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

top of (you). If I wouldn’t have been high on something I never
would have went with her (laughs).”
Survival often is dependent on drug connections. Other “players” and
their gatherings provide the context for unprotected sexual activity to
occur. For example, Mark identified Daniel as the person he would go to
for help. Daniel is his 34-year-old “former lover” who is also one of the
main methamphetamine suppliers in his neighborhood. Daniel provides
Mark with a free $20 bag of speed daily, and does not make any sexual or
financial demands in return. According to Mark, “He loves me.” Mark
reported that he is not now actively involved full-time in sexual activity
for money, although he does sometimes run into former clients and “falls
into old patterns.” Occasionally he will walk down the main male sex
worker street (“my daily stroll”) while high on methamphetamine, and if
a car stops, he does not say no to advances.
HIV-risk behavior can escalate within the context of sex-for-money
exchanges. Jim’s first experience with anal receptive intercourse
occurred with a trick. He had not anticipated being the receptive partner
when sexual activity began.
“The first time I did do it and it was for money, we had already got to
his house and we agreed that he’d pay me $50 to have oral sex.
Right in the middle of it, he told me he’d give me an extra $100 if I’d
let him do that (anal sex). I said okay and he put on a rubber and did
it....It hurt! I felt that feeling, for months, ugh! I couldn’t stand it, I
hated it! It made me feel like a woman! I felt real cheap.”
Similar routine, negotiated, or forced sexual situations or behaviors are
dictated by immediate survival needs. Relationships often are entered
into only for support, protection, or survival. Mark, for example,
emphasized that he is not attracted to men his own age because he feels
they are “generally stupid and without direction.” While Mark likes the
financial stability usually characteristic of older men (age 40 to 50), he
describes these men as generally dysfunctional, saying they “fall in love
too easily.” While discounting those his own age, Mark’s choice of
partners usually is based on the potential benefits he can obtain. Money
to purchase speed is a frequent benefit of his cross-generational
relationships.
“...My track record, I mean it’s not exactly, you know, making the
best time, the best mileage, I’ve left a lot of accidents (laughs) on my
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