Loneliness, Methamphetamine Use, and Cardiovascular Risk Factors Among Sexual Minority Men in the COVID-19 Era

Emily J Ross; Daniel E Jimenez; Delaram Ghanooni; Armando Mendez; Sabina Hirshfield; Keith J Horvath; Britt DeVries; Samantha E Dilworth; Adam W Carrico; Claudia A Martinez

doi:10.1007/s12529-024-10288-0

Loneliness, Methamphetamine Use, and Cardiovascular Risk Factors Among Sexual Minority Men in the COVID-19 Era

Int J Behav Med. 2024 Apr 29. doi: 10.1007/s12529-024-10288-0. Online ahead of print.

Authors

Affiliations

¹ Department of Public Health Sciences, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
² Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Suite 1436, Miami, FL, 33136, USA.
³ Department of Public Health Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Miami, FL, 33136, USA.
⁴ Division of Endocrinology, Diabetes and Metabolism and the Diabetes Research Institute, Department of Medicine, University of Miami Miller School of Medicine, 1450 NW 10 Ave, Miami, FL, 33136, USA.
⁵ Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
⁶ Department of Psychology, San Diego State University, Alvarado Court, San Diego, 6363, CA, USA.
⁷ Department of Medicine, Center for AIDS Prevention Studies, University of California San Francisco, 550 16 Street, San Francisco, CA, 94158, USA.
⁸ Cardiovascular Division, Department of Medicine, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA. cmartinez5@med.miami.edu.
⁹ Department of Cardiology and Interventional Cardiology, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL, 33136, USA. cmartinez5@med.miami.edu.

PMID: 38684565
DOI: 10.1007/s12529-024-10288-0

Abstract

Background: Important gaps exist in our understanding of loneliness and biobehavioral outcomes among sexual minority men (SMM), such as faster HIV disease progression. At the same time, SMM who use methamphetamine are approximately one-third more likely than non-users to develop cardiovascular disease. This study examined associations of loneliness, stimulant use, and cardiovascular risk in SMM with and without HIV.

Method: Participants were enrolled from August 2020 to February 2022 in a 6-month prospective cohort study. The study leveraged self-report baseline data from 103 SMM, with a subset of 56 SMM that provided a blood sample to measure markers of cardiovascular risk.

Results: Loneliness showed negative bivariate associations with total cholesterol and LDL cholesterol in the cardiometabolic subsample (n = 56). SMM with methamphetamine use (t(101) = 2.03, p < .05; d = .42) and those that screened positive for a stimulant use disorder (t(101) = 2.07, p < .05; d = .46) had significantly higher mean loneliness scores. In linear regression analyses, negative associations of loneliness with LDL and total cholesterol were observed only among SMM who used methamphetamine.

Conclusion: We observed lower cholesterol in SMM reporting loneliness and methamphetamine use. Thus, in addition to the observed associations of loneliness with cholesterol, there are important medical consequences of methamphetamine use including cardiovascular risk, higher HIV acquisition risk and progression, as well as stimulant overdose death. This cross-sectional study underscores the need for clinical research to develop and test interventions targeting loneliness among SMM with stimulant use disorders.

Keywords: HIV; Loneliness; Sexual minority health; Social isolation; Stimulant use.

Abstract

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