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The global epidemiology of methamphetamine injection: A review of the evidence on use and associations with HIV and other harm

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Author: Louisa Degenhardt, Bradley Mathers, Mauro Guarinieri, Samiran Panda, Benjamin Phillips, Steffanie Strathdee, Mark Tyndall, Lucas Wiessing, Alex Wodak, on behalf of the Reference Group to the United Nations on HIV and injecting drug use

Resource Type: Working papers/discussion papers

Amphetamine type stimulants (ATS) have become the focus of increasing attention worldwide because of a substantial increase in the production of these drugs over the past decade, and increasing consumption and harm related to their use, particularly dependence and “drug-induced” psychotic episodes.

There has also been understandable concern about whether associations between ATS use and HIV risk are causal. The debate about this possibility – heavily concentrated in North America – has focused largely upon risky sexual behaviour, namely unprotected anal intercourse (UAIC), among men who have sex with men (MSM).

To our knowledge, there has been no review of the global epidemiology of ATS use, injection, and HIV prevalence. Most global reviews of illicit drug use have placed greater focus upon the injection of opioids. In the present report, we review the existing literature (peer reviewed and grey) on the epidemiology of use and injection across the globe, and the prevalence of HIV and HCV among users. We also summarise evidence on the extent and nature of the risks and consequences of use.