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

the city. It was the first time I’d ever been to this one gay area, and I
said ‘Wow. I don’t believe this.’ There was guys holding hands
walking down the street together, it’s amazing... But I didn’t go back
up there for a while just because I was busy doing things with straight
people, with people my own age, which was also something very
strange, cause I never hung out with people my own age in the
Midwest.”
It was during this period of masking his sexual orientation that Rob
started using drugs.
Most of the youth in the larger study group experienced conflict over
“coming out” and choosing a gay or bisexual lifestyle. This conflict was
interconnected with methamphetamine use for Mark, Jim, and Rob.
Many youths who identify as gay or bisexual do not adopt substanceabusing
patterns. However, negative societal reactions to gay and
bisexual youths appear to lead some youths out of traditional mainstream
cultural practices in order to find acceptance, personal worth, and value.
Some social worlds and subcultures are more accepting of diversity and
welcome gay youths. Once accepted into alternative subcultures, some
youth become vulnerable to the negative or destructive activities or
practices characteristic of these adopted social worlds.
While many youths experienced an increased sense of meaning,
self-worth, pleasure, and disinhibition associated with initial
methamphetamine use, eventually there were negative consequences of
chronic use. For each benefit, a contrasting cost arose-costs far higher
than the benefits and almost unavoidable. As Jim summarized:
“So it just kept going down, down, down, and so he moved, and kept
doing more drugs, and I did drugs with him. We stayed up all night
and we’d fight, and we’d get back together again and have great sex.”
Most youths experienced a downward spiral and were addicted to the
drug and to the lifestyle that surround usage. Activities and relationships
of physical and emotional ecstasy and disinhibition became
dysfunctional. For example, while methamphetamine was initially an
aphrodisiac, it soon became necessary for sexual arousal. Episodic or
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