New York City Health Workers Say Crystal Meth Use Helping to Spread HIV Among Men Who Have Sex With Men

Methamphetamine use among men who have sex with men has fueled a "sharp increase" in the number of new syphilis cases and could lead to a "resurgence" of HIV infection, according to New York City health officials, the New York Times reports. New York City HIV/AIDS specialist Dr. Howard Grossman said that more than 50% of men who tested HIV-positive in his private practice said that methamphetamine use led to the risky behavior that led to their HIV infections, according to the Times. "This drug is destroying our community," Grossman said, adding, "It just seems to be getting worse and worse, and no one is doing anything about it." Methamphetamine, also known as crystal meth or crystal, "erases inhibitions and spurs sex marathons with multiple partners," health officials say. The New York City Department of Health and Mental Hygiene does not track methamphetamine use among individuals newly infected with HIV, but the city's poison control center received approximately 48 methamphetamine overdose reports in 2002 and 2003, compared with no such reports during the previous two years, according to the Times. New York City Health Commissioner Dr. Thomas Frieden said that a survey showed that HIV-positive men are twice as likely to use methamphetamine as HIV-negative men, adding that men who use methamphetamine are less likely to wear condoms during anal intercourse, according to the Times. "We're seeing a general increase in risky sexual behavior, and we're concerned," Frieden said. The Callen-Lorde Community Health Center, the city's largest private clinic for lesbians and gays, reported that two-thirds of individuals who tested HIV-positive since June 2003 said that methamphetamine use was a factor in their infection, according to the Times.

Addiction, Treatment
Methamphetamine is a highly addictive drug that users often initially snort, then smoke and eventually inject when their tolerance for the drug increases, according to the Times. According to Dr. Antonio Urbina, a researcher at St. Vincent Catholic Medical Centers who studies methamphetamine's impact on neurological function, the drug can compromise immune function and interfere with antiretroviral drugs. "If you're HIV-positive, crystal is a disaster," Urbina said. In New York City, methamphetamine use is "largely confined to gay white men in Manhattan" but likely will spread to the wider community of MSM and the general population, according to the Times. Although health care workers say that methamphetamine use among MSM is an "emerging crisis," New York public health officials and private organizations that serve MSM in the city have not done much to address the problem, according to the Times. In San Francisco, the city plans to spend $425,000 for methamphetamine treatment and education. There is no "silver bullet" to treat methamphetamine addiction, and there are about two dozen 12-step meetings held each week around New York City for individuals who want to stop using the drug. In 1999, there were no such meetings for methamphetamine addicts in the city, according to the Times. Peter Staley, a "driving force" behind the AIDS advocacy group ACT UP, has spent $6,000 of his own funds to place "provocative" ads on phone booths in New York City to "demonize" methamphetamine, the Times reports. One ad says, "Huge Sale, Buy Crystal, Get HIV Free!" Staley, who is a recovering methamphetamine user, said, "My goal is to get the drug the reputation it deserves," adding, "My fear is that young gay men think it's the latest party drug. I want crystal to get the stigma that heroin has. It is not glamorous, it is not alluring" (Jacobs, New York Times, 1/12).

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