METH ABUSE ELEVATES HIV CRISIS FOR GAYS

Drug's Link to Unsafe Sex Stokes Experts' Concerns, Propels AIDS Education
Efforts.

When Patrick Smith started using methamphetamine, he quickly found
that sex and the potent drug - which gay men call Tina or Crystal
- - became hopelessly connected.

Whenever he had sex, he wanted meth. Whenever he was high on meth, he
wanted sex.

A methamphetamine user since he was 16, Smith spent years having
anonymous, unprotected sex while high. He took the drug whenever he
could. He hooked up with male partners - he has no idea how many -
at large dance parties and at all-night sex clubs.

Smith ran out of money and prostituted himself. He was hospitalized
about six times after overdosing on combinations of drugs. Meth was
always in the mix.

One morning about two years ago, Smith woke up in his living room
after a meth binge. His head was gashed and bleeding. Shattered glass
lay everywhere.

"My head had crashed through a glass table, and I didn't remember any
of it," said Smith, 24.

He checked into a yearlong drug rehab program. After medical tests,
counselors told him he had contracted HIV, the virus that causes AIDS.
He believes he contracted the disease while having sex with strangers
while on meth.

According to a new study of gay men in San Francisco by the U.S.
Centers for Disease Control and Prevention, men who used meth were
twice as likely to have unprotected sex as those who did not. Another
study, by the San Francisco Department of Public Health, found that
men who used meth were more than three times as likely to be
HIV-positive.

Gay health organizations in San Francisco and New York have launched
public awareness campaigns warning about meth use and HIV transmission
through risky sexual behavior.

Smith is one of a growing number of young gay men in Atlanta who
believe they contracted HIV after meth abuse and risky sex. But in
metro Atlanta, which has the largest concentration of gays in the Deep
South, AIDS groups have not yet started meth-specific education
campaigns. The problem, however, has become a crisis, say some
therapists and medical experts who treat gay men.

"They are taking outrageous risks," said John Ballew, an Atlanta
therapist who says two-thirds of his clients are gay men. "It has
really become associated with the fast-lane night life among certain
gay men. My professional take on it is, the problem is just as bad as
[in] New York or San Francisco or Los Angeles."

Meth use among gay men in Atlanta is "really, really insidious," said
Michael Dubin, a counselor whose clients are all gay men. "From what I
am hearing from friends and from clients, it is a lot more extensive
than any of us would like to think, especially in the club scene. And
it leads to people throwing caution to the wind --- when they know
better."

Dr. Sanjay Sharma, a psychiatrist at Grady Health System's infectious
disease program, said the drug's use among gay men has become a
serious health concern. "A lot of these substances, crystal meth in
particular, are associated with euphoria and hypersexuality," he said.
"And along with that, increased sexual risk-taking behaviors, and then
an overall impaired judgment. That's not a good combination of effects."

Many gay men have never tried methamphetamine. Some have only
experimented briefly with the drug. But a minority of gay men
habitually abuse the drug during sexual encounters with multiple
partners. For these men, meth use has become part of sex.

Meth, a psychostimulant that excites pleasure centers in the brain,
makes users feel euphoric for hours. The drug impairs judgment, lowers
inhibitions, keeps people awake for days, and can increase sexual arousal.

"They go from feeling like wallflowers to feeling like supermen,"
Ballew said. "Safer sex messages are just forgotten."

Many men have told Ballew the drug is rampant in their social circle.
"This drug has become almost normalized in the community," he said.
"It's hard to see how it could become more of a problem."

Decades of Drug Abuse

Methamphetamine has been abused in the United States for decades,
especially on the West Coast. The drug can be snorted, injected,
swallowed and smoked, and some gay men insert it anally.

The meth crisis among gay men is occurring in tandem with a dramatic
surge in meth use by heterosexuals, especially in rural areas across
Georgia and the nation. The potent, cheap drug is the leading
illegally manufactured drug in the nation, according to the U.S. Drug
Enforcement Administration.

Meth abuse among urban, rural and suburban heterosexuals has increased
crime and caused enormous health and social problems. But the drug use
among heterosexuals has not been as associated with risky sexual
behavior as it is among young gay men living in cities like Atlanta.

Smith said he had sworn off meth and other illegal drugs since he fell
through the table. But he said the allure of the drug was powerful.

"It gives people a way to have sex for hours and hours and hours,"
said Smith, who grew up in Marietta and now lives in Decatur. "It's
the greatest euphoria you can ever feel."

'Party and Play'

Meth is so linked with this subculture of gay men engaging in
anonymous sex with strangers that men advertise either that they have
the drug or want it during sex in personal ads and on the Internet.
Their notices carry the phrase "PnP" for "party and play," a euphemism
for crystal methamphetamine and sex.

"People will have what they call Tina sex parties," said Danny
Sprouse, coordinator of HIV prevention and mental health services for
gay and bisexual men at Positive Impact Inc., an Atlanta nonprofit
that counsels people with HIV. "They may set up some rules at the
beginning to say, 'You can only have safe sex.' So they'll have a lot
of condoms available."

Or they may have Tina parties where condoms aren't even allowed,
Sprouse said, "where they say, 'We're only going to have unsafe sex.'"

Even at condoms-only Tina parties, men don't always use protection as
the drug kicks in and the night wears on, he said.

John, a 36-year-old gay man who lives in Midtown, said he wished he
had never touched the stuff.

"On Tina, you make bad judgments about safe sex, about your life,
about just about everything," he said.

John asked that his last name not be published. He has known since
1997 he is HIV-positive. He used meth for more than 18 months until he
quit, with great difficulty, this Jan. 1, he said.

While on methamphetamine, he frequented all-night Atlanta sex clubs
and often had anonymous, unprotected sex with men who also were high
on the drug, he said.

"I think there's a possibility that I may have infected someone. I
couldn't tell you who," John said. "And I have the feeling that the
people that I did have unprotected sex with had already had
unprotected sex with other people, so there's no way for them to know
if it would have been me or someone else."

Clubs Encourage Safety

All-male clubs in Atlanta, such as the bathhouse Flex, generally have
policies banning drugs on the premises, distribute free condoms, and
encourage their patrons to use protection.

At Flex, if a customer is discovered using or selling drugs, "we
revoke their membership and immediately dismiss them from the
property," said Charles Fleck, who lives in Miami and owns a chain of
male bathhouses including Flex in Atlanta.

Gay men are much more likely to associate meth with sex, though
prolonged abuse of the drug has been known to affect a man's ability
to maintain an erection, according to Michael Siever, founder and
director of the San Francisco-based Stonewall Project, which counsels
gay and bisexual men about the risks of abusing methamphetamine.

Immune System Hurt

Researchers have found that meth abuse also wears on the immune
system, making it more dangerous for men with HIV.

Some researchers have said the drug also adversely interacts with HIV
medications.

Meth use and attendant HIV transmission has become such a concern in
New York City that Gay Men's Health Crisis, one of the nation's
largest gay AIDS/HIV groups, has launched a major education campaign
there. The organization is putting up billboards, sending out
mailings, sponsoring workshops and dispatching counselors into the
community to talk about meth abuse and HIV.

"We want to cut the chain link between using crystal, impaired
judgment, risky sex and HIV transmission," said Eric Altman, a GMHC
associate director.

While no such methamphetamine education program is under way in
Atlanta, AID Atlanta has launched a program that includes passing out
condoms at gay clubs.

"I'm not telling them what to do as far as how many sex partners they
have," said Michael Clifford, an HIV prevention specialist with AID
Atlanta who visits the clubs. "What I am telling them - or asking
them to consider and think about - is the way that they practice
their sex, to protect themselves."

'Just One Weekend'

Sprouse said several of his clients at Positive Impact believed they
contracted HIV after having unsafe sex while they were high on meth.

One client was diagnosed with the virus after only one weekend of meth
use and sex, he said. The man, whom Sprouse described as shy,
churchgoing and in his mid-20s, told him he had had "very limited"
sexual experience and had practiced only safe sex before that weekend.

"Some friends of his introduced him to Tina on a Thursday evening,"
Sprouse said. "He started using Tina that night and stopped on Monday
morning. . . . He lost count over the weekend when he hit having sex
with 12 men."

About a month later, the man "developed a flulike syndrome, went and
got tested, and was HIV-positive," Sprouse said. "He came in clearly
overwhelmed. In his mind he was thinking this was just one weekend.
One weekend, and it has impacted him for the rest of his life."

By the end of last year, John, the HIV-positive man in Midtown, was
using meth every day, a habit that cost him about $250 a week, and he
had quit his job.

He also had stopped taking his HIV medications.

"I was like, 'I'm just going to let it take me down. I'm just going to
keep doing it until it kills me.' "

He also was imagining voices. "They would repeat everything I thought.
They would make fun of me."

One night at home, enraged at the voices in his head, John took a
black marker and wrote --- over and over --- on a white leather chair,
"They stole your mind."

He keeps the chair in his bedroom as a personal warning: Stay away
from Tina.

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MORE INFORMATION

Some groups to contact regarding meth abuse in the gay community
include:

AID Atlanta

1438 W. Peachtree St. NW

Suite 100

Atlanta, GA 30309-2955

404-870-7700

Georgia AIDS & STD Infoline: (800) 551-2728

www.aidatlanta.org

Gay Men's Health Crisis

The Tisch Building

119 W. 24 St.

New York, NY 10011

212-367-1000

www.gmhc.org/

The Stonewall Project

3180 18th St.

Suite 202

San Francisco, CA 94110

415-502-1999

www.tweaker.org

Positive Impact Inc.

Danny Sprouse

159 Ralph McGill Blvd.

Suite 605

Atlanta, GA 30308

404-589-9040