The Context of HIV Risk Among Drug Users and Their Sexual Partners

that they are intending or desirous of the sexual or NMPD use activity. Is
it coincidental that most popular meeting spots for casual sexual
partnerships are places where alcohol and/or poppers are sold, or is this
the result of marketing that takes advantage of the synergistic interaction
of sex and drugs? The latter suggests the possibility that NMPDs differ
in their relative abilities to diminish unpleasant affects associated with
sexual intercourse (mainly anxiety and cognitive suppression of preferred
but feared activities) and maximize pleasurable feelings, such as euphoria
and sensual pleasure. The relative balance of such properties can be
conceptualized as the aphrodisiac index of each NMPD, but the
possibility should be considered that such pharmacological effects are
subject to differences in dosage as well as individual, social, and cultural
variations.
Social Influences and Social Setting Models
Use of NMPDs is frequently associated with special types of behaviors or
celebrations-a time out from normal social restraints and an inducement
to unusual or otherwise prohibited behaviors. To the extent that modern
societies have institutionalized times such as holidays and vacations, and
commercialized settings such as pick-up bars or crack houses where
NMPD use and sexual encounters are mutually available, people may
learn to associate NMPD use with high-risk sexual activities. Certain
personality types and heavy participants in either or both activities can be
expected to be most susceptible to social influence or setting effects on
subsequent behavioral patterns.
Intrapersonal Factors
Most studies concerned with possible causal relationships have made
mention of either the high-risk personality, characterized by impulsive
and sensation-seeking behavior, or the addictive personality. Either of
these personalities could predispose to both NMPD use and multiple
casual sex partners or high-risk sexual behaviors. Researchers’ inability
to disentangle any direct effects of NMPD use upon sexual behaviors
from cross-sectional or even prospective studies may ultimately be a
relatively unimportant consideration. Such personality characteristics are
probably represented more frequently among gay/bisexual men who
combine NMPD use with high-risk sexual behaviors than among men
who are abstinent from either type of activity, at least to the extent that
men with impulsive, sensation-seeking, or addictive personalities are
prevalent among gay/bisexual men.
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