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Mar 17, 2005

I am single 34 year old HIV+ 9 years in May-- very healthy. I have isolated myself at times since my diagnosis. I am trying dilligently to overcome this in the year 2005, trying to get out and socialize more, meet people online for coffee dates, go to support groups when I can. I also go to many fundraisers. I am in therapy once a week. On re-entry to the gay world I find that in bars, clubs, and at fundraisers in Boston and NYC many guys seem to be under the influence of something more than a few stiff Cosmos. There is a wide eyed, dialated look that is prevelant and obvious and it is not the freshly arched brows. Is everyone on stimulants these days?

I sense the allure of these drugs, there is a certain glamour that seems to go along with them, despite the reality that they have very unglamourous consequences. This scares the crap out of me-- since it also seems to be an excepted norm in gay culture. Where is the culture going? We have just rebounded from years of mortality, come as close as ever to a effective treatment for HIV, have made some dramatic leaps in respect to our rights and become somewhat mainstream. But now we seem to be falling into another epidemic. Is this as prevelant as it seems to be or am I overreacting? I realize that in social settings like this there is going to be more of a element of people who are drug users but it seems to be more apparent than I recall it was in the past before I went into isolation.

Response from Dr. Frascino


Crystal meth use is indeed an epidemic within an epidemic (AIDS). Many folks who have tried it or at least researched the subject know the intensity, effects, costs and damage that crystal methamphetamine addiction can cause. Stories abound about the power of the stimulant on self-esteem and libido, as well as the trance-like illusion that can capture both body and soul. However, equally prevalent are stories about the life-threatening cost of addiction the paranoid and isolated qualities of the downward spiral.

The underlying issues that lead people to jeopardize their lives are still being explored. Escapism? Alienation? Acting out?

Crystal meth use is not really a "gay issue." Its use is on the rise in many communities, particularly those that are in some way disenfranchised or oppressed.

Within the gay community, the reasons for using crystal may even be different for pozitoids and neggies. HIV-negative folks may use crystal to overcome social anxiety and more easily "connect" with peers socially, emotionally and sexually. For poz folks, crystal may be more about sex feeling hot and desirable and finding a mental context where, at least for a time, HIV "doesn't matter". Adding to the problem is that crystal meth is relatively inexpensive, readily available and highly addictive.

"Is everyone on stimulants these days?" Although it may seem that way, in reality, no. Some are already in recovery. Kidding aside, crystal is a major problem and no, you are not overreacting. Our community is beginning to recognize the scope of the problem and the "unglamorous consequences." Recently I've seen more targeted programs for both education and treatment, which are steps in the right direction. Why not try volunteering at one of these programs? It might also be a great place to meet other health-conscious guys while helping our community.

Good luck.

Dr. Bob

Raising the steak?

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