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Meth Finds a New Market in New York

The NewYork Times, June 7, 2015

The waiting room of Gay Men of African Descent, a service agency near Downtown Brooklyn, is almost always quiet and empty. Artful photographs of naked men under tinted lights hang on the walls without an audience. Magazines for people who are H.I.V. positive sit untouched in a swirl on a carved African pedestal.

The office, in the basement of a nondescript building, is the kind of place that you would find only if you were looking for it. The men who ring the buzzer to enter do not linger; they head straight for the receptionist, who greets them by name and sends them back to their appointments.

Mostly they come seeking counseling. They are gay and bisexual black men who flocked to the city in search of sexual freedom and found darker things with it — H.I.V., homelessness, social isolation. And many carry a deeper shame. “When people started to talk about their sexual lives,” said Chris Johnson, a therapist at GMAD since 2006, “they would introduce that crystal meth became a part of that sexual experience.”

Beginning five or six years ago, Mr. Johnson started hearing in therapy sessions about 24-, 36- and 48-hour sex binges fueled by meth, which can intensify sexual desire while delaying orgasm for hours. Mr. Johnson recalled his concern for an addicted client working in fashion who used a phone sex line to find “partner after partner after partner after partner,” and for a former member of the military who liked to “party and play,” lingo for attending meth-rich sex parties. There have been many others. “I’m thinking, ‘Wow, this is becoming a big problem,’ ” Mr. Johnson said.

They are men like J., a closeted gay black man from the Caribbean living in Brooklyn, who has been smoking meth for a few years and is ambivalent about stopping. For him, being high is a single-minded pursuit of his deepest desires. He thrills in the chase and in the catch, in the craving and satisfaction. We spoke in the conference room of GMAD, where J. has been going since he found he had contracted H.I.V., five or six years ago. He asked to be identified only by his first initial.

When he is high, he said, he will see men on the street or train and hope to have sex with them. “Whatever is on your mind, that is what your desire is going to be,” he said. “When you get that desire, you’re just going to be looking and looking.”

But more than lust is driving him, and he sees that. “Sometimes I feel hopeless and all of that stuff,” he said. “Lonely. Loneliness will make you want to do it.” And disappointment and boredom, too, he said.

Meth is not new to New York, nor is it new to the gay sex scene, but its use is a relatively new phenomenon among black and Hispanic men who have sex with men. Ten or 12 years ago, meth, or Tina, as it is known on the street, was popular among an affluent, white gay and bisexual set; those men were the urban faces of a drug often associated with the rural poor. In New York, using meth was more glamorous then, more stylish, more of a diversion and less of an escape.

When gay-rights activists and officials began wondering if the drug was linked to rising H.I.V. infection rates, news reports and public awareness campaigns followed, and a stigma replaced the sheen. Meth use moved further underground.

Reliable statistics are hard to come by — meth is used, shared and sold in such intimate confines — but there is a collective sense among doctors and therapists that the drug has taken a new turn. Joseph Ruggiero, an addiction specialist who 10 years ago started the city’s main group therapy program for gay and bisexual men who abuse meth, said that in the early days, 85 to 90 percent of participants were white. Now most are black or Hispanic, a shift he noticed two or three years ago.

“There is resentment that this is such a powerful drug that white men who have sex with men introduced to men of color,” Dr. Ruggiero said of his newer clients.

Therapists at GMAD in Brooklyn, which mostly serves men with H.I.V., said they were seeing more and more cases of meth use. Mr. Johnson guessed that as many as 20 percent of his 300 clients were meth users; another counselor put the number at 30 or 40 percent. Therapists at Callen-Lorde Community Health Center, the city’s largest clinic for lesbians and gay men, said they had also noticed an increase.

Academics are seeing the same shift. Travis Wendel, who has taught at John Jay College of Criminal Justice and is research director of a needle-exchange program in the Bronx, was an author of a federally financed study of the city’s meth-using population published in 2012. (The study estimated that the population of users in the city was more than 12,000, with a range of about 8,000 to 24,000.) “There’s no doubt that at that point a couple of years back, it was something they encountered with white dates,” Dr. Wendel said, referring to black men. “ ‘That’s that white drug.’ But there was certainly an enthusiasm for it.”

Enthusiasm turned into habit. Perry N. Halkitis, a psychologist at New York University who has also researched meth use in New York, found in his last study that most users were H.I.V. positive and black.

As a group, black men who have sex with men are usually more vulnerable than their white counterparts, Dr. Halkitis said. Many of them have been ostracized by their families. Many fled to New York from Caribbean countries where they were targets of violence because of their sexuality. In New York they are less stably employed and at greater risk of contracting H.I.V. Meth users seeking to get sober must often sort through those issues. That they are using meth as a sex drug only complicates things; their very identities are largely defined by sex.

Mr. Johnson at GMAD said his group was doing what it could to curb the drug’s use, getting men to come and return to therapy, but he felt as though he was operating a revolving door.

“We’ve had people that have come in here and they are in full psychosis,” he said, adding, “You get them grounded, and then you send them back out to the same environment.”

Mr. Johnson introduced me to J., who is 34 and shy. He came to the United States because he feared he would suffer violence if he expressed his sexuality openly in his home country. He slept on his lovers’ couches until he found he was infected with H.I.V. Now he lives in city housing.

J. doesn’t remember all of the details of the first time he used crystal meth, but it was about three years ago, two years after he became H.I.V. positive. He regularly came across men using meth. “It’s very popular in N.Y.C. in the black community,” he said. “I like to try stuff. I see other people doing it. Why not do it? I’m going to do it too.” That first time, he invited three or four men to his apartment. “It’s a party,” he said. “We smoke and freak.”

J., who is handsome and muscular, said he had become popular on the scene, a prize, never paying for drugs. But meth began to affect his mood. He would lose his temper at his parties, screaming and cursing, jealous that other men were more handsome. He became paranoid. He lost his friends. “I think people are going to kill me, and all that stuff,” he said.

He did not always use a condom, but that did not concern him much, he said. “Most of these people who are using are positive, too,” he said. “I guess they feel some type of way about themselves. They feel hopeless.”

In a program they call Crystal Clear, Dr. Ruggiero and other clinicians push participants to talk about race, sexual identity and internalized homophobia. They ask participants to stop having sex for 90 days. Some must get rid of their computers, so they won’t cruise the Internet.

“I think you have to build something for yourself if your goal is to stay sober,” Dr. Ruggiero said. “Sometimes the message of ‘Don’t use drugs’ can feel so depriving. A lot of the guys who I worked with who have been so successful, we helped them stop using drugs and rebuild other parts of their lives.”