Gay and bisexual men who used ecstasy, GHB and/or crystal were more likely to be infected with HIV that is resistant to antiretroviral drugs, say the authors of a study to be published in a forthcoming issue of the Journal of Acquired Immune Deficiency Syndromes.
Pamina Gorbach, MHS, DrPH, of the School of Public Health at the University of California, Los Angeles, and her colleagues administered surveys between 2002 and 2006 to 117 men who have sex with men (MSM) who had been recently infected with HIV. The average age of the participants was 35 years and 71 percent identified as white.
Of 112 who had a genotypic resistance test, 12.5 percent were infected with HIV resistant to at least one class of antiretrovirals. Of the 117 who had a phenotypic resistance test conducted, 14 percent were found to have resistant virus.
Fifty-one percent of the men reported substance use during sexual activity in the 12 months before being surveyed. Men who used drugs during sex were more than four times as likely to be infected with drug-resistant virus, compared with men who did not use drugs during sex. Men who used more than one drug during sex were nearly six times more likely to be infected with drug-resistant virus.
The drugs most strongly associated with being infected with resistant virus were MDMA (ecstasy), gamma-hydroxybutanol (GHB) and crystal methamphetamine, with ecstasy and GHB users being nearly seven times more likely to have drug-resistant virus and crystal users over four times as likely. Alcohol, the most commonly used recreational substance among MSM, was not reported in the study results.