Special Populations – Men Who Have Sex With Men (MSM)

In the United States, methamphetamine use is a significant problem among urban men who have sex with men (MSM). Methamphetamine use is significantly associated with high-risk sexual behaviors, which has resulted in high rates of HIV prevalence within many MSM populations. Methamphetamine-using MSM consistently report using methamphetamine to enhance their sexual encounters, often describing sex while on methamphetamine as more “intense,” “heightened,” “prolonged,” and “uninhibited.” The effect of methamphetamine use on the sexual health of MSM has become a public health concern. Data on methamphetamine-using MSM populations in Los Angeles point to a “time-to-event” association between the level of methamphetamine use and the likelihood of reporting HIV infection (Shoptaw & Reback, 2006). Findings demonstrate that the more involved MSM are in their use of methamphetamine (as measured by their history of use and their frequency of use), the higher their prevalence of HIV infection. As methamphetamine use is associated with high-risk sexual behaviors among MSM, users report an increased number of sexual partners, decreased use of condoms, multiple-partner sexual activities, engaging in sex with casual and anonymous partners, engaging in unprotected receptive and insertive anal sex with casual partners, an increased likelihood of being HIV-infected or having a sexually transmitted infection, and an increased likelihood of have hepatitis A, B or C infection.

Methamphetamine is frequently used in gay-owned and gay-operated venues such as bars, bathhouses, sex clubs and circuit parties, i.e., weekend-long events that celebrate gay sexuality and sensibility. Consequently, among MSM, the experience of using methamphetamine has become institutionalized within certain sectors of gay culture through gay-identified businesses. Many MSM methamphetamine users report that the drug enables them to meet other men more easily, connect socially and sexually with other men, and alter rigid attitudes toward sex. Research studies have found that MSM methamphetamine users report engaging in higher-risk sexual activities not typically practiced when not using the drug (Reback et al., 2004).