Pubdate: Thu, 10 Nov 2005
Source: Georgia Straight, The (CN BC)
Copyright: 2005 The Georgia Straight
Contact:  http://www.straight.com/
Details: http://www.mapinc.org/media/1084
Author: Guy Babineau

RESEARCH SAY HIV-POSITIVE MEN AT HIGHER RISK FOR METH USE

Beautiful young men dance in the centre of the World. It's almost 3 
a.m. on a Sunday morning and the dance floor at the downtown 
after-hours club is packed. Although the crowd is mixed, there are 
many more men than women, and most of them are gay. If anyone is over 
thirty-five, they hide it well.

These guys must have steady incomes, because the cover charge is $25, 
a can of Red Bull costs $7, and bodies like that don't come cheap. 
(Or easy.) The majority of men dance shirtless. They all have the 
same hairless, buff, porn-star physique, designer jeans that fit just 
so, and perfect hair. Every now and then, someone in the throng lifts 
a small vial to his nose, and sniffs. Is it the party drug K 
(ketamine)? GHB (gamma hydroxybutyrate)? Coke? Maybe it's Tina.

Tina is a circuit-party colloquialism for crystal meth. Throughout 
the year, some well-heeled gay men crisscross North America to attend 
circuit parties, weekendlong events comprising a series of dance 
fests that last all night. From time to time, a few of them engage in 
risky sexual behaviour frequently fuelled by powerful party drugs 
that make you feel like a million bucks. Crystal, which is also 
showing up to some degree in bathhouses, sex-play spaces, and via 
on-line hookups under the acronym PNP (party and play), is the drug du jour.

"It's evil," says gay club promoter Michael Venus over lunch at a 
sidewalk cafe in the West End.

Venus was shocked when he discovered that his best friend had been 
addicted to crystal for years. A drag entertainer and performance 
artist, he was a popular figure in Vancouver's gay nightlife scene.

"I thought he did it occasionally, but he was doing it all the time. 
He hid it really well. People always wondered why he was so 'up' all 
the time, and how he got so much done. But then he started to look 
sick, really sick, and he started to become a different person. He 
was lying and stealing he ended up going back East to recover. We 
talk on the phone sometimes. He's really ashamed."

Venus says he tried it a couple of times, and that was enough. "It 
makes everything fabulous, and you feel like you can do anything. I 
understand why it's addictive. That's why I stopped."

Over the last year, gay men have been singled out with a few other 
groups as particularly prone to addiction, and mainstream news 
stories have associated crystal meth with risky sexual behaviour and 
HIV transmission. In the U.S., many powerful so-called faith-based 
groups have manipulated this supposed link in widely read articles 
attacking the evils of the "homosexual lifestyle". The association of 
crystal meth use with HIV is based primarily on hearsay, and 
potentially dangerous assumptions about its role in risky sex obscure 
other contributing factors.

"The media has overemphasized the use of crystal meth [among gay men] 
to the detriment of good reporting, and it detracts from the impact 
on straight people," says Perry Halkitis by phone from New York.

Halkitis is a research director with NYU's Center for HIV/AIDS 
Educational Studies and Training. He was involved with a yearlong 
study that monitored crystal meth use among 450 openly gay and 
bisexual men in New York City who identified themselves as party-drug 
users. Sixty-five percent of the participants had tried crystal at 
least once in the four months before the study began. By the 
project's end, only 31 percent reported using crystal within the same 
time period. At least one story misconstruing this study hit the 
newswires. It cited some iffy statistics from a few years back 
indicating that five to 25 percent of all gay men used crystal, and 
that the number had skyrocketed to more than 60 percent. The study 
focused on self-identified drug-using gay men, not all gay men, and 
like most news stories, this one did not differentiate between 
one-time use, occasional use, and addiction.

"Overall, among gay men in general, a more realistic figure for 
crystal use is probably 10 to 20 percent, and probably closer to 10," 
Halkitis says.

That number of people toying with a particularly toxic drug in any 
community is large enough to warrant serious concern. That's why 
individuals representing AIDS Vancouver, Vancouver Coastal Health 
Authority, YouthCo AIDS Society, and the BC Centre for Excellence in 
HIV/AIDS (BCCFE) have formed a working group on crystal use among 
Vancouver's gay men, as well as men who have sex with other men but 
don't identify themselves as gay. An outreach campaign--and no one 
has any idea what that means yet--will be administered at Gayway, 
AV's Davie Street drop-in centre for gay men.

"The biggest thing prompting us is the discussion in the [gay] 
community," says Michael Mancinelli, an HIV prevention and awareness 
educator at AIDS Vancouver. "They've seen their friends, lovers, and 
family members affected by it. An epidemic? I don't know."

Dr. Tom Lampinen of BCCFE has some surprising revelations based on 
the centre's multipronged, five-year Vanguard project study of 
several hundred young, HIV-negative gay and bisexual men.

"We saw that the trend toward the increase in unsafe sex is 
statistically independent from the trend toward increasing crystal 
meth use," Lampinen says by phone.

In other words, even if there is some crossover, one does not 
necessarily relate to the other. The Vanguard information is too 
detailed and extensive to relate here, but in a nutshell, Lampinen, 
like Halkitis, figures that crystal use among all gay men (including 
one-time and occasional users) is in the 10- to 20- percent range, 
although he leans toward the higher number. Another related Vanguard 
study indicated that the rate of crystal use is higher among 
HIV-positive men, though not the cause of their infection.

"Let's not ignore the elephant in the room; there's great currency in 
misinterpreting studies that show meth users are two to four times 
more likely to be HIV-positive," Lampinen says. "In fact, most often 
it's the other way around: HIV-positive men are at a two-to four-fold 
risk for using crystal meth."

BCCFE studies show that 8 out of 10 times, these men began using 
crystal after they had acquired HIV infection. Centre studies 
conducted with the British Columbia Centre for Disease Control also 
show that B.C.'s HIV rates among gay men increased 50 percent in 2000 
and have not declined since.

So why have health agencies, as well as community groups at the 
grassroots level, failed for the past five years to respond to 
crystal meth as a substance-abuse problem among gay men, independent of HIV?

Another question gay men in this city need to ask themselves and each 
other is why, aside from the obvious pursuit of pleasure, are a 
substantial number drawn to a habitual use of crystal and other 
confidence- and/or sex-boosting substances. Can it have anything to 
do with self-esteem?

Besides the challenges of living in a homophobic world, gay culture 
pressures men to conform to an unrealistic physical ideal. But one 
day we all wake up to find that we're no longer young, beautiful, and 
at the centre of the world, and no drug in the universe can ever 
change that. Then what?
- ---
MAP posted-by: Beth