Drugs Use and HIV

From GAy.com

Drug use is biggest single cause of HIV transmission in gay men
Gus Cairns
Using recreational drugs such as poppers, cocaine and crystal meth is the biggest single contributory factor to continued HIV transmission between gay men, the 12th Retrovirus Conference was told.

Grant Colfax of the San Francisco Department of Public Health told the conference that using crystal raised the risk of unsafe sex two to three times, and the risk of HIV infection by 60 percent.

Being "bottom" during unprotected anal sex raised the risk of infection by nearly 300 percent. But because taking drugs during sex was more common than getting penetrated bareback, the "attributable fraction" of HIV cases due to drug use (that is, the contribution drug use made to HIV transmission) was 29 percent, beating passive barebacking by 1 percent.

On the surface, Colfax admitted, it was puzzling that using a drug was even more risky than doing what you'd think would be the riskiest thing.

But all sorts of factors could come together to make users of coke and crystal particularly vulnerable. Pain was dulled, so injuries for HIV to pass through could be more common. Other drug users were already more likely to be HIV-positive, and also less likely to remember to take their HIV pills, and therefore more infectious. And users might simply not be able to remember what they'd done.