Crystal Methamphetamine Use and Its Associations with Sexually Transmitted Infections Among GBM: Identifying Modifiable Treatment Targets

Gay, bisexual, and other men who have sex with men (GBM) continue to be disproportionately affected by sexually transmitted infections (STIs), with increasing incidence of bacterial STIs. A related problem is the increasing crystal methamphetamine (CM) use among GBM. A robust body of literature supports an association between CM use with bacterial STIs. Among GBM, CM use and STIs are best understood as components of a syndemic, defined as multiple health conditions that cluster and worsen the health of a given population. Despite increasing bacterial STIs and CM use among GBM, little work has examined the modifiable mechanisms that could serve as intervention points in this syndemic for different types of CM use. The goal of this multiphase biopsychosocial study is to examine CM use and bacterial STIs and promising interventions to intervene in the GBM CM use and STI syndemic. The first phase of the study will be a multi-city biobehavioural study, including both a survey and biomedical testing of bacterial STIs. This study will also identify different classes of CM using GBM. Second, qualitative interviews will be conducted with different types of CM using GBM to better understand their experiences of both CM use and bacterial STIs, to ask them about their health needs, and to learn which CM interventions would be most feasible and acceptable. Next, we will ask expert panels to identify priority prevention and treatment interventions for GBM in each class. Upon completing this 3-phase study, we will work with our community partners to create or implement the most prioritized interventions to reduce CM use harms and bacterial STIs among GBM. Our team of GBM and CM use researchers brings together experts in large-scale, multicity data collection, CM and multi-substance use, STBBI prevention, and experts in community-based and clinic-based interventions for GBM. Our team is therefore well-placed to translate this study into future intervention research.