DRUGS TIED TO GAYS' STD SURGE

HIV, VD Rates Rise Among Users Of Meth And Viagra

The drugs methamphetamine and Viagra and the Internet appear to be fueling
recent increases in HIV and syphilis among gay men, complicating efforts to
reduce both diseases.

Some of those factors also are associated with gonorrhea, for which
drug-resistant strains are rapidly emerging among gay men, researchers say.

And while syphilis and gonorrhea rates are down among heterosexuals, the
rise in HIV among African-Americans serves as a reminder diseases often
don't stay cloistered in certain groups.

"It also should wake people up in the general community," said Dr. Kenneth
Mayer of Fenway Community Health in Boston. "They may be impacted by these
increases over the next few years."

The new findings about sexually transmitted diseases, along with Mayer's
warning, came Wednesday at the National STD Prevention Conference in
Philadelphia, co-sponsored by the Centers for Disease Control and Prevention.

Reports of HIV among gay men have increased 17 percent since 1999, after
more than a decade of decline in AIDS cases. Syphilis rates, which dropped
steadily among Americans during the 1990s, have gone up the past three
years, and men who have sex with men account for nearly two-thirds of new
cases.

Researchers say "AIDS fatigue" and the awareness of new treatments for HIV
have led some men to become careless about sex.

New studies suggest that drugs and the Internet also play a role --- and
that new programs must be implemented to combat the widening range of risk
factors.

"Efforts on multiple fronts, with community involvement all along the way,
is critical," said Dr. Gordon Mansergh, a CDC behavioral scientist.

About 16-17 percent of gay men at STD clinics in some cities use
methamphetamine, researchers found.

In a San Francisco study, gay men who used meth --- which causes inhibition
and feelings of euphoria --- were twice as likely to have unprotected sex.
Those taking Viagra, which sustains an erection, were almost seven times as
likely not to use condoms.

In a separate study in San Francisco, gay men who used meth and Viagra were
six times as likely to have syphilis, which can cause sores on the genitals
or mouth and lead to blindness, paralysis and death if untreated.

Another study found that gay men using meth were more than three times as
likely to have HIV.

"Methamphetamine use in gay men is an extraordinarily powerful determinant
of HIV infection," said Hunter Handsfield, director of the STD control
program at the Seattle/King County Health Department.

Nearly a fourth of gay men with early-stage syphilis in Los Angeles had met
sex partners on the Internet, and gay men with syphilis in San Diego were
much less likely than straight men to have contact information for their
partners, making it more difficult to notify them to get tested, other
studies said.

Men who used the Internet to find sex partners were more likely to have HIV
and have anonymous sex.

Researchers also found that gay men with HIV have higher rates of syphilis
and gonorrhea, which causes a burning sensation while urinating and can
lead to infertility.

Gonorrhea is becoming more difficult to treat, with cases among gay men in
Seattle increasingly resistant to the antibiotic ciprofloxacin.

That is a problem that could easily jump to the general pop-ulation, noted
Dr. Ron Valdiserri, deputy director of the CDC's National Center for HIV,
STD and TB Prevention.

Referring to the resistant gonorrhea issue and the general findings about
increasing STD rates among gay men, Valdiserri said: "CDC is very concerned
about this."

Researchers said new STD prevention programs are being developed to target
gay men, such as testing people outside bars, offering vouchers for free
tests at clinics, allowing men to make testing appointments over the
Internet and using "social marketing" to raise awareness of diseases.

But Valdiserri said society's reluctance to talk about STDs and the belief
that the diseases are not serious make it difficult to attack them. "We
have a double-headed challenge," he said.