While recreational drugs, the most universal one being alcohol, can help us to relax socially and make it easier to initiate sexual liaisons, they don’t necessarily improve the choices we make. We are all familiar with the morning-after scenario and the remorseful “I must have been sooo out of it” excuse.
Although some people report enhanced sexual experience under the influence of some drugs, this is not everyone’s experience, nor necessarily the experience of their non-drug affected partners. At best drugs can enhance a sexual experience, at worst they can kill us.
Some drugs, (speed, for example) can make you feel most sexual the day after taking them. Casual sex and risk-taking is more likely to happen then. Being vigilant about sticking to what is safe for you and your partners is particularly important at these times.
Some gay men with HIV only occasionally take drugs, at dance parties for example, and so the temptation to go all out can be very strong. While taking illegal drugs is not something we would recommend, if you do plan to use drugs then consult your doctor, local PLHIV group or AIDS Council about appropriate harm minimisation guidelines for the drugs you are planning to take. Also prepare for the possible post-party 'come down' and seek counselling and support from your friends if it continues for too long.
Of particular concern to people with HIV is the possible interaction of recreational drugs and HIV antiretrovirals. Protease inhibitors in particular tend to take priority over other drugs in the liver. This means that your other drugs may take longer to break down. Ritonavir, for example, which is probably the HIV medication to be most wary about, can be particularly dangerous when taken with ecstasy, speed or crystal meth.
Although a prescription drug, Viagra, like any drug can cause side effects. Of particular concern to gay men with HIV are the possible drug interactions. If your doctor prescribes Viagra for you, ask him or her about potential interactions with any medications you may be on. For example: Viagra and Ritonavir are known to be potentially dangerous when taken together; a lower dose of Viagra is needed to get the same effect. And remember, don’t sniff amyl nitrate if you’re on Viagra as both drugs reduce blood pressure and this could prove fatal .
If you are going to mix drugs and treatments, avoid taking them at the same time. Another good idea is to only take a small amount of the party drug first, say a quarter. Then wait for at least 30 minutes. More detailed information on drug interactions can be obtained from your local AIDS Council or treatments information officer.
If you are injecting drugs with friends or a partner be very careful about not sharing any equipment. Always have enough fits on hand and dispose of them immediately and carefully after use.
“It had been a big night. I’d taken a lot of speed and the next day I felt horny as hell. Anyway, I went to the sauna and had lots of great sex. It was only afterwards I realised that some of it wasn’t as safe as it could have been. But at the time I couldn’t have cared less.”
“I don’t usually take drugs but tried some ecstasy with a new boyfriend. Anyway, the only thing I got out of it was a stomach ache and sex was the last thing on my mind. It certainly wasn’t the fabulous experience we expected.”
“After the honeymoon, my partner and I started to lose interest in sex. We introduced party drugs into the scene and it got more interesting. Then we realised we were relying on them to get off and getting really shitty with each other between times. Now we’re back to doing it straight once or twice a week and saving the drugs for special occasions.”
“I went through a bit of a cycle of meeting guys at dance parties when I was on ecstasy. The sex was great, and I really fell for a few of them. But, with the ones I did see again when I was straight, I’d almost always be disappointed. Now, I still have good sex with guys when I’m on ecstasy, but I try to stay realistic about my expectations about what may happen afterwards.”
Excerpt from HIV Positive Gay Sex.