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Antiretroviral Drug Resistance and Risk Behavior Among Recently HIV-Infected Men Who Have Sex With Men

Gorbach, Pamina M MHS, DrPH*; Drumright, Lydia N MPH, PhD; Javanbakht, Marjan MPH, PhD*; Pond, Sergei L PhD; Woelk, Christopher H PhD; Daar, Eric S MD§; Little, Susan J MD

JAIDS Journal of Acquired Immune Deficiency Syndromes: April 15th, 2008 - Volume 47 - Issue 5 - p 639-643
doi: 10.1097/QAI.0b013e3181684c3d
Brief Report: Epidemiology and Social Science

Objectives: Examine associations among behaviors including substance use during sexual encounters, and transmitted HIV drug resistance in recently HIV-infected men who have sex with men (MSM).

Methods: Between 2002 and 2006, 117 recently HIV-infected MSM completed questionnaires regarding their 3 most recent sexual partners. Serum samples were tested for the presence of genotypic and phenotypic HIV drug resistance. Logistic regression analysis was used to assess the association of substance use, behaviors, and resistance to at least 1 class of HIV drugs.

Results: The mean age of participants was 35 years; 71% identified as white and 19% as Hispanic. Sixty (51%) reported substance use during sexual activity in the past 12 months. A total of 12.5% of 112 had genotypic drug resistance to at least 1 class of antiretroviral medications, and 14% of 117 had phenotypic drug resistance. Substances used during sexual activity associated with phenotypic drug resistance in multivariate models included any substance use (adjusted odds ratio [aOR] = 4.21, 95% confidence interval [CI]: 1.13 to 15.68), polysubstance use (aOR = 5.64, 95% CI: 1.62 to 19.60), methamphetamine (aOR = 4.00, 95% CI: 1.19 to 13.38), 3,4-methylenedioxy-N-methylamphetamine (MDMA)/Ecstasy (aOR = 7.16, 95% CI: 1.40 to 36.59), and γ-hydroxyl butyrate (GHB) (aOR = 6.98, 95% CI: 1.82 to 26.80). The genotype analysis was similar.

Conclusions: Among these recently HIV-infected MSM, methamphetamine use during sexual activity and use of other substances, such as MDMA and GHB, was associated with acquired drug-resistant virus. No other behaviors associated with acquisition of drug-resistant HIV.

From the *Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, CA; †Division of International Health and Cross-Cultural Medicine, Department of Family and Preventive Medicine, University of California, San Diego, San Diego, CA; ‡Antiviral Research Center, Departments of Medicine and Pathology, University of California, San Diego, San Diego, CA; §Los Angeles Biomedical Research Institute at Harbor-University of California, Los Angeles, and the David Geffen School of Medicine, University of California, Los Angeles, CA; and ∥Antiviral Research Center, Department of Medicine, University of California, San Diego, San Diego, CA.

Received for publication September 27, 2007; accepted January 11, 2008.

Correspondence to: Pamina M. Gorbach, MHS, DrPH, BERG-Department of Epidemiology, University of California, Los Angeles, PO Box 957353, 10880 Wilshire Boulevard, Suite 540, Los Angeles, CA 90095-7353 (e-mail: pgorbach@ucla.edu).

© 2008 Lippincott Williams & Wilkins, Inc.