Breaking the Bond Between Stimulant Use and Risky Sex: A Qualitative Study

ABSTRACT

Stimulant-using men who have sex with men (MSM) are at increased risk for human immunodeficiency virus (HIV) transmission, and are more likely to practice unprotected anal sex than MSM who do not use methamphetamine and/or crack cocaine. In this paper the authors report on interviews with stimulant-using men who have sex with men who have participated in Crystal Meth Anonymous and other 12-step groups, focusing on those who did not have unprotected anal intercourse during a 6-month follow-up period and their reasons for doing so. The authors find 4 common themes cited: a diminished sexual drive; exclusive sex with a primary partner; greater sense of responsibility/commitment to safer sex; and most commonly of the four, an overall healthier sex life. Participants’ use of terms such as “healthy,” “enjoyable,” and “fulfilling” to describe sex not on stimulants, and avoidance of these terms for sex on stimulants, suggests a distinct dimension of sexual experience.

KEYWORDS:

• Cocaine
• gays/bisexuals
• methamphetamine
• peer support groups
• sexual behavior

This study was supported by National Institute on Drug Abuse grant R03 DA 16539 (Lyons, Principal Investigator). The authors are grateful to David Schwartz for helpful suggestions and to Jacob Grossman and Chris Duquette for excellent research assistance.