanging sex for the drug. Additionally, cocaine use was more common among participants with non-adherence.

Factors Associated with Non-Adherence

Several factors were associated with non-adherence to HIV treatment in the study. These included (Jiménez-Rivagorza et al, 2023):

1. HIV-related stigma
2. Progression of HIV to AIDS
3. Exchanging crystal meth for sex
4. Higher rates of cocaine use

On the other hand, factors such as having health insurance and higher educational attainment were found to be protective against non-adherence.

Limitations of the Study

It is important to acknowledge some limitations of the study. The data relied on self-reporting by participants, which can be prone to bias. Additionally, the study employed non-probabilistic sampling, which may limit the generalizability of the findings to the wider gbMSM population. Finally, the relatively small sample size is another factor to consider. (Jiménez-Rivagorza et al, 2023)

Conclusion

Jiménez-Rivagorza and colleagues (2023) state that the study highlights the significant role of HIV-related stigma as a barrier to treatment adherence among gbMSM who use crystal meth:

• It also emphasizes the importance of educational attainment and health ins
  
  
  
  
  urance as protective factors. Substance use, particularly cocaine, was found to be associated with non-adherence.
• Further research is needed to gain a deeper understanding of the complex interplay between these factors. 
• By addressing stigma and substance use challenges, healthcare providers can work towards improving HIV treatment outcomes for gbMSM who use crystal meth

References

• Jiménez-Rivagorza, Leonardo & Orozco, Ricardo & Medina-Mora, Maria & Rafful, Claudia. (2024). HIV-Related Stigma and Treatment Adherence Among Gay, Bisexual, and Other Men Who Have Sex with Men Who Use Crystal Meth in the Metropolitan Area of Mexico City. Archives of Sexual Behavior. 53. 1-14. 10.1007/s10508-024-02816-6.