#AskTyler: I'm HIV-Positive and Into Chem Sex. Do I Need to Change?

“I’m really into chem-sex but I’m not an addict. Do I need to change just because I have HIV?”

In case you didn’t know, chem sex is when gay men take drugs like crystal meth, GHB, or molly (MDM or ecstasy) before engaging in sex. There has been quite the furor over the rise in popularity of chem sex parties and their connection with HIV transmission. Naturally, participants in chem sex are more uninhibited and, therefore, often partake in riskier sexual practices. But this question is not about whether you should participate in chem sex or not.

I know that drugs are bad for you. You know that drugs are bad for you. We all know that drugs are bad for you. However, it isn’t my job to tell you how to live your life. It is my job to give you advice that is related to your health and the health of your sexual partners. So here it goes…

This question is not about whether or not you should participate in chem sex; it is about assessing your behaviors, understanding your motivations behind them, and evaluating your risks. Ask yourself these two simple questions: Have you ever put yourself or one of your partners at risk for HIV infection while under the influence of substances? And have you ever regretted a sexual act you participated in during chem sex once you came down from your high? If the answer yes, then you need to re-evaluate your actions in order to reduce your risks of spreading the virus and of developing a co-infection.

Maybe that means talking with your partners beforehand about your HIV status so that they may take the proper precautions – via condoms or PrEP – so that when you are under the influence, the risk of transmission is reduced. Maybe it means making sure that you are compliant with your HIV medication and are maintaining undetectable viral levels and thus unlikely to pass along the virus. Or maybe it means asking yourself why you feel the need to take substances such as crystal meth in the first place.

I do not know exactly what the right answer is for you because I am not a drug counselor and I am not your mother. But I will tell you this: if you were my friend, I would ask you why you feel the need to escape reality in order to enjoy yourself. I would tell you that you are worth more than this and I would ask if this behavior truly makes you happy. I would push past your quick responses about it being “fun” and “not a big deal” and I would try to get to the root of why you are harming your body. I would do this because I want you to truly be well, and if you are asking me this question, then you already know the answer.