Clinicians should ask all patients about their current levels of methamphetamine use. The medical consequences of methamphetamine, particularly the neurologic, dental, and dermatologic sequelae, should be discussed in detail. All HIV risk assessments should include an assessment about whether methamphetamine is contributing to high-risk sexual or drug-using behaviors. All methamphetamine users should receive HIV risk-reduction counseling and condoms; frequent STD screening is warranted, including HIV testing among HIV-negative methamphetamine users. A careful assessment of adherence to ART should be conducted, with close attention to the patient's reported pattern of adherence in the setting of methamphetamine binges. Patients should understand the medical consequences of poor adherence to ART that can result from methamphetamine use.
It is imperative that all methamphetamine-using patients be offered treatment for their substance use. If patients initially are unwilling to participate in treatment programs, at subsequent visits clinicians should continue discussions about drug use and offer treatment referrals. Clinicians should familiarize themselves with the treatment resources in their communities, including whether both abstinence-based and harm-reduction approaches are available, as well as the characteristics (gender, sexual orientation, age) of patients served by specific treatment programs. Careful consideration of the patient's current level of methamphetamine use and receptivity to treatment will help determine the optimal treatment strategy. Although relapse rates are high, it is important to remember that duration of treatment for methamphetamine use is strongly correlated with better outcomes.
The literature review surveys information about the effects of methamphetamine on the user, clinical effects, the relationship between meth and sexual risk/HIV transmission, the possible effects on HIV itself, and options for treatment. It's worth a read. Here's at least one reason why: