Crystal methamphetamine and ecstasy differ in relation to unsafe sex among young gay men.
OBJECTIVE
Poly-substance use in gay social ('club') settings is common. Recent studies suggest a link between 'club' drug use and sexual risk behaviours. In this qualitative study, we compare and contrast two 'club' drugs: crystal methamphetamine and ecstasy (MDMA).


METHODS
Life history interviews were conducted with 12 HIV seroconverters and 12 age-matched controls recruited from a prospective cohort study of young gay and bisexual men in Vancouver, British Columbia. Textual data concerning illicit substance use and unsafe sex were analyzed using NUDIST software.


RESULTS
Most men related a substantial knowledge of and experience with crystal and ecstasy. Both drugs had attributes that enhanced gay socialization and were used in the same venues. Crystal was used to remain awake and increase energy. Ecstasy was used to induce euphoria and group connectedness. However, unlike ecstasy, crystal was associated with a distinct pattern of sexual arousal that frequently included unprotected (sometimes group) sex, was more likely to be used regularly by HIV-positive men, and was reportedly highly addictive and problematic.


CONCLUSIONS
Crystal and ecstasy are used in the same social venues but differ markedly in relation to sexual risk behaviour.
Schilder
Arn J
AJ
British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC.
Lampinen
Thomas M
TM
Miller
Mary Lou
ML
Hogg
Robert S
RS
D000328:Adult; D001143:Arousal; D001955:British Columbia; D016022:Case-Control Studies; D015658:HIV Infections; D006679:HIV Seropositivity; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008694:Methamphetamine / Q000494:pharmacology*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000494:pharmacology*; D012307:Risk Factors; D012309:Risk-Taking; D012944:Social Support; D019966:Substance-Related Disorders / Q000503:physiopathology*; D047568:Unsafe Sex
D008694:Methamphetamine; D018817:N-Methyl-3,4-methylenedioxyamphetamine