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

I’ve freebased, I’ve done acid, I’ve done mescaline, mushrooms,
cocaine, crank.”
Rob’s first homosexual experiences were with men in their 20s who also
had “good jobs” (a disk jockey, a grocery store bagger). His first
boyfriend was a man he met in a “cruising” area in downtown Denver.
He turned out to be a hustler who was hooked on methamphetamine. His
mother moved to California with Rob and his sister about 5 years ago.
She began to use speed when forced to work graveyard shifts. One day,
when Rob “was going through one of her boxes,” he discovered her
“cross-tops.” With the move to California, methamphetamine became the
central feature of his life. He arrived in the Bay Area when he was 20.
Mark, Jim, and Rob came from different geographic areas, and their
families had varying personal and economic resources at their disposal.
However, their lives took a similar path after they began their drug-using
activities. Three central themes permeate their stories: “getting high” or
the initiation into substance use and the perceived functional value of this
activity; “tweaking and freaking” or the behavioral patterns during
substance-using episodes or careers, including unprotected sexual
activity; and “over-amping” or an extended state of anxiety and
discomfort (“hitting the wall”) when substance use activities are
perceived as clearly self-destructive or negatively affect the course of
their lives. Usually at this point they realize drug use must stop.
Examples of each of these themes provide insight into the motivations for
methamphetamine use and the rhythm and life patterns once involved in
the drug-using subculture, and suggest intervention strategies for ceasing
or moderating speed use.
GETTING HIGH: PATTERNS OF INITIATION AND
METHAMPHETAMINE USE
Getting high serves many functions and means many things to
disenfranchised inner-city youths, as demonstrated by the actions and
beliefs of Mark, Jim, and Rob. For example, methamphetamine use
results in a strong pleasurable feeling, so strong that it can become the
meaning of one’s existence, as Jim reported after his first high.
“He hit me (i.e., injected drugs). I started coughing and the rush hit
me! The room started shaking and right from then, I knew what my
mission was! (laughs) To keep that feeling up!...It made me feel like
161