Bob Roehr: Methamphetamine use drives HIV infections among gay Thais

Published: September 13, 2011

One in 10 gay and bisexual men aged 18 to 21 became infected with HIV during their first year of enrollment in a cohort study in Bangkok. The rate of new infections slows down a bit after that, in part because those most likely to become infected already are. Fully 1 in 3 of them carry the virus by the time they reach 30.

“From 18 to 21 it has been a slaughterhouse,” says Frits van Griensven, shaking his head in dismay. “They are getting the best prevention information possible, counselling every four months, condoms and lubricants. They know the facts of incidence of new infections.” And yet the infections continue to occur, “It is something that we cannot control with behavioural interventions.”

Van Griensven runs what is believed to be the only HIV prevention clinic in all of Asia that was created to serve men who have sex with men. This is despite the fact that in Asia, that group is 18.7 times more likely to become infected with HIV than the general population.

“It’s my opinion that the epidemic in young men is driven by methamphetamines – crystal ice. I don’t know what to do about it,” he says.

He is not alone. The drug has been a major factor in the spread of HIV among gay men in the US and Europe, though its use seems to be receding because of educational campaigns and because other drugs have become more chic to use.

Rather than adopt a harm reduction approach, the Thai government has taken the approach favoured by most governments, namely a “war on drugs,” and it is having the same lack of success.

The day after our conversation the Bangkok Post reported a billion baht drug bust near the city of Chaing Rai when police stopped a pickup truck for a routine inspection and the driver fled. Left behind were 2.46 million pills of speed (methamphetamine), 95 kilograms of “ya ice,” a form of crystal methamphetamine, and 3.4 kg of heroin.

Ya ice is the drug of choice of most addicts, half of whom are between 15 and 24, said Naramon Chuangrungsi, director of the Narcotics Control Strategy Bureau. It is a purer form of meth, can be absorbed by the body more quickly, and many users mistakenly believe that it is safer than methamphetamine.

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