Methamphetamine use and HIV risk behaviors among heterosexual men--preliminary results from five northern California counties, December 2001-November 2003.

Methamphetamine (meth) is a highly addictive stimulant that gained widespread popularity in California in the 1980s and has since spread to most regions of the United States, including rural areas. Analyses of survey data among noninjection-drug users from California in the mid-1990s determined that, among heterosexual persons and among men who had sex with men (MSM), meth users reported more sex partners, were less likely to report condom use, and were more likely to report sex in exchange for money or drugs, sex with an injection-drug user, and history of a sexually transmitted disease (STD). Subsequent studies among MSM have indicated an association between meth use and sexual risk behaviors, syphilis infection, and incidence of human immunodeficiency virus (HIV) infection. Subsequent studies among heterosexual populations have been less extensive than those among MSM and often have not used population-based samples nor adjusted for possible confounders. To further assess the association between meth use and high-risk sexual behaviors among heterosexual men, the California Department of Health Services, Office of AIDS, analyzed population-based data from five northern California counties in the HEY-Man (Health Evaluation in Young Men) Study. This report summarizes the results of that analysis, which determined that recent meth use was associated with high-risk sexual behaviors, including sex with a casual or anonymous female partner, anal intercourse, and sex with an injection-drug user. The results suggest the need for states to consider including referrals to meth prevention and treatment programs in their HIV prevention programs and for broader assessment of the relation between meth use and high-risk sexual behaviors.