Department of Public Health Sciences, University of Miami Miller School of Medicine, 1120 NW 14th St., Office 1010, Miami, FL, 33136, USA.
Calder Memorial Library, University of Miami, FL, Miami, USA.
Curr HIV/AIDS Rep. 2022 Aug;19(4):235-250. doi: 10.1007/s11904-022-00608-y. Epub 2022 Jun 14.
Patterns of sexualized drug use, including stimulants (e.g., methamphetamine) and chemsex drugs, are key drivers of HIV incidence among sexual minority men (SMM). Although pre-exposure prophylaxis (PrEP) mitigates HIV risk, there is no consensus regarding the associations of substance use with the PrEP care continuum.
SMM who use substances are as likely or more likely to use PrEP. Although SMM who use stimulants experience greater difficulties with daily oral PrEP adherence, some evidence shows that SMM who use stimulants or chemsex drugs may achieve better adherence in the context of recent condomless anal sex. Finally, SMM who use substances may experience greater difficulties with PrEP persistence (including retention in PrEP care). SMM who use stimulants and other substances would benefit from more comprehensive efforts to support PrEP re-uptake, adherence, and persistence, including delivering behavioral interventions, considering event-based dosing, and providing injectable PrEP.
性化药物使用模式，包括兴奋剂（如甲基苯丙胺）和化学性行为药物，是性少数男性（SM）中 HIV 发病率的主要驱动因素。尽管暴露前预防（PrEP）可以降低 HIV 风险，但目前对于物质使用与 PrEP 护理连续性之间的关联尚无共识。
使用物质的 SM 男性使用 PrEP 的可能性与不使用物质的 SM 男性相同或更高。尽管使用兴奋剂的 SM 男性在日常口服 PrEP 依从性方面遇到更大的困难，但有一些证据表明，在最近无保护肛交的情况下，使用兴奋剂或化学性行为药物的 SM 男性可能会有更好的依从性。最后，使用物质的 SM 男性在 PrEP 持续（包括保留在 PrEP 护理中）方面可能会遇到更大的困难。使用兴奋剂和其他物质的 SM 男性将受益于更全面的努力来支持 PrEP 的重新摄入、依从性和持续，包括提供行为干预、考虑基于事件的剂量以及提供注射用 PrEP。
