Sexual behavior and illicit drug use

Sexual behavior in drug users varies in association with the drug used, the drug subculture and setting, and the need to maintain the drug addiction. We review the literature on sexual behavior in drug-using subcultures, most of which centers on HIV risk reduction, and the drug-associated and economic pressures that influence sexual behavior. Most data available are on opioid (predominantly heroin) users and crack cocaine users. The recent phenomenon of the circuit party has led to investigation of the context in which drug use and sex have become the focus of large gay-oriented parties over long weekends. Sexual behavior in association with drugs in Western societies is important for its role in the spread of sexually transmissible pathogens, as well as injection-related pathogens.