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Published on: January 22, 2016
Methamphetamine use and HIV risk behavior among men who inject drugs: causal inference using coarsened exact matching
Mehdi Noroozi1, Peter Higgs2, Alireza Noroozi3
1Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
Background:
Understanding the association between methamphetamine (MA) use and HIV risk behavior among people who inject drugs (PWID) will assist policy-makers and program managers to sharpen the focus of HIV prevention interventions. This study examines the relationship between MA use and HIV risk behavior among men who inject drugs (MWID) in Tehran, Iran, using coarsened exact matching (CEM).
Methods:
Data for these analyses were derived from a cross-sectional study conducted between June and July 2016. We assessed three outcomes of interest-all treated as binary variables, including distributive and receptive needle and syringe (NS) sharing and condomless sex during the month before interview. Our primary exposure of interest was whether study participants reported any MA use in the month prior to the interview. Firstly, we report the descriptive statistics for the pooled samples and matched sub-samples using CEM. The pooled and matched estimates of the associations and their 95% CI were estimated using a logistic regression model.
Results:
Overall, 500 MWID aged between 18 and 63 years (mean = 28.44, SD = 7.22) were recruited. Imbalances in the measured demographic characteristics and risk behaviors between MA users and non-users were attenuated using matching. In the matched samples, the regression models showed participants who reported MA use were 1.82 times more likely to report condomless sex (OR = 1.82 95% CI 1.51, 4.10; P = 0.031), and 1.35 times more likely to report distributive NS sharing in the past 30 days, as compared to MA non-users (OR = 1.35 95% CI 1.15-1.81). Finally, there was a statistically significant relationship between MA use and receptive NS sharing in the past month. People who use MA in the last month had higher odds of receptive NS sharing when compared to MA non-users (OR = 4.2 95% CI 2.7, 7.5; P = 0.013).
Conclusions:
Our results show a significant relationship between MA use and HIV risk behavior among MWID in Tehran, Iran. MA use was related with increased NS sharing, which is associated with higher risk for HIV exposure and transmission.
Insights
Methamphetamine use significantly increases HIV risk behaviors among men who inject drugs in Tehran. This includes higher odds of condomless sex and needle/syringe sharing, raising concerns for HIV transmission.
Area of Science:
- Public Health
- Epidemiology
- Addiction Research
Background:
- Understanding methamphetamine (MA) use and HIV risk is crucial for targeted prevention among people who inject drugs (PWID).
- This study focuses on men who inject drugs (MWID) in Tehran, Iran, to investigate the association between MA use and HIV risk behaviors.
Purpose of the Study:
- To examine the relationship between methamphetamine use and HIV risk behaviors, specifically needle/syringe sharing and condomless sex, among MWID in Tehran.
- To provide data to inform HIV prevention strategies for this population.
Main Methods:
- A cross-sectional study involving 500 MWID was conducted in Tehran.
- Coarsened exact matching (CEM) was used to balance demographic characteristics and risk behaviors between MA users and non-users.
- Logistic regression models estimated the association between MA use and HIV risk behaviors (distributive/receptive NS sharing, condomless sex).
Main Results:
- MA use was significantly associated with increased condomless sex (OR = 1.82) and distributive needle/syringe (NS) sharing (OR = 1.35).
- A strong association was found between MA use and receptive NS sharing (OR = 4.2).
- CEM successfully attenuated imbalances between MA users and non-users.
Conclusions:
- Methamphetamine use is significantly linked to increased HIV risk behaviors among MWID in Tehran.
- The findings highlight the importance of addressing MA use in HIV prevention programs for PWID.
- Increased needle and syringe sharing associated with MA use poses a higher risk for HIV transmission.
