AIDS seems to be a disease that has never succumbed to predictability. In fact, it’s a constant mutation, intent on surviving and conquering. Although AIDS has become more manageable that it used to be, it’s still a critically dangerous disease.
But even with the danger of AIDS and other sexually transmitted diseases, there are strange dynamics playing out. For gay men, “Barebacking”, the practice of having unprotected sex for the thrill, is a well known term. Men on the “down low” endanger unknowing spouses by having secret and often unprotected sex with other men. AIDS, now more than 23 years in our lives, carries less weight than it used to, making younger generations fear it less and less. It’s a problem when a society becomes so accustomed to something that they forget, at times, it’s even there.
Has our apathy become the catalyst HIV needs?
Our world is ripe with the fruits which allow us to dismiss consequence and approach risk. In the world of HIV and STD’s, the current enabler seems to be crystal meth, a cheaply and easily produced drug responsible for a startling rise in HIV and STD infection rates.
A study by the Michigan AIDS Prevention Project in 2004 shows that for MSMs (Men who have sex with men) crystal meth use jumped from 4% to 9%, and a recent survey from the Center for HIV Educational Studies and Training in New York City states that “crystal meth has physiological effects that suggest It plays a stronger role in HIV infections than even cocaine and alcohol”. Another study by the San Francisco Health Department came to startling conclusions, including that 25% of HIV-negative gay men who tested positive for syphilis also reported recent speed use. It went on to state that among approximately 63,000 gay and bisexual men tested between 2001 & 2002 at public clinics, 7.1% of meth users were HIV positive, as opposed to 3.7% for non meth users.
Crystal meth has managed to increase infection rates for a few documented reasons. First of all, meth increases the sex drive and enhances sexual experience. meth increases euphoria while reducing inhibitions. A “liberation” is created with the use of crystal meth, which makes it so detrimental to judgment. It’s easier, even more so with the additions of alcohol and temptation, to let your guard fall.
Meth creates risk even outside a sexual encounter. If it’s smoked, sharing a pipe could possibly transmit blood from one user’s cut lips to another. If it’s snorted, bloody noses, more common to those who use the drug, can transmit blood from one person to another through the sharing of a straw. Injection poses even more danger with the sharing of needles. HIV may not survive well in air or dried blood, but other STD’s do.
I spoke with Jena Adams, Supervising Communicable Disease Specialist with the Fresno County Health Department. Jena works daily with disease testing, prevention and counseling, and provided me with statistics surrounding meth and STD infection rates.
She told me that meth is often used by gay men to initiate, enhance and prolong sexual encounters, and that reports indicate a much higher percentage of meth use in regards to STD infection rates. I learned that Fresno is #3 in California for meth use among the 19 counties included in the study.
The data is from a state office of AIDS study covering the years 2001 & 2002. It shows that condom use is lower among gay methamphetamine users who tested at publicly funded clinics.
Of those who contracted gonorrhea, 10.1% were meth users compared to 6.1% who were not. Of those who contracted hepatitis C, 4.7% were meth users compared to .8% who were not. Statistics covering meth users sexual practices show that meth users only practiced safe sex 25.9% of the time when compared to non-meth users who were safe 42.7% of the time.
In fact, in all the categories we covered, meth users consistently were more unsafe than non-meth users, and were higher in all categories of contracted sexually transmitted diseases.
I asked Jena if this was a top concern for California health departments, and what was being done about it.
“Absolutely. It’s the number one concern right now. We’re providing more education for counselors and outreach workers so they can have the tools to deal with this. There’s more HIV education through community based organizations. We’re asking questions of the people we test and talk to, such as when the last time was that they used meth, when was the last time they were tested for HIV and other STD’s and how often they use protection.
When we talk to individuals, we’re also trying to identify what stage of behavior change they’re in. In other words, do they see it as a problem? If they don’t see it as a problem, it becomes much more difficult to educate them on treatment, whereas someone who’s ready for help is more likely to accept our suggestions and programs. They have to be ready for action. If they are, we can get them into a treatment program.”
As we discussed the specific areas of concern which tend to be posing a higher risk for gay men, Jena brought up gay circuit parties.
“With syphilis on the rise in the last couple of years, particularly in San Francisco and Los Angeles, a lot of focus has been put on outreach to those who frequent circuit parties.”
Jena pointed out that meth use tends to be much higher within the confines of a circuit party. People from all over the world travel to be a part of these events, and tend to have multiple sexual partners before returning home. Subsequent positive test results reveal the difficulty in tracking down sex partners. The information, such as a full name or home town, is sketchy at best. This makes it easy for the disease to spread quickly.
Regardless of sexual orientation or number of encounters or partners, regardless of whether you believe the person you’re sharing a monogamous relationship with is keeping their end of the bargain, it only takes one slip to contract a sexually transmitted disease.
Choices are personal, but survival is universal. This isn’t a place where it’s okay to break the rules once in a while. Sex has to be safe, no matter what your head is telling you. With meth thrown in the equation the chances of making the wrong decision is much, much higher. Meth disrupts the safety and self-preservation centers of the brain. What you think is okay under the influence of drugs can be the one decision which changes everything forever.
AIDS clearly depends on our hedonism in order to survive, and crystal meth ramps up our delusions of invincibility.
That’s a dangerous combination.
The Fresno County Health Department Specialty Clinic is located at 1221 Fulton Mall on the first floor. The clinic performs confidential testing (you must sign a consent form) on Mondays, Wednesdays & Fridays from 8am to 11am and 1pm to 4pm, and on Tuesdays from 1pm to 4pm. Anonymous testing (no identity required) is available Tuesdays from 8am to 11am and Thursdays from 1pm to 4pm.
The clinic can be reached at 559-445-3434. The internet connection is http://www.fresnohumanservices.org/communityhealth/communicabledisease
Rapid HIV testing (30 min.) is offered on the Health Department’s mobile unit. For dates and locations for the mobile unit, please contact the clinic.