Recreational Drug Use Leads To Higher Risk of Acquiring HIV

A new Dutch study, published in the June 1 issue of the journal AIDS that analyzes risk behaviors in gay men who are statistically at a high risk of HIV infection over time. Sexual risk behaviour trajectories among MSM at risk for HIV in Amsterdam, the Netherlands investigated how repeated behaviors are related to risk of HIV infection. The patterns of the risk of HIV were analyzed in rising and falling risk groups, as well as low-risk groups.

Studies and common sense tell us that casual drug use is one of the most important factors of increased risk of HIV— but this study examines how those risks evolve over time.

Researchers studied 815 participants in an Amsterdam Cohort Study, made up of HIV-negative gay men. The study has been collecting data since 1984, and participants are required to visit a clinic under the Public Health Service of Amsterdam and report on their sexual behavior over the last six months.

Men who participated between May 2007 and January 2017 were observed for the latest study. Participants ranged from 18 to 70 years of age with a median age at first visit of 35.6.

“Three trajectories of sexual risk behaviour were identified, which were labelled low risk (90.3 percent of the sample), falling high risk (6.5 percent) and rising high risk (3.3 percent). MSM following the falling high risk (20.5 percent) and rising high risk (25.0 percent) trajectories were more likely to acquire HIV during follow-up,” researchers stated. “The falling high risk trajectory was associated with younger age at sexual debut, fewer steady partnerships and high percentages of substance use. The rising high-risk trajectory was associated with increasing percentages of substance use over time.”

Researchers, as usual, found a disturbing connection between drug use and the risk of HIV. The high risk was present, however, even in normally lower-risk groups.

Timing is everything. One in 15 men who have sex with men were identified as group for starting sex at an earlier age than average and practicing high-risk sex in their youth, but their risk of HIV infection fell even to less than average over a period of time.

In contrast, one in 30 gay men were identified as a group for starting to practice sex later than average and who were more likely to be in a long-term relationship early on. Strangely, however, their risk of HIV increased over time until it was much higher than that of other group that was observed.

But the most important factor among all groups was — you guessed it — casual drug use.

The risky-when-young group, predictably, faced higher rates of HIV. But the risky-with-age group faced even higher HIV rates. It would appear that gay men who live a risky young life live and learn, but still faced high HIV rates.

The group with falling high risk  were still 75 percent more likely to use recreational drugs than the lower-risk majority even when their risk of HIV had fallen below average. The group with rising high risk were still 56 percent more likely than the lower-risk majority to use recreational drugs.

Identifying risky behaviors early on was the best way to prevent HIV infection. “Early identification of MSM following a trajectory of falling or rising high-risk behaviour and adequate timing of individual-based preventive interventions may reduce HIV transmission,” researchers concluded.

This study illustrates that it’s never too late to turn around risky behavior, and that staying away from excessive recreational drug use could make the difference from becoming HIV-positive.