Alcohol and Drug Use and Sexual Activity

Many people think of gay men as sexually obsessed, in part as a result of the general media’s focus on gay male sexual activity and reporting on and concern over human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Gay men are probably no more sexually obsessed or active than males in general, and certainly interest level and activity vary with age. Still, there are important links between sexual activity and alcohol and drug use that add to the risk of gay men developing substance abuse problems and that pose challenges for recovery.

As noted earlier, many gay men may feel particularly ashamed or uncomfortable about having sex with another man. This manifestation of internalized homophobia can lead to sexual activity in inappropriate places such as parks or public bathrooms, and it can strengthen the link between alcohol and drug use and sexual activity.

A small subsection of gay men focus on sexual activity with many partners and/or with great frequency. Many have discovered that using nitrates, cocaine, and, primarily, amphetamines greatly enhances sexual intensity and activity. Amphetamines, in particular, seem to increase and prolong sexual feelings and sexual stamina. Many gay men who use amphetamines also develop a side effect associated with amphetamines—transient impotence. Sexual desire is still greatly enhanced—for up to 14 hours—thus these men are at greater risk for HIV infection if precautions are not taken.