My partner and I are both positive and sometimes party with crystal meth. Can it do additional harm?

                            —Party Pal

Dear Pal,
Let’s be real: Crystal methamphetamine is an attractive drug. It offers seemingly limitless energy, makes you feel more attractive and turbocharges sexual pleasure. It can invigorate a couple’s sex life. But, even for recreational users, the drug can become an addiction. Whether smoked, snorted, injected or inserted anally, meth can fuel sexual risk-taking, like unprotected sex with multiple partners, and other behaviors by which you could transmit or receive the virus.

For positive men and women, using meth recreationally or regularly can further compromise the immune system—especially for those who don’t sleep, eat, exercise and take meds properly. In my own study of 300 positive gay men on meds, those on meth were less likely to take them.

Meth’s psychological high affects the brain’s levels of dopamine, which regulates feelings of pleasure.

Indeed, many people who’ve regularly used meth report decreased sexual enjoyment for as long as two years after quitting.

Dopamine neurons and receptors can even become permanently damaged—a condition associated with Parkinson’s disease.

Meth can also make you more infectious, leaving you and your partner vulnerable to swapping HIV strains (superinfection) or other STDs. If your meth use is out of control, support is available. Many cities offer Crystal Meth Anonymous groups, and most AIDS service organizations can direct you to help. If you’re not ready to quit, reduce risk by avoiding injection, which causes skin infections that heighten transmission risk. You can take care of yourself even while partying.

+ Perry N. Halkitis, PhD, is a professor at New York University and director of the Center for Health, Identity, Behavior & Prevention Studies.

Got a question for our sexpert? E-mail it to