HIV-1 Infection is associated with adverse outcomes in endocrine systems. Illicit drug abuse is a major risk factor for contracting HIV-1 infection and is also associated with abnormal endocrine outcomes. Several studies including ours have reported exacerbated endocrine abnormalities among drug abusing HIV-1+ individuals. But these investigations have been carried out among cocaine and/or opioids addicts, and the culture of drug abuse in the United States is changing. Methamphetamine (meth) is becoming a drug of choice all over the country and its abuse in South Florida particularly among MSM has skyrocketed. There is, however, a scarcity of investigations on the impact of methamphetamine on endocrines in HIV-1 infection. It is hypothesized that adrenal activity will be increased, there will be a hyper activity of thyroid as well as an increased incidence of insulin resistance, among HIV-1+ meth abusing MSM. In order to test these hypotheses, this 5 year application proposes to investigate cross sectionally adrenal, thyroid, and insulin activity in a total of 450 men in three groups: HIV-1+ meth abusers (n=150), HIV-1- meth abusers (n=150), HIV-1 - non-meth abusers (n=150) distributed among African Americans, Caucasians, and Hispanics. Because of the planned focus on MSM, only men will be included in the study. The following are aims:
Aim 1 : To investigate adrenal activity (ACTH and cortisol levels) as well as response to the combined dexamethasone-CRH challenge among meth abusing-HIV-1+ MSM, meth abusing HIV-1- MSM and HIV-1- meth-free control participants.
Aim 2 : To investigate thyroid activity (TSH, T4 and T3) as well as thyroid antibodies among meth abusing-HIV-1+ MSM, meth abusing HIV-1- MSM and HIV-1- meth-free control participants.
Aim 3 : To explore insulin activity among meth abusing-HIV-1+ MSM;meth abusing HIV-1- MSM and HIV-1- meth-free control participants. These endocrine disturbances may lead to enormous burden of a number of serious medical consequences and outcomes in meth abusing MSM and further allow developing suitable interventions.

Public Health Relevance

Methamphetamine (meth) abuse particularly among MSM in South Florida has skyrocketed. Although endocrine outcomes in HIV-1 infection as well as drug abusers with HIV- 1 infection have been investigated, there is scarcity of information regarding such outcomes in HIV-1+ meth abusing MSM. This proposal investigates adrenal, thyroid and insulin activities in this population. It is proposed that adverse endocrine outcomes may result in an enormous medical burden.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Research Project (R01)
Project #
5R01DA031201-03
Application #
8423064
Study Section
NeuroAIDS and other End-Organ Diseases Study Section (NAED)
Program Officer
Khalsa, Jagjitsingh H
Project Start
2011-04-01
Project End
2016-01-31
Budget Start
2013-02-01
Budget End
2014-01-31
Support Year
3
Fiscal Year
2013
Total Cost
$572,711
Indirect Cost
$189,951
Name
University of Miami School of Medicine
Department
Psychiatry
Type
Schools of Medicine
DUNS #
052780918
City
Coral Gables
State
FL
Country
United States
Zip Code
33146
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