Archives of Sexual Behavior, Vol. 34, No. 5, October 2005, pp. 483–486 ( C  2005) DOI: 10.1007/s10508-005-6274-9 Guest Editorial Crystallizing the HIV Epidemic: Methamphetamine, Unsafe Sex, and Gay Diseases of the Will Heather Worth, Ph.D. 1,2 and Patrick Rawstorne, B.A.(Hons.) 1 In the past few years, there has been increasing concern in Europe, North America, and Australia about the rates of recreational methamphetamine use (among other terms, called “P,” “ice,” “crystal,” and “crystal meth”) in the gay community. Gay media headlines, such as “The party drug crystal meth is fueling a new epidemic of unsafe sex and ... some experts fear the party’s only just begun” (Brown, 2002), have kindled anxieties around methamphetamine and sexual risk in gay men’s health professionals and HIV educators. In the U.S. and other countries, numerous community forums have been held to discuss the “epidemic of crystal,” methamphetamine- oriented HIV education programs have been put in place, and “crystal meth anonymous” chapters and special- ist rehabilitation centers have sprung up. Further, the associations between methamphetamine use and risky sex are most often mediated through a psychobiological explanatory framework (Rhodes, 1996). Drug use and sex are both exceedingly social prac- tices, historically and culturally embedded. The almost universal uptake of condoms in the early 1980s among the gay community represented much more than individual behavior change; rather, it was a social phenomenon, embedded within a community which took action against the HIV epidemic (Kippax & Kinder, 2002). And HIV prevention in the gay community was predicated not on reducing the numbers of casual partners—it assumed that sexual liberation and multiple partnering were a keystone of gay community. However, since the beginning of the epidemic, there has been an often conservative counter- argument that these gay community sexual noms are, in fact, pathological (e.g., Signorile, 1997) and, recently, that many gay men are sexually compulsive and addicted (see 1 National Centre in HIV Social Research, University of New South Wales, Sydney, New South Wales, Australia. 2 To whom correspondence should be addressed at National Centre in HIV Social Research, University of New South Wales, Sydney 2052, New South Wales, Australia; e-mail: h.worth@unsw.edu.au. Dew & Chaney, 2004; Guss, 2000; Sandowick, 1998). Not only that, but drug use in the gay community has also been viewed negatively. For example, even though amyl nitrite was widely used in gay communities in the early 1980s and was available and legal in many parts of the world, it soon became seen as a drug associated with gay men and unsafe sex and, in particular, with “difficulty controlling sexual behavior” (Exner, Meyer-Bahlburg, & Ehrhardt, 1992). Indeed, prior to the isolation of the human immunodeficiency virus, amyl nitrite was seen as a possible cause of what was termed GRID (gay-related immunodeficiency disease) (see Goedert, Neuland, & Wallen, 1982). The recent increase in the use of party drugs and, in particular, methamphetamine—a drug that is tied to sexual pleasure—provides a further channel for such thinking. PSYCHOLOGICAL EXPLANATIONS OF METHAMPHETAMINE USE AND RISKY SEX The increase in unprotected anal intercourse with casual gay partners over the past few years (Van de Ven, Rawstorne, Crawford, & Kippax, 2002) and the concomitant rise in gay men’s use of club drugs in general, and methamphetamine in particular (Swanson & Cooper, 2002), have resonated with gay community media who have reported the particular pharmacological effects of methamphetamine—increased sexual libido (Meng, Dukat, Bridgen, Martin, & Lichtman, 1999)—leading to what one Australian newspaper reported as “really, really rampant sex” (Benzie, 2003). According to the American gay newspaper, The Advocate, “for some sex addicts, sex alone isn’t enough of a high. They turn to crystal meth, a form of speed that doubles as an aphrodisiac” (Sandowick, 1998). There have also been a plethora of findings reported by some researchers linking the two phenomena (see, e.g., Frosch, Shoptwa, Huber, 483 0004-0002/05/1000-0483/0 C  2005 Springer Science+Business Media, Inc.