MDMA and Sexual Behavior: Ecstasy Users' Perceptions About Sexuality and Sexual Risk

Abstract

This study examines the relationship between MDMA (Ecstasy), sexual behavior, and sexual risk taking. The sample consisted of 98 current and former users of MDMA. Several strategies were utilized to recruit respondents and data were collected through in-depth interviews during 1997 and 1998. The majority of respondents had used MDMA during the 6-month period prior to the interview and a large percentage had consumed the drug on 100 occasions or more. Most respondents reported feelings of emotional closeness while consuming MDMA but without the desire for penetrative sex. Others, however, reported that MDMA increased sexual arousal and some respondents (in particular, gay and bisexual females) had used MDMA specifically for sexual enhancement. Sexual risk taking (e.g., having multiple partners, engaging in sex without a condom) was prevalent among respondents who did engage in sexual activity during MDMA episodes. Explanations for the findings are offered and implications for prevention/intervention are discussed.

Keywords:

• MDMA
• ecstasy
• sexual behavior

Notes

^aThe author acknowledges the subjectivity of the phrase, “recreational drug use.”

^b“Sexual risk taking” is also a subjective phrase. Behaviors defined as “risky” by researchers may not be perceived as such by drug users.

^cBecause the content of Ecstasy tablets can vary considerably (DanceSafe, 2000; Sherlock et al., 1999), perceptions concerning the effects of MDMA refer only to what users believed they have consumed.

^dThe vast majority of respondents who were interviewed during the first 4 months of the study resided in Belfast, the largest city in Northern Ireland. After this time we narrowed the criteria for participation in the study in an attempt to interview respondents 1) from outside Belfast or 2) former users. Current users from Belfast continued to contact us but for the most part we stopped interviewing Belfast residents for a period of approximately 2 months. At other times, we modified the study criteria so as to avoid overrepresentation of certain categories, e.g., middle-class students.

^eThe project directors chose deliberately to not use clubs as recruitment sources. Local folklore suggests that some paramilitary groups are closely tied to the ownership, operation, or management of various clubs. Anecdotal evidence suggests that while some paramilitary groups have been linked to drug trafficking, other paramilitary groups remain opposed to both trafficking and personal use. We believed that recruitment from clubs might have generated suspicion and may have placed potential respondents and the researchers at risk.

^fAll interviewers were trained during a 2-week period before the study commenced. Training topics included the nature and importance of confidentially (all staff members signed a “statement of confidentiality” and this document was framed and displayed in the main interview room), effective interviewing techniques, role playing, drug categories and effects, the local club scene (sites, locations, clientele, entrance fees, availability of alcohol, music), Ecstasy and the gay population, recruitment, and sampling issues. Additional training occurred throughout the study period during discussions in staff meetings.

^gMarijuana is not widely available in Northern Ireland. Cannabis consumed in Northern Ireland is largely hashish, which is often mixed with tobacco, rolled in a cigarette, and smoked.

^hWe asked respondents how they could ascertain whether a person had consumed MDMA. Visible cues included large black pupils, clenched teeth, “irregular” jaw formation, extreme friendliness, particularly with strangers.

ⁱDuring the data collection phase, a number of respondents reported that water taps or faucets were turned off in the public restrooms within certain clubs. There were also reports of the availability of hot water only in public restrooms. In several clubs, free glasses of water were not available from bar staff; rather, only bottled water was available, and sold for profit.

Additional information

Notes on contributors

Karen McElrath

Karen McElrath Ph.D., is a Reader in the School of Sociology and Social Policy, Queen's University, Belfast. Her current research focuses on stigma and risk among injecting drug users, drug use and political conflict, and measurement issues. She is the co-editor (with James Inciardi) of The American Drug Scene (Roxbury, 4th edition) and editor of HIV and AIDS: A Global View (Greenwood).