HIV & Meth Page 1

"Crystal meth is the newest and most important threat to the HIV epidemic in the U.S."

Dr. James Dilley, Director - University of California-San Francisco AIDS Health Project

Too often, the gay "community" is stereotyped and perceived as one cohesive, consistent, homogenous group. And they aren't. Like any other type of community, there are many different groups or sub-communities within that community. And to show you how much the gay community is like any other type of community, consider the following observations:

So the conclusion is, as a sub-group within a population, either the gay community is a lot more like mainstream society than we care to think, or mainstream society is a lot "queerer" than they're willing to admit. And we're betting most people in mainstream society are going to choose the first hypothesis.

So this section isn't about gays and methamphetamine, it's about HIV & meth which directly involves a percentage of people in the gay community, not the gay community in total. And for those that have anonymously sent us what ostensibly amounts to hate mail about even having a section that deals with the issues we're about to discuss, the 18th century called and they want you to come back where you so obviously belong.

As we mentioned earlier when discussing methods of injection, meth users, particularly intravenous meth users face a strong possibility of contracting diseases such as Hep C when sharing needles. Remember, meth lowers your inhibition level, so the danger and fear of needle sharing tends to fade into the background in your thinking. As you will see, this also applies to risky sex practices as well.

Infection rates for HIV cases during the 1990's were fairly stable, however in the last few years, there's been a spike in new transmissions of the virus across the population as a whole, and in particular among gay and bisexual men. This increase is thought to be attributable to at least two dynamics. One is that attitudes toward HIV have become softer and more complacent, often described as "condom fatigue." People are still practicing safe sex, but it would seem that they're not as vigilant as they were in earlier years.

The second factor involves "club drugs," which is really a bit of a misnomer since these types of drugs are used everywhere in any type of environment. Drugs falling into this category include methamphetamine, typically referred to as "Tina" in the gay community, as well as MDMA (Ecstasy) Ketamine (Special K) and Rohypnol (Roofies) Cocaine is also present to a degree. More and more, these drugs are not used in isolation, but increasingly in combinations. Methamphetamine and Viagra almost go hand in hand.

National estimates of crystal meth use among gay and bisexual men range between 11-28 percent, a rate reportedly more than 10 times higher the general population, according to a recent report published by the Gay & Lesbian Medical Association. The report included findings from several GLMA focus groups and a review of crystal meth research, and suggests that various cultural factors may make gay men may be more susceptible to meth and other drugs. Gay men are by some estimates, 10 to 20 times more likely than the general public to use methamphetamine and four times as likely to become HIV positive.

Meth works in a very powerful combination in the gay community. Within one drug or substance, we have something that increases sexual desire or libido, increases energy levels to act out that increased libido, and lowers your level of inhibition. And in the gay community, where HIV and AIDS are of particular concern, that's obviously a big problem.

Furthermore, a relatively large proportion of gay men have high levels of depression and anxiety disorders, another characteristic of people who have survived emotional trauma. Studies estimate that gay men have about twice the levels of depression than are found in Americans generally. Depression is strongly linked to high-risk behavior, including drug use, alcoholism, and risky sex, and meth is to say the least, an incredible depression lifter. (At least in the beginning.)

So the result is an individual who is incredibly horny, has almost superhuman energy and stamina to feed that need, and now far less inhibited, is willing to engage in unprotected and dangerous sex. It's thought that the probability of "bare-backing" (anal sex without the use of a condom) just about doubles when crystal meth is added to the equation.

For those unfamiliar with male to male sex, someone who is a "bottom" is shall we say, "the catcher" and someone who is a "top" is "the pitcher." Crystal meth users are twice as likely to perform the role of bottom without a condom and they are also twice as likely to test positive for HIV. Meth users are also four times as likely to have syphilis, and 1.7 times as likely to have gonorrhea.

According to a survey conducted in 2006, approximately one in four gay and bisexual men in New York City indicated using meth in the period of six months running up to the study date. In a previous study conducted over 2004 and 2005, this figure was estimated to be 14 percent. If accurate, the new numbers make New York second only to San Francisco as the U.S. city with the greatest number of gay and bisexual men who use methamphetamine.

On the next page, we look at the spread of meth use among the gay community, and why meth is so ideally suited to certain factions within that community.