Abstract
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 agematched 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.
Conclusion
Crystal and ecstasy are used in the same social venues but differ markedly in relation to sexual risk behaviour.
MeSH terms: Ecstasy (drug), HIV-1, homosexual, male, methamphetamine, sexual behaviour, street drugs
Résumé
Objectif
La consommation de plusieurs drogues est courante dans les milieux (« clubs ») gais. Des récentes études montrent un lien de corrélation entre la consommation de drogues dans ces « clubs » et les comportements sexuels à risque. Dans le cadre de cette étude qualitative, nous effectuons une analyse comparative de deux drogues utilisées dans les milieux gais: la métamphétamine en cristaux et l’ecstasy (MDMA).
Méthodes
Des entrevues ont permis de recueillir les témoignages de 12 personnes qui ont été séroconverties et 12 témoins du même âge recrutés dans une étude prospective des cohortes de jeunes gais et de bisexuels à Vancouver, en Colombie-Britannique. Les données textuelles concernant l’utilisation de substances illicites et les pratiques sexuelles peu sûres ont été analysées à l’aide du logiciel NUDIST.
Résultats
La plupart des hommes ont indiqué bien connaître la métamphétamine en cristaux et l’ecstasy et ont même reconnu en avoir consommés. Les deux drogues favorisent les rencontres sociales dans le milieu gai et sont consommées dans les mêmes endroits. On a utilisé la métamphétamine en cristaux pour ses effets d’accroissement du niveau de vigilance et d’énergie et l’ecstasy pour sa capacité à créer un état euphorique et de favoriser les rapports sociaux. Toutefois, contrairement à l’ecstasy, la consommation de la métamphétamine en cristaux est associée à une augmentation du désir sexuel, effet qui donne souvent lieu à des pratiques sexuelles non protégées (parfois en groupe); les hommes séropositifs étaient plus susceptibles d’en faire une utilisation courante. On dit que cette drogue crée une forte dépendance et que sa consommation est source de problèmes.
Conclusion
Même si la métamphétamine en cristaux et l’ecstasy sont consommés dans les mêmes milieux, elles sont utilisées à des fins très différentes pour ce qui de l’adoption de comportements sexuels à risque.
Footnotes
Sources of support: This study was supported by a grant from the National Health Research and Development Program. Drs. Lampinen and Hogg are supported by the Michael Smith Foundation for Health Research.
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