RELEVANCE: Methamphetamine (MA) use is common among MSM and is an important driver of the HIV/STI epidemic. Understanding the biological and behavioral risk factors that drive ongoing HIV/STI transmission among MA-using MSM is critical to designing potent HIV prevention interventions. Prevalence of MA use is substantially higher among MSM (5.9% among HIV-negative MSM and 12.3% among MSM living with HIV) than the general population (0.7%) (2,3), with a 707% increase in MA-related mortality in Los Angeles County over the past decade. MA use is associated with increased risk for HIV/STI acquisition and impaired HIV virologic control. Lack of HIV virologic control among HIV-positive MA-using MSM, combined with increased HIV/STI prevalence within their sexual networks, contributes to ongoing HIV/STI transmission. As MA use is associated with high-risk behavior, it is important to study the impacts of MA use on the biological and behavioral factors that are driving HIV/STI transmission among MSM.

DESCRIPTION: This study will evaluate whether methamphetamine use and/or sexually transmitted infections influence levels of inflammatory markers (cytokines) in the blood and in the rectum. The study uses contingency management and will include visits three times a week over 8 weeks. Participants will also be asked to complete surveys, provide samples (blood samples and rectal swabs), and have urine tested for the presence of drugs. They will also be offered a prescription for HIV pre-exposure prophylaxis at enrollment.

STATUS: In development