RESEARCH SAY HIV-POSITIVE MEN AT HIGHER RISK FOR METH USE

Beautiful young men dance in the centre of the World. It's almost 3
a.m. on a Sunday morning and the dance floor at the downtown
after-hours club is packed. Although the crowd is mixed, there are
many more men than women, and most of them are gay. If anyone is over
thirty-five, they hide it well.

These guys must have steady incomes, because the cover charge is $25,
a can of Red Bull costs $7, and bodies like that don't come cheap.
(Or easy.) The majority of men dance shirtless. They all have the
same hairless, buff, porn-star physique, designer jeans that fit just
so, and perfect hair. Every now and then, someone in the throng lifts
a small vial to his nose, and sniffs. Is it the party drug K
(ketamine)? GHB (gamma hydroxybutyrate)? Coke? Maybe it's Tina.

Tina is a circuit-party colloquialism for crystal meth. Throughout
the year, some well-heeled gay men crisscross North America to attend
circuit parties, weekendlong events comprising a series of dance
fests that last all night. From time to time, a few of them engage in
risky sexual behaviour frequently fuelled by powerful party drugs
that make you feel like a million bucks. Crystal, which is also
showing up to some degree in bathhouses, sex-play spaces, and via
on-line hookups under the acronym PNP (party and play), is the drug du jour.

"It's evil," says gay club promoter Michael Venus over lunch at a
sidewalk cafe in the West End.

Venus was shocked when he discovered that his best friend had been
addicted to crystal for years. A drag entertainer and performance
artist, he was a popular figure in Vancouver's gay nightlife scene.

"I thought he did it occasionally, but he was doing it all the time.
He hid it really well. People always wondered why he was so 'up' all
the time, and how he got so much done. But then he started to look
sick, really sick, and he started to become a different person. He
was lying and stealing he ended up going back East to recover. We
talk on the phone sometimes. He's really ashamed."

Venus says he tried it a couple of times, and that was enough. "It
makes everything fabulous, and you feel like you can do anything. I
understand why it's addictive. That's why I stopped."

Over the last year, gay men have been singled out with a few other
groups as particularly prone to addiction, and mainstream news
stories have associated crystal meth with risky sexual behaviour and
HIV transmission. In the U.S., many powerful so-called faith-based
groups have manipulated this supposed link in widely read articles
attacking the evils of the "homosexual lifestyle". The association of
crystal meth use with HIV is based primarily on hearsay, and
potentially dangerous assumptions about its role in risky sex obscure
other contributing factors.

"The media has overemphasized the use of crystal meth [among gay men]
to the detriment of good reporting, and it detracts from the impact
on straight people," says Perry Halkitis by phone from New York.

Halkitis is a research director with NYU's Center for HIV/AIDS
Educational Studies and Training. He was involved with a yearlong
study that monitored crystal meth use among 450 openly gay and
bisexual men in New York City who identified themselves as party-drug
users. Sixty-five percent of the participants had tried crystal at
least once in the four months before the study began. By the
project's end, only 31 percent reported using crystal within the same
time period. At least one story misconstruing this study hit the
newswires. It cited some iffy statistics from a few years back
indicating that five to 25 percent of all gay men used crystal, and
that the number had skyrocketed to more than 60 percent. The study
focused on self-identified drug-using gay men, not all gay men, and
like most news stories, this one did not differentiate between
one-time use, occasional use, and addiction.

"Overall, among gay men in general, a more realistic figure for
crystal use is probably 10 to 20 percent, and probably closer to 10,"
Halkitis says.

That number of people toying with a particularly toxic drug in any
community is large enough to warrant serious concern. That's why
individuals representing AIDS Vancouver, Vancouver Coastal Health
Authority, YouthCo AIDS Society, and the BC Centre for Excellence in
HIV/AIDS (BCCFE) have formed a working group on crystal use among
Vancouver's gay men, as well as men who have sex with other men but
don't identify themselves as gay. An outreach campaign--and no one
has any idea what that means yet--will be administered at Gayway,
AV's Davie Street drop-in centre for gay men.

"The biggest thing prompting us is the discussion in the [gay]
community," says Michael Mancinelli, an HIV prevention and awareness
educator at AIDS Vancouver. "They've seen their friends, lovers, and
family members affected by it. An epidemic? I don't know."

Dr. Tom Lampinen of BCCFE has some surprising revelations based on
the centre's multipronged, five-year Vanguard project study of
several hundred young, HIV-negative gay and bisexual men.

"We saw that the trend toward the increase in unsafe sex is
statistically independent from the trend toward increasing crystal
meth use," Lampinen says by phone.

In other words, even if there is some crossover, one does not
necessarily relate to the other. The Vanguard information is too
detailed and extensive to relate here, but in a nutshell, Lampinen,
like Halkitis, figures that crystal use among all gay men (including
one-time and occasional users) is in the 10- to 20- percent range,
although he leans toward the higher number. Another related Vanguard
study indicated that the rate of crystal use is higher among
HIV-positive men, though not the cause of their infection.

"Let's not ignore the elephant in the room; there's great currency in
misinterpreting studies that show meth users are two to four times
more likely to be HIV-positive," Lampinen says. "In fact, most often
it's the other way around: HIV-positive men are at a two-to four-fold
risk for using crystal meth."

BCCFE studies show that 8 out of 10 times, these men began using
crystal after they had acquired HIV infection. Centre studies
conducted with the British Columbia Centre for Disease Control also
show that B.C.'s HIV rates among gay men increased 50 percent in 2000
and have not declined since.

So why have health agencies, as well as community groups at the
grassroots level, failed for the past five years to respond to
crystal meth as a substance-abuse problem among gay men, independent of HIV?

Another question gay men in this city need to ask themselves and each
other is why, aside from the obvious pursuit of pleasure, are a
substantial number drawn to a habitual use of crystal and other
confidence- and/or sex-boosting substances. Can it have anything to
do with self-esteem?

Besides the challenges of living in a homophobic world, gay culture
pressures men to conform to an unrealistic physical ideal. But one
day we all wake up to find that we're no longer young, beautiful, and
at the centre of the world, and no drug in the universe can ever
change that. Then what?