A Personal Take on Crystal Meth and Positive Prevention

By Jos Greene, BLC Intern

In the age of Google as a verb and Wikipedia as a cited source in college papers, we sometimes overlook the knowledge of people around us.  Articles and websites can offer technical information, but we shouldn’t close ourselves off to the wisdom of lived experience and thoughtful reflection.  This week I sat down with Wayne Callahan, BLC member and Member Services staff, who was generous enough to offer his insight on crystal meth and HIV prevention.


J:  I know you’re very passionate about raising awareness around crystal meth use and HIV prevention.  Do you see that information available more widely?

In my community– gay, MSM, HIV-positive– I don’t hear enough dialogue about positive prevention and crystal meth.  In the U.S.A., the infection rate for MSMs is the only transmission category that is increasing; I think the reasons have much to do with crystal meth use.  Personally, I’m HIV positive because I made poor decisions and engaged in health risking behaviors while using crystal meth.  Sadly, I didn’t do anything about it for 8 years until I became gravely ill and I decided to start valuing my health and taking better care of myself.

I hear and see many prevention messages targeted for HIV-negative persons; however, I don’t hear or see enough messages targeted for HIV+ persons.  I would like more messages targeted to “containing” the virus, however controversial those messages might be.  I engaged in many risky behaviors when I first became HIV-positive and I continued to use crystal meth.  Those behaviors were risky not only to my health but also to the health of my partners.  Much like there is ‘combination’ therapy for HIV medications, I believe a continuum of prevention messages, targeted to both HIV-negative and HIV-positive persons are needed.

J:  Could you address the effects of crystal meth use on the body when someone’s HIV-positive?

Crystal meth use speeds up the HIV replication rate.  I didn’t know that for eight years.  I think people generally understand that consistent use of crystal meth decreases the healthy functioning of one’s immune system– weight loss, decreased appetite, poor sleeping etc.   While using crystal meth, what little nutrition I had was just washing through me.  But speeding up HIV replication?  I never thought about that.

It’s harder to remember to take medication if you’re high.  Doctors generally think that with HIV meds you should be 95% compliant.  One missed dose a month equates to 3%, so two missed doses a month and doctors begin to think about developing resistance, perhaps to an entire class of HIV meds.

J:  Do you see crystal meth use posing risks to mental, as well as physical, health?

My use of crystal meth absolutely increased my social isolation.  What initially was a socially ‘lubricating’ drug eventually became a socially isolating drug… just me alone with crystal meth.  I remember having a pattern of many more conflicts with people while I was coming down from a crystal meth binge.  Today, I don’t have any of those conflicts.  Crystal meth use gets in the way of so many things.  I feel comfortable here at the BLC and I have strong and safe relationships here.  When I was using and I didn’t have a community space like the BLC available to me, I was having an irrational abundance of sex, but there wasn’t significant intimacy… just bodies banging into one another.  I don’t hear much about persons dying directly from a crystal meth overdose; however, I do understand that the risk of suicide for a crystal meth user is high.  After a binge I would feel bleak and lonely.  I thought there was no way out of the mess that was my life.

HIV and Crystal Meth: Beyond Just Primary Prevention

By Joss Greene, BLC Intern

Public health education about HIV and IV-drug use must be expanded beyond risks of transmission.  While researchers promote more comprehensive, lifestyle-oriented models for studying HIV/AIDS, many continue to isolate the topic of crystal meth use to conversations around primary prevention.  HIV positive people face considerable health risks if they are crystal meth users, and information about those affects should be more widely circulated.

A 2007 report from the Multicenter AIDS Cohort Study showed that men using meth and poppers who had unprotected receptive anal sex with one partner had a 2.71risk rate relative to men who didn’t use the drug; men who had unprotected sex with 5+ partners had a 13.57risk rate.[1] This study leaves too many variables unaddressed to conclude meth diminishes CD4 count or speeds up HIV replication, but scientists analyzing the interaction between meth and HIV at a chemical level have supporting evidence.

In 2009 a New York-based research team explored the effect of meth on the rate of HIV replication and determined that while further tests must be done, crystal does appear to hasten the progression of HIV.  Adding meth to test tubes with immune cells produced a marked increase in HIV replication, particularly in CD4 cells.  When HIV-infected mice were given crystal, a segment of the HIV genetic code was switched on and began producing tumor necrosis factor alpha, a protein linked to accelerated HIV disease progression.[2]

Some speculate that the correlation between meth use and increased HIV disease progression is due to lifestyle factors.  Meth users may have more difficulty sleeping, eating properly, or maintaining a routine.[3] A decline in healthy living habits has been linked to weakened immune system and may contribute to accelerated HIV progression.  An additional component of living healthy with HIV is commitment to medication.  Users who have difficulty following a schedule may struggle with adhering to their medication regimen and compromise their health in this way.

Crystal meth use compromises healthy living practices and recent research suggests that crystal may have a direct influence on the rate of HIV replication.  It is, therefore, important for anyone who is HIV-positive and currently using crystal to address risks with a healthcare provider.  If you are HIV-positive and want to reduce or stop your crystal meth use, you’re in the right city! Many organizations in the Greater Boston area provide assistance with addiction and several have distinguished themselves for attentiveness to the needs of HIV+ people:

Fenway Health offers acupuncture detox and multiple support groups, as well as their New Champions program which provides peer support and referral services to gay and bisexual men struggling with meth addiction.

Victory Programs offer a range of recovery services with a focus on residential alcohol and addiction treatment programs.

Crystal Meth Anonymous hosts meetings to offer peer support staying clean and discuss challenges of recovery.

[1] Michael Carter, “Gay men who use methamphetamine have greater risk of HIV seroconversion,” AIDSmap, May 29, 2007.  <http://www.aidsmap.com/en/news/62AA3D55-32FE-41B4-9C6D-3C7E8042E6B4.asp&gt;

[2] “Crystal meth accelerates HIV reproduction,” AIDSMeds, November 9, 2009.  <http://www.aidsmeds.com/articles/hiv_crystal_meth_1667_17533.shtml&gt;

[3] “Methamphetamine,” AIDSmap, June 4, 2010.  <http://aidsmap.com/cms1045235.asp&gt;