'Crystal Meth' Use Boosts STD Rates Among Gay Men

The amphetamine seems to be fueling rise in syphilis, HIV infections

THURSDAY, March 11, 2004 (HealthDayNews) -- Crystal methamphetamine -- or "speed" -- seems to be a driving factor behind higher rates of sexually transmitted disease among gay and bisexual men.

In one study from San Francisco, gay men who visited a health clinic were twice as likely to be infected with the AIDS virus if they had recently used the illegal drug. And they were nearly five times as likely to be diagnosed with syphilis.

Armed with the new statistics, federal health officials said Wednesday they're searching for effective ways to cope with what they see as a growing threat. Among other things, researchers are studying the value of rapid sexually transmitted disease (STD) tests and exploring the use of the Internet to notify the sex partners of STD patients about their risks.

"There are a lot of innovations under way. We expect to be able to share more of these as we learn more about their success and limitations," said Dr. Ronald O. Valdiserri, deputy director of the HIV, STD and TB prevention center at the U.S. Centers for Disease Control and Prevention. He spoke during a press briefing Wednesday at the National STD Prevention Conference in Philadelphia.

Overall, sexually transmitted diseases strike an estimated 19 million Americans a year, at a cost of $15 billion, said Dr. John Douglas, director of the CDC's STD prevention efforts. While many of those infected are heterosexual, federal health officials are devoting much of their attention to what Douglas calls "crescendoing" STD rates among gay and bisexual men.

Syphilis, in particular, is drawing much attention. The federal government had hoped to virtually eradicate the disease during this decade, but an epidemic among gay and bisexual men during the past four years has scuttled those plans.

Gonorrhea also strikes men who have sex with men, but rates have dropped over the last few years.

AIDS, meanwhile, remains the greatest threat of all the sexually transmitted diseases. Researchers can't easily track the rate of new HIV infections because many people don't get diagnosed for years. However, federal statistics released last fall revealed that infection rates among gay and bisexual men in 29 states grew by 17 percent from 1999 to 2002.

Experts fear the AIDS epidemic is growing worse because gay men are abandoning safer sex practices, possibly because of "condom fatigue" or a misplaced belief that AIDS is a treatable condition.

In recent months, community activists and researchers have focused on the role of crystal meth, also known as "crystal" or "meth." The drug heightens sensations of all types, making it a popular drug to take before intercourse. According to researchers, the drug seems to be especially popular among men who engage in unprotected anal sex, Valdisseri said.

Several new studies from San Francisco released Wednesday document the link between crystal meth use and unsafe sex. One study found that 16 percent of gay and bisexual men used crystal meth the last time they had anal sex; the users were twice as likely as others to not use condoms during receptive anal sex, Valdisseri said.

Another study reported that 17.4 percent of gay and bisexual men who visited an STD clinic had used crystal meth within the past four weeks, he said.

Elsewhere, research in Seattle suggests crystal meth users are three to four times more likely to be infected with HIV than other gay and bisexual men.

The findings also provide more evidence that many HIV-positive men continue to put others at risk by having unprotected sex. "They need a lifetime of support to maintain safe behaviors and protect their health and their partners' health," Valdiserri says.

Researchers say there are several promising ways to prevent STDS among gay and bisexual men:

  • Notification of sex partners of STD patients through the Internet. Experts say a growing number of gay and bisexual men meet anonymous sex partners through the Internet. Several small studies suggest that many men would respond to heads-up e-mails from health officials warning them that their partners are infected with STDs.
  • Better outreach to the gay community through the media and in venues like bars, sex clubs and parties. Researchers say the efforts need to both educate gay men and encourage them to take responsibility for their decisions regarding sex.
  • More free STD tests and greater use of rapid tests for HIV infection and, now, for syphilis that allow people to get results immediately. "If we can do 'one-stop shopping' for people at various high-risk venues that's going to help," Valdiserri said.

But a one-size-fits-all approach to STD prevention remains elusive. "If we had a simple answer, we could close up shop," said Dr. Kenneth Mayer, an AIDS expert and professor of medicine and community health at Brown University.

More information

To learn more about HIV/AIDS and treatments, visit the U.S. Centers for Disease Control and Prevention or the National Institute of Allergy and Infectious Diseases. To get information about crystal methamphetamine and HIV, try AIDSHotline.org.

SOURCES: Ronald O. Valdiserri, M.D., deputy director, HIV, STD and TB prevention center, U.S. Centers for Disease Control and Prevention, Atlanta; John Douglas, M.D., director, STD Prevention Division, CDC, Atlanta; Kenneth Mayer, M.D., professor, medicine and community health, Brown University, Providence, R.I.; March 10, 2004, presentation, National STD Prevention Conference, Philadelphia
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