It’s the grope, not the dope

Despite the recent prominence of local methamphetamine labs in the news — and a nationally reported link between meth use and increased risk of AIDS — the number of new AIDS cases reported in Buncombe County has held steady, and unprotected sex remains the primary risk factor for area residents.

Dr. Douglas Richman of the Center for AIDS Research at the University of California, San Diego, recently told the Los Angeles Times: “Rapid progression [from HIV infection to full-blown AIDS] occurs in a subset of people. … Rates of promiscuity among men who have sex with men, especially those who abuse methamphetamines, [are] frighteningly high.”

But according to Michael Harney, outreach coordinator for the Western North Carolina AIDS Project, the connection with methamphetamine use may be more a matter of geography than physiology. “There is a significant amount of crystal [meth] use among men who have sex with men in the big cities,” said Harney. “Is meth being used here? Of course it is. We see it in the news, but it looks like straight couples. We see children are being taken from the family because the parents are running a meth lab in their kitchen. You don’t hear about a connection of the gay community to meth that you do in the big cities.”

Public Information Officer John Dankel of the Asheville Police Department told Xpress, “Meth first became an issue for us about a year ago, but it is still not the main ‘drug of choice’ inside the city of Asheville. Crack continues to fill that role, and crack abuse continues to contribute to our other crime problems, such as thefts and burglaries.”

The heightened concern about meth use grew out of a flurry of reports back in February that a fierce new strain of AIDS — perhaps the harbinger of a global plague — had apparently emerged in New York City.

“Vicious New AIDS Strain,” blared the New York Daily News; “New AIDS Nightmare Shocks U.S.,” reported The Guardian of London, followed by “Super-AIDS Strain Hits California,” in the New York Post. A month later, The New York Times announced, “Rare AIDS Strain Is Very Aggressive, Study Says.”

Such reports, it turned out, were based on a single case involving a man whose disease had advanced from HIV to AIDS in just a few months and was not responding to the major anti-AIDS drugs. And AIDS experts have since reconsidered the case, concluding that rather than representing a rare “scare” strain of AIDS, this man’s case merely reflected the fact that the disease tends to advance more rapidly and be particularly virulent in people with high numbers of sexual partners and a low rate of condom use.

Some of those people are also prone to methamphetamine use. But in Harney’s view, the key point is not which drug is involved but the effect of many drugs on people’s sexual behavior. “Alcohol or any drug use does put you in another mindset; it lowers your inhibitions,” he notes. “So maybe people are trying out crystal [meth]; certainly, that puts them at risk. It’s the same smoking a joint.”

Legal drugs, argues Harney, can have the same effect. “You can have too much to drink, it blacks you out, and you wake up next to somebody you didn’t even know. I don’t know that I would put it all on crystal.”

And despite WNC’s growing meth problem, the rate of AIDS infection appears essentially unchanged. In 2004, there were 1,641 new reports of HIV infection in the state, according to the most recent HIV/STD Quarterly Surveillance Report published by the N.C. Department of Health and Human Services. Twenty-four of those cases were in Buncombe County.

“We never have very many case reports; it has stayed between 20 and 26 over the last five years,” Harney reports. “In Mecklenburg — the Charlotte area — there were over 400 of those positive tests. The high numbers are in Wake, Guilford, Mecklenburg and New Hanover counties.” North Carolina, he notes, tests about 130,000 people each year, but there’s no way to know who’s not being tested but should be.

Harney also emphasizes that the optimum strategy for confronting AIDS remains unchanged. “Prevention is the best technique. You can abstain and that’s great, but it’s not realistic. You can be monogamous, which is great.” But he adds: “I always say when I do education forums, if you’re being monogamous but you happen to slip out of that paradigm, then use a condom. Don’t bring something back to your main partner.”

Some people, however, regard a negative HIV test as a “free-sex card,” notes Harney. “During National Testing Day, we were doing the rapid test at Scandals. It gives test results in 20 minutes. By 1 o’clock, people [were] a little toasted, and one guy came out and said, ‘Whoa, yeah, I can go out and have sex!’ But that’s not it at all.

“The goal after you’ve been tested and found negative is to keep it that way.”