Whether smoking it, snorting it, popping it or injecting it, recreational drug use appears to be higher among gay and bisexual men than among the rest of the population. Why is that and how can we protect ourselves?
While there's not a huge amount of statistical information on this in South Africa, at least one study has tackled the issue; research in 2004 by OUT Well-being in Pretoria looked at the use of recreational drugs among lesbian, gay, bisexual and transgender people in Gauteng.
It found that 27% of those surveyed had used recreational drugs. The report added that "it is thought that this figure could be an under representation due to a fear of disclosure because drug use is illegal".
Compare this to a 2012 journal article by Sonja Pasche and Bronwyn Myers of the University of Cape Town that looked at drug use in the general population.
It concluded that dagga is “used by approximately 2% of the population, with cocaine (0.3%), sedatives (0.3%), amphetamines (0.2%) and inhalants, hallucinogens and opiates (0.1% each) being less common”.
A 2012 UK study, conducted by the Lesbian and Gay Foundation and the University of Central Lancashire, concluded that gay people are seven times more likely to take illegal drugs than the straight population.
That doesn’t mean that all gay and bi men use drugs (and this stereotype can be harmful) but it does mean that more gay or bi men are likely to do so, and ignoring this trend can be dangerous.
Without disputing the many health and social issues that may accompany drug abuse, moralising about the issue or heavy handed criminalising could also be counter-productive.
A 2012 report by the Global Commission on Drug Policy argued that the global ‘war on drugs’ is actually fuelling the HIV pandemic among people who use drugs and their sexual partners.
According to the Open Society Foundations, the report concluded “that repressive drug law enforcement practices force drug users away from public health services and into hidden environments where HIV risk becomes markedly elevated”.
The report also outlined “how the fight against HIV is being won in countries where addiction is treated as a health issue” rather than a criminal offence.
While no one knows for sure, there are a number of possible reasons why we seem to have a stronger taste for the forbidden fruit of intoxicating substances.
There’s the theory that drug use could be a way of dealing with prejudice and low self esteem among gay and bi men, thanks to a society that often excludes, discriminates and looks down on us.
Certain kinds of drug use are associated with social subcultures, such as the clubbing or party scene. Feeling like you fit in and bonding can be powerful motivators to use drugs. Some guys also choose to use drugs in their sex play as a way to feel hornier, to let go, or to make sex kinkier or more exciting.
Regardless of the cause, it’s important to try to ensure that we stay as safe as possible if and when we use drugs, especially when it comes to HIV.
Injecting drug use is correctly seen as one of the biggest infection dangers. Shared needles are an easy way for the HI virus to be spread around. But it goes much deeper than that.
There have been many studies that confirm that drug use can make it more likely for us to have risky sex. For example, a 2008 study of Israeli men who have sex with men found that "substance use... was strongly associated with risky unprotected anal intercourse and other high risk sexual behaviours”.
While being high and horny can be extremely exciting, this can also be a particularly nasty combination when it comes to forgetting our common sense and not using condoms and water-based lube.
Here are some tips to help make your substance use safer.
• Consider going on PrEP - a daily pill that is extremely effective in preventing HIV infection (as long as it’s taken consistently).
• If you inject, never, ever share needles. Make sure you use a new needle and syringe every time.
• Drug use and barebacking don’t have to go hand in hand. Always keep condoms and water-based lube around – and use them!
• Before combining drugs and sex, agree on what you’ll do and won’t do with your partner or partners. Don’t be pressured by others.
• If you do choose to bareback, then make sure you use lots of lube to avoid anal tearing. Remember, the bottom is at more risk. Pull out before coming.
• If you’ve had risky sex, you have 72 hours to get onto PEP medication to avoid infection. Don’t worry and wait – do it!
• Get tested regularly. If you are HIV positive, the sooner you know your status, the faster you can take charge of your health.
• Avoid mixing drugs with other drugs and/or alcohol. The side effects can be particularly dangerous.
• If you’re HIV positive, be aware that drug abuse may negatively affect your immune system and health.
• If you feel you’re losing control of your drug use or it’s negatively affecting your life, work or relationships, get help from a professional.
For advice, counselling and information on help with drug abuse, getting PrEP, PEP and other health services for men who have sex with men in Pretoria, South Africa, contact OUT on 012 430 3272 .