Bring back Dynasty!!! Alexis Carrington et al would be the perfect template for a campaign against the scourge of crystal methamphetamine, aka P. I mean, can't you just hear her dulcet tones proclaiming "Crystal is white trash!!!" Be that as it may, I was trawling through Xtra, Canada's national LGBT newspaper, when two articles caught my eye. They provided food for thought. One discussed HIV+ Brian Finch, who did crystal, E and GHB (gamma hydroxybutyrate) for twelve years. After two overdoses, he got clean, and is now involved with the Canadian Treatment Action Council. In August 2005, Utah hosted a National Conference on Methamphetamine, HIV and Hepatitis. Harm reduction was the focal point of the conference, which led to an emphasis on pragmatic, non-judgemental responses and open-ended resources. As one can guess, conservative US Republicans and the Christian Right interfered, denouncing the conference focus on practical prevention methods. So, why do some gay men have unprotected sex while high on P/crystal? In some cases, internalised homophobia may provide an incentive for its abuse, which facilitates sex and overcomes guilt- as well as commitment to safer sex. What do Canadian HIV/AIDS organisations think? In Ontario, the AIDS Committee of Toronto noted that meth abuse might facilitate unprotected sex, but that psychological factors like those above might lead to willingness to use crystal. For some HIV+ men, it might be an opportunity to escape from the rigours of meds adherence, enhance self-perceptions of desirability and short-circuit the aforementioned homophobic guilt. Like New Zealand did, Canada's federal government is moving to impose tougher penalties for producing, distributing or dealing in crystal, as well as controlling precursor chemicals. Montreal and Toronto are already experiencing problems with the drug's behavioural effects, although Ottawa doesn't seem to have encountered that level of seriousness, and it's about the size of Auckland. One problem is that IV needle exchanges are no use for point of supply health promotion materials, as crystal is usually smoked, rather than injected. If you're tempted to dismiss this as drug prohibitionist claptrap, be aware that the Ontario Ministry of Health AIDS Bureau found that gay and bisexual crystal users are four times as likely to have unprotected anal sex with HIV+ partners, and that P/crystal might be added to E tablets. Ottawa's Gay Men's Wellness Initiative is working on a Canadian national study, which will hopefully clarify matters and enable better practical health promotion outreach. Recommended: Xtra Canada: http://www.xtra.ca AIDS Committee of Toronto Crystal Factsheet: http://www.actoronto.org/website/home.nsf/cl/act.docs.0468 Craig Young - 9th October 2005