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Sex, drugs and HIV/STIs

VAC/GMHC - Sex, drugs and HIV

Drugs and alcohol

People use substances for a variety of reasons and not everyone who uses or drinks experiences significant problems or dependence. Two common substances that appear to affect people living with HIV and GLBT people are alcohol and methamphetamine.  Substances can either be classified as depressants, stimulants or hallucinogens. Depressants slow the brain and the body down (valium, xanax, alcohol, heroin, cannabis, GHB). Stimulants speed the brain and the body up (methamphetamine, ecstasy, cocaine, cigarettes). Hallucinogens change the way you see, hear or think about things (acid, ketamine).
 

GLBT people and people living with HIV are at risk of abusing or becoming dependent on drugs or alcohol, as they are used commonly at gay and lesbian parties and bars, and seen as normal and sometimes necessary in these places. Also, people living with HIV and GLBT people may use drugs or alcohol to cope with discrimination, stigma and low self-esteem, and to enhance sexual experiences. Using drugs or alcohol before and during sex may disrupt normal thought processes and can lead to unsafe sex and sexually transmitted infections.  

Drinking or using in excess may cause mental illness, heart problems, infections, mouth, throat and lung cancer and also relationship, employment and financial problems. Depending on how often, how much and whether you snort, smoke, swallow or inject these substances will determine if you eventually become dependent on drugs and alcohol so much that you need to have it every day.

Alcohol

Drinking beyond the recommended two standard drinks a day may affect your immune system and ability to recover from infections. If you are living with HIV and not taking anti-retroviral treatment, alcohol consumed frequently and in large quantities can lead to lower CD4 counts. Some anti-retroviral treatment can cause an increase in blood fats and drinking heavily can make this worse. If you are living with HIV and Hepatitis C, it is generally recommended not to drink, or to drink at a minimum as alcohol damages the liver.

Methamphetamine

Using the illegal drug methamphetamine, (commonly referred to as ‘ice’ or ‘Tina’), can place increased pressure on the heart and result in lack of sleep and reduced appetite, which can all negatively affect your immune system. Methamphetamine use can also affect your mental health and can cause paranoia, psychosis, anxiety and depression. The combination of methamphetamine and HIV can be damaging for your brain and can lead to neurological problems.  Long sessions or binges on methamphetamine may also mean that some people forget or stop taking their anti-retroviral medication. The protease inhibitor, Ritonavir (Norvir) can increase levels of methamphetamine in the body to dangerously high levels. It is always recommended that you talk to your doctor about your methamphetamine use and the potential interaction it may have with other medications.

Keeping Safe

You may want to continue drinking or using drugs but still have concerns about the potential risks and harms involved. There are some strategies you can use to reduce these risks and harms.

If you want to reduce your alcohol consumption:

  • Slow down your drinking and have smaller mouthfuls
  • Put your drink down in between sips so it’s not always in your hand
  • Begin with a non-alcoholic drink
  • Alternate between one alcoholic drink and one non-alcoholic drink
  • Try low-alcohol drinks or light beer
  • Eat some food before or during drinking
  • Avoid top ups so you can keep track of how many glasses you’ve had
  • Set a limit in your mind before you begin drinking
  • Ask a friend to support you in keeping to this limit
  • Cut down or avoid salty food and snacks as they make you more thirsty
  • Take enough money to get a taxi home, or ensure there is a designated driver who remains alcohol-free

If you want to reduce the potential harms whilst using methamphetamine:

  • Set a limit on how long you will party and play for and stick to it
  • Set a limit on how much methamphetamine you will use. Don’t go beyond a particular quantity if you know it will make you feel anxious, paranoid or psychotic
  • Have some emergency money on you in a safe place so you can get home, but try not to bring valuables out with you
  • Plan on taking breaks to ensure you take your HIV medication
  • Avoid using methamphetamine if you are taking the protease inhibitor Ritonovir (Norvir)
  • Don’t share needles – go to a needle and syringe program to make sure you have your own clean equipment
  • Take regular breaks to rest and hydrate with liquids that have sugar and electrolytes
  • Methamphetamine can cause a dry mouth – if you have cuts, bleeding or infected gums, don’t have oral sex
  • Chewing sugar-free gum can help with saliva production and grinding your teeth
  • Use condoms and lube and ensure you have a big supply with you
  • Use plenty of lube as mucous membranes in the anus and vagina can tear, particularly during long sessions
  • Don’t make any big or major life decisions whilst wired or coming down as methamphetamine can raise your level of impulsivity

Safer Injecting

Injecting is the riskiest way to use a drug. Consider using smoking, snorting, swallowing or shafting before you inject. If you do choose to inject, following these strategies will reduce the risk:

  • Wash your hands before injecting
  • Use a new sterile needle and syringe every time
  • Clean the spoon by wiping once in one direction with an unused swab
  • Use another, unused swab, in one direction only over the injecting site
  • Remove rings and tight bracelets in case of swelling
  • Never inject if there is pain, swelling or infection at the injecting site
  • Recap your own syringe and dispose of it in a disposal container
  • Wash your hands and arms with warm soapy water afterwards

Your choice

You may want to stop using drugs or drinking alcohol completely. Or you may want to continue, but use or drink less. If you’re concerned about your alcohol or drug use, ask yourself the following questions:

  • What worries do you or other people around you have about your drug or alcohol use?
  • What do you predict will happen in the future if you continue to use drugs or alcohol?
  • How important is it for you to change your alcohol or drug use?
  • How ready are you to change your alcohol or drug use?

If you decide to keep drinking or using, how could you either reduce the amount, or drink or use less often?

Getting help

Getting support from others about your substance use can help a lot, whether it’s from professional or personal supports. Talking with others about your triggers, ways of delaying and distracting yourself, and keeping safe when it comes to sex or injecting can be useful. VAC/GMHC offers a secondary needle and syringe program at 6 Claremont Street and the Positive Living Centre at 51 Commercial Road. VAC/GMHC also offer counselling and therapeutic groups (Over the Limit, Re-wired) to support you in your recovery:

Counselling: http://www.vicaids.asn.au/counselling-services

Over the Limit: http://www.vicaids.asn.au/over-limit

Re-wired: http://www.vicaids.asn.au/in-the-loop

In addition, you may want to access more information through the following links:

http://hrvic.org.au/

Harm Reduction Victoria is a peer-based organisation concerned with providing information and support about illicit drug use, safer injecting, pharmacotherapy and blood-borne viruses.

http://www.health.vic.gov.au/aod/directline.htm

Directline – ph: 1800 888 236

Directline provides state-wide telephone and online alcohol and other drug counselling, information and referrals 24 hours a day, seven days a week.

http://www.health.vic.gov.au/aod/

The Department of Health’s alcohol and drug pages contain information about treatment, services and other resources on alcohol and other drugs.

http://smartrecoveryaustralia.com.au/

Smart Recovery: voluntary self-help groups providing support to help people recover from alcohol and drug use and other addictive behaviours.

http://www.aa.org.au/

Alcoholics Anonymous: Group support following a 12 step program for people recovering from alcohol use.

http://www.crystalmeth.org.au/

Crystal Meth Anonymous: Group support following a 12 step program for people recovering from crystal methamphetamine use.