Biomedical HIV Protection Among Gay and Bisexual Men Who Use Crystal Methamphetamine

  • Mohamed A. HammoudEmail author
  • Fengyi Jin
  • Lisa Maher
  • Adam Bourne
  • Bridget Haire
  • Peter Saxton
  • Stefanie Vaccher
  • Toby Lea
  • Louisa Degenhardt
  • Garrett Prestage
Original Paper


Use of crystal methamphetamine (crystal) among gay and bisexual men (GBM) has been associated with condomless anal intercourse with casual partners (CLAIC) and HIV infection. Pre-exposure prophylaxis (PrEP) and undetectable viral load (UVL) are important biomedical HIV prevention strategies. We investigate the relationship between crystal use and HIV sexual risk behaviours in the context of PrEP and UVL. In 2018, 1367 GBM provided details about crystal use and HIV prevention strategies. Binary logistic regression was used to estimate associations between crystal use and behaviour. Recent crystal use was independently associated with greater social engagement with gay men and having more sexual partners. Crystal use was also independently associated with use of PrEP and UVL among GBM who engaged in CLAIC. Although GBM who used crystal were more likely to have engaged in CLAIC, they were also more likely to use biomedical HIV prevention which mitigates against the risks of HIV infection.


Crystal methamphetamine Gay and bisexual men (GBM) HIV prevention Pre-exposure prophylaxis (PrEP) Undetectable viral load (UVL) 



The study team would like to thank all participants for their continued participation in the Flux Study.

Author Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Mohamed A. Hammoud. The first draft of the manuscript was written by Mohamed A. Hammoud and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.


This work was funded by the Australian Research Council (ARC). ARC grant number: DP140102483. The Kirby Institute receive funding from the Australian Government Department of Health. Lisa Maher is supported by a National Health and Medical Research Council Senior Research Fellowship. Peter Saxton was supported by a New Zealand AIDS Foundation Fellowship. Toby Lea is supported by an Alexander von Humboldt Foundation Research Fellowship. In 2018, this study was partly funded by the Gilead Australia Fellowship: Research Grants Program. Funders had no input in the data collection, analysis, interpretation, or presentation of any findings.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Authors and Affiliations

  1. 1.HIV Epidemiology and Prevention Program, Kirby InstituteUNSW SydneySydneyAustralia
  2. 2.Viral Hepatitis Epidemiology and Prevention Program, Kirby InstituteUNSW SydneySydneyAustralia
  3. 3.Australian Research Centre in Sex, Health and SocietyLa Trobe University, MelbourneBundooraAustralia
  4. 4.Public Health Interventions Research Group, Kirby InstituteUNSW SydneySydneyAustralia
  5. 5.Department of Social and Community Health, School of Population HealthUniversity of AucklandAucklandNew Zealand
  6. 6.German Institute for Addiction and Prevention ResearchCatholic University of Applied SciencesCologneGermany
  7. 7.Centre for Social Research in HealthUNSW SydneySydneyAustralia
  8. 8.National Drug and Alcohol Research CentreUNSW SydneyRandwickAustralia

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