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Published on May 21st, 2013 | by Healthy Gay Lifestyles

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Meths Contribution to HIV Infections in Gay Men

by Dr. Richard A. Martin Jr.

Methamphetamine is a drug that has been around for decades. Slang names for the drug include meth, crystal meth, Tina, ice, and glass. Back in the 60’s it was commonly referred to as “speed”.

Meth is a brain stimulant classified by the U.S. Food and Drug Administration as a Schedule II drug like OxyContin or morphine. Like OxyContin, it is widely abused. It can cause dependence with repeated use.

Meth is very addictive. It can be injected. It can increase sexual arousal while reducing inhibitions. Meth use has been linked with increased numbers of HIV infections in MSM (men who have sex with men). Studies show that MSM who use meth may increase their sexual risk. They may use condoms less often. They may have multiple sex partners. They may engage in practices that increase their risk for HIV infection, such as unprotected receptive anal sex. Risk factors for HIV transmission by drug use (like injecting meth instead of smoking or snorting it) may increase, also.

The Substance Abuse and Mental Health Services Administration, in 2004, estimated 12 million persons aged 12 and older had used meth at least once in their lifetime. 600,000 (0.2% of the US population) had used it during the past month. They estimated that from 1993 through 2003, admissions for the treatment of meth abuse increased from 13 to 56 admissions per 100,000 population of people aged 12 or older!

Several studies show a higher rate of meth use among MSM. For example, a 2001 study found that 15% of MSM in San Francisco had used meth during their most recent anal sex (within the past 3 months). Meth use was a close third on the list of recreational drugs used. It was preceded only by the use of the number 1 and 2 drugs, alcohol and marijuana respectively. The current increase of meth use began in the western United States. By the mid-2000s, its use had become a nationwide concern. Lab seizures and restrictions on purchasing ingredients needed to manufacture meth have reduced its production in the United States. Use is still ongoing, though.

Meth causes the release of large quantities of chemicals in the brain. These so-called neurotransmitters cause increased heart rate and blood pressure. They produce sensations of pleasure, self-confidence, energy, and alertness. They also depress the appetite and enhance sexual arousal. The long-term use of meth can lead to reduced levels of these chemicals. This makes the user crave meth to raise those levels. Long-term use of meth can cause physical symptoms. Decayed teeth, weight loss, skin sores, stroke and heart attack can occur. Mental symptoms like paranoia, hallucinations, anxiety, and irritability can occur. Meth can cause behavioral symptoms such as aggressiveness, violence, and isolation.

Coming down from the high is often described as a “crash”. It can include a phase of depression. Additional doses of the drug are often used to relieve these negative feelings. This cycle can lead to addiction, which can be very difficult to overcome. Some researchers feel meth can produce physical addiction with its initial use.

Because meth can often cause impotence at the same time that it is increasing libido, some users may use erectile dysfunction medications. They may then engage in unprotected anal sex while under the influence of the drugs. Meth’s effects last longer, and it is less expensive than cocaine, so it is attractive to many populations, including young people, who sometimes refer to it as “poor man’s cocaine.”

Growing research shows the relationship between the use of meth by MSM and an increase in behaviors (both sexual and those related to injection drug use) that can put the user at risk for HIV infection. Use may impair the ability or the desire to be safe, both sexually and when injecting drugs. Meth may dry the rectal lining, which may lead to more chafing and abrasions, providing an entry for HIV during sexual activity . Meth use is linked with sexual practices that may increase the likelihood of HIV and other STD transmission. Factors like long sessions, leading to chafing or sores; multiple partners; lack of inhibition; and low level of condom use have been identified. Use may cause mental confusion and impair one’s ability to take medications that have been prescribed for HIV infection. This increases the likelihood of spread of the infection.

It is becoming clear that the use of meth can contribute to sexual risk behaviors, regardless of the sexual orientation of the user. Current information shows a strong link between meth use and sexual risk among MSM, and perhaps among heterosexual adults and youth.

The public health implications are obvious. There is a need for a broad approach in addressing meth use and risk for infection with HIV and other STDs. HIV and STD prevention and treatment programs could be modified to include assessment for meth use, with referrals to treatment.

I remember back in the ’60’s there was a radio spot ad campaign aimed at decreasing the use of meth, which, in San Francisco in the late ’60’s, was rampant. Great rock stars of the day would present their pleas for caution regarding meth use. The spot I remember vividly was one featuring the late Frank Zappa, who was one of my heroes of the era. “Speed…..rot your liver, rot your teeth, rot your kidneys…..cucaracha!” it went. Probably good things to keep in mind! Thanx, Frank!

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Dr. Richard A. Martin, Jr. is a retired Emergency Medicine physician with over a quarter century of diverse clinical experiences. He graduated with his MD in 1976 from the University of Missouri – Kansas City and did post-graduate work in Seattle, Denver, West Virginia and South Florida. Since retirement, he has worked with agencies in his hometown of Seattle developing programs to enrich the health and well-being of the Gay community there. He is a long-term (30 years) survivor of HIV/AIDS, originally exposed through a workplace accident in the late 1970’s. He is now going back to school with a goal of becoming a Licensed Mental Health Counselor with interest in fostering the mental health of the LGBT community. His areas of expertise include HIV-1 and -2 infections in humans, trauma care, bariatrics, mood disorders and chemical dependency. In his spare time he’s a free-lance disc jockey and loves remixing music. He lives on the top of First Hill with his partner of seven years and dog. He has a 31 y/o son, a photographer, living in Atlanta. You can reach Dr. Martin at rosti@comcast.net or through Twitter: @DJROSTI.

 

 

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