METH USE ADDS TO RAVAGES OF AIDS

The powerful, highly addictive drug is growing more popular among
gays, and experts believe it's undermining efforts to promote safe
sex

Keith O'Brien was damaged goods. That's how the former bank executive
felt for years after learning he had the AIDS virus. Until, at last, a
powerful drug temporarily took the psychic pain away.

The drug was methamphetamine, and it erased the heartache of AIDS in a
rush of euphoria. But judgment evaporated with memory, sending the
Chicago resident into a whirlwind of promiscuous sex without
protection, putting scores of sexual partners in danger.

Today, methamphetamine--or meth as it's commonly called--is
threatening long-standing efforts to stem the spread of sexually
transmitted diseases in Chicago's gay community.

"It's the biggest challenge we've faced in two decades," said Mark
Ishaug, executive director of the AIDS Foundation of Chicago.

The risk is stark: Meth is a highly addictive, sex-enhancing stimulant
that dissolves inhibitions. If infected gay men become users and
abandon safe sex, cases of HIV/AIDS could multiply with potentially
devastating results.

"When men with HIV take meth, they're not taking [AIDS] medications as
prescribed ... and [are] transmitting the virus to others who are not
infected," said Dr. Dan Berger, medical director at North Star Health
Care, the largest private HIV treatment center in Chicago. "It's an
unprecedented problem."

The danger was highlighted last month when health authorities in New
York City said a gay man who had developed a rare, highly
drug-resistant strain of AIDS was a meth user and had sex with more
than a hundred partners.

In Chicago, the recent arrest of a Howard Brown Health Center
fundraiser on charges of dealing meth has helped shock the gay
community into action. Groups are speaking out about the drug, holding
meetings and planning public education and outreach campaigns for this
year.

Though its popularity is on the upswing, meth isn't a new drug. Its
latest resurgence started on the West Coast in the mid-1990s; since
then, the stimulant has been moving eastward, finding a home in rural
communities and recently making inroads in major cities.

Chicago police report 14 meth-related drug raids in Lakeview and
Uptown this year, a rate that promises to outpace the 27 raids in
those neighborhoods in 2004.

"Our primary targets are the dealers," said Town Hall District Cmdr.
Gary Yamashiroya. "They're far different than the typical street deals
. professionals, male, white, generally."

Cheap, powerful

Part of meth's allure is its ready availability, relatively cheap
price, and highs that last longer and are reputed to be more intense
than cocaine or alcohol.

The health consequences of meth addiction are severe, even without
taking HIV into account. But in the era of AIDS, the drug's escalating
use presents novel challenges.

"We are very concerned," said Ron Stall, chief of prevention research
for HIV/AIDS at the Centers for Disease Control and Prevention. In
January, the CDC held its first national forum on meth abuse and HIV;
the agency also is testing an intervention to reduce the risk of
high-risk sex among meth users in four cities, including Chicago.

Recent research underscores the connection between the drug and the
disease. In San Francisco, researchers found that gay men who use
meth--also known as crystal, tina, ice and crank--were more than twice
as likely to have HIV than non-users. A separate report showed that 30
percent of people testing newly positive for HIV had taken the drug in
the last six months.

Twelve percent to 20 percent of gay men report using the stimulant in
the previous year.

"It's now the drug of choice," said Steven Tierney, director of HIV
prevention at San Francisco's Health Department. "What's most needed
in all cities, including ours, is more treatment options."

In Chicago, AIDS and gay-service groups have just begun discussing a
potential public education effort modeled after New York City's
"Crystal Free and Sexy" ads or San Francisco's "Crystal Mess"
campaign--in-your-face ads that bring home the drug's harm.

"The best way we can fight the use and abuse of crystal meth is by
discussing it with one another open and frankly," said Bill Greaves,
Mayor Richard Daley's liaison to Chicago's gay community.

Programs fight use

Meanwhile, a new $150,000 pilot program offering intensive outpatient
treatment for gay meth users started in February at Howard Brown
Health Center in Lakeview.

This week the city also is expected to release a major report on drug
and alcohol abuse among gay residents. Among its recommendations: the
need for more culturally sensitive treatment options for gay meth
users, according to Greg Harris, chief of staff for Ald. Mary Ann
Smith (48th).

Meth stands out from other commonly abused substances because "it's
more powerful, more addictive and more damaging to people more
quickly" than other drugs, said Harris, a recovered alcoholic.

O'Brien, who grew up in Kenilworth and began using drugs as a
13-year-old at New Trier High School, found that out the hard way.

As a teenager, O'Brien kept his sexual preferences to himself,
pretending to be "normal" and using marijuana and alcohol to take the
edge off his social anxiety.

By college, he graduated to cocaine, having sex with other men when he
got high and putting it out of his mind when he was sober.

This was the 1980s, and AIDS was just surfacing as a killer in the gay
community. O'Brien became an early victim, learning in 1986 he was
HIV-positive in spite of regularly using condoms.

Ten years of sobriety followed as O'Brien pulled himself together
personally and professionally, rising to become a senior vice
president at a Chicago-area bank. During the decade, O'Brien lost more
than 60 friends to HIV/AIDS as he struggled to maintain his health.

A friend's death sent him over the edge in the mid-1990s as he sought
refuge from depression in alcohol and then crystal meth.

O'Brien had never had anything like the drug.

"You feel like Superman, like you can do anything and nothing can get
in your way," O'Brien said.

Taking a quick toll

Within a couple of months, O'Brien was a daily user, taking meth first
thing in the morning and then "bumping along through the day until I
found people who wanted to party." Never coming off a meth-induced
high became a primary goal, made easier by the fact that the drug's
effects can last for half a day or more.

"The crash on crystal is so intense, so incredibly horrible, you'll do
anything to avoid it," said O'Brien, describing the feeling as "I am a
worthless piece of garbage and I don't deserve to live."

When meth users come down from their typically manic highs, "Their
personalities change. They can become paranoid and lose their sense of
reality," said Berger, who specializes in treating gay men in his
North Side practice. "Often, they're flooded with shame and guilt at
what they've done."

Sex usually is the main issue. On meth, O'Brien said, "all your
inhibitions are lost and the sex is unbelievable, psychologically and
physically. It gets so that nothing else matters except for this
incredible sex and you don't want anything to get in your way."

Walter Odets, a psychologist in Berkeley, Calif., notes that meth,
like other drugs, plays to users' vulnerabilities.

"We have a widely depressed [gay] community living in the midst of a
deadly epidemic and a society that's still, for the most part,
unapproving," Odets said.

Meth "is a drug that can make men who feel socially awkward or
unattractive believe they're in the swing of things," he said. "It's a
terrific self-esteem enhancer."

For O'Brien, the meth subculture of non-stop partying and non-stop
sex--often occurring at bath houses, bars and circuit parties--became
a way to escape the feeling of rejection associated with being
HIV-positive.

"Everything seems totally fabulous; the HIV issue just seems to
disappear," he said. "You get caught up with this idea that everyone
in this group is just like you: They're all positive. ... You don't
even think about protecting them."

Peter Staley, a former addict and founder of the Crystal Meth Working
Group in New York City, said: "I don't think there's any drug that
leads to more shameful behavior. It's not about immoral people doing
bad things.

"It's about moral people doing bad things, and feeling terrible about
it afterwards."

Effects damaging

The good feelings that meth brings don't last. Many meth users don't
eat or sleep for days at a time, leading to numerous health problems.

O'Brien had five heart attacks while taking the blood pressure-raising
drug; violent behavior also occurs with alarming frequency.

"I'm constantly treating people [on meth] with enlarged hearts and
[soaring] blood pressure," Berger said.

Many have depleted their bank accounts and lost their jobs, their
friends--even their homes--but still are in denial over their addictions.

Users can seem to age rapidly in a matter of months, especially people
with HIV, who become more susceptible to the virus as they stop taking
medications or following even basic health precautions.

"I know five people who've died on meth because of overdoses or
suicides," said Howard Gelb, 41, a former addict who founded the
Chicago branch of Crystal Meth Anonymous in 2002. The 12-step support
group hosts daily meetings in the city.

Last week, Town Hall District police and an informal, recently formed
coalition of Chicago-area community groups concerned about meth met
for the first time with representatives of bath houses, bars, dance
clubs, bookstores and other gay businesses to talk about a coordinated
response to the emerging epidemic.

"It's time to get the word out: We all need to focus attention on how
to stop the use of this drug," said Robbin Burr, executive director at
the Center on Halsted, a gay and lesbian community center. "We're
really at a pivotal point with this drug in Chicago."