GAYS' RISING METH USE TIED TO NEW HIV CASES

For seven years methamphetamine helped Ron Conner believe he was the
talented, sexy, bold man he had always dreamed of being. The
37-year-old graphic artist would have sacrificed everything to hold
onto that glamorous vision of himself - and, ultimately, he nearly
did.

"I lost my house, two cars, my checking and savings accounts, my
piano, my boyfriend," he said.

"I had sex with guys I knew were [HIV] positive, who said they were
positive, and I just didn't care," he added.

Although Conner, who is sober and working again, did not end up
HIV-positive, such is not the case for many gay meth users.

Health officials and AIDS activists nationwide are alarmed at the
increasing correlation between new HIV diagnoses and methamphetamine
use among gay men.

The drug's ability to heighten arousal and erase inhibitions is
proving a deadly combination - leading to sexual behavior that
increases the chances of infection with HIV and syphilis.

Methamphetamine has been in the gay party mix on the West Coast since
at least the mid-1990s. But, more recently, the trend has pushed east,
galvanizing health officials and gay activists in Houston, Chicago,
Atlanta, Miami and New York. Meanwhile, other circumstances have
conspired to make the flare in use by gay men particularly harmful to
public health.

The Internet has made it easy to arrange liaisons and score drugs from
the safety of home, while erectile dysfunction drugs like Viagra allow
for encounters to last for hours and even days. Meanwhile, activists
said, improved HIV treatment regimes have lulled some gay men,
particularly those who did not experience the AIDS epidemic at its
worst, into lax attitudes toward condom use.

"We've had Ecstasy, pot, acid - but this is the crack of the gay
community," said Jason Riggs, spokesman for San Francisco's STOP AIDS
Project, which recently launched a campaign aimed at casual users and
those tempted to try the drug.

Scientifically linking meth use to the spread of disease is difficult
because multiple factors come into play. But studies in several cities
show that a growing number of HIV-positive men report recent meth use.

One recent Centers for Disease Control and Prevention study based on
San Francisco data showed that use of both meth and Viagra was
connected to a marked increase in unsafe sex. Others have shown that
gay men who use meth are up to three times as likely to test positive
for HIV as those who do not.

"Our hypothesis is that it's due to riskier sexual practices while
using meth," said Dr. Sam Mitchell of the San Francisco Department of
Public Health. "We think it's probably causal."

For those men who inject the drug, shared needles can also increase
the risk of infection.

In Los Angeles County last year, a third of all people recently
diagnosed with HIV reported using methamphetamine, a survey found. The
majority of those people are believed to be men who have sex with men.

That correlation was particularly disturbing because the same survey
found that use of methamphetamine among HIV-diagnosed people had
dropped steadily, from 13% to 5%, between 1990 and 2000, said Doug
Frye, director of the county's HIV epidemiology program.

"Then kaboom! Suddenly it started to take off," Frye
said.

Health officials readily concede that methamphetamine use is not the
sole factor in new HIV cases. However, because men who have sex with
men still lead the nation in new HIV diagnoses, meth use within that
group is of particular concern to federal officials.

Enough correlations have been found across the country to spark a
national CDC meeting on the topic last week.

"We know that among men who have sex with men, meth use has been
associated with high-risk sexual practices," said Jessica Frickey, a
spokeswoman for the agency's National Center for HIV, STD and TB
Prevention. "This is an emerging issue. We want to make sure we have
gathered the people together to talk about where we are and where we
should be going."

Gay activists and local health officials across the country have not
waited for medical data to catch up with what they are seeing up close.

In West Hollywood, San Francisco and New York, they have unveiled
aggressive anti-meth campaigns in the last year to change opinions
about the drug and direct users to treatment programs. Some are
traditional 12-step programs that insist on complete sobriety.

Others, like San Francisco's Stonewall Project, reach out to men who
aren't ready to stop using but want to minimize damage to themselves
and others while under the influence.

"Our community is being destroyed," said Cleve Jones, executive
director of L.A. Shanti, a nonprofit organization that provides
services to people with HIV/AIDS. L.A. Shanti has recently added two
counseling programs for meth users.

"For 10 years I lost loved ones - every week in the papers, there were
three pages of obituaries. I survived all this, and now we're
continuing to be destroyed by this drug," Jones said.

In San Francisco, where one-third of gay and bisexual men are
HIV-positive, the situation is equally grim. The STOP AIDS Project,
which surveys 10,000 gay and bisexual men yearly and has analyzed
county health data, reports that one-fifth of gay and bisexual men in
San Francisco have used speed in the last six months. A third of men
who recently tested HIV-positive had used the drug in the previous six
months, the project found.

The curse of methamphetamine, also called speed, crank, tina and
tweak, is not unique to gay men. As addictive as crack, more powerful
than Ecstasy and cheaper than cocaine, methamphetamine has become the
leading demon in drug treatment programs nationwide.

But meth's inroads into the lives of middle-class, professional gay
men threaten to destabilize gay communities at a time when they have
largely bounced back from the initial ravages of the AIDS epidemic.
Otherwise productive "weekend warriors" who believed that they could
limit their use to special occasions or weekend parties are finding
themselves hooked.

In some cases, they are contracting HIV or syphilis, or realizing that
they have probably infected others. They are losing jobs, friends and
relationships as they sink deeper into addiction.

"It would be hard to find a gay or bisexual man S who doesn't have a
friend or friend of a friend who has dealt with a person in their life
who is a heavy user," Riggs said. Conner is a case in point.

"For two years I was super-creative and super-productive," he said.
"Then everything started to fall apart."

An overdose landed him at Cedars-Sinai Medical Center in L.A. with an
IV in his arm. Then came hallucinations and voices as paranoia set
in.

One night, Conner said, "I heard someone under the floorboards say he
was a Pisces and that I'd dumped him. He was threatening to kill me
and my cat, pointing a gun under our feet as we walked across the
floor. I called the police - I actually called the police - to come
take a look under the building."

He had hit rock-bottom. Soon after, he confessed his addiction to his
father and stepmother who, along with friends, stood by him through
treatment and recovery.

Figuring out how to reach a new generation of meth users has proved
vexing.

Efforts have ranged from in-your-face campaigns to more genteel
approaches promoting a clean life.

"Our current campaign is to tell people there are sexy, glamorous, fit
guys who you might want to meet one day who don't do this, and here's
why," said Dan Carlson of New York's HIV Forum.

One of the group's previous campaigns - "Crystal meth, nothing to be
proud of" - was criticized as "preachy," Carlson said, and some
members of the forum's focus groups said the wave of guilt and shame
that it triggered drove them to use again.

"I have to say, negative responses to an ad are not necessarily bad,"
Carlson said. "We're not here to make people feel good about these
ads; we're here to give people pause and prompt them to think twice
about what they're doing."

Van Ness Recovery House in Hollywood, a treatment center that
specializes in helping gay, lesbian and transgender addicts, includes
anti-meth messages with the condoms it distributes. "Meth wants you
for the long haul. It's not a recreational sport," one reads.

An anti-meth campaign in Los Angeles will enlist owners of gay clubs
and bars along Sunset and Santa Monica boulevards in posting anti-meth
posters in bathrooms and corridors.

"There's a sentiment toward recreational drug use that's accepted,
almost a peer pressure not to talk about it. But we need to," said
Jeff Prang, a West Hollywood councilman.

In San Francisco, Riggs' group plans to place posters in the bathrooms
of 100 gay bars and clubs. "Years of Safe Sex Up in Smoke," reads one.
San Francisco public health officials launched a billboard blitz as
part of the

"Crystal Mess" campaign in the fall. It featured unflattering photos
of gay men on speed. "Your career took up too much time anyway," read
one billboard. "Horny and impotent. What an attractive combination,"
said another.

Conner said he shares his story as a cautionary tale - an anti-meth
billboard come to life.

"Nobody starts using crystal meth thinking, 'I'm gonna become an
addict,' " he said. "But I probably would never have started if I had
better self-esteem."

A message that might have helped him during his depression and isolation,
Conner said, is one that did not stigmatize addiction. "Maybe if I saw a
billboard with, like, 50 men on it, men like me saying, 'I used meth and
kicked it,' then I wouldn't have felt so alone."