c) Social context of risk behaviours at parties

Andrew Mattison

School of Medicine, University of California, 2760 5^th Ave, San Diego, 92103, USA. Phone no: +1 –619 238 6040. Fax no: +1 –619 238 7020 E-mail: amattison@ucsd.edu

In about 1997, the straight and gay press and some gay journalists in the United States began writing stories vilifying circuit parties, claiming they were virtual cesspools of reckless drug users having lots of risky sexual behaviours. There was virtually no data supporting these claims, so with the approval of the University of California a study was designed which proposed four simple questions:

1. Does a problem exist?
2. What is the nature of the problem?
3. Can risky groups or risky situations be identified?
4. Can innovative interventions be developed?

Firstly it had to be demonstrated that such an on-site party study was feasible. Secondly, we had to ensure that major party producers would agree to this investigation, because, after all, their business is to produce dance parties and academics or so called ‘party poopers’ might spoil the fun of people who are there to dance and have fun. It was not known if party patrons themselves, in the context of the party weekend, would be interested and willing to share intimate details of their lives, their HIV status, their sexual behaviours and drug use.

A pilot or small test study was carried out with West Hollywood’s famous Jeffery Sanker, the most successful American profit-party producer. His famous Easter weekend ‘white party’ in Palm Springs involved about 7000 gay men for a weekend of dancing. The Gay Men’s Health Crisis project in New York City invited me to attend and observe their annual major fund-raiser called ‘The morning after party’ on the legendary ‘Fire Island’. Both this major US AIDS agency and Sanker realised the need for such a study and welcomed the opportunity to talk about themselves and their party activities.

Some party producers would be involved regardless of what the findings were, so the next phase of the study was to develop a 15 item standardised questionnaire that could be completed in about two minutes. Information was gathered at three large weekend parties in North America: the Black and Blue Festival in Montreal, now the largest party in North America (25,000 people); the White Party in Miami Florida; and the White Party in Palm Springs.

Methodology

Appropriate young party patrons who were off duty from work for the weekend carried out ‘intercept surveys’. The survey was relatively brief, anonymous and confidential, and they were handed in when people were in the cloakroom.

Findings

The people were predominately young, white, gay men; only about 25% of the sample are persons of colour. There is an unusually symmetrical distribution of age, and this ranges from 16 to 60 years old. (The men who were aged from 45 to 55 had lots of interesting stories). The average age is about 33.5.

This is a fairly educated group, unlike at the local club parties, called ‘fly in’ parties at hotels: 41% of people have a college education; 20% have higher education; less than 1% have high school education; 7% have a high school degree and 24% have some college education.

At ‘circuit parties’ people come from all over, so the famous DJs and production team (light shows and so forth) stay at hotels. These were people generating a fair income.

Sexual orientation

This is a gay men’s health survey so 92% were gay, 5% bisexual and 2% straight. Some of the straight and bisexual crowd were at the Black and Blue festival. Towards the middle of the evening, a lot of young, gay, ‘cool clubbers’ are very attracted to the Black and Blue.

80% of people who reported that they had been tested for HIV were negative, whilst 13% were positive, 3% had never been tested, and the ‘don’t knows’ were people who had been tested but never picked up their results.

Almost half of the people at these parties were in partnered relationships and 51% were single. ‘Single’ is a bit of a misnomer as people going to these large circuit parties generally travel with groups of friends and there are a lot of rituals in preparing for it: going to the gym together; buying drugs; working on party outfits; and basically partying, dancing and being in hotels as a group of friends. The median length of relationship is about 2 years. There were about as many couples together under 2 years as over 2 years but there is quite a large range from under 1 year to more than 10 years together as a couple.

Lots of people at these parties have a great deal of fun and in their view they party safely with regards to chemical use. ‘Savvy users’ is an expression amongst party-goers; they are the people who are very careful and very knowledgeable about the drugs they take. They get a good night’s sleep, eat lightly and well, hydrate, titrate, space out what they take, and they take days off in between certain drugs. Come Monday and Tuesday they either stay at the hotel to kind of ‘chill out’ and relax or they go home, but do not go back to work for a day or two. At the other extreme, there are people who will put their hand out and take almost anything. Often these people are newer to the club scene. Therefore, there is a wide range from novices and ‘messy’ drug users to ‘savvy’ drug users.

Reasons for attending clubs

During the observation point of the pilot study, people were asked their reasons for coming to these clubs and these reasons were ranked and ordered into the top ten. During the question portion of the survey a Likert scale was developed and people were asked to endorse these reasons, from ‘least I agree’ to ‘most I agree’. The reasons were numerous: to have sex; be wild and reckless; to escape from AIDS messages; to have fun; to do drugs; or just to dance. The item that was endorsed the first by far was ‘to be with friends’. Friendship is at the heart of the gay and lesbian social movement, including ‘circuit parties’ and clubs. Most of the ‘circuit parties’ are AIDS fund-raisers; fund raising events all depend on people calling upon their friends. It is through movements like ‘circuit parties’ that gay men meet others like themselves and develop friendships that are crucial to the development and maintenance of their identity. Friendships not only serve as a means of forming gay identity but they also contribute to the development of community, lending support to the classic statement of Aristotle that "Friendship consists in community" and that "Friendship also seems to hold states together".

Other reasons included validation and feeling good about being a gay man among other gay men in a kind of cool, supportive, playful and creative atmosphere. There is a spiritual aspect to this which was described in many different ways. With the tribal trance music in particular, there is a sense of bonding together.

Years ago, people typically met in a bar or a ‘bath house’ and then it shifted to the gay gym. Now people often meet at a ‘circuit parties’ and form meaningful relationships there. At a ‘White Party’ in Palm Springs, I was reminded of a summer camp reunion. Everybody was by the pool, the music was playing, and people were sharing a few drinks, remembering each other from previous years and making friends.

Chemicals and risky behaviours

The most commonly used single substance was alcohol at 73%. Unlike the club parties which are one night for 5, 6 or 7 hours, these are 3 day long events. Typically, when the camp reunion begins it is around the poolside and there is a disco, so people were having a beer, a cocktail or a glass of wine. At midnight or 2 in the morning alcohol consumption is much lower because it does not mix with other chemicals, but on the whole alcohol is drunk. A diverse selection of substances are consumed: 68% took ‘ecstasy’; 54% ‘Special K’; 23% GHB; 34% cocaine; 30% methamphetamine; 38% marijuana; and 33% ‘poppers’.

Out of almost 1200 histories, there is huge poly-chemical use. The most common 2 substances are alcohol and ecstasy The most common 3 substances are alcohol, ecstasy and ketamine. The most common 4 substances are alcohol, ecstasy, ketamine and ‘coke’. There are also others that are really close and they all blend together.

Number of drugs used in 12 months

66 individuals (9%) used nothing and 142 individuals (10%) used 1 substance. There is somewhat of a bell shaped curve so there is some distribution of a central tendency. Almost 50% mix lots of substances together. The methodology was translated into ‘lower’, ‘medium’ and ‘higher acute toxicity’. Under ‘acute low toxicity’ are ecstasy, ‘poppers’ and marijuana. Under ‘medium acute toxicity’ are the stimulants ‘coke’ and ‘methamphetamine’, and under ‘high acute toxicity’ are ‘Special K’ and GHB. 412 people, a high percentage of the population, are on a combination of low, medium and high toxicity drugs. Alcohol was disregarded here.

Sexual behaviour

A considerable percentage of party patrons had unprotected anal sex in the 12 months prior to the survey during circuit party weekends. The same was true of party patrons having unprotected anal sex in the previous six months.

Advice for clubs

A club in San Diego was about to lose its license. Undercover police agents had infiltrated the club and busted lots of folk for the sale and possession of drugs. They noticed some rowdy behaviour, as well as an excessive number of calls to the police for help and a high number of ‘drops’ (people collapsing from GHB and being transported on public funds to hospitals). A security agency and myself were hired to see if we could help save the club’s license. The main objective, however, was to institute new safety and security measures that would protect the health and safety of club patrons and thereby help not only to keep the club in business but to do good business.

Whilst undercover surveillance was carried out, certain recommendations were made. Some inappropriate ‘messy’ sexual behaviour and passing around of chemicals was noticed, as well as some outbreaks of violence. It was therefore recommended that security personnel should be more appropriately dressed and that better hi-tec identification machines should be installed in order to quickly establish valid and non-valid cards and therefore reduce arguments and fights. People were also thrown out of the club for sale and possession and if they tried to re-enter they were out for good. This strict law enforcement is necessary because the US and San Diego has a drug policy of ‘no tolerance’.

It was also recommended that the club had a second level of security. This involved appropriately aged ‘clubbers’, dressed in different polo shirts, working for the club and actually being on the dance floor to help develop ‘party ethics’. They would approach patrons who were dancing in another’s space and tell them that their behaviour was not ‘cool’. People engaging in other kinds of inappropriate behaviour and any sale or use of drugs would politely and respectfully be walked to the door. It is not possible at this point in time to say "hey, why don’t you just sit down or walk around the block and then come back". Other safety measures suggested were a first aid station, ‘chill out’ room, extra water and so forth. I hope to stay on at the club to implement and keep refining the recommendations, so San Diego can hopefully be a model club in the city and in the USA, doing what clubs in Europe and Australia are already doing.

The future

I will be collaborating with Dr Steve Morin from the faculty of the University California in San Diego to get a grant to design and develop ‘hi-tech’ innovative prevention programmes that will help reduce dependency and over-use of chemicals, in the context of promoting safer sex. There will be multi-sites with built in outcome measures in order to improve efficacy and so forth. In the first year there will be ‘formative’ research, which is not academics or Public Health people sitting in offices of the universities dictating policies like "use condoms". This is somewhat like Nancy Reagan saying "do not use drugs". The younger people especially just laugh in your face. We need to be much better at getting focus groups of our younger people, our consumers, in order to get opinion leaders. They will tell us what they see as problems, ways to identify risky situations, how to approach them and what kind of interventions work.

For example, we need to listen to people like Tony Valenswalo, who was a 16 year old Latino guy in San Diego who ‘came out’ and grew up. He was an AIDS educator activist and at 20 years old he ‘sero converted’. He then became a very articulate proponent of ‘bare backing’. He talks about the risks of this but he also turns to people in public health and says "Hey! You smoke, you drink and you are vilifying ‘bare backing’". Thus people like Tony and his friends should be listened to, otherwise this wave of primary and secondary prevention in 2000 onwards will not be successful.

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