Meth Sex, Chemsex, and PnP

By: Jennifer McMillen Smith, MSSA, LISW-S, Division of Infectious Disease and medically reviewed by Ann Avery, Infectious Disease Physician at Metrohealth Medical Center

Thinking about sex can cause you to feel all sorts of things—excited, intimidated, you name it! Sometimes, these attitudes toward sex depend on the people involved, or where in the world you’re hanging out. And, other times, sex comes along with substance use. You might be familiar with this, or it might be new to you!

Maybe it begins with a glass of wine before a sexy evening or smoking a joint to "get in the mood." For those who love to go out clubbing to mingle, they might find themselves combining sex and methamphetamines, for what is commonly known as meth sex.

Meth sex is also known as chemsex or PnP, short for ‘party n’ play.’ Meth makes people less inhibited and enhances all the sexy feelings. Combining meth and sex is more common and widespread in the LGBTQ+ community—we’re talking about the circuit scene and in-home group sex parties.

Hold up, though… meth sex comes with some major drawbacks.

For those living with HIV, meth holds all sorts of additional risks, especially when it’s combined with sex.

Look, we're not here to judge; we want you to enjoy the sex you are having. We just care about that beautiful body of yours and want it to remain as healthy as possible. 💪

What exactly is meth sex?

Well, on the surface, it’s basically what it sounds like—sex, involving two or more people who are also using meth in some way or another. When people smoke crystal meth or take meth through the rectum 🍑, they end up with a huge high that makes those frisky feelings start up. Their inhibitions lower, and their guard comes down, making sex seem more appealing. Generally, a higher sex drive is a common side effect of meth use.

Is that a bad thing? The having sex part doesn't have to be—however, the effects of the drug cause some potentially severe issues. Meth boosts dopamine levels (the 'feel-good' hormone that your body produces to make you happy), and that's how people get hooked. However, it’s easy to quickly develop a tolerance to meth, making someone more likely to use more each time. Soon, the body absolutely needs it to feel good in general. At this point, people find themselves with an intense and all-consuming addiction. The withdrawal symptoms can be tremendously difficult. It makes sense why; meth is known to be one of the more addictive substances out there.

Is meth sex safe when living with HIV?

Let's be honest–it's easy to forget things 🤔 or even set boundaries when you're high. You might miss taking your meds which affects your viral suppression, or engage in riskier sex which can lead to issues around consent. Those who take meth rectally are more likely to take too much and overdose. Sadly, people who regularly engage in meth sex, usually find it hard to enjoy sex—that is, unless they’re taking meth.

For anyone living with HIV, a healthy 🏋️ body is their best line of defense. However, meth hurts all sorts of body parts, including the heart and brain. Here are some common health problems that it causes:

  • Increased blood pressure
  • Higher heart and respiratory rates
  • Anxiety
  • Paranoia
  • Aggression
  • Hallucinations
  • Mood disturbances

Unfortunately, meth also has some nasty long-term effects, and some stick around even when you stop using the drug. We don't want to get too doomsday-y, but it is important to know this stuff. 💗 Long-term meth use can lead to:

  • Teeth problems (you've probably seen pictures of this in school/on the web)
  • Permanent damage to your heart or brain
  • Liver, kidney, and lung damage
  • Psychotic symptoms that can last for months or years after you've stopped using it (aggression, hallucinations, and paranoia are likely)
  • Sores from a powerful need to itch
  • Bone disease
  • Complications caused by long-term high blood pressure, like a heart attack or stroke, both of which can be fatal

In addition to all of this, research studies have found (from studying animals) that meth could damage the immune system. 🧬 This is harmful to people living with HIV, since HIV strains your immune system. There's also research that suggests meth use worsens some mental conditions like dementia, which has ties to HIV, too.

Basically, your body is seriously working overtime when you’re on meth. And, faster than you might think, it’ll get tired and worn out, causing a laundry list of problems.

So, what do you do if you are using meth?

This is such an important question, and to answer it starts with you!

If you’re not using meth, this doesn’t mean you’re out of the woods. Resisting the urge to say “yes” is a great way to avoid it, and this starts with a conversation about consent-- especially if you’re having meth sex! (read more here)

If you’re using meth, go through the list below, and answer each question truthfully and honestly.

  • Are you using meth even though it's causing you problems?
  • Do you need to use increasingly more meth to feel good?
  • Are everyday things no longer bringing you joy?
  • Is taking care of your body and hygiene no longer a priority?

If you answered yes to any of these questions, meth is probably interfering with having a healthy, positive daily life. This might mean you’re dependent on or addicted to meth: your body and mind are managing meth’s effects, negatively impacting the way you can interact with others and take care of yourself. In this situation, it’s extremely important to talk to your doctor🧑‍⚕️. They're there to help you, listen to you, show empathy, and help you make positive changes in your life ❣️

If you are using meth, please know that you're not alone. Recovery is possible, and there are people out there that want to help. Talk to your doctor, find support groups, and if you're living with HIV, consider joining the Positive Peers app to find others that have gone through what you’re managing, too.