Dr. Jose Narciso Melchor Sescon – president of the AIDS Society of the Philippines and current Chief of Clinics of Sta. Ana Hospital – answers all your HIV-related inquiries. For all your questions, email firstname.lastname@example.org or email@example.com.
Posit po ako (I am HIV-positive), and I already take ARVs. But sometimes, I still get invited to attend PnP (partee and play) – we particularly use shabu (methamphetamine), and sometimes E (Ecstasy). Hindi ko guaranteed na mapigilan ang pag-PnP ko (I can’t guarantee stopping attending PnP), but I want to know how to make sure my ARVs will work effectively.
Let me qualify for purposes of understanding: When you say that you have been invited to attend PnP (for partee n play), you mean attending sex parties among MSM while using recreational drugs such as methamphetamine (shabu) and Ecstasy (MDMA-derivative).
Right off, let me say that PnP puts a person at risk of either contracting and/or transmitting HIV and other STIs.
The risk here is the high chance of not using condom correctly and consistently as protection at the time of the sexual act. This is as a result of impaired judgment, particularly when one is feeling “high” (that feeling of being “liberated”) as a result of the effects of drugs.
There are available (more current) studies that show that, for a person living with HIV but with undetectable viral loads for at least two years, the chances of transmitting/receiving new strains of HIV is very low or even nil (CHECK THIS, THIS, THIS and THIS). However, let me stress this, the risk to get infected with STIs is high, as a result of multiple sexual partners.
It is still highly recommended to use condoms correctly and consistently at every sexual encounter. As a clinician, I would await for a multi center or a meta-analysis studies across the years that have reviewed its efficacy.
On another note, consider drug use and HIV disease progression (CONSIDER THIS and THIS). Heavy drug use affects a person’s sleep schedule, appetite, health and nutrition… the overall health, at large. Drug use can cause the immune system to weaken and exacerbate the side effects of ARVs. In turn, this can provide a pathway for opportunistic infections to develop. Yet another risk of drug use is missing ARV doses and poor adherence, and this can lead to HIV resistance and/or treatment failure.
It is because of these that it is recommended for one not to participate in PnP; there are just too many deleterious effects. If one really cares for one’s health status and are already taking ARVs, a personal decision has to be made, and when this is made, one has to be accountable for its outcome/s.