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Gay and bisexual men who are infected with HIV are twice as likely to use the drug methamphetamine as the population at large, Congressional staff heard at a briefing this week.
Perry Halkitis, a researcher at New York University, told the Capitol Hill briefing that one myth about the drug was that it was used primarily by white people. Pointing to survey data from several US cities, he said, “This is a drug that cuts across racial and ethnic lines within the gay and straight populations.”
Dr Halkitis conducted detailed interviews with dedicated users of gyms in New York city and found that nearly 25% of these men had used methamphetamine in the past six months. Most of them also used a number of other drugs, with most reporting use of cocaine, ecstasy, and other “party” drugs, as well as a lot of alcohol.
HIV positive men were more likely to use methamphetamine than gay men who were not infected, the research showed. Dr Halkitis said, “They tell us over the years that methamphetamine provides them with a way to deal with their stigma for being gay and HIV positive. It gives them energy. It is completely understandable why they would turn to this drug.”
One implication for the delivery of services, said Dr Halkitis, is that gay users of methamphetamine “don't believe they have a problem, they don't want to go to an addiction facility—they are much more willing to come into a gay agency where they can work at a more holistic approach on their methamphetamine use.”
Another myth about the drug was that the addiction was not treatable, said Elizabeth Disney, of the Chase Brexton Health Service in Baltimore. That was not true: recovery rates were about the same as from cocaine and similar substances.
Good evidence exists that bupropion (marketed in the United States as Wellbutrin and in the United Kingdom as Zyban)—which is used to help people give up smoking—reduces both the “high” of use and the craving of withdrawal; and other pharmaceutical interventions were showing promise. “But none of them are silver bullet, standalone interventions,” said Dr Disney. “They all have to be given in the context of behavioural treatment, learning how to change your life.”
Dr Disney described information and treatment programmes developed by the integrated substance abuse programmes of the University of California at Los Angeles. Barbara Warren, of the LGBT (lesbian, gay, bisexual, and transgender) Community Center in New York, said, “What we need from Congress is support for adequate resources to continue the programmes that we now have and to implement more.”
She said that the National Coalition for LGBT Health is calling for the addition of $2m (£1m; €1.5m) to include a question on sexual orientation in the next US national health interview survey, to help create a baseline understanding of incidence at the national and state levels.
Dr Halkitis said that understanding what happens to users at the age of 18-25, the transition into adulthood, was crucial. “We need to better understand what is happening to kids in childhood and adolescence that is predisposing them to use drugs. We have to help them get to the next stage of their lives without depending on drugs.”
More information about methamphetamine programmes can be found at www.methamphetamine.org.