Following strong criticism for failing to issue a warning before, the AIDS Committee of Toronto (ACT) has posted an alert on its Web site stating the link between crystal methamphetamine use, risky sex, and HIV. "Crystal meth use increases sexual risk-taking among gay and bisexual men," warns the site. It also notes that meth's physiological effects on the body heighten the risk of HIV transmission during sex.

ACT's previously cautious stance had come under fire from some U.S. health officials and activists. "This approach, to be cautious, in the face of a much more hysterical approach in the [United States], was taken to be denying this link. We're not denying it," said ACT spokesperson Tyler Stiem. "We've been trying very diligently to say that if there's a connection it hasn't been fully fleshed out in studies."

But U.S. experts say the studies are clear. In a survey, conducted for CDC, of people testing for HIV in San Francisco, meth users were three times more likely to be infected.

Shaun Proulx, a journalist and community member of Toronto's new crystal meth task force, applauded ACT's "more direct and aggressive stance." "In Toronto there has been a problem for a while and people look to ACT for a response as a leader in the community," said Proulx.

Toronto's public health officials have also been criticized by their U.S. counterparts for not taking a position as to whether meth leads to riskier behavior than other drugs. Dr. Rita Shahin, the city's associate medical officer of health, said it is too early to attribute Toronto's continued high HIV rate to meth use. "From what I've read there seems to be more sexual risk taking, but I can't compare that to what that would be with other drugs," she said, adding that more studies are needed to assess how prevalent meth use is in Toronto and which prevention programs work best.

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