AIDS Foundation Working to Address Speed Use Among Gay Men

Methamphetamine use, particularly among gay men, is a serious issue in San Francisco and nationally. Most gay men are familiar with the damage that has been done by methamphetamines (also known as speed, crystal, and Tina) either through direct personal experience or through the experiences of friends and loved ones. For many, using speed has resulted in lost relationships, damaged careers, and poor health.

The AIDS Foundation is particularly concerned about the link between speed and HIV transmission. Studies show that speed users can be four times more likely to become infected with HIV. For HIV positive men, speed use can make it much more difficult to maintain good health. The AIDS Foundation recently held a series of focus groups comprised of current and former speed users and asked them to tell us why they used speed, how speed affected their sex lives and health, and what might help them stop using.

While some participants said they started using speed to feel comfortable in social settings and have fun, others reported using because they felt depressed or isolated and believed that speed would boost self-confidence. As one man said, "It frees your mind, especially if you are someone with self-esteem issues. It allows you to get to a point that you are better looking, you're better in bed, which encourages you to pursue someone on the dance floor or in the park." Gay men reported continuing speed use for various reasons, including heightened sexual pleasure and adventure, an increased sense of productivity at work or with household chores, or as a means to deal with depression--some of which was produced by the drug itself.

Men handled speed, sex and HIV risk in many ways. Although some did not have sex when using speed and others were able to have protected sex while using, most men made it clear that condom use interfered with their goal of having uninhibited sex. Although many HIV-positive men were concerned about transmitting HIV, most felt it was their partner's responsibility to ask about HIV status and request condom use. One man said, "When you are high and in that mindset, you really don't care. Doing it (without condoms) feels good. I want it to feel better. That is what I'm going to do."

Some men said they were able to use speed infrequently and felt their use was under control. Others had successfully stopped using. Interestingly, most of these men had done so not by attending a formal recovery program, but through their own efforts and with the support of friends and loved ones. "We wrote each other letters saying this is our last time and we would support each other," said one former user. Others realized that they were placing their health at risk and wanted to quit, but could not find a healthier activity to replace their speed use.

Participants suggested several strategies for helping to better understand and address the impact of speed on their health: a non-judgmental place to go for information and counseling, a needle exchange site specifically for gay men, support to help cultivate healthy relationships and life planning support. One man said, "I feel that I am aimless and have no focus. I need to have something to focus on." Many men indicated that they enjoyed the focus groups and welcomed more opportunities to talk with peers about their speed use.

The AIDS Foundation is developing programs to stimulate community dialogue about speed and to work directly with speed users. Recently, we co-sponsored a community forum with the STOP AIDS Project at which Frank Sanello, author of Tweakers: How Crystal Is Ravaging Gay America, and a panel discussed the impact of crystal on the community. Over 80 people attended this meeting and many shared accounts of the devastation speed has caused in their lives. The Foundation is also participating in a recently appointed Mayor's Task Force to address speed use.

We welcome your thoughts about how the San Francisco AIDS Foundation can help tackle this complex and challenging issue. Please contact William Bland at 415-487-3000 if you have ideas about speed-related programs.