Associate Professor Jeffrey Klausner, Director of Sexually Transmitted Disease Prevention and Control Services in San Francisco gave some disturbing news of the effects of regular use of methamphetamine (ice) by men who have sex with men. Somewhere between 50 and 70% of regular users are dependent on the drug. (Weknow this because other surveys have shown that an impressive 90% of gay men are prepared to discuss their recreational drug use with their doctors.)

The implications of the use of antiretrovirals and ice have been sketchy to date but it has been long known that using the drug while on protease inhibitors, particularly ritonavir, can boosts the level of the crystal meth to harmful levels. It is now known that methamphetamine use can cause nerve damage and lead to early onset of HIV dementia.

Cognitive Behavioural Therapy with a therapist, individually or in groups, has been shown to help people get off the drug and those with major dependency issues can be prescribed alternatives to get them over the initial hump of withdrawal.