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New meth study confirms suspected realities

Finds HIV+ and two-spirited men particularly at risk

A new study about crystal meth use among gay men in Vancouver confirms that use of the drug presents a serious health problem “associated with sexuality, HIV/AIDS, class and race.”

But the results are unexpected, says Dr Robert Hogg, director of epidemiology and population health at the BC Centre for Excellence in HIV/AIDS.

“We knew there was a problem with methamphetamine use among gay men,” says Hogg. “However, we did not know which groups experienced heavy or problematic use.”

“We now understand that men with HIV, and particularly Aboriginal two-spirit men, are over-represented in our samples, indicating directions for future health care initiatives,” Hogg explains.

“We also did not understand some of the specific issues surrounding the drug in the lives of men and how this intersected with their sexuality in terms of recovery services and health care providers.”

Entitled “Methamphetamine Use Among Gay Men in Vancouver,” the study is the second phase of a project that the Gay Men’s Methamphetamine Working Group (GaMMa) started in 2004. The first was an Outreach Project that ended in September 2006.

Methamphetamine is a potent stimulant drug that many gay men use in dance clubs and during sex. It increases levels of the brain’s chemicals dopamine, serotonin and the hormone norepinephrine. On the street it can have many names, including Crank, Crystal, Ice, Meth, and Tina.

Funded by Health Canada as part of its Drug Strategy, this study contains interviews with 89 gay men, which is almost three times the size of any similar study. Approximately half of the people interviewed are current users. The balance are either former users or the partners or friends of users.

Nevertheless, the results cannot be generalized to other groups because of the qualitative nature of the study. Qualitative research is more subjective and often used to develop theories by collecting, analyzing and interpreting information based on what individuals do or say, as opposed to the more structured data collected in quantitative research.

“The study was conducted at the request of the community to explore problematic methamphetamine use among gay men in Vancouver,” Hogg explains. “In addition, we explored the implications for health care services for gay men who are heavy users.”

“This is an in-depth analysis of a particular social group,” says Francisco Ibáñez-Carrasco, the research technical assistant at the BC Person With AIDS Society, one of the study’s partners. “It’s quite commendable that it was done this way. It’s a very solid piece of research.”

The BC Centre for Excellence in HIV/AIDS also worked with the Vancouver Coastal Health Authority, AIDS Vancouver and the Downtown Eastside Youth Activities Society on the study.

“The value of this very thorough, systematic study is to confirm in a very rich way a number of things that we knew, somewhat anecdotally and from general epidemiology,” asserts Ibáñez-Carrasco.

“It [accomplishes] one of the most important things that we do in science, which is to confirm a reality that we all suspect. We make this information legitimate, and easier to use by scientists and a community.”

Jody Jollimore, a university graduate student who worked on the GaMMa Outreach Project, supports the research. “I read between the lines and saw it as a call for more monitoring, and more gay men’s health committees that act. It shouldn’t take a handful of citizens to say, ‘Crystal meth is becoming a problem. Let’s set up a committee.’ There should be somebody who’s already looking after those things, who has [his] pulse on the community, and understands gay men’s issues.”

Ibáñez-Carrasco believes the study is valuable in the way it presents information on “the use of methamphetamine, its relation to HIV, to First Nations persons, to sexuality, to the culture of gay men in the city. We also learned quite a great deal in terms of treatment [and] detox.

“For me,” he says, “the most important part is that research processes themselves actually change the culture around the particular subject. Doing the research, aside from the results, was a great community development piece. There were all kinds of activities attached to [it] that were very successful. The issue was brought to visibility in the public arena, particularly among gay men. The participation of the community at all levels was quite impressive.”

Still, Jollimore says he doesn’t know how much impact the study will have on crystal meth use in the community.

“We need to do a better job of protecting gay men’s mental health, and responding to those needs,” he says. “We need to be more responsive to addiction issues in gay men’s health. That’s the first thing it leads to.”

“Where does it [go] in the long-term?” he asks. “I have been reading a bit about a health organization that is solely responsible for gay men that’s looking out for [their] very specific health-related needs. This report shows that there needs to be a quicker response in our community to gay men’s health issues.”

Ibáñez-Carrasco agrees, and hopes “that various agencies will look at the results, discuss them, and integrate them into their programming and policy.”