Indicators of use of methamphetamine and other substances among men who have sex with men, San Francisco, 2003-2006

BACKGROUND: Substance use has been associated with high-risk sexual behavior among men who have sex with men (MSM) both in the U.S. and around the world. Recent efforts by local organizations in San Francisco have specifically targeted methamphetamine use in this population. METHODS: We tracked methamphetamine and other substance use among men who have sex with men (MSM) in San Francisco from 2003 to 2006 using an indicator available in community outreach surveys of a prevention education program targeting MSM (n=4602). RESULTS: Overall, use of diverse substances tended to decrease from 2003 to 2006, many significantly so. Reported use of methamphetamine significantly decreased among HIV-negative MSM. However, methamphetamine and alcohol use during sex was associated with unprotected potentially HIV serodiscordant sex. CONCLUSION: Intensified prevention efforts to reduce methamphetamine use in San Francisco may be having some impact; however, strong associations of substance use and high-risk sex persist.