Can Methamphetamine Use and HIV be Risk Factors for COVID-19?

The co-occurrence of methamphetamine use and HIV – two intertwining epidemics – could create double jeopardy for the coronavirus disease 2019 (COVID-19) pandemic among men who have sex with men, according to a newly published commentary in AIDS and Behavior.

“We raise the possibility that the combination of methamphetamine use and HIV represents a ‘perfect storm’ for the COVID-19 pandemic in men who have sex with men,” said Adam W. Carrico, Ph.D., associate professor in the University of Miami Miller School of Medicine, who was the lead author on the commentary.

A collaborative group of experts from San Diego’s State University’s Department of Psychology, the City University of New York Graduate School of Public Health, Northwestern University’s Feinberg School of Medicine, and the State University of New York – Downstate Health Sciences University, served as co-authors along with Dr. Carrico.

In the commentary, they provide an overview of biological and behavioral risks of co-occurring methamphetamine use and HIV for the COVID-19 pandemic.

They include: 

• Methamphetamine and HIV could synergistically enhance immune dysregulation, increasing the risk for infection with the novel coronavirus (SARS-CoV-2) and promoting COVID-19 progression. This is partially supported by prior research from Dr. Carrico’s laboratory demonstrating that recent use of stimulants, such as methamphetamine, is associated with amplified immune dysregulation in people receiving effective HIV treatment. 
  • AIDS: Substance-associated Elevations in Monocyte Activation Among Methamphetamine Users With Treated HIV Infection
  • Brain, Behavior, and Immunity: Recent Stimulant Use and Leukocyte Gene Expression in Methamphetamine Users With Treated HIV Infection
  • Journal of Neuroimmune Pharmacology: Psychosocial Correlates of Monocyte Activation and HIV Persistence in Methamphetamine Users

• Methamphetamine users could experience greater difficulties in adhering to COVID-19 social distancing guidelines. There are reports, for example, of COVID-19 clusters from a recent Miami circuit party, emphasizing the need for research that will examine substance use and other behavioral correlates of adherence to social distancing guidelines.

• Barriers to engagement in HIV care as well as substance use disorder treatment, which could increase the risk for unsuppressed HIV viral load and stimulant relapse.

• Chronic stress related to COVID-19 that could exacerbate psychiatric disorders and increase the risk for the SARS-CoV-2 infection.

• The use of alcohol and substance use could be triggered by COVID-19-related stress and social isolation and increase the risk for the SARS-CoV-2 infection.

• Identify a clear need for scalable, mHealth interventions to address the psychiatric burden of the COVID-19 pandemic in order to optimize adherence to social distancing guidelines is imperative.
  • Carrico is currently leading a National Institute on Drug Abuse-funded randomized controlled trial to test the efficacy of a mHealth intervention for this population in collaboration with Dr. Keith Horvath from San Diego State University, and Dr. Sabina Hirshfield from the State University of New York – Downstate Health Sciences University, who will serve as multiple principal investigators. More information about the project can be found here.

These risks emphasize the urgent need for further research to halt the COVID-19 pandemic and to further protect high priority populations like those with co-occurring meth use and HIV.

Read the full commentary on AIDS and Behavior here.

Written by Amanda Torres

Published on April 8, 2020