Needle exchange programs report more gay, bisexual men among their client base
Some New York City needle exchange programs that swap used syringes for clean ones have reported that they are seeing more gay and bisexual male clients who are injecting crystal meth.
Rafael Ponce, director of health promotion services at the Positive Health Project (PHP), said his group began seeing more gay meth injectors among its new clients in 2004.
“For the past four or five months, it’s been about 15 percent,” Ponce said.
In all of 2004, PHP enrolled 300 new injecting drug users, so roughly 45 of those new clients would be gay and bisexual men.
“We have had a very diverse group,” Ponce said. “The majority have been white guys.”
The agency also offers a range of counseling, health care and disease prevention services. Beginning on January 21, PHP, located at 301 West 37th Street, will start “drop-in hours” every Friday between 5 and 7 p.m. for gay and bisexual men “with concerns about crystal meth.”
PHP has also asked some gay sex clubs to distribute information about its needle exchange program and other services.
The Lower East Side Harm Reduction Center, which ex-changes needles and offers other services similar to PHP’s, has also seen an increase in gay and bisexual male clients who are shooting meth.
“We haven’t kept any formal numbers, but we are seeing a definite increase… I would say within the last year especially over the summer,” said Sam Orlando, vital service care coordinator at the harm reduction center.
The 2001 New York State law that made it legal to obtain and possess syringes required needle exchange programs to obtain waivers, which limit the areas in which the groups may operate. The Lower East Side center has applied to the state to expand its waiver to include the West Village.
Orlando and at least one other employee of the harm reduction center have gone to gay sex clubs and private parties where they have instructed men in proper injection techniques.
“I have personally gone into three [sex clubs], and private parties as well,” Orlando said.
Staff at both agencies said that these drug users generally understood that they should not share needles, but the men did not necessarily know that sharing other items, such as the water used to clean a needle or a dish in which the meth is mixed with water before shooting, also posed a risk for HIV transmission.
“They are getting new information especially for men who are booty-bumping crystal,” Orlando said. “Most people, for the most part, know that you can’t share needles.”
Booty-bumpers remove the needle from a syringe and inject meth mixed with water, like an enema, into their anus. This procedure can damage the colon and make it easier to acquire HIV, the virus that causes AIDS, if it is followed by unsafe sex.
PHP’s Ponce said their gay clients had a range of knowledge about needle use.
“There are little pockets of guys who know a little bit more than others,” he said.
Sharing needles, cookers, or other injection equipment could place these gay and bisexual men at increased risk for acquiring HIV and hepatitis C, a virus that attacks the liver. Giving users clean needles through needle exchange programs and teaching them how to shoot safely have proven to be highly effective at stopping the spread of HIV among injecting drug users.
Men who have sex with men who are injecting meth do not appear to be visiting those agencies that traditionally serve gay men, such as the Gay Men’s Health Crisis (GMHC) or the Lesbian, Gay, Bisexual and Transgender Community Center.
Noel Alicea, a GMHC spokesperson, said that “one or two” clients have reported injecting meth.
“Smoking and snorting are the primary modes for the guys who come here,” Alicea said. “[Injecting is] just not a primary mode of use in terms of the men who come here.”
Dr. Barbara E. Warren, director of organizational development, planning and research at the Center, said that no clients there have reported injecting meth.
“We have very little data that indicates that anybody is injecting,” she said.
The Center and GMHC do not offer needle exchange services, which appears to be the primary reason these men are visiting PHP and the harm reduction center.
While the 2001 law allows anyone over 18 to purchase up to 10 syringes per transaction in retail locations, the needle exchange programs are attractive because they distribute free needles. They also supply instructions on injecting.
The city’s Department of Health and Mental Hygiene has noted that more gay men are shooting meth.
At a January 7 hearing of the state Assembly’s committees on alcoholism, drug abuse and health, convened by Manhattan Democratic Assemblyman Richard Gottfried, Dr. Isaac Weisfuse, the health department’s deputy commissioner of the Division of Disease Control, said that “use of crystal meth appears to be increasingly associated with high-risk injection practices, which transmit hepatitis C,” according to a transcript of his testimony.
Some former meth users said that injecting was becoming common. One former user, who did not inject, said it appeared that more guys were using needles.
“My only opinion comes from seeing more and more guys coming into [Crystal Meth Anonymous],” the former user said. “It’s hard to tell, but it seems like half of them,” adding, “From what I understand, it’s a very social thing. They inject each other.”
A second user, who injects the drug, reported that while the practice was common, many guys also understood that they should not share needles.
“There was a level of education out there,” the second former user said. “There is still a certain thrill about sharing a needle.”
Another former user, who was interviewed last March, reported watching the transition in how meth was ingested since he first used the drug in 1995.
“It started out everyone was snorting and if you smoked it you were an addict,” he said. “Then everyone was smoking it and if you shot it you were an addict… The last time I went out, everyone was shooting.”
Dan Carlson, a co-founder of HIV Forum, a group that has produced a series of town meetings on gay men, HIV and crystal, said the trend toward increased meth injecting was disturbing.
“Injecting cystal is a lot more dangerous,” Carlson said. “It increases the chances of HIV. It’s a lot harder to kick this addiction when you start injecting it. That trend is alarming to me… It says to me that we need to talk openly about what this drug does to people.”