A gay man hopes the story of his crystal meth addiction will help save those still in the closet about their own drug problems.
The men are careful not to offend Blue Ball organizers or partygoers. But they believe a lot of their target audience will attend the annual community fundraiser.
"The Blue Ball isn't all about sex and drugs," says one man.
The others laugh.
"Not everyone there is doing drugs," he insists.
Just 15 minutes into the meeting the group lands in culturally treacherous territory. They want to change the conversation, to get the gay community-their community-to start looking at the cost meth exacts. But crystal sits at an emotionally charged nexus between gay men, sex and HIV, making it a difficult subject to broach. Because of this task force, however, and because city health agencies also perceive a growing crisis, the drug will soon get a very public coming-out party.
"Crystal Is Linked to Sexual Behavior"
"We don't know the extent of the problem in Philadelphia," says David Acosta, coordinator of prevention programs for the city's AIDS office. "But a problem exists. Anecdotally, more and more people tell me there's a lot of crystal out there."
The city is now convening a task force to quantify and address the problem. The Mazzoni Center, a resource hub for the LGBT community, offers some statistics. In 2004, 30 percent of those who tested positive for HIV at their facilities listed using crystal meth as one of their "high-risk" behaviors.
"That's up significantly from the year before," says Mazzoni Center executive director Nurit Shein. "We've been seeing meth use increase for more than a year. We want to deal with it now, while it's still a problem and not yet a catastrophe."
Shein says she believes the number of men listing crystal as a high-risk behavior should be higher, but the methods of questioning leave room for dissembling. Shein also says the drug is probably linked to the increased spread of syphilis and other sexually transmitted diseases. The Mazzoni Center is planning an afternoon forum for healthcare providers and a town hall meeting for the community to discuss crystal meth.
Other cities, like New York, San Francisco and Miami, have already confronted the link between crystal meth abuse and HIV infection rates. In New York a small group of activists led the charge.
Playwright Harvey Fierstein moderated a November 2003 public forum attended by more than 300 people. HIV-negative and -positive men openly addressed the stigmatization each felt from the other. Some spoke of seeing twentysomethings being barebacked in New York City bathhouses by older men with KS lesions-the brown, red or purple growths that can signal full-blown AIDS. Peter Staley, a well-known gay activist, stunned the crowd by admitting to abusing meth and engaging in unprotected, anonymous sex without disclosing his HIV-positive status to his partners.
Whether the forum succeeded in diminishing crystal meth use isn't known, but signs are encouraging. "Crystal Meth Anonymous tells us attendance has doubled in New York in the past year," reports Dr. Bruce Kellerhouse, one of the city's leading crystal activists. "But I can't speak with any authority about whether use has peaked yet in New York."
Though much of the evidence linking the drug to HIV infection is anecdotal, the Centers for Disease Control is targeting crystal as a factor in new HIV cases. According to statistics the CDC receives from 32 states, new HIV diagnoses increased in the "men who have sex with men" (MSM) subgroup by 11 percent during the most recent four-year period. New York City suffered a 17 percent spike in new HIV infections among gay men over three years.
Some of this increase can be traced to simple condom fatigue. But meth abuse plays such a big role that it's been touted as the "new gay epidemic."
"Crystal is linked to sexual behavior for a lot of people in the MSM community," says CDC scientist Gordon Mansergh. "And statistically we tend to see a far greater incidence of crystal meth use in the MSM community than in other groups."
Mansergh quotes one study in which men who used meth in their last encounter were twice as likely to have engaged in unprotected receptive anal sex. Meth users were also twice as likely to report unprotected sex with someone of a different HIV status.
Philadelphia's Department of Public Health won't disclose local HIV statistics because they don't trust the accuracy of the numbers they receive from healthcare providers. The difficulty in nailing down statistics for such a pressing public health issue is another example of the topic's sensitivity. The need for political correctness sometimes works counter to the need for openness and honesty, which is why Jay Dagenhart hopes telling his story will help others tell theirs.