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“It had been a big night. I’d taken a lot of crystal and the next day I felt horny as hell. I went to the sauna and had lots of great sex. It was only afterwards that 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 went for a sexual health check and my tests came back positive for syphilis even though I felt OK.”

“We introduced party drugs into the scene to spice up our sex life. 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.”

“Maybe it was the extra pressure about being HIV positive but I found that I couldn’t have sex without using crystal to take the edge off my nerves. It started to affect my work and I lost heaps of weight. A couple of friends set me right about it and with their help I left the scene for a while and stopped seeing a few old contacts. After a few months I was over it and now only have a few joints and the occasional ‘E’ at a party. It just didn’t work for me.”

“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.”

“I thought that having HIV meant I didn’t need to worry about condoms. I am hearing more about how hep C is sexually transmitted. One of my fuck buddies was recently diagnosed with hep C and he doesn’t inject or get fisted. We always use condoms now.”
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Treatment, Drugs and Sex

While alcohol is the most consumed recreational drug worldwide, many people, including people with HIV, take illicit drugs (often just called drugs) regularly or occasionally. AFAO does not condone using drugs, but we do support harm reduction approaches to reducing the risks associated with drug use. Along with the usual health issues associated with recreational drug use, there are some extra considerations for people with HIV.

Letting Your Guard Down

Drugs can help people to relax socially, giving confidence to talk to others and cruise for sex. Drugs can also cloud our judgement when it comes to sex, sometimes leading to choices that we wouldn’t normally make. Choices might include who we have sex with, where we have sex, what sort of sex we have and decisions about safe sex. When using drugs, it’s important to remember your rules and stick to them. And remember to prepare for the ‘come down’ and get support if it gets too hard. Talk to your friends, doctor or a counsellor if you need to. Drugs like crystal, ecstasy, MDA and others can make you hornier the next day. Casual sex and risk-taking can be more likely when we are wired (being under the influence of amphetamines) or during chem-sex (sex on drugs). When diagnosed with HIV, many gay men say that drugs or alcohol were part of the reason they didn’t have safe sex.

Looking After Yourself

If you are taking treatments there are a few important things to know. Some HIV treatments can increase the level of other medications and drugs in the body. This is the principle behind ritonavir boosted combinations. Ritonavir is often used with other protease inhibitors to ‘boost’ the level of the other medication to therapeutic levels in our blood, allowing a lower dose of the other treatment. This effect is caused by ritonavir blocking the liver from processing the other drugs, causing their levels in blood to rise.

The Effects of HIV Treatments

Ritonavir will also boost the level of some recreational drugs (ecstasy, crystal, MDA, cocaine and others) in your system. Ritonavir will increase the level of amphetamines by two or three times, or more. If you are taking ritonavir or another protease inhibitor, take a lower amount of the party drug. Taking Ritonavir and normal doses of drugs can lead to an accidental overdose and can ruin a night out. Ritonavir also boosts medications used to help people achieve and maintain an erection (Viagra, Levitra and Cialis). If you are taking ritonavir it is important to lower the dose of these medications. You should discuss how much to take with your prescribing doctor.

Less Is More

If you are going to mix drugs and treatments, don’t take them at the same time. Take a small amount of the party drug first, say a quarter. Then wait at least thirty minutes to see how your system is reacting. More detailed information on drug interactions can be obtained from your local AIDS Council or People Living with HIV (PLHIV) organisation.

Partying

To avoid unexpected treatment breaks while partying, always take a supply of your HIV meds with you. Small pill boxes are cheap and available at pharmacies. If you are taking treatments into a dance party the organisers will often have staff on hand to confirm your treatments so they are not mistaken for anything else by security staff.

Injecting Drugs

If you are injecting drugs with friends or a partner be very careful about not sharing any equipment. Always have enough fits (syringes) on hand and dispose of them immediately and carefully after use. Contact your local AIDS Council or PLHIV organisation to find out where your local needle exchange is located.

Hep C Transmission

Recent research suggests that hepatitis C might be more easily passed on sexually through barebacking (unprotected anal intercourse). The risks may be increased with crystal and amyl use. The theory goes that crystal dries out the lining of your arse and dick, and amyl dilates (makes bigger) the blood vessels in these areas. Both of these factors make it easier for hepatitis C and other STIs to be passed on.

Alcohol and Other Drugs

Drinking alcohol can increase the side effects of treatments containing efavirenz (Stoctrin, Atripla). Efavirenz can also increase the effects of alcohol, sometimes resulting errors in judgement.

Talking To Your Doctor

It is important to be able to speak openly to your doctor about your drug use. If your drug use or treatments are impacting heavily on your health and social life you can talk to your doctor, AIDS Council or PLHIV organisation about alternative treatments or getting help to reduce or stop your drug use. If you don’t feel that you are able to communicate freely with your doctor you might like to mention this to him/her or seek a second opinion.



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