Background: Little research has been conducted that compares the independent and combined contextual effects of methamphetamine and HIV on sexual behavior and mood among men who have sex with men (MSM). The purpose of this study was to examine sexual behavior and mood profiles of non-monogamous MSM concordant and discordant for HIV-infection and methamphetamine dependence, as well as to elucidate the relationship between mood and condom use. We hypothesized; participants in the HIV⁺/methamphetamine⁺ group would report less frequent condom use and more frequent negative moods than controls. We also hypothesized that a negative association between negative mood and condom use would be detected.
Methods:  The study sample included 175 non-monogamous MSM concordant or discordant for methamphetamine and HIV who were recruited as part of a cohort study that focused on central nervous system effects of HIV and methamphetamine use. Analysis of variance (ANOVA) was conducted to examine sexual behavior and mood differences between groups and linear regressions were used to examine the relationship between mood and condom use.
Results: Participants in methamphetamine⁺ groups reported significantly more injection-drug-using sexual partners and sex while intoxicated than did the methamphetamine^– groups. HIV⁺ and methamphetamine⁺ status were associated with significantly higher depression scores. Furthermore, methamphetamine was found to substantially reduce condom use among HIV⁺ participants. Within the methamphetamine⁺/HIV⁺ group condom use was reported <25% of the time, whereas the methamphetamine^–/HIV⁺ group reported condom use 51 to 75% of the time. Univariate analysis revealed significant relationships between all measured mood scales (e.g., depression, tension, vigor, anger, fatigue, and confusion) and condom use. When methamphetamine status was included in each of these univariate models, tension, vigor, and fatigue remained significant. When HIV status was included in the univariate models, all but the anger model remained significant. Significant main effects for methamphetamine, but not HIV-status were found for condom use regardless of the mood scale being tested.
Conclusions: Findings suggest that sexual behavior and mood profiles of non-monogamous MSM differ depending on the context in which they are examined. As hypothesized, methamphetamine⁺/HIV⁺ participants reported significantly lower condom use and negative mood than controls. These findings also suggest a complex relationship between negative mood and condom use, in which methamphetamine use and to a lesser extent HIV-status partially eclipse this relationship.