Simon is a party boy in Toronto's gay community. At 36, he's hot, popular and loves what he calls "sexual fender-bender weekends," which he describes as "disappearing on Friday and not coming up for air until late Sunday." They happen at least once a month, he says, and inevitably involve two key ingredients: unsafe sex with as many different men as possible and crystal methamphetamine.
Simon (not his real name), who began using crystal meth four years ago, is HIV-positive and blames the extremely potent effects of the drug.
"Whatever it took you to be sexually active yet stay HIV-negative for up to 20 years, crystal meth takes all that away," he says.
"Safe sex isn't important. That [attitude is]beyond comprehension unless you're on Tina."
Crystal meth, known by users as Tina, ice, hydro, crank or chalk, is the latest drug of choice among those who use illegal substances to enhance sexual experiences, a practice known by some in the community as "party and play." Snorted, smoked or "slammed" (injected), the popularity of crystal meth is on the rise: The World Health Organization estimates that 34 million people use it daily, and it has become prevalent on the "PnP" scene in Toronto.
It's highly addictive, and the comedown can leave users despondent, depressed and even suicidal. And within the gay community it's now becoming linked to another frightening threat: the spread of HIV.
Users cite the drug's perceived positives: increased pleasurable sensation, a huge rise in confidence and boundless energy that can last for hours or days. It is also cheap: $60 for a quarter-gram supply that can go a long way. But most of all, according to users, crystal increases sexual desire to unimaginable levels, while smothering inhibitions into non-existence, including abandoning strongly upheld, decades-old safe-sex practices.
Health officials, in an announcement that has grabbed headlines worldwide, have highlighted frequent use of crystal meth in relation to the diagnosis late last year of a mid-40s man in New York with a "highly resistant strain" of HIV (referred to as 3-DCR HIV). It has been unresponsive to three classes of antiretroviral medication, and the patient, who practised unprotected sex with multiple partners, is now experiencing rapid onset of advanced AIDS symptoms. Officials have cited the case as a "wakeup call" to men who have sex with men and who use the powerful recreational drug.
Concerns about the drug have led the AIDS Committee of Toronto to apply to Health Canada for support in creating a crystal-meth awareness campaign and propose a new study that would interview crystal users.
This is not the first time the drug has been pinpointed as a possible cause of HIV infections. But many users who say they are ready to quit are finding themselves unable.
Simon has been fighting to stop using for more than two years, including seeking counselling. But shunning crystal is far from easy. An estimated 42 per cent of first-time users report the desire to use it again, with an estimated 84 per cent of second-time users beginning a pattern of use, according to the United Foundation for AIDS.
Chris Lau, gay men's community education co-ordinator at the AIDS Committee of Toronto, notes that while crystal-meth use has not enveloped an entire community -- many gay men don't use drugs -- there are signs of increasingly widespread use of the drug among those who do. "We have anecdotal evidence," Mr. Lau says. "Reports from within the community that use is growing and so is the associated sexual risk-taking."
He also says some clients of ACT have come forward to discuss concerns about crystal-meth dependency. Years ago, he says, when ACT ran a program called Party Safely, which aimed in part at harm reduction by providing information about popular drugs, "it was about ecstasy, ketamine, coke. But if we ran the same program today in the community, I would fully expect more focus on meth."
Rod (not his real name), 44, is an ex-user. He says his addiction to crystal meth caused him to lose his job, and that it took moving away from Toronto for a year, along with weekly counselling that still continues today, to put him on the road to kicking his habit. "If you think every day without Tina gets better or easier, you're wrong," he says. "I'd take some now if you offered."
While Simon says his weekend binges occur monthly, Rod says his were every weekend, usually as 48-hour sessions at bathhouses, costing $1,000 per weekend. "And I would do nothing to take care of myself," he adds. "I was focused on uninhibited sex, that's it."
While crystal-meth use is not exclusive to the gay community (past flags have been raised regarding teens in B.C. enjoying its cheap high, as well as road workers in Alberta using the drug for increased energy on the job, among others), it is gay communities in Canada and the United States, where HIV issues remain paramount, that appear to be taking the lead in outing crystal meth and its damaging effects.
Gay communities in Los Angeles, San Francisco and Seattle have called the use of crystal meth a crisis. San Francisco's department of public health's HIV prevention program, in an effort to educate gay men about HIV infections associated with crystal, launched a confrontational media campaign entitled Crystal Mess. It says gay men who use crystal are 400 per cent more likely to become infected with HIV than non-users.
In New York, gay-focused Callen-Lorde Community Health Center says two-thirds of clients testing HIV-positive since June of 2003 cite crystal meth as a component in their becoming positive. There, ads in bus shelters in the heart of heavily gay-populated Chelsea read, "Huge Sale! Buy crystal, get HIV free." To raise awareness about the drug, New York federal prosecutors also recently unveiled posters featuring the names and mug shots of alleged crystal-meth dealers.
Toronto may not soon see such forceful anti-crystal-meth campaigns from ACT, although last fall it held a community forum and also partnered with the on-line magazine GayGuideToronto.com to create the anonymous on-line forum "InterACTion," where hot-button issues such as crystal meth could be discussed honestly and without fear of stigma.
ACT's Mr. Lau says he is not comfortable with the U.S. hard-line approach on crystal meth. "We're not just going to follow the Joneses," he says. "Crystal meth is an issue, but we need to learn more. Prevention programming must be based on knowledge, fact, not just anecdotal information."
ACT is organizing a local task force to develop a plan of action, in addition to planning its user study and awareness campaign.
"We've learned from experience we don't want to be alarmist."
But based on his experience, ex-user Rod would prefer alarmist. "What is going on now is as scary as what people went through when AIDS hit our community in the eighties. People have to understand before it's too late that crystal meth is different. It's not like any other drug. Alcohol may destroy your liver and cocaine may destroy your nose, but this drug destroys your soul. You can't get that back. As for a new HIV strain, while high on Tina that wouldn't have mattered to me. Crystal meth is the new AIDS."
The distinct link New York Health officials made between the patient with 3-DCR HIV and his crystal meth use has been criticized by some, including Mr. Lau.
"This 'super virus' is a single case. Science hasn't had time to examine it," he says. "ACT is definitely paying attention to the news, but this might even be an individual with a compromised immune system, leading to quicker progression.
"People are becoming positive for many other reasons besides that drug. Very real reasons."
Nevertheless, would the emergence of a possible new strain concern party boy Simon at all? "It's a concern in general if it turns out to be real," he says. "But I'm not sure how there could be a direct link between it and meth."
Does that mean he won't be curbing his use of crystal meth? "That's my constant battle," he says. "But even with this weekend: There's a big party on Saturday night. I'll be surprised if I'm not in another fender-bender."