National Amphetamine-Type Stimulant Strategy Background Paper

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of the fact that frequently people who use ATS may well be using other drugs. For example,
some use a variety of drugs to manage the come down effects of ATS, while some will be
coincidentally intoxicated on ATS and alcohol. In addition, a large number of participants
commented on the challenge of accessing the ‘ hard to reach’ and/or ‘hidden populations’
who use ATS, particularly given that the perceptions of use and patterns of use might not
bring many consumers into contact with helping services. It appears that while there is some
agreement on the need for targeting strategies, there needs to be some work focusing on
how such targeting should be informed.
Gay, lesbian, bisexual and transgender populations
As noted in Chapters 2 and 3, global research indicates an association between drug taking
and unsafe sexual practices among men who have sex with men (MSM). In particular,
methamphetamine use has been associated with increasing STI/HIV transmission rates
among this population (Boddiger, 2005; Halkitis et al., 2001). This highlights the need for
prevention campaigns targeted specifically at ATS use within these populations, particularly
in light of the social stigma experienced by these groups that creates difficulties in access
and delivery of services.
In 2005, ACON and NDARC conducted research of crystal methamphetamine and GHB use
among gay, lesbian, bi-sexual and transgender populations (GLBT) in NSW (Degenhardt et
al., 2005). This report identified the following key issues for GLBT:
• Limited understanding of psychosis amongst those using methamphetamine;
• Consumers presenting to GPs did not disclose their methamphetamine use;
• There was an increase in consumers seeking treatment for methamphetamine use,
however few treatment modalities and culturally appropriate interventions are available;
• Community concern tends to focus on drug use among gay men, however, use of crystal
methamphetamine appears to be as prevalent among lesbian and bisexual women;
• More information on methamphetamine and associated harms needs be provided to
consumers, frontline services and workers in the HIV sector; and
• Culturally sensitive GLBT training needs to be conducted with generalist AOD services.
It is pertinent to note that research is currently being conducted that may inform future
initiatives. For example, the Australian Research Centre in Sex Health, La Trobe University
is investigating patterns of crystal methamphetamine use among homosexual populations
of both genders.
Interventions have been demonstrated to reduce risks, and drug treatment services are
an effective site for intervening in high-risk behaviours and in particular reducing HIV risk
behaviours among methamphetamine users. In particular, cognitive behaviour therapy
(CBT) -based treatment approaches have been developed specifically to reduce sexual
risk behaviour among gay and bisexual males (Shoptaw et al., 2005). A recent study by
Mausbach and colleagues (2007) examined the efficacy an intervention for reducing sexual
risk behaviour among HIV-positive, methamphetamine-using MSM within the context of