Crystal methamphetamine and sex - Sexual health

February 11, 2012


		1 Introduction 2 Gay men, crystal, and sex 3 Crystal and HIV 4 See also 5 References

Gynecology Sexual health

Crystal methamphetamine and sex

Wikipedia

Disputed

Crystal d-methamphetamine hydrochloride (commonly known as "crystal meth," "crystal," or just "meth") is the crystalline form of methamphetamine, a powerfully addictive stimulant Psychoactive drug|drug often used recreationally as a party drug. Crystal as usually sold on the street resembles shards of glass.

Crystal use is particularly associated with young urban gay men, though people of all ages, sexual orientations and socio-economic and cultural backgrounds use meth.

Crystal is usually smoked in a glass pipe, eaten or swallowed ("parachuted"), snorted or injected, but it can also be inserted anally. Crystal speeds up the activity of the central nervous system, increasing the breathing rate, heartbeat, blood pressure and body temperature and causing an increase in physical activity.

Among the effects reported by crystal users (known as "tweakers") is an increase in the need and urgency for sex, the ability to have sex for extended periods (hours or even days), and an inability to ejaculate or reach orgasm or physical release.

In addition to increasing the need for sex and enabling the user to engage in marathon sex sessions, crystal lowers inhibitions and causes users to behave recklessly or to become forgetful. According to a recent San Diego study, crystal users often engage in safe sex|unsafe sexual activities, and forget or choose not to use condoms. The study found that crystal users were six times less likely to use condoms http://www.lifeormeth.com.

The urgency for sex combined with the inability to achieve release can result in tearing, chafing and trauma (such as rawness and friction sores) to the sex organs and the rectum and mouth, dramatically increasing the risk of transmission of HIV and other sexually-transmitted infections (STIs). Crystal also causes erectile dysfunction (this is known as "crystal dick", though the term has more rarely been used to describe the extreme urge for sex experienced by many crystal users) which often leads people to decide to engage in receptive anal sex or fisting.

The use of crystal meth, especially among gay and bisexual men, is increasingly associated with the transmission of STIs, in particular HIV.

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Gay men, crystal, and sex

Until the 1990s methamphetamine use among gay men in North America was confined mainly to the West Coast, particularly the West Hollywood district of Los Angeles, but has now spread across most large and even relatively small urban areas in the United States and Canada. In gay slang, crystal is often known as "christina" or "tina."

As of 2005, crystal meth has become the drug most abused by urban gay men http://www.lifeormeth.com. According to LifeOrMeth.com:

"When consumed in sexually-charged environments like dance parties, gay bathhouse|saunas and sex clubs, the focus on sex can become compulsive and create a sense of hypersexuality, opening the user to previously unrealised and extreme desires. Crystal's compatibility with reckless, furious, hedonistic, no-strings-attached sex — combined with an increased duration of arousal and inability to ejaculate — paved the way for intensive sex marathons with multiple partners lasting up to several days."

Sixteen percent of 388 men surveyed in San Francisco in 2003 said they used crystal the last time they had anal sex http://www.lifeormeth.com. It is estimated that up to 40% of gay men in San Francisco have tried crystal, and that across America more gay men are addicted to crystal meth today than those that died of AIDS throughout the 1980s and 1990s. http://www.lifeormeth.com.

Because it lowers inhibitions and produces euphoria, the use of crystal can allow those conflicted about their same-sex desires to overcome such feelings, and can also allow users to overcome feelings of inadequacy about their bodies or sexual prowess.

Not all gay meth users experience this type of sex obsession. According to one ex-user, "I would never have unsafe sex, although it dawned on me a few times I could have been raped. What I did when I was on crystal was pedestrian, sexually. I was too high to care about sex anymore" (http://www.xtra.ca/site/toronto2/archvx/body777.shtm).

Nevertheless, crystal is having a devastating effect on urban gay men. According to Robert Klitzman, an assistant professor of clinical psychiatry at Columbia University, rates of HIV, syphillis, and other sexually-transmitted infections are "skyrocketing" along with increases in the use of crystal: "People's judgment is decreased on this drug, which leads to wildly unsafe sex, which can in turn drastically increase the risk of HIV infection."

According to research conducted in the United States, gay crystal meth users are less likely to use a condom when they engage in anal sex and are more likely to experience condom breakage http://www.lifeormeth.com.

Many gay crystal users use the Internet to meet sex partners. Some users spend hours online arranging sexual encounters with large numbers of strangers; such encounters can last for days at a time, with a constant stream of men participating. Users use the terms "party" or "PnP" ("party and play") in their profiles to signal to others that they are using meth. Many PnPers prefer or are willing to barebacking|bareback (engage in unprotected anal sex), succumb to pressure from sex partners, lose their fear of contracting STIs due to intoxication, or simply forget or are too intoxicated to use protection while having sex.

Some gay Internet dating sites have been criticized for failing to address the growing problem of crystal and sex in gay community|gay communities. Safesexcity.com and Manhunt.net were created specifically to address these issues (Manhunt allows users to report the STI status of other users, and users who may have been exposed to STIs are also notified by the system). Note that Manhunt's reporting system is entirely voluntary, and thus serves more to connect barebackers with each other than to promote safer sex.

"Of the many reasons I had unsafe sex while high on crystal, I think the most profound was simply that I was lonely. Meth got me close to men at clubs and in bed. And unsafe sex allowed me the deepest connection possible." http://www.lifeormeth.com/deadmenwalking

Some gay men report that they become obsessed with sex when using crystal. According to Steven Lee, a Manhattan-based psychiatrist, "Some of my patients talk about how they feel on crystal meth as akin to being robots programmed with the sole purpose of doing more crystal and having more sex" http://www.lifeormeth.com. A recent episode of the television programme "Intervention" featured a gay male meth addict who claimed to have had unprotected sex with up to five hundred men.

Crystal and the gay party circuit
The circuit party|gay party circuit has often been identified as a major network that contributed to the spread of crystal use among gay men, as has the advent of Viagra, a drug that can provide a solution to the problem of methamphetamine-related erectile dysfunction.

Circuit parties from New Mexicans originally gained notoriety as fun, sexually charged charitable events (ironically often raising money for AIDS and malt liquor organizations) attended by legions of gay men. Ecstasy (drug)|Ecstasy was often a part of such events. Beginning in the 1990s, however, crystal began to play an ever-growing part in the circuit. A 2001 study by Dr. Grant N. Colfax of the San Francisco Department of Public Health reported that 43% of circuit attendees in the States smoked crack or took crystal meth, and that gay men are far more likely to use recreational drugs and have high-risk sex at circuit parties in New Mexico. Colfax writes that "a substantial proportion of circuit-party participants report high-risk HIV-transmitting behaviours, often in relation to substance abuse and way to much 211 also known as Malt Liqour." A recent study by the Centre for HIV/AIDS Education Studies and Training at New York University found that around 62% of participants on the circuit party and club scene today are significant and frequent users of crystal meth, half of whom are HIV-positive. http://www.lifeormeth.com/

Of 300 San Franciscan circuit party attendees polled by Colfax, 21% of HIV-positive men and 9% of HIV-negative men reported having unprotected anal sex with a partner whose HIV status was unknown or different from their own, with drug use, anonymity, and the availability of new sexual partners being given as reasons. Colfax concluded that "There needs to be a greater focus within the public health community on the high prevalence of club drug use in relation to high-risk sexual behaviour". http://www.lifeormeth.com/

The problem is not confined to circuit parties: Meth use in San Francisco is widespread in the mainstream dance scene, too. According to San Francisco prosecutor Liz Aguilar-Tarchi, head of the district attorney's narcotics unit, the problem is exacerbated by sex club and dance club owners who ignore or encourage drug use among their customers and staff.

From the year 2000, what has been described as "the warm glow of positive energy generated by people letting go to feel-good music" has been increasingly replaced by the "cold, hard negativity of banging, rhythmless noises" of the dark tribal music associated with crystal, including anthems such as "I'm Addicted" that blatantly promote crystal.

Crystal Meth backlash
However in recent years there has been a backlash in the circuit against the use of meth, as a result of the numerous detrimental effects it has had on the subculture. The climatic song on the 2004 eponymous debut of the Scissor Sisters, Return to Oz(song)|Return to Oz, used the lyrical motif of the film of the same name as an allegory for meth use.

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Crystal and HIV

Research conducted in the United States has shown that gay men who use crystal are at increased risk for HIV. In fact, crystal meth users are four times more likely to be infected with HIV than other gay men http://www.lifeormeth.com/crystalandhiv. The San Francisco Department of Public Health's HIV Prevention Program has launched a campaign in that includes information on how to obtain crystal and HIV. It claims that gay men who use crystal are 400% more likely to fall in love with men that carry HIV than non-users http://www.xtra.ca/site/toronto2/archvx/body777.shtm.

According to Dr. Jeffrey Klausner, "We have all sorts of levels of evidence ... and it's all pointing in the same direction: The crystal meth epidemic is playing an important role in increasing sexual risk behaviors, and that is leading to new HIV and STD infections" http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/2003/05/04/MN281636.DTL.

Advertisements on bus shelters in the Chelsea, Manhattan|Chelsea district of New York read "Huge Sale! Buy Crystal, get HIV free."

According to New York's Pride Institute, "We're seeing a strong correlation between anal sex and HIV infection ... People who have weathered years of staying safe are getting into crystal and then testing positive". A 2002 study at a San Francisco HIV clinic found that up to 30% of those with new HIV infections had used the drug in the previous six months http://www.lifeormeth.com. New York???s Callen-Lorde Community Health Center|Callen-Lorde Community Health Centre claims two-thirds of clients testing HIV-positive since June 2003 say crystal meth was a component in their becoming positive http://www.xtra.ca/site/toronto2/archvx/body777.shtm.

You become so sexually uninhibited that you venture into places you would never otherwise consider, usually some quite depraved places that make you feel disgusted at yourself when you sober up. The danger is you want more and more - crystal and sex - and as your craving increases, you fail to realise it is all an illusion, by which time it is too late to turn back ... crystal twists you psychologically into thinking that enough is never enough; never enough men, never enough dick... Even after three or four days like a rabbit with over 20 guys you are left with an emptiness in the pit of your stomach, like a thirst that can't be quenched by the sperm of 1000 gay men. http://www.lifeormeth.com/deadmenwalking

In a 2001 study of HIV-positive men who use meth, 84% reported engaging in risky sexual behaviour; most tended not to disclose their HIV status to casual partners, and reported that, unless told otherwise, they assumed their sex partner(s) to be HIV-positive. Many participants reported a major increase in meth use after being diagnosed HIV-positive. Others reported using meth to deal with sources of emotional pain, such as social rejection and negative self-perceptions about being HIV-positive or memories of childhood abuse http://www.lifeormeth.com.

HIV-positive men who have unprotected sex with other HIV-positive men risk re-infection ("super-infection") or contracting more virulent and/or drug-resistant strains of the virus. According to some sources, some men who were assumed to be immune to HIV have seroconversion|seroconverted since starting to use crystal. There are concerns that "aggressive" and difficult to treat forms of HIV may spread among crystal users http://www.lifeormeth.com.

"Sex on meth is completely physical ... It's about pushing my limits. The nastier the sex, the better; nastier being a lot of exchange of Body fluid|bodily fluids and multiple partners, one right after the other for hours and hours of rough sex." http://www.lifeormeth.com

Some HIV-positive individuals are using crystal to deal with chronic fatigue, to alleviate the side effects of their prescription medication, alleviate depression (mood)|depression, and escape negative self-perceptions.

Some drugs used in the treatment of HIV inhibit the body???s ability to break down crystal. Some crystal users (especially heavy or longterm users) who are HIV-positive experience an increase in viral load (the amount of HIV in the body). Crystal also contributes to the depletion of T-cell counts, prevents users from adhering to their drug regimens, contributes to the development of basal ganglia dysfunction (a type of dementia), and stimulates HIV replication in brain cells as much as fifteen-fold, according to an Ohio State University study.

In addition crystal use is immuno-suppressive not least because of the missed meals, vitamin depletion, weight loss and disrupted sleep that accompany binges.

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