Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles

Allison D Rosen; Marjan Javanbakht; Steven J Shoptaw; Marissa J Seamans; James O Lloyd-Smith; Pamina M Gorbach

doi:10.1016/j.josat.2023.209228

Association of current substance use treatment with future reduced methamphetamine use in an observational cohort of men who have sex with men in Los Angeles

J Subst Use Addict Treat. 2024 Feb:157:209228. doi: 10.1016/j.josat.2023.209228. Epub 2023 Nov 21.

Authors

Allison D Rosen¹, Marjan Javanbakht², Steven J Shoptaw³, Marissa J Seamans², James O Lloyd-Smith⁴, Pamina M Gorbach²

Affiliations

¹ Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA; Department of Family Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA. Electronic address: a.rosen@ucla.edu.
² Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, CA, USA.
³ Department of Family Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine, Los Angeles, CA, USA.
⁴ Department of Ecology and Evolutionary Biology, University of California, Los Angeles, Los Angeles, CA, USA; Department of Computational Medicine, University of California, Los Angeles, Los Angeles, CA, USA.

Abstract

Introduction: Methamphetamine use is highly prevalent among men who have sex with men (MSM), but knowledge of the long-term dynamics, and how they are affected by substance use treatment, is limited. This study aimed to describe trajectories of methamphetamine use among MSM, and to evaluate the impact of treatment for any kind of substance use on frequency of methamphetamine use.

Methods: This analysis used data from a cohort of MSM in Los Angeles, CA, who participated in semi-annual study visits from 2014 to 2022. The study characterized trajectories of methamphetamine use using a continuous time multistate Markov model with three states. States were defined using self-reported frequency of methamphetamine use in the past six months: frequent (daily), occasional (weekly or less), and never. The model estimated the association between receiving treatment for any kind of substance use and changes in state of frequency of methamphetamine use.

Results: This analysis included 2348 study visits among 285 individuals who were followed-up for an average of 4.4 years. Among participants who were in the frequent use state, 65 % (n = 26) of those who were receiving any kind of substance use treatment at a study visit had reduced their methamphetamine use at their next visit, compared to 33 % (n = 95) of those who were not receiving treatment. Controlling for age, race/ethnicity, and HIV-status, those who reported receiving current treatment for substance use were more likely to transition from occasional to no use (HR: 1.63, 95 % CI: 1.10-2.42) and frequent to occasional use (HR: 4.25, 95 % CI: 2.11-8.59) in comparison to those who did not report receiving current treatment for substance use.

Conclusions: Findings from this dynamic modeling study provide a new method for assessing longitudinal methamphetamine use outcomes and add important evidence outside of clinical trials that substance use treatment may reduce methamphetamine use.

Keywords: Men who have sex with men; Methamphetamine; Multistate models; Substance use treatment.

Publication types

Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Homosexuality, Male
Humans
Los Angeles / epidemiology
Male
Methamphetamine*
Sexual and Gender Minorities*
Substance-Related Disorders* / epidemiology

Substances

Methamphetamine

Abstract

Publication types

MeSH terms

Substances

Grants and funding