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Public Health Messages to All Men Who Have Sex With Men (MSM) About Crystal Meth Use

Part One of Two

June 3, 2004

In response to growing concern among prevention providers and the MSM community about crystal and HIV, Public Health has developed key messages about crystal. They are aimed towards specific sub-groups of MSM to address the full spectrum of crystal use and non-use.

These messages are intended to:

  • Summarize essential talking points about the health impacts of crystal and the harm reduction options men can adopt to avoid or reduce their risks.
  • Recognize and support positive, incremental behavior change driven by the individual's willingness and ability to adopt such changes.
  • Emphasize self-efficacy and personal assets.
  • Help counteract the stigma and shame that often only induce further drug use or risk behavior.

While these messages are specific to crystal, they should always be reinforced with standard sexual risk reduction and HIV/STD prevention messages endorsed for all MSM.

Community Resources for MSM Crystal Users

Project NEON: (206) 323-1768,

Health information, print media, community outreach, information and referrals, website, and drop-in "clinic" for crystal users every Wednesday evening (HIV/STD/Hepatitis screening, vein care consultation, needle exchange). FREE counseling services include individual drug use and risk reduction assistance, social/health service advocacy, treatment, pre-abstinence and relapse prevention groups. (program of SCS)

Seattle Counseling Services: (206) 323-1768

Intensive outpatient and outpatient chemical dependency treatment. Comprehensive mental health services and domestic violence program. Multiple funding options including sliding scale.

Capitol Hill Alano Club: 1222 E. Pine Street

LGBT 12-Step meetings every day of the week.

Narcotics Anonymous: 206-329-1618

Call for current meeting times and locations.

Needle Exchange: 205-7837 for all times and locations.

On Capitol Hill, every day 6-8:30 pm at 10th and Seneca (between IHOP and Lifelong AIDS).
Downtown, M-F 1-5:30 pm, Sat 2-4pm at 2nd Ave and Pike
Syringe exchange, clean injection equipment, condoms, lube, service referrals, vein care.

Essential Messages for MSM About Crystal

  1. If you don't use, don't start.
  2. If you do use, seek help to reduce or stop use.
  3. If stopping isn't an option, act consistently to reduce sexual risk and protect general well-being as described below.

    To Men Who Don't Use or May Be Curious About Using

    Don't start. Crystal meth is highly addictive and dependency can develop quickly, even if you think you can control your use.

    Despite popular perception, most gay/bi men do not use crystal.

    You can have a great, satisfying sex life without crystal. Most gay men do.

    Using crystal regularly can cause tooth loss, undesirable weight loss, paranoia, brain damage, and impotence. It impairs sexual choices and greatly increases your risk of HIV.

    To Men Already Using

    Seek help to reduce or stop crystal use.

    Get tested for HIV and STDs every three months.

    Before you get high:

    • Plan for sexual safety before you get high. Decide how and with whom you want to have sex. Make a commitment to disclose/ask about HIV/STD status and use condoms once you're high.
    • For bottoms, insert a Reality condom before getting high or leaving your house for sex.
    • Pack plenty of condoms and lube. Put them where you will see them once you're high.

    While you are high:

    • Eat, drink extra water, and sleep.
    • You can play safely and use condoms -- even while you're high. Most men do.
    • Prolonged crystal sex leads to excessive friction and can cause condoms to dry out more quickly or break. Change condoms every hour.
    • Use more water-based lubricant than usual. Too much lube is almost enough.
    • Crystal use in combination with other drugs such as Viagra, poppers, and Ecstasy can cause serious and even life-threatening health problems.

    Keistering ("booty bumping") is not a safer way to do crystal. It can seriously damage your bowels or anus. This may make anal sex very painful and increases your chance of getting HIV.

    If you're not injecting, don't start. Reject offers from sex partners to inject you or show you how. Injecting greatly increases your chances of HIV, STDs, hepatitis C, abscesses, other soft tissue infections, and social/sexual rejection.

    If you're using crystal and you don't take these precautions consistently, your chances of staying HIV negative are slim. Especially if you inject.

    To Men Who Inject

    Nearly one half of all MSM who inject crystal are HIV+. This is more than any other MSM.

    Seek help to stop or reduce crystal use.

    Use a new, sterile syringe every time you inject or divide drugs. You can acquire sterile syringes at the needle exchange or at pharmacies without a prescription.

    Do not share syringes, cookers, or other paraphernalia with other users or sex partners.

    If sterile needles are not available, proper use of bleach can kill HIV (3 step method). Bleach is not proven effective against hepatitis B or C.

    To HIV Positive Men Who Use

    Research shows that using crystal meth often leads to higher viral loads, faster HIV progression, worsened immune function, and increased neurological damage.

    Using crystal does not increase T-cells or boost your immune system. These are myths.

    Your chances of successfully managing your HIV get better the sooner you stop using crystal.

    Crystal can have bad interactions with many HIV meds.

    While you're high, you may forget to take your meds or follow food and water guidelines. This can make your meds less effective and increase your viral load. Kidney stones are also common.

    Be honest with your doctor about your drug use. If you can't, get a new doctor. Talk about whether taking HIV medications while you're still using is right for you.

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This article was provided by Seattle Treatment Education Project. It is a part of the publication STEP Ezine.
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