The National Institute on Drug Abuse has awarded UCLA a $7 million grant to investigate the links between substance abuse and HIV among Latino and African-American men who have sex with men.
Researchers will examine how non-injected drugs and alcohol can directly interact with the virus and other infectious diseases, to damage these men's health. Enrollment in the study begins in January.
Called MASCULINE (MSM and Substances Cohort at UCLA Linking Infections Noting Effects), the study will be led by Pamina Gorbach, a professor of epidemiology at UCLA's Fielding School of Public Health and a professor of infectious diseases at the David Geffen School of Medicine at UCLA, and Steven Shoptaw, a professor of family medicine at the Geffen School and director of the UCLA Center for Behavioral and Addiction Medicine.
For the study, researchers will establish and maintain an extensive repository of tissue, blood and fluid samples. This repository will be headed by Dr. Peter Anton, a professor of digestive diseases at the Geffen School. Anton, Gorbach and Shoptaw are also members of the UCLA AIDS Institute.
"Alcohol, non-injection use of cocaine and methamphetamine are linked to HIV sexual risk behaviors and transmission of infectious disease," Gorbach said. "But little is known about how these substances can affect biology to produce health threats among those living with or at risk for HIV - especially among minority men who have sex with men."
MASCULINE will be a companion study to the Multisite AIDS Cohort Study, the first and largest study specifically created to examine the natural history of AIDS. It will be conducted through the Fielding School's Behavioral Epidemiology Research Group.
A team of clinical researchers, epidemiologists and basic scientists will collaborate to examine the direct effects of drug use on HIV acquisition and treatment, with the primary aim of determining whether and how the use of stimulants and other substances impacts the transmission of HIV and other infections among minority males who have sex with men whose HIV is poorly controlled or who are at high risk of being infected with the virus.
The study will involve a cohort of young substance users - particularly users of stimulants - who have poor histories of adhering to antiretroviral treatment, allowing researchers to test the biological influences of substances on immune function.
Findings from this unique cohort will shed light on the effects of substance use on the behaviors and clinical outcomes of both HIV-positive and high-risk, HIV-negative minority men that can ultimately be used to improve access to HIV prevention, treatment and care.
The epidemic of HIV among minority men who have sex with men in Los Angeles County, as well as in the U.S. as a whole, may be driven by the effects of drug use on individuals' adherence to their treatment regimens and on biobehavioral prevention, and it may be enhanced by network effects, the researchers said.
"This cohort is central to prevention and treatment efforts and will provide well-characterized, extensive repository samples for leveraged use with other cohorts, networks and individual's studies," Shoptaw said. "This unique cohort will facilitate studies on interactions between substance use and HIV progression and transmission, which are of critical public health significance."
The L.A. Gay and Lesbian Center will be one of the community sites for recruitment of HIV-positive participants for the study; the UCLA Vine Street Clinic will recruit HIV-negative participants.