Use of crystal methamphetamine among gay men in London


Jonathan Elford, City University, Institute of Health Sciences, St Bartholomew School of Nursing and Midwifery, 24 Chiswell Street, London EC1Y 4TY, UK. E-mail:


Aim  To examine the use of crystal methamphetamine (crystal meth) and its association with high-risk sexual behaviour among gay men in London. 

 Design  Cross-sectional surveys using self-administered questionnaires.

Settings  National Health Service (NHS) out-patient human immunodeficiency virus (HIV) treatment clinic in London; NHS HIV testing/sexual health clinics in London; central London gyms.

 Participants  HIV-positive gay men attending the HIV treatment clinic in 2002–03 (n = 388); HIV-negative gay men attending the HIV testing/sexual health clinics in 2002–03 (n = 266); gay men using the gyms between January and March 2003 (n = 445), 2004 (n = 653) and 2005 (n = 494).

Measurements  Percentage of gay men who reported: (i) using crystal meth in the previous 12 months; (ii) using other recreational drugs (e.g. cocaine, ecstasy, ketamine); (iii) high-risk sexual behaviour in the previous 3 months.

Findings  The percentage of gay men who had used crystal meth in the previous year varied by sample (HIV treatment clinic, 12.6%; HIV testing/sexual health clinics, 8.3%; gyms, 19.5%; P < 0.001) but did not change over time in the gyms (19.8%, 20.7%, 17.8%; P = 0.5). In all samples, the majority of men used crystal meth only once or twice a year. Most crystal meth users (> 80%) had taken other recreational drugs. Crystal meth and other drug users were more likely to report high-risk sexual behaviour than other men, e.g. HIV treatment clinic sample: crystal meth users, 34.7%; other drug users, 18.9%, non-users, 10.6%, P < 0.001. Cause and effect could not be established.

Conclusion  Among gay men in London surveyed in clinics, approximately one in 10 reported using crystal meth in the previous 12 months (HIV-positive men 12.6%; HIV-negative men 8.3%). Most men used it infrequently—only once or twice a year. There was no evidence of increasing use of crystal meth between 2003 and 2005.