• By Michael Smith, MedPage Today
[27 August 2007]
EVEN IN THE rural southeast, a high proportion of gay men are using crystal methamphetamine, a drug that promotes risky sexual behavior, researchers said.
But a study of 1,189 gay men in North Carolina reveals some surprising facts about the crystal meth users among them – including a generally higher level of education – as well as a cautionary tale about combining drugs and sex, according to Scott Rhodes, Ph.D., of Wake Forest Baptist School of Medicine here, and colleagues.
The study, reported in the August issue of AIDS Patient Care and STDs and conducted through interviews online and face-to-face at gay bars, showed that 6% of the participants had used the drug within the past 30 days.
While that's lower than observed among gay men in urban centers, the researchers noted, it's sharply higher than the 0.2% of the general population who use the drug.
The researchers also found that participants who reported using the drug were more likely to report being HIV-positive, having a history of STDs, being inconsistent condom users during anal sex within the previous three months, and using medications designed to treat erectile dysfunction.
"Until now, there has been little data on meth use in the southeast," Dr. Rhodes said. "Our findings, including that meth users were more likely to be HIV-positive, suggest that prevention, intervention and treatment efforts are urgently needed."
The researchers interviewed 741 men in five gay bars in 2005, and combined the results of that survey with answers from 448 who completed an assessment online.
The participants were ethnically diverse, with 34.5% identifying themselves as black or African American, 32.1% as white, 24.6% as Hispanic or Latino, and smaller percentages as Hawaiian, Indian, or Asian. The average age was 29.12.
Nearly half of the participants said they had only a high school education or less, while 23.9% said they had a college degree or higher. One fifth reported an annual income of less than $10,000 per year and 24.4% reported $40,000 or more.
But a multivariate analysis comparing the meth users to the majority showed that they were:
• Four times as likely to be HIV-positive. (The odds ratio was 4.1, with a 95% confidence interval from 1.4 to 11.9, which was significant at P=0.009.)
• Four times as likely to have better than a high school education. (The odds ratio was 4.2, with a 95% confidence interval from 3.1 to 6.1, which was significant at P
• By Ryan Lee, Southern Voice
[22 September 2006]
IN NOVEMBER 1999, a young gay man named
Skanda sat in the passenger seat of a car headed cross-country to Atlanta, dreadfully afraid that he was leaving the party behind in Phoenix. “To be honest, I didn’t want to move to Atlanta because I didn’t think crystal meth would be big here, and so I was scared,” said Skanda, who asked that his last name not be used. “Little did I know how huge it would be here — it’s everywhere, and not just with the gay community.”
Like many gay men who use crystal meth, Skanda was introduced to the drug as a powerful stimulant during sex. “It was like you wanted to engage with as many partners as possible,” Skanda said. “And you wanted it to be raw as it possibly could be.” Skanda’s initial fears of living in Atlanta minus crystal meth were erased within weeks upon his arrival, after he discovered a couple of sure-fire locations for him to score the drug. “It was pretty common — if I wouldn’t find it with the drug dealer I could go to the club and easily find,” he said.
During about eight years of using crystal, Skanda lost a dizzying number of jobs, was on the brink of homelessness and had a trio of friends launch an intervention in his sparsely decorated apartment. After hitting bottom once again in 2002, Skanda embraced a 12-step program to fight his addiction, with the help of his yoga instructor and other close friends. “I started losing my mind — I was filled with fear, paranoia and self-hatred,” Skanda said. “I had nothing, I was losing everything all over again, I had been here before, and knew I needed to do something about it.”
Despite the surge in meth use and distribution in Atlanta, the city “is very much behind the times” when it comes to heightening awareness and prevention, according to Brian Dew, an assistant professor in the Department of Counseling and Psychological Services at Georgia State University. “I think the GLBT community — not just Atlanta, but at large — has been quite slow in critiquing behaviours that are not conducive to positive mental health, and some forms of physical health as well,” Dew said.
According to several recent, 65 to 70% of gay and bisexual men in Atlanta has at least one friend who has used crystal, and 75% believe the drug is responsible for the rise in HIV among gay men in Atlanta. Another study indicates that almost four out of every five gay and bisexual men surveyed said they desire more educational campaigns about the risk of crystal. “That says that even within our own community, there is a recognised need to do more,” Dew said. “This is not just a small group of people sitting on the outside saying, ‘Oh, you need to change your behaviour.’”
Atlanta’s location along several interstates has made the city the crystal meth hub of the southeast, and is one of the reasons it “has the fastest growing rates of meth use than any metropolitan area in the country,” according to Dew. Various measures indicate elevations in meth use over the last five years, including emergency room admissions, the amount of confiscated drugs, Drug Enforcement Agency data and the number of people seeking public substance abuse treatment, Dew said.
But whereas crystal meth use was once synonymous with the gay party scene, currently among the state’s most affected regions are rural areas like the foothills of the Appalachian Mountains in north Georgia. “Five years ago, I would’ve said the meth problem, especially in metro Atlanta, had been focused largely in [gay and bisexual men]” Dew said. “I can’t say that anymore.”
One thing that continues to make crystal meth use among gay men worrisome is its impact on the safer sex practices of many users. “We know that just a small amount of meth, even a recreational amount such as using one time a weekend, that individuals are less likely to protect themselves because of the drug’s impact on the limbic system, which controls your reasoning and memory,” said Dew, who also noted the unique circumstances for HIV+ meth users. “Meth reduces the stigmatisation and shame they feel about being HIV+, and it reduces the potential for rejection when they seek out sexual partners,” he said. “They’re also less likely to be able to use a condom, and it’s less likely they’ll be asked to use one.”
As part of her quarterly meet-and-greets with constituents, Officer Darlene Harris, the Atlanta Police Department’s gay liaison, hosted a workshop on crystal among gay men and lesbians on September 26. “We recognised the community wanted a discussion on this,” Harris said. “The police department wants to bring in perspective that there are programs that help — people who want to get help can get help.” •
• By Ryan Lee, Southern Voice
[22 December 2006]
A RECENT STUDY commissioned by the Georgia Department of Human Resources indicates that crystal methamphetamine is perceived as the most problematic drug for gay and bisexual men in Atlanta, as researchers across the country continue to worry about increasing use of crystal meth and its possible impact on the HIV/AIDS rate among gay men.
Some 74% of respondents in the DHR survey – which included interviews with 2,046 local gay and bisexual men in social venues such as bars, Gay Pride and internet chat rooms —-said they believed crystal meth use was on the rise in gay Atlanta.
Some 58% said the drug is either somewhat or very acceptable among gay peer groups. Nearly all respondents – 95% – said they believed crystal meth was causing an increase in HIV infections among the city’s gay and bisexual men.
More than 34% of those who were surveyed ranked crystal meth as the most serious drug problem facing gay men in Atlanta, compared to 19% who said alcohol was the most troublesome substance.
On average, the men who completed a face-to-face interview reported that about 70% of their friends had used crystal meth at least once; that figure climbs to more than 90% for those who completed the DHR survey online.
“Due to the supply of crystal meth in our city, and given the size of the gay male population, the risk for increased rates of use is probable,” said Brian Dew, an assistant professor in the Department of Counseling & Psychological Services at Georgia State University, who conducted the study for DHR.
The study was conducted throughout 2006 and the full results have yet to be released.
Dew estimates that between 10-20% of gay men in Atlanta have tried meth at least once, but notes that his study couldn’t nail down an exact figure because instead of asking individuals about their own drug use, the survey gauged their perception of others’ drug use.
“We wanted to go in bars and social clubs to have people fill out the questionnaires, and in order for us to get into those locations, we were prohibited from asking about individual drugs use,” said Dew, who is gay and co-founded the Atlanta Meth Task Force.
But measuring people’s perception of the meth problem does little to shed light on the actual scope of the epidemic, said Ryan King, a policy analyst for The Sentencing Project, a non-profit organization that lobbies for reform of the nation’s prison sentencing policies. With a seemingly endless stream of media stories hyping the ravages of crystal meth, even people who have never come in contact with crystal meth could consider it an out-of-control epidemic, King said.
“There’s no question the coverage of crystal meth has shaped public opinion,” said King, author of a recent Sentencing Project study entitled The Next Big Thing? Meth in the United States. “I think there’s no question people’s perceptions are going to be affected by the media message,” King said.
National estimates of crystal meth use among gay and bisexual men range between 11-28%, 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.
“Our experts felt that methamphetamine is attractive to many gay men because it makes them feel better in the context of a hostile society,” GLMA Executive Director Joel Ginsberg said.
Routine homophobia can cause low self-esteem or depression in some gay men, who are often exposed not to gay role models or mentors, but to a culture where smoking, drinking and recreational drug use is less frowned upon, according to the GLMA report.
The GLMA report sounds an alarm to the rest of the medical establishment to not write-off meth addiction as hopeless and untreatable, and to existing drug prevention programs to become more culturally sensitive to the unique social and sexual role crystal meth plays for some gay users.
“So many existing treatment programs are not places where people are receptive to honest conversations about gay sexuality,” Ginsberg said. “And so many health care providers are overly stigmatising meth users — being afraid of taking them, and sending out a message of hopelessness.”
Meth-specific prevention programs are in an embryonic stage and remain largely untested. Comprehensive, but tailored prevention programs that combine teaching recovering meth users how to abstain from the drug, offering incentives to remain clean, motivational counseling and traditional strategies such as 12-step programs offer the greatest possibility for success, according to the GLMA report.
Federal law enforcement officials in Georgia sent an e-mail last month to thousands of students in the state’s public and private colleges, warning them of the physical and legal dangers of meth. There are no similar federally funded prevention campaigns targeting gay and bisexual meth users in Georgia, according to Ruth Porter-Whipple, public information for the Atlanta division of the Drug Enforcement Agency. “The majority of our demand-reduction programs target kids,” she said.
Calling attention to the crystal meth problem among gay men without slipping into hysteria is difficult, Ginsberg said. “What’s the right level of alarm? We just really don’t know. It’s not something one needs to be hyperbolic about, but this is a very serious problem.”
Several participants in the GLMA focus groups expressed weariness of so-called “reefer madness” prevention campaigns that use taglines such as Meth=Death to frighten people away from the drug. “There’s always the potential people will write off something if they think it’s exaggerating,” Ginsberg said.
The Atlanta Meth Task Force placed two Meth=Death billboards along Cheshire Bridge Road in recent months, and Dew said the group went for “shock value” to ignite discussion about meth use. “In Atlanta, we don’t have the infrastructure, the community awareness that other cities [in the GLMA focus groups] have, and so we’re not starting at the same place those communities are,” Dew said. “What we’re trying to do is generate interest and discussion, and in doing that, it’s often very helpful to run a provocative ad.” •
