Long Term Health Effects of Methamphetamine Use in the MACS

描述(由申请人提供)：本研究项目的首要目标是确定在参与多中心艾滋病队列研究(MACS)的现有男男性行为者(MSM)中使用甲基苯丙胺(以下简称“冰毒”)对健康的长期影响。更具体地说，这项提案侧重于兴奋剂滥用对心理健康、药物滥用和艾滋病毒感染交叉出现的健康问题的影响。男男性接触者中使用冰毒已成为日益重要的行为风险因素，与艾滋病毒和其他生物-心理-社会健康问题的共同流行有关。然而，MSM中的冰毒研究一般仅限于横断面研究或相对短期的队列研究。因此，我们对冰毒开始使用的预测因素、冰毒使用如何导致长期健康后果的具体机制、兴奋剂使用是否对少数MSM产生独特的健康后果、或者冰毒使用是否会导致HIV+MSM中较差的健康结果的理解仍然不明确。这些差距抑制了我们有效应对男男性接触者中使用冰毒对健康造成的后果的能力。这项提案的具体目的是确定男男性接触者中使用和/或滥用冰毒的前驱因素，确定男男性接触冰毒的共病发展，测试物质使用是否会在少数族裔男性中引发艾滋病毒风险，并测试在HAART时代，冰毒使用是否会加速艾滋病毒阳性男性的疾病进展。使用现有的队列将使我们能够严格审查冰毒使用对健康的长期影响，其方式不仅在财政支出方面具有成本效益，而且在及时性这一更为重要的经济方面也是如此。

DESCRIPTION (provided by applicant): The overarching goal of this research project is to determine the long-term health effects of methamphetamine (hereafter "meth") use within an existing cohort of men who have sex with men (MSM) participating in the Multicenter AIDS Cohort Study (MACS). More specifically, this proposal focuses on the stimulant abuse effects on health issues that occur at the intersection of mental health, drug abuse and HIV infection. Meth use among MSM has become an increasingly important behavioral risk factor associated with co-occurring epidemics of HIV and other biopsychosocial health problems. However, meth research among MSM has generally been limited to cross-sectional or relatively short-term cohort studies. Therefore our understandings of the factors that predict initiation of meth use, the specific mechanisms of how meth use results in long term health consequences, whether stimulant drug use has unique health outcomes among minority MSM or whether meth use results in poorer health outcomes among HIV+ MSM remain poorly defined. These gaps inhibit our ability to respond effectively to the health consequences of meth use among MSM. The Specific Aims of this proposal are to identify the precursors of meth use and/or abuse among MSM, to identify the development of co-morbidities among MSM meth users, to test whether substance use drives HIV risk among minority men and to test whether meth use hastens disease progression among HIV-positive men in the HAART era. The use of an existing cohort will allow us to rigorously examine the long-term health effects of meth use in ways that are not only cost-effective in terms of financial expenditures but also in terms of the even more important economic dimension of timeliness.