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

are short-term sexual partners from whom Mark receives money, whereas
“johns” can be “worked” over long periods of time, as is the case with
“sugar daddies.” The youths’ descriptions of bartering sex demonstrate
how initial attributions of self-worth and potency associated with chronic
drug use eventually are replaced by alienation, as demonstrated by
Mark’ s account.
“He is in love with me too, another sorry guy who fell in love with
me (laughs), I kept saying, well I want to buy some dope with you...
so she (sic) says, here’s the money go buy the coke...She likes to get
people real full (high) and give them dope and have sex.”
Methamphetamine use as a means of connecting and experiencing
intimacy with others eventually evolves into situations where drug use
increases, and the relationships dissolve in conflict. Rob’s description of
his problems with Alex demonstrates this pattern.
“Alex was addicted and at first he told me he was gonna quit. And
then he didn’t, and then, when he and I started to fall apart, he started
to do methamphetamine a lot more, and then I started to do it with
him, cause it was one way we could be together.”
Youths get high and use methamphetamine for various reasons that often
influence their present circumstances. Rob succinctly summarized the
reasons for his former partner’s speed use.
“He said he was doing it to lose weight, but that wasn’t the truth.
The truth was he was trying to forget that his father abandoned him,
his uncle molested him, or his mother didn’t love him; his brothers
were messed up, and he was gay.”
Youths who become part of the methamphetamine-using subculture find
that their sexual satisfaction is enmeshed with their survival needs and
feelings of self- worth. To them, getting high is characterized by a
euphoric physiological rush, and is used to increase personal feelings of
self-worth and sexual potency, to connect with others, and to explore
one’s sexual orientation without guilt. Getting high also makes it easier
to participate in undesirable but necessary sex work in order to provide
for one’s immediate survival needs. However, in time, the long-term
consequences of chronic methamphetamine use become more apparent:
sexual dysfunction, alienation from others, and marginalization into
destructive interdependent subcultural social networks.
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