Investigating associations between methamphetamine use, mental health and risky sexual behaviours amongst Aboriginal and Torres Strait Islander peoples

Aboriginal and Torres Strait Islander communities have expressed significant concern about methamphetamine use and its associated harms. Additionally, there has been an increase in sexually transmitted infection (STI) notifications among Aboriginal and Torres Strait Islander people in recent years. This cross-sectional study explored associations between high STI risk sexual behaviour (HSRSB), methamphetamine and mental health among Aboriginal and Torres Strait Islander people who use methamphetamine. Multivariate logistic regression and population attributable risk that accounts for the correlation structures were used. Participants were 224 Aboriginal and Torres Strait Islander men (52%) and 209 women (48%). Those who used methamphetamine weekly or more were more than twice as likely to engage in HSRSB, compared to those who used methamphetamine less frequently (i.e. > weekly) (aOR: 2.10, 95% CI: 1.13, 3.90, and 2.73, 95% CI: 1.52, 4.93 for males and females respectively). Among other drugs, using ecstasy was also significantly associated with HSRSB in both genders (aOR: 3.97, 95% CI: 1.17, 13.42 and aOR: 5.32, 95% CI: 2.05, 13.82 for males and females). The combined impact of mental health conditions was substantially higher among females than males (PAR%: 46% and 27%, respectively). The findings may inform the targeting of health promotion programs for STI prevention towards those at higher risk due to methamphetamine use and mental health issues.