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Battling H.I.V. Where Sex Meets Crystal Meth
Crystal Meth & Minorities in NYC
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NY Times
Feb 21, 2006
By ANDREW JACOBS
Terry Evans turned on the computer, punched in his password and set out on the prowl. It was a Saturday night, and with more than 900 men logged onto the sex site Adam4Adam.com, he had no problem finding his quarry: a 25-year-old man nicknamed "Bronxplayer" who was looking to "party-n-play," cyberspace lingo for engaging in a sexual encounter enhanced with crystal methamphetamine.
"Wanna play?" Mr. Evans wrote. "Let's talk and make it happen." But Mr. Evans, an outreach worker for Positive Health Project, an advocacy group that strives to reduce the spread of H.I.V., was not looking to do drugs. He was trying to lure Bronxplayer into his support group for black and Latino men whose lives have been hijacked by crystal meth, an illegal stimulant known to melt away inhibitions. After a few minutes of back-and-forth banter, Mr. Evans revealed his hand and the man begged off.
"Not everyone's happy with the bait-and-switch, but there aren't many ways to get people's attention," Mr. Evans said as he scrolled down, searching for his next prospect. "Sometimes a guy will get hostile, but then he'll come back later to ask me questions." But he has succeeded, via the Internet, in persuading some men to join his group.
Mr. Evans, a recovering crystal meth addict, is among a handful of drug abuse counselors trying to stanch the powerful amphetamine's increasing popularity among black and Hispanic gay men, a trend that has alarmed city health officials who link the drug to the spread of H.I.V. and other sexually-transmitted diseases.
Over the past decade, as crystal meth has made its way into New York, it has led to a steadily rising number of arrests, hospitalizations and health problems.
A recent study of 19,000 men in Los Angles showed that new H.I.V. infections were three times higher among methamphetamine users than among nonusers. Further, drug abuse experts and some law enforcement officials in New York say they fear that the drug could follow the trajectory of another stimulant that spread violent crime, death and the dissolution of communities across New York City a generation ago: crack cocaine.
"From our point of view," said Dr. Ronald O. Valdiserri, deputy director of the National Center for H.I.V., S.T.D. and TB Prevention at the Centers for Disease Control, "crystal meth is a very serious public health issue."
Like AIDS itself, which was once largely confined to the world of white gay men, the abuse of crystal meth is beginning to find favor among those who live far from Chelsea.
In a recent New York University study of 312 crystal meth users, 32 percent were white, 23 percent were Latino and 22 percent were black. At a methamphetamine support group run by Gay Men's Health Crisis, blacks now make up more than 10 percent of the participants, up from fewer than two percent in 2001.
Dr. Perry N. Halkitis, an applied psychologist at New York University who led the study, said that "the problem has been brewing for the past year, but now it's beginning to boil."
Dr. Richard Rawson, a researcher at University of California, Los Angeles, who has been studying the drug for two decades. says the appeal of meth is even greater than crack: methamphetamine, which can be smoked, snorted or injected, is just as cheap but packs a more potent and prolonged high. And unlike crack cocaine, whose raw materials are imported from South America, methamphetamine can be made locally from widely available ingredients.
"From a pure marketing point of view, meth really gives you a bigger bang for your buck," Dr. Rawson said.
The drug's route from gay enclaves to a heterosexual population, experts say, could come about via gay men of color, especially those who lead double sex lives, similar to the path of AIDS over the last decade.
Just as homosexuality is more stigmatized among some minority groups, so, too, is the use of a drug associated with gay sex. And just as AIDS is now firmly entrenched among black and Latinos - black women make up 34 percent of all new cases - crystal meth abuse may soon follow the same course.
Although meth's distribution remains limited in the city, some drug abuse experts say it is only a matter of time before it makes its way into communities that were once ravaged by crack. "Ten years ago, if I had told people in Iowa that they would be coping with a meth crisis in Des Moines, they would have laughed at me," Dr. Rawson said. "Now they're drowning in meth. The Hudson River is not going to stop it from coming to New York."
Keith, a 39-year-old office assistant and a client at the AIDS organization Harlem United, took his first drag on a crystal meth pipe last April at a sex party where almost everyone was black. The next morning, he says he was hooked. Ashamed, depressed and on the brink of homelessness, he would not give his last name.
"It used to be the only people I knew who did crystal hung out with Caucasians," he said. "Now there are plenty of black guys doing it on their own."
Public health campaigns that take aim at meth use among minorities are just getting under way, although it is widely acknowledged that earlier efforts that targeted recreational drug users in Manhattan's gay neighborhoods will not necessarily work in Washington Heights or the Bronx.
Donald Suggs, outreach coordinator at Harlem United, said such campaigns, which relied on scare tactics, have helped stigmatized crystal meth among whites but have made its use among black and Latino men more secretive. "It might be O.K. to talk about party drugs in Chelsea, but there's very little room for discussion in the black and Latino community, where the stigma is much stronger," he said.
With money provided by the New York City Department of Health and Mental Hygiene, the organization has been placing Spanish-language ads on the Internet, and it is preparing to send volunteers into bars and clubs where Latino men congregate. Organizations like Harlem United are starting support groups that focus on black men.
Mr. Evans has gone one step further. In addition to the Saturday afternoon drop-in center he runs near the Port Authority Bus Terminal, Mr. Evans heads out after midnight each weekend to private sex parties where crystal meth use is the norm. It can be an awkward job, one that often requires Mr. Evans to strip down to his underwear, the better to blend in. Sometimes he does condom demonstrations; other times he just answers questions about meth. Often, he is just ignored.
"I don't judge people," said Mr. Evans, 32, who said he has been sober for three years. "I know I can't stop them from doing drugs, but at least I can make sure they're safe when they're doing them."
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