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Use of Cocaine, Meth, Opioids Remains High in US MSM: 2008-2014
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Conference on Retroviruses and Opportunistic Infections (CROI), February 13-16, 2017, Seattle
Mark Mascolini
Almost 20% of men who have sex with men (MSM) in 20 US cities used cocaine in 2008, 2011, and 2014, according to a survey by the Centers for Disease Control and Prevention (CDC) [1]. Frequency of opioid and methamphetamine use hovered close to 8% across study years in these men. Opioid use rose from year to year among black MSM, men with less education, and men with low income.
Across the United States, CDC researchers observed, MSM have higher rates of drug use and HIV infection than the general population. To track noninjected drug use over recent years, they analyzed data from MSM in National HIV Behavioral Surveillance (NHBS) program in 2008, 2011, and 2014. NHBS monitors HIV risk behaviors and HIV prevalence in populations at high risk in 20 US cities with high HIV prevalence. This analysis involves MSM at least 18 years old reporting at least 1 male sex partner in the past 12 months. The CDC team used Poisson regression models to calculate prevalence ratios of noninjected cocaine, meth, and prescription opioids in the past 12 months.
Across the 3 study years, cocaine use proved twice as frequent as opioid or meth use in the study population: 18.6% in 2008, 16.9% in 2011, and 19.0% in 2014. Respective frequencies in those 3 years for meth were 7.8%, 6.6%, and 8.0%, and for opioids 7.5%, 7.7%, and 7.8%. Use rates did not change significantly from year to year for any of the three drugs in the overall study population.
Cocaine use proved more common in whites than in other racial/ethnic groups and in young men. Meth use was also more common in whites, in those with less education, in those who earned less than $20,000 yearly, in Western cities, and in men with HIV. Opioid use was more common in whites, younger men, those with less education, those who earned less than $20,000 yearly, and those who lived in Western cities.
Opioid use rose significantly among black MSM, from 4.2% in 2008 to 5.6% in 2011 and to 5.9% in 2014 (adjusted prevalence ratio [aPR] 1.24, 95% confidence interval [CI] 1.06 to 1.45). Opioid use also rose among Hispanic men, but not significantly, while use by white MSM drifted downward from 10.2% in 2008 to 9.5% in 2014. Thus opioid use remained far less frequent in black MSM than white MSM in 2014.
Over the 3 study years, opioid use rose significantly among men with a high school education or less versus more education, from 7.1% to 9.1% to 10.1 (aPR 1.21, 95% CI 1.02 to 1.43). Opioid use also climbed significantly over time in men who earned less than $20,000 yearly, from 6.7% in 2008 to 7.6% in 2011 and to 9.3% in 2014 (aPR 1.23, 95% CI 1.02 to 1.49). Use declined nonsignificantly among MSM earning $75,000 or more, from 8.5% to 7.2% to 6.4%.
The CDC team urged that prevention program "consider assessing use of opioids and other commonly abused drugs among MSM of all races and offer early treatment for drug dependence to prevent transition to injection."
Reference
1. Hoots B, Broz D, Nerlander L, Paz-Bailey G. Changes in prescription opioid, meth, and cocaine use among MSM in 20 US cities. Conference on Retroviruses and Opportunistic Infections (CROI), February 13-16, 2017, Seattle. Abstract 871.
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Changes in prescription opioid, meth, and cocaine use among MSM in 20 U.S. cities
Hoots BE, Broz D, Nerlander L, Paz-Bailey G for the NHBS Study Group
Behavioral and Clinical Surveillance Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA
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