The use of crystal meth during sex is not limited to gay men or other men who have sex with men. Meth is widely used, both nationally and internationally, with over one million users in the U.S. Nationwide, the profile of a "meth user" is as diverse as our population, including heterosexual men and women of all ages and cultural, social, and ethnic backgrounds.

Meth users reported more sex partners; were less likely to report condom use; and were more likely to report sex in exchange for money or drugs, sex with an injection-drug user, and history of a sexually transmitted infection (STI).

On average, sexual behavior under the influence of crystal is related to higher sexual risk. For example, Mansergh et al. (2006) estimated that methamphetamine use doubled the likelihood that men who have sex with men engage in unprotected receptive anal intercourse. Among gay men with unknown HIV status, methamphetamine use was associated with 18 times more unprotected receptive anal intercourse in men who eventually tested HIV-positive compared to those who were HIV-negative. Similarly, Wong et al. (2006) delineated that methamphetamine use increased the likelihood of contracting syphilis 6-fold, and Plankey et al. (2007) indicated that there was a 1.46 increase in relative hazard for HIV seroconversion associated with methamphetamine use.