Published on August 8, 2007
Meth, Sex and HIV: Meth, Sex and HIV Alaska Forum on Crystal Methamphetamine October 29, 2005 Beth Saltonstall, MD The views expressed in this presentation are my own and do not necessarily represent those of the Alaska Native Tribal Health Consortium Peter Staley 4/24/05 Agenda: Agenda HIVand the immune system The STI effect Psych HIV, Meds and Meth Toxicity Slide3: Slide4: Slide5: The Immune System: The Immune System HIV: Attacking the Immune System: HIV: Attacking the Immune System DHS/HIV/Pathogenesis/PP Picture Lymphocytes Macrophages HIV CD8 CD8 Neutrophils CD4 CD4 Slide8: Slide9: Slide10: NEJM Images in Clinical Medicine 1998;339(1):32 Slide11: HIV Transmission: Most Common Ways: HIV Transmission: Most Common Ways Sexual intercourse (anal, vaginal, or oral sex) with an HIV-infected person By sharing needles or injection equipment with an injection drug user who is infected with HIV From HIV-infected women to babies before or during birth, or through breast-feeding after birth Other risk factors...: Other risk factors... Alcohol abuse when normal inhibitions are decreased. Blacking out when sexual abuse might occur. Drug use that also decreases inhibitions Mental illness/ FAS/ developmental delay STIs !!!!!!!! Multiple sex partners STIs and HIV Transmission: STIs and HIV Transmission Slide15: Slide16: STIs makes the giving and receiving of HIV 2-5 times more likely Tissue breaks The cells that fight infection are the cells that HIV needs Slide17: Alaska Chlamydia rates Rates /100,000 by gender Total = 3954 Slide18: Alaska Gonorrhea rates 567 total cases in 2004 Rates / 100,000 by gender Slide19: Primary and Secondary Syphilis Cases, by Sex, 1997-2002: Some Large US Cities New York City 0 200 400 Los Angeles 0 200 400 San Francisco 0 200 400 Chicago 0 200 400 1997 1998 1999 2000 2001 2002 1997 1998 1999 2000 2001 2002 1997 1998 1999 2000 2001 2002 1997 1998 1999 2000 2001 2002 (CDC, 2003) Slide20: Slide21: Slide22: Slide23: Syphilis in Alaska, 2005: Syphilis in Alaska, 2005 9 cases of infectious syphilis reported in the first 6 months of 2005 44% (4) have a reported methamphetamine connection Methamphetamine: Methamphetamine Crank, crystal, meth, speed, Chrissy, tina Snorted, smoked, ingested, injected, 'booty bump' 6-12 hour effect General sense of well being, alertness, euphoria, 'heightened self-confidence and freedom from the anxiety about HIV.' Frequent and protracted sexual encounters Focus July 2005, v20, n6 HIV, Meth and Psych: HIV, Meth and Psych Meth Use Adds to Ravages of AIDS: Meth Use Adds to Ravages of AIDS Chicago Tribune By Judith Graham Published March 13, 2005 'Keith O’Brien was damaged goods. That’s how the former bank executive felt after learning he had the AIDS virus. Until, at last, a powerful drug temporarily took the psychic pain away.' San Francisco: San Francisco Compared to nonusers, crystal meth users were: Twice as likely to be HIV+ 1.9 times more likely to be chlamydia+ 4.9 times more likely to be syphilis+ New York: New York Center for HIV/AIDS Education Studies and Training (CHEST) Among drug users, 62% indicated 'frequent and significant' meth use MSM meth users 3 times more likely to contract HIV through RAI 50% of meth users were HIV+ Slide30: Meth and Sex: Meth and Sex 6-12 hour high Quadruples the risk of unprotected insertive sex with an HIV- person or a person of unknown status (UCSF 2005) Booty bumping Increased and prolonged sexual sensitivity Anesthetic 'Crystal dick' Combo with erectile dysfunction drugs Booty Bumping: Booty Bumping Increased sexual intensity Anesthetic effect Dehydrating effect Rougher Condom tears Tissue tears Meth and Sex: Meth and Sex 6-12 hour high Quadruples the risk of unprotected insertive sex with an HIV- person or a person of unknown status (UCSF 2005) Booty bumping Increased and prolonged sexual sensitivity Anesthetic 'Crystal dick' Combo with erectile dysfunction drugs Slide34: Behavioral Change on Meth: Behavioral Change on Meth 'I think that's really the biggest gorilla in the room. Being in a sex club for 36 hours on crystal meth and engaging in unprotected anal sex is really the most profound effect.' Dr. Steve Shoptaw, a research psychologist at the University of California, Los Angeles, Integrated Substance Abuse Programs Slide36: HIV, Meds and Meth: HIV, Meds and Meth Adherence: Adherence Perhaps the greatest potential for methamphetamine to negatively affect the health of HIV-positive patients is via its effects on decreasing adherence to ART Slide39: Drug-Resistant HIV Strain Alarms OfficialsNew York man developed full-blown AIDS within months: Drug-Resistant HIV Strain Alarms Officials New York man developed full-blown AIDS within months Saturday, February 12, 2005 (CNN) -- Health officials in New York City are alarmed after a man infected with a highly drug-resistant strain of HIV progressed to full-blown AIDS within months of diagnosis. “New strain of HIV…”: 'New strain of HIV…' He reported having multiple partners and unsafe anal sex, often while using a crystallized form of methamphetamine, known as 'crystal meth.' Found to be transmission from a single contact Slide42: Slide43: Toxicity: Toxicity The Immune System: White Blood Cells: The Immune System: White Blood Cells DHS/HIV/Pathogenesis/PP Picture Lymphocytes Macrophages CD8 CD8 Neutrophils CD4 CD4 Toxicity: Toxicity Speed/Methamphetamine 2- to 3-fold buildup of methamphetamine in the blood, increased anxiety, manic behavior, shortness of breath, racing heart beat, and dehydration. Ecstasy 3- to 10-fold buildup of 3,4-methylene-dioxymethamphetamine (MDMA) in the blood, bruxism (teeth grinding), palpitations, joint stiffness, dehydration. Possibility of liver and kidney damage. May be deadly. AIDS: Hiding in Plain SightHow Lurid Reports Obscure the Bigger StoryBY KAI WRIGHT: AIDS: Hiding in Plain Sight How Lurid Reports Obscure the Bigger Story BY KAI WRIGHT The result is a myopic understanding of this epidemic. We see white where there’s actually black. We see drug-induced orgies where there are really complex sexual choices complicated by the search for intimacy. And we see something that demands our attention for just a few fleeting, hysterical moments when we’re actually facing a systemic, decades-long problem. New York City HIV Forum: New York City HIV Forum
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