Research
Reducing widespread pipe sharing and risky sex among crystal methamphetamine smokers in Toronto: do safer smoking kits have a potential role to play?
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* Corresponding author: Carol Strike carol.strike@utoronto.ca
1 Human Biology Program, University of Toronto, Toronto, Canada
2 Dalla Lana School of Public Health, University of Toronto; Centre for Addiction and Mental Health, Toronto, Canada
3 Shout Clinic, Central Toronto Community Health Centres, Toronto, Canada
4 AIDS Committee of Toronto, Toronto, Canada
5 The Works - Needle Exchange, Toronto Public Health, Toronto, Canada
6 Toronto Drug Strategy Secretariat, Toronto Public Health, Toronto, Canada
7 Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7, Canada
Harm Reduction Journal 2012, 9:9 doi:10.1186/1477-7517-9-9
Published: 16 February 2012Abstract
Background
Crystal methamphetamine smoking is associated with many negative health consequences, including the potential for transmission of hepatitis. We examined whether or not a kit for crystal methamphetamine smoking might have some potential to reduce the negative health effects of crystal methamphetamine smoking.
Methods
Five focus groups were conducted with crystal methamphetamine smokers recruited by community health agencies and youth shelters in Toronto, Canada. Target groups included homeless/street-involved youth, sex workers, men who have sex with men, and youth in the party scene. Participants (n = 32) were asked questions about motivations for crystal methamphetamine use, the process of smoking, health problems experienced, sharing behaviour, risky sexual practices, and the ideal contents of a harm reduction kit.
Results
Pipe sharing was widespread among participants and was deemed integral to the social experience of smoking crystal methamphetamine. Heated pipes were unlikely to cause direct injuries, but participants mentioned having dry, cracked lips, which may be a vector for disease transmission. Many reported having sex with multiple partners and being less likely to use condoms while on the drug. Demand for harm reduction kits was mixed.
Conclusions
Changing pipe sharing behaviours may be difficult because many participants considered sharing to be integral to the social experience of smoking crystal methamphetamine. Within the context of a broader health promotion and prevention program, pilot testing of safer smoking kits to initiate discussion and education on the risks associated with sharing pipes and unprotected sex for some communities (e.g., homeless/street-involved youth) is worth pursuing.