San Francisco Chronicle - November 4, 2005
Wyatt Buchanan, wbuchanan@sfchronicle.com.

The data were collected through interviews, not a scientific survey, and methamphetamine experts say the results should be corroborated by other research.

But it may show that crystal meth use among San Francisco's gay men -- often described as an epidemic -- is falling, in contrast to gay communities in other parts of the country, some experts said.

"For us, this is a very good sentinel of a shift or a change," said Dr. Willi McFarland, epidemiologist for the San Francisco Department of Public Health's Office of AIDS.

A 2004 study conducted by public health researchers in cities across the country and a study of San Francisco residents that McFarland contributed to in 2005 show that when gay men use crystal meth, it doubles their risk of contracting HIV.

Among the general population, 583,000 Americans -- two-tenths of 1 percent -- used crystal meth in the month they were surveyed in 2004, it was reported in a federal study, the National Survey on Drug Use and Health.

McFarland said 10 percent of gay and bisexual men interviewed by Stop AIDS between January and July of this year in San Francisco said they used crystal meth at some time in the previous six months.

In 2003, 18 percent of gay and bisexual men Stop AIDS interviewed said they had used the drug in the preceding six months.

Both surveys depended on street interviews of self-identified gay and bisexual men in different parts of the city.

The 4,197 people interviewed for the research were not randomly selected, but McFarland said the consistency of the survey techniques and the questions asked mean the data can reliably show a trend.

In New York City, 14 percent to 18 percent of gay and bisexual men now say they use crystal methamphetamine, Perry Halkitis, a New York University professor who focuses on HIV/AIDS and drug abuse, said in an interview. He said use of the drug among gay and bisexual men in the city is leveling off.

But meth use is rising among the gay and bisexual men who go to the L.A. Gay and Lesbian Center in Los Angeles for HIV and sexually transmitted disease testing and counseling, according to Jim Key, spokesman for the center. In 2001, 5.8 percent of those men said they used meth recently, and in 2004 10.3 percent said they had.

In Chicago, Pittsburgh and the Baltimore-Washington, D.C., area, about 10 percent of gay and bisexual men involved in the national Multicenter AIDS Cohort Study said they had used crystal meth at least once every six months, said David Ostrow, who is chairman of the behavioral working group for the study. Those numbers have stayed consistent over several years, he said.

San Francisco Supervisor Bevan Dufty, co-chairman of a city task force examining meth use in general, said that he is encouraged by the Stop AIDS numbers but that it is "certainly not an occasion to declare victory and move on." The city task force is to vote Tuesday on recommendations on addressing the meth problem that it will then send on to Mayor Gavin Newsom and the Board of Supervisors.

Stop AIDS officials believe several factors may have contributed to a decrease in meth use in San Francisco: treatment that focuses on harm reduction, prevention campaigns, cycles in drug popularity and gay men's firsthand experience with the drug.

Those are the educated guesses by people working on the meth problem, however, said Jason Riggs, spokesman for Stop AIDS.

"The 'why' part is for everybody to look at," Riggs said.

Several researchers question whether people are less willing to tell a surveyer on the street that they use meth now that the drug is getting increased public attention.

Michael Siever, executive director of the Stonewall Project crystal meth recovery program at UCSF, said he doesn't see meth use falling, though there is no waiting list right now to get into his program. He said, though, that most people use the drug for years before seeking help so a decrease could be in the offing.

Capt. Tim Hettrich of the San Francisco police narcotics unit said more crystal meth is sold in the city every year. But the fact that four officers focus on crystal meth sales in the gay community could explain some of the decrease, he said.

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