Crystallizing the HIV Epidemic: Methamphetamine, Unsafe Sex, and Gay Diseases of the Will

Abstract

In the past few years, there has been increasing concern in Europe, North America, and Australia about the rates of recreational methamphetamine use (among other terms, called “P,” “ice,” “crystal,” and “crystal meth”) in the gay community. Gay media headlines, such as “The party drug crystal meth is fueling a new epidemic of unsafe sex and . . . some experts fear the party’s only just begun” (Brown, 2002), have kindled anxieties around methamphetamine and sexual risk in gay men’s health professionals and HIV educators. In the U.S. and other countries, numerous community forums have been held to discuss the “epidemic of crystal,” methamphetamineoriented HIV education programs have been put in place, and “crystal meth anonymous” chapters and specialist rehabilitation centers have sprung up. Further, the associations between methamphetamine use and risky sex are most often mediated through a psychobiological explanatory framework (Rhodes, 1996). Drug use and sex are both exceedingly social practices, historically and culturally embedded. The almost universal uptake of condoms in the early 1980s among the gay community represented much more than individual behavior change; rather, it was a social phenomenon, embedded within a community which took action against the HIV epidemic (Kippax & Kinder, 2002). And HIV prevention in the gay community was predicated not on reducing the numbers of casual partners—it assumed that sexual liberation and multiple partnering were a keystone of gay community. However, since the beginning of the epidemic, there has been an often conservative counterargument that these gay community sexual noms are, in fact, pathological (e.g., Signorile, 1997) and, recently, that many gay men are sexually compulsive and addicted (see