ANNOUNCER: Thanks to advances in HIV treatments people in the US who have good access to healthcare are living longer healthier lives. But experts are now seeing a worrisome trend.
PERRY HALKITIS, PhD: Infection rates were stable during the 1990s, but, in the last few years, there's been a spike in new HIV transmissions across the population and especially among gay and bisexual men.
ANNOUNCER: Explaining this turnaround is not so simple.
PERRY HALKITIS, PhD: First of all, there's a fatigue around HIV that we're seeing in the gay population and in the general population. People feel that the HIV epidemic is over, they're more complacent about safer sex practices, they think there's a cure and, as a result, people are not being as safe or as responsible in their sexual behavior.
So number two, I think what's happening is that prevention efforts really haven't evolved and haven't become as sophisticated as people have become sophisticated around HIV. So "Use a condom every time" campaigns, which worked fine in the early 1980s and the mid-1980s are no longer effective.
What we're also seeing is this complex interaction that exists between sexual risk-taking and drug use. And in particular with a subset of drugs known as "club drugs."
ANNOUNCER: And if hearing the term "club drugs" conjures up images of a disco ball or a rave you'd be mistaken.
PERRY HALKITIS, PhD: Our research shows very clearly that people do them at home, they do it with their friends, they do it in the park, they do it wherever they need to do it.
ANNOUNCER: So what are the so called "club drugs?"
PERRY HALKITIS, PhD: You know, twenty years ago, we would have been talking about cocaine as the primary drug, but that doesn't seem to be the big problem. It is a problem, but not the biggest problem these days.
We're talking about methamphetamine, also known colloquially as "crystal." We're talking about MDMA, which is known commonly as "ecstasy." We're talking about ketamine and we're talking about Rohypnol and we're still talking about cocaine, to some extent. And we're talking about, more importantly, not just each of these drugs in isolation, but each of these drugs being used often in combination with each other, in combination with alcohol, in combination with prescription drugs such as Viagra.
ANNOUNCER: And that, say experts, is a menacing mixture.
PERRY HALKITIS, PhD: Perhaps the most worrisome is methamphetamine crystal. This is a psychostimulant, it's a form of speed; it's related to ecstasy. It's related to other amphetamines and it has been a huge problem.
Crystal is a hypersexual drug. It's a hugely disinhibiting drug, so that we know, and it's been clearly documented, that people who are using this substance have sex without rational thinking, they have multiple partnerings; they just let go. They feel like they're on top of the world, so nothing is a problem and any rational thinking, any logical thinking around safer sex practices completely gets wiped away.
Do they realize after they come down from their high that they've had unsafe sex? Yes, they do. Can they do anything about that? No, it's too late.
ANNOUNCER: And as users try to keep the high going, they move from snorting to smoking and eventually to injecting.
PERRY HALKITIS, PhD: We not only have a drug in which people's inhibitions are erased, basically, around safer sex, but now men, women, whoever are using these substances, whoever is using meth is injecting. And so transmission through injection and the sharing of needles and the sharing of works creates another route of HIV transmission that is linked to methamphetamine use.
ANNOUNCER: And using crystal can have severe consequences for HIV positive people taking lifesaving antiretroviral medications.
PERRY HALKITIS, PhD: What we know, from our work, is that adherence, taking your medications the way you're supposed to take them, is a problem across the board. And if we believe the literature, people are supposed to be adherent 95 percent of the time. Very hard for people to be adherent 95 percent of the time when they're high. When they're feeling good, the last thing they want to do is actually stop to remember to take their medications.
Number two, we know that methamphetamine is an immunosuppressant. Methamphetamine that is sold on the street is not pure methamphetamine. It's been cut with talc; it's been cut with heroin; it's been cut with a variety of other substances. That has an effect on people's immune systems.
Number three and probably most alarming of all is some recent studies that came out that indicate, even if an individual is highly adherent to his or her medications, even if. If they're using methamphetamine, replication of the virus in the brain is accelerated.
ANNOUNCER: So whether you're a man, woman, gay or straight you are walking on dangerous ground when you mix drugs with sex.
PERRY HALKITIS, PhD: To people who haven't started who hear wonderful tales about this drug: Don't. This is not a wonderful drug. The price that you will pay in the long run is not worth it. To people who are started, I say, look for help. Because what do we know about methamphetamine and its affects on people's lives? There's enormous social deterioration. People become physically ill and they become socially ill. They lose their friends, they lose their family and they lose their jobs.
I think, as a society, we need to step up to the plate with HIV. Men, women, young adults who are becoming sexually active need to realize that the HIV epidemic is not over.