Double Jeopardy: Methamphetamine Use and HIV as Risk Factors for COVID-19
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Double Jeopardy: Methamphetamine Use and HIV as Risk Factors for COVID‑19 Adam W. Carrico1,6 · Keith J. Horvath2 · Christian Grov3 · Judith T. Moskowitz4 · Savita Pahwa1 · Suresh Pallikkuth1 · Sabina Hirshfield5
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Among men who have sex with men (MSM), the co-occurrence of methamphetamine (meth) use and HIV could create a double jeopardy for coronavirus disease 2019 (COVID19). Co-occurring meth and HIV could amplify biological and behavioral risk for infection with the novel coronavirus (SARS-CoV-2), presenting unique challenges to halting community-level transmission. This confluence of biobehavioral risk factors related to meth and HIV may also synergistically enhance vulnerability to COVID-19 progression. Below we provide an overview of important areas for further research regarding the potential implications of the intertwining epidemics of meth use and HIV for the COVID19 pandemic in MSM. The use of meth and other stimulants has consistently been identified as a potent driver of the HIV/AIDS epidemic in MSM [1–3]. Despite successful deployment of public health interventions that specifically targeted meth in MSM [4–6], there is a resurgent epidemic of meth use in the United States [7]. Beginning in 2011, recent meth use doubled (from 4 to 9%) among MSM in New York City [8], and comparable increases in meth use were observed among MSM in San Diego [9]. This trend is corroborated by concomitant increases in meth use in other urban areas * Adam W. Carrico [email protected] 1
University of Miami School of Medicine, Miami, FL, USA
2
San Diego State University Department of Psychology, San Diego, CA, USA
3
City University of New York Graduate School of Public Health, New York, NY, USA
4
Northwestern University Feinberg School of Medicine, Chicago, IL, USA
5
State University of New York – Downstate Health Sciences University, New York, NY, USA
6
University of Miami Department of Public Health Sciences, 1120 NW 14th St., Office 1005, Miami, FL 33136, USA
such that national rates are meeting or exceeding 2005 peaks [10]. There is also increasing recognition that stimulant use is prevalent in ethnic minority MSM where HIV incidence is the highest [11]. For example, recent findings from our team indicate that one-in-five young Black MSM in Texas reported stimulant use in the past 2 months [12]. There is an urgent need to deploy comprehensive, multi-level interventions targeting the intersection of stimulant use and HIV among MSM [1, 13]. The resurgence of meth use in MSM threatens to compromise biomedical approaches to HIV/AIDS prevention, such as treatment as prevention (TasP), and fuel the COVID-19 pandemic. The prevalence of stimulant use is twofold greater among MSM living with HIV [14], and stimulant use undermines the clinical and public health benefits of TasP. Our team and others have demonstrated that people living with HIV who use stimulants experience profound difficulties with navigating the HIV c
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