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26 August 2008
Alcohol, drugs and age pivotal to HIV risk
by George Atkinson

Younger men who binge drink, use substances like methamphetamine and have sex with men account for nearly half of all new HIV infections in the United States, the XVII International AIDS Conference in Mexico City has been told. The new study, led by a researcher at The Miriam Hospital, should pave the way for the development of more targeted prevention programs aimed at this demographic.

Based on the study's findings, the researchers suggest that prevention programs for HIV-infected men who have sex with men focus on younger, more recently diagnosed men, who may indulge in illicit substances. "Although the number of HIV diagnoses among men in this group decreased the last two decades, recent data shows these rates are on the rise again, making it critical that we continue to understand this group in order to guide prevention and education efforts," says study author Kenneth H. Mayer, an infectious disease physician at The Miriam Hospital.

For the study, 200 HIV-infected men who have sex with men completed an assessment that showed just about half of the men had a detectable amount of virus in their blood, known as an HIV viral load, and 57 percent were on highly active antiretroviral therapy (HAART), a combination of antiretroviral drugs aimed at treating HIV. Three-quarters of the men were Caucasian and more than half were college-educated.

Based on this data analysis, the researchers determined that about half of the participants in the study met the criteria for being a high-risk HIV transmitter. This was defined as engaging in unprotected insertive or receptive anal intercourse over the last six months. It also includes men who have a detectable HIV viral load or have been diagnosed with a sexually transmitted infection (STI) within the past year. Nearly a quarter of men surveyed said they consumed five or more alcoholic drinks daily at least once in the previous three months and 65 percent reported other substance use, including 30 percent who admitted to using methamphetamine.

"When one drinks or uses other substances, inhibitions are lowered, making people more likely to engage in risky behavior, like unprotected sex. This is particularly true for young people, who often take risks without thinking about the consequences. Some patients who are newly diagnosed might be in denial, which could lead to poor decisions when it comes to sex," Mayer says. "Unfortunately, such behaviors put the partners of these men at great risk for contracting HIV and unknowingly transmitting it to others."

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Source: XVII International AIDS Conference

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