CONFERENCE TO FOCUS ON 'COMPREHENSIVE CARE'

Organizers Want To Explore Mix Of Drug, Unsafe Sex, HIV

A two-day conference later this month in Salt Lake City is expected to draw
about 900 healthcare workers, law enforcement officials and researchers to
explore the growing epidemic of methamphetamine use and its impact on HIV
and hepatitis.

Planning for the First National Conference on Methamphetamine, HIV &
Hepatitis, set for Aug. 19-20, began as a way to respond to a belief that
increased meth use will lead to higher HIV and hepatitis rates, according
to Luciano Colonna, executive director of the Harm Reduction Project, which
is playing host to the conference.

"We were alarmed by the heath risks associated with the spread of
methamphetamine," Colonna said. "But we were also very concerned at the
lack of infrastructure in rural areas of the U.S. when it came to dealing
with issues like HIV and hepatitis, and also just the basic fiscal toll and
care toll that outbreaks for methamphetamine use could have on communities."

By gathering together groups that address meth use, Colonna said he hopes
to create a better understanding of the "continuum of care" that includes
treatment, prevention, harm reduction and law enforcement.

Dangerous mix Several of the conference's presentations discuss meth's
impact on gay men, including sessions on meth use and sexual risk for men
who have sex with men, meth dependence and treatment among gay men and a
"Tweaking Tips for Party Boys" discussion by Michael Siever, director of
the Stonewall Project at the University of California, San Francisco.

Recent studies show that 15 percent to 17 percent of gay men used meth in
the last three months and as many as 20 percent have used in the last year,
according to Gordon Mansergh, a senior behavioral scientist at the Centers
for Disease Control & Prevention who plan to take part in the conference.

Mansergh also said research drew links between men who have sex with men,
meth use and unprotected sex.

"What we see in over a dozen studies is that meth users exhibit greater
rates of unprotected anal sex than non meth users," he said.

Mansergh added that in a study of MSM meth users in Southern California,
the No. 1 reason for using meth was to increase sexual experience.

Michael Shernoff, a professor at the Columbia University School of Social
Work who is scheduled to present at the conference, is author of the
upcoming book "Without Condoms: Unprotected Sex, Gay Men and Barebacking."

"A lot of men who might not initially be bottoming, I've heard this from
dozens of men, that crystal makes people instant bottoms," Shernoff said.
"It increases anal sensitivity. It puts them in a position where they can
be at risk to getting the virus."

Shernoff said when gay men mix sex, meth and erectile dysfunction drugs
like Viagra, the combination can be dangerous.

"We have research that says a lot of people who use crystal who used to
suffer from crystal dick are using Viagra or one of its sister drugs and
are no longer having erectile problems. People who were not able to get it
up can get it up and are doing things under crystal that lead to high risk
behavior," he said.

Shernoff said current safer sex messages that promote condom use in each
sexual encounter are no longer effective. Harm reduction techniques, such
as strategic positioning or making sure the HIV-positive sexual partner
bottoms, may be a better message for preventing HIV infections, he said.

Likewise, Colonna said current anti-meth campaigns aren't effective and
that harm reduction is a more reasonable path toward change.

"Meth equals death, I don't think is a good campaign. I don't think it's
going to stop someone from using meth," Colonna said. "For a lot of people,
meth use is a rite of passage and it really does increase sexual pleasure."