Larry Buhl

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“More data are needed to understand how methamphetamine may serve as a barrier to PrEP initiation, adherence, and long-term retention in care.”

Study: Meth Use Is the Biggest Factor for HIV Seroconversion Among Gay and Bisexual Men

Juan Michael Porter II

Staff Writer

Juan Michael Porter II-JMPII; Grade 12 edit

"I hope that you dance in a sea of oddities and fabulosities even as it feels as if the sky is falling—because whether the world ends tomorrow or continues for another million years, we all deserve to be seen and known on our own terms."

It's National Coming Out Day. Tell Yourself Who You Are.

Tim Murphy

Contributing Editor

Henry van Ameringen-2943987077 88e054c4e1 o

The gay fragrance heir constantly opened his checkbook for projects to support the queer community’s most vulnerable.

Fairy Godfather: Remembering Henry van Ameringen, Who Gave Nearly $150 Million to HIV and LGBTQ Causes

JCM MatthewPlacekheadshotHiRES

The very political *New American Dream* is how the actor, musician, and director overcame a coronavirus slump and collaborated remotely with a new generation of queer artists.

We Talked To ‘Hedwig’ Creator John Cameron Mitchell About His New COVID-era Benefit Album

Anni Irish

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Gonzalez-Torrez’ installations and their commentary on loss and time speak to us during the present pandemic.

The Lasting Legacy of Artist Felix Gonzalez-Torres

Antinoös-iStock-116849133

Amid controversial allegations against congressional candidate Alex Morse, some gay guys say that age differentials only matter if the senior partner holds direct power over the junior.

He’s Older. He’s More Powerful. But Does That Mean I’m Being Exploited?

Bobby Box

ass of stone-iStock-172933976

CBD suppositories can help eliminate anal pain for receptive partners—without numbness, which can mask problems.

I Got My Ass Stoned to Ease the Discomfort of Anal Sex

alarm-iStock-1166460347

COVID-19 may be fueling an increase in meth use, not reducing it.

Prevention Experts, Community, Sound Alarm on LA’s Meth Crisis

handing out masks Fire Island-Screen Shot 2020-07-13 at 11.09.43 AM

Fire Island Folks Talk Anonymously About Hitting the Maskless Parties That Caused a Social-Media Ruckus

Sherri Lewis

Abdi Nazemian

Sherri Lewis interviews award-winning novelist and screenwriter Abdi Nazemian about his new book, *Like a Love Story*.

Coming of Age in the Early Days of the HIV Pandemic Is ‘Like a Love Story’

  
When I see documentaries or fiction films about the early days of the AIDS epidemic that focus on the lives and relationships of gay men, I see a lot of people taking care of one another. In many cases, one partner might find out he's HIV positive, the other partner finds out his status, the two stay together, and one takes care of the other until one or both are met with the unfortunate fate of certain death. I'm sure it also happened that many men, who were brave enough to finally disclose their status at a time when there were no available treatments to keep them alive, were in fact deserted by their lovers and left to other family and friends to care for them until they died.

But in neither scenario do I recall seeing images of a man, upon learning of his partner's HIV status, sneaking quietly into another room and dialing 9-1-1 to report to the police that he may have been exposed to the virus.

And yet, that is happening. And I'd ask all gay men reading this to please stop.

There are laws that criminalize the lack of disclosing one's HIV status to sexual partners in about 34 states. Some make the act of "exposing" someone to HIV a felony crime. And some make the act of not disclosing one's status to sexual partners a crime. Now, we can debate the fact that "exposing" someone to HIV is often based on ideas about transmission that are 30 years old and no longer relevant. Spitting doesn't transmit HIV, for example. And we also know if a person is on antiretroviral therapy and the virus is suppressed in their body, they cannot transmit the virus through sexual contact -- even if it's sex without a condom (or what we call [undetectable equals untransmittable, or U=U](/article/hiv-undetectable--untransmittable-uu-fact-sheet)).

While it's important that we all know the latest information about HIV transmission, it still shouldn't matter. No gay or bisexual men, as maligned as we all are still in the world, should ever think the best solution to deal with HIV -- whether you contract the virus or not -- is to use the police and the specter of a prison sentence.

I've been working on issues of HIV criminalization for about 10 years. And in the past few years, I've done some support on two particular cases where gay men have opted to bring down the force of punitive police and prison onto people they say didn't disclose they were HIV positive, even if they didn't contract HIV. [Michael Johnson](/article/michael-johnson-bypasses-trial-enters-no-contest-p) is a young black gay man in Missouri, currently serving a 10-year sentence for exposing several sex partners to HIV, only one of whom contracted HIV. Whether or not he disclosed his status is something only the people involved know. But the person who called the police, and who is HIV positive, says he contracted HIV from Johnson. He does not say that the sex they had was coerced, or anything approaching assault. It was consensual.

More recently, 24-year-old [Sanjay Johnson](/article/sanjay-johnson-faces-prison-sentence-in-arkansas-h) is facing trial in Arkansas, in early 2019, after disclosing his status after having sex with another young man. There is documented evidence that Johnson was in fact virally suppressed at the time of their sexual encounter, and the other person in question told TheBody that he tested positive just weeks later and was concurrently given an AIDS diagnosis, which suggests he may have also been HIV positive at the time he had sex with Johnson, but did not know. The accuser also suggests that when he called the police, he didn't realize they would charge Johnson with a felony and that it would mean Johnson would be sent to prison.

I am a black gay man who turned 44 this year. I straddle the generation of men who literally lost dozens if not hundreds of friends and lovers, and those who are now coming of age at a time when we have great treatments that will suppress the virus to make condomless sex of no risk of HIV transmission. We also have PrEP -- an option other than condoms to prevent HIV for those who are HIV negative. I'm on PrEP and made the choice to use PrEP several years ago so that I would take my own HIV prevention into my own hands, and not leave it to guess whether someone is HIV positive or negative. And I also am open to dating or having sex with men who are HIV positive (and already have), but I don't need someone to disclose their status in order for me to make decisions about my own body.

But I've been disheartened by the fact that we have such fear and mistrust of one another that people think calling the police on someone for their health status is something that will keep us safe. Police and prisons do not bring about safety. Access to quality health care that is affordable is safety. Housing, substance abuse treatment, and harm reduction is safety. And having the love and support of other men -- as friends, as lovers, as a community -- is what will make us safe and heal us all of the specter and the stigma of HIV, whether HIV positive or negative.

Kenyon Farrow

Police car

Featured image for Gay Men: It's Time to Stop Calling the Police on One Another for HIV Non-Disclosure

"No gay or bisexual men, as maligned as we all are still in the world, should ever think the best solution to deal with HIV ... is to use the police and the specter of a prison sentence," Kenyon Farrow writes....

"No gay or bisexual men, as maligned as we all are still in the world, should ever think the best solution to deal with HIV  is to use the police and the specter of a prison sentence," Kenyon Farrow writes.

Gay Men: It's Time to Stop Calling the Police on One Another for HIV Non-Disclosure

Gay Men

Charles Sanchez

Image for My Pal Tina: West Hollywood, Waiting Tables, and Crystal Meth

Personal stories, support, and information for gay men living with HIV.

HIV/AIDS Resource Center for Gay Men

When I talk about my experience of using crystal meth, I often joke about it. I'll say things like, "When I was on meth, I was so skinny I could wear a garbage bag, belt it, and look fabulous!"

[Crystal methamphetamine](/article/meth-the-other-epidemic-poses-a-real-risk-for-hiv) has a lot of nicknames: "tweak," "rocket fuel," "ice," "speed." "Redneck cocaine" has a charming twang to it. "Scooby snax" sounds like the name of a kid's breakfast cereal.

My favorite moniker for the powerful addictive drug is "Tina." Tina sounds like your crazy friend, you know? Hang out with Tina, and you don't know where you'll end up: maybe at a bar, maybe at a cool party, maybe at a sex club, maybe in jail. Adorable Tina.

It was 1998. I had spent over a decade living in New York City, failing to succeed at an acting career. I realized one day that my career wasn't as an actor, but as a waiter. As the Broadway dream died, I countered that death by numbing myself with ever increasing amounts of alcohol, cannabis, and cocaine. I couldn't keep a waiting job, and I was couch surfing. I decided to leave New York, and my best thinking lead me to move to West Hollywood.

  

When I Met Tina
---------------

I moved into a building on Formosa Avenue called "The Merry Lee." It was kind of a gay boy sorority house. Instead of our own names, the mailboxes campily listed "Julie Newmar," "Greta Garbo," and "June Cleaver." I was "Holly Golightly." I lived on the second floor, and the drag queen building manager, "Marlene," lived beneath me.

I had no plans when I moved to L.A. No dreams of making it big in the movies. I did what I did: I waited tables. I begrudgingly told people the specials and picked up their grimy plates. And I was bitter, resentful, and drunk, looking for further escape.

I don't remember who first introduced me to Tina, and it doesn't really matter. After my first taste, I knew I wanted more. Tina made me feel strong and cool, and something I rarely feel: sexy. Oh, I was the most slinky, sexy little minx of a gay guy you could ever meet if I was on crystal. The speedy drug encouraged me to indulge every sexual whim, every naughty, dirty little thought.

My memories of this time are blurry, like the view out the window of an accelerating runaway train. In the few years I lived in WeHo, my use of Tina increased, and I decreased things like sleep and food. For nutrition, I cleverly invested in six packs of Ensure.

I was awake and high for days at a time, then I'd crash. I'd managed to get a job as a room service captain in a swanky Beverly Hills hotel, working the graveyard shift, 10 p.m. to 6 a.m. At work, I often stayed awake via the plastic pouch of powder in my pocket. I went straight from work to a divey gay bar on Santa Monica Boulevard that was open at that hour, catering to others like me who'd been up with Tina for a day or three. The most eligible bachelors are available at saloons in the morning.

While some of the experiences with said bachelors were fun, mostly they were just drug-fueled, jittery, sweaty encounters. I'm sure I was as meaningless to them as they were to me. There's nothing safe about that kind of sex. As a friend once said: "Crystal has the power to make condoms just POOF! Disappear!"

There were times when I was in danger from these encounters. There were times when I had to physically push men off me and run out the door. I was threatened, stolen from, shoved, and hit. Compared with being high on Tina, these were minor troubles: the cost of doing business.

  

The Downward Spiral
-------------------

As my drug use increased, I stopped contacting my family. I have a loving, wonderful family, one that cares deeply for me. When I hadn't talked to them in weeks, they drove -- my parents, two brothers, and sister -- from my hometown of Phoenix to L.A. to find me. They spent two days going from my apartment, to my work, to friends' houses, and I managed to evade them. My life was none of their fucking business! I was pursuing sex, drugs, and rock and roll, baby! And I wanted none of their concern or love, or anything that might dissuade me from my best friend, Tina. My family left L.A. without ever seeing me. I'd fooled 'em. Or so I thought.

In a message given to me by a friend, my mother exclaimed: "Why are you doing this? Why are you avoiding us? _We know you._ We love you." I didn't hear it. Or if I did, I didn't care.

My ability to pay the rent was shaky. There were several months when building manager Marlene tapped her nails on my door, and I pretended not to be home. There were some nights when I was so paranoid of running into her that I stayed out all night and all day in fear. Once, I slept in the park because I couldn't pay the rent.

One evening, I'd been up for a couple of days. I decided to go to my favorite bar for happy hour before my graveyard shift at the hotel. Usually, I carried my stash of Tina either in a pocket or in my sock, but for some reason this particular night, I didn't take it with me. At around 8:30 p.m., I scurried out of the bar to try to catch the bus to work. A policeman spotted me and drove his car on the sidewalk to stop me. The officer said he was stopping me for "suspicious behavior." He searched me and found no weapons (as if!) or, thankfully, illegal substances. However, the officer ran my name through the system and found a warrant out for my arrest. A year earlier, I'd received a DUI that I never took care of.

  

Tina Takes Me to Jail
---------------------

As I sat in L.A. County Jail, serving a 30-day sentence for that DUI, I thought: "I'm not supposed to be here. My life has taken a severely wrong turn somewhere." It never occurred to me that drugs or alcohol might be the cause.

Another joke I often make is that jail is not nearly as sexy as it is in porn. While that statement is very true, jail is also an incredibly frightening place. In L.A. County, they segregate gay men from the general population for our safety, but there were still bloody fistfights every day in my housing facility. People fought over jailhouse boyfriends, over the homemade hooch [pruno](https://en.wikipedia.org/wiki/Pruno), over coming down off drugs, or over what was for lunch. I was fortunately never in a fight nor targeted, but I felt the tension and threat every day that I was there.

When I was released from the downtown jail (early, after 16 days), I ran for about six blocks, just running and running. Then, I had to figure out how to get back to my apartment. I had no money, but I had to find a way. I had a stash of Tina waiting for me.

I'd lost my job at the hotel (going to jail made it a "no call, no show" situation), my apartment was once again in jeopardy, and I wasn't feeling so sexy anymore. Mostly, I felt desperate and desperately lonely. Turns out, Tina's a pretty selfish girl. Like most addictions, she demands all your time, all your attention, all your money, and if she can get it, all your life. In less than three years in West Hollywood, my life was in shambles. Crystal was my problem, and to get away from crystal, I needed to get away from California. I got on a Greyhound bus and got the hell out of Dodge.

That was the end of my Tina relationship, but it was another ten years before I could dump my first love: booze. In that ten years' time, I was diagnosed with AIDS (in 2003). When the doctor told me the diagnosis, he said that he thought I'd been positive for a long time and just didn't know it. Taking care of my health had never been a priority. It took another seven years before I became drug and alcohol free.

When I look back at that tumultuous time, I can't believe that I made it through alive. I fought so hard to be the cool, sexy guy hanging out with Tina. I wasn't. Yet, I made it through to the other side. I'm healthy and sober. I have terrific friends and a great relationship with my family.

Not to be too kumbaya, but there must have been a guardian angel or higher power or something looking out for me. And that's no joke.

Recounting his downward spiral with crystal meth, Charles Sanchez writes, "Hang out with Tina, and you don't know where you'll end up: maybe at a bar, maybe at a cool party, maybe at a sex club, maybe in jail."...

My Pal Tina: West Hollywood, Waiting Tables, and Crystal Meth Img

Promo Image My Pal Tina: West Hollywood, Waiting Tables, and Crystal Meth

Recounting his downward spiral with crystal meth, Charles Sanchez writes, "Hang out with Tina, and you don't know where you'll end up: maybe at a bar, maybe at a cool party, maybe at a sex club, maybe in jail."

My Pal Tina: West Hollywood, Waiting Tables, and Crystal Meth

David Fawcett, Ph.D., LCSW

Image for Let's Talk About Chemsex in the Gay Community, and Here Are 6 Ways to Do It

Meth-sex. Chemsex. Party and play. By any name, the use of certain drugs, such as methamphetamine, GHB, ketamine, and mephedrone, in conjunction with sex is exacting a painful toll on the lives of many gay men. Chemsex (the term I prefer) is responsible for overdoses, arrests, acquiring HIV and hepatitis C, the life-shredding destruction of addiction, and even death. It occurs, of course, among other populations, as well. The transgender community is particularly impacted, as are bisexuals and heterosexuals. But it is the seductive appeal of chemsex to mitigate shame, loneliness, the search for connection, and even boredom among gay men that [I believe is particularly disturbing](/article/meth-the-other-epidemic-poses-a-real-risk-for-hiv) and that our community must directly confront.

Mood-altering drugs, including alcohol and harsher substances like meth, have long cycled through the gay community, but the tsunami of stimulants hitting us in the new millennium has been different. HIV meds and AIDS fatigue changed the sexual landscape, new production methods courtesy of the Mexican cartels made drugs purer and cheaper, and technology in the form of websites and apps made it easier than ever to connect socially and sexually with other men. To be sure, not everyone who uses meth and other drugs with sex experiences such harmful effects, but an honest look around one's gay social network in any urban center around the globe will reveal no shortage of men who are struggling.

I believe chemsex in the gay community is a syndrome encompassing behaviors and characteristics that go far beyond the effects of specific drug molecules on the brain. Gay men have always sought heightened sexual experiences. But sex on chems can quickly deteriorate into empty, sometimes abusive, and often unfulfilling high-risk sexual behavior that leaves the user feeling more disconnected and lonely than before. While chemsex can serve as a sort of social leveler, allowing men from a variety of racial and socio-economic backgrounds to interact, such opportunities can open the door to the exploitation of power and privilege, especially notable in the marked rise of chemsex among young [black](/article/gay-black-men-confront-crystal-meth) and [Latinx](/article/crystal-meth-use-among-young-latinx-gay-men-in-sou) men. It is true that chemsex momentarily wipes away self-doubt, low self-worth, and shame, replacing them with a sense of reckless invincibility and an insatiable sex drive. But with continued use, such intensity resets the amount of stimulation the brain requires for arousal, resulting in an intensification of behaviors (usually toward more high-risk and taboo) to trigger the rush of dopamine.

It greatly concerns me that, despite the known risks, so many gay men continue to use chemsex regularly. Here are some actions I feel are necessary to address this serious concern.

*   **Conduct open community dialog:** There is a reluctance to speak openly about chemsex, perhaps because drug use (in the U.S.) is conflated with moral failure. An open dialog not only elicits community solutions but effectively reduces stigma, as well. Many men I know who use chemsex experience shame and stigma and gradually tighten their social networks to include only other users. We need to engage the community for this problem, just as we did for HIV.
*   **Provide accurate information:** Facts alone are not the only solution, but they could surely save lives. Gay men deserve safe, non-judgmental sources of accurate information about various drugs, their effects and risks, and how to intervene when necessary. Harm-reduction practices should be discussed for those wishing to make their drug use safer or, for those contemplating abstinence, information should be provided to help with that decision and, if necessary, to find community resources for treatment.
*   **Improve treatment capacity:** The unique aspects of chemsex and the properties of its component drugs require specialized knowledge and treatment, which is still lacking. Methamphetamine, for example, uniquely hijacks the brain's reward system and destroys its ability to distribute dopamine, damage that requires up to 24 months to repair. During that time, an individual is likely to experience persistent depression, poor cognitive performance, and increased impulsivity. These factors heighten risk for relapse unless both clients and professionals understand them.
*   **Foster opportunities for connection:** The issue of loneliness and isolation in the gay community, a problem compounded for those living with HIV, has begun to receive well-deserved attention. Chemsex is a broader issue than any group of men or social divide based on physical appearance, income, or ethnicity. We need to actively create communities that are welcoming to everyone, including those men who can find little sense of worthiness or compassion for themselves. We all need to belong.
*   **Remain sex positive:** Any discussion of chemsex in the gay community must be open and tolerant of sexual behaviors. The goal is not to define acceptable sexual behavior or put limits on kink, but rather to support men as they define what works for them. For those seeking a change in self-defined problematic sexual behavior, open dialog with peers and professionals can be instructive. Men who give up chemsex often fear they are doomed to a life of vanilla sex or no sex at all, yet many men with sustained recovery from chemsex describe far more rewarding intimacy and sexual connection than they ever experienced with drugs.
*   **It can't be done alone:** Moving beyond problematic chemsex requires abundant support. While few treatment facilities have developed competence treating chemsex among gay men, both outreach and treatment resources are starting to be found in urban areas. Support groups such as [Crystal Meth Anonymous](https://crystalmeth.org/cma-meetings/cma-meetings-directory.html) and [SMART Recovery](https://www.smartrecovery.org/) are often available and, for those who are concerned about stigma or can't access support groups, an increasing number of online resources exist, such as [In the Rooms](https://www.intherooms.com/).

A friend whom I respect once told me that chemsex, and methamphetamine in particular, is the "HIV" of this generation. That saddens and terrifies me, but drives me toward action and advocacy, as well.

David Fawcett, Ph.D., L.C.S.W.

"It is the seductive appeal of chemsex to mitigate shame, loneliness, the search for connection, and even boredom among gay men that I believe is particularly disturbing and that our community must directly confront," writes David Fawcett Ph.D., LCSW....

Let's Talk About Chemsex in the Gay Community, and Here Are 6 Ways to Do It Img

Promo Image Let's Talk About Chemsex in the Gay Community, and Here Are 6 Ways to Do It

"It is the seductive appeal of chemsex to mitigate shame, loneliness, the search for connection, and even boredom among gay men that I believe is particularly disturbing and that our community must directly confront," writes David Fawcett Ph.D., LCSW...