There’s no evidence to show that occasional use of recreational drugs will make HIV progress any faster, but there is evidence to show that frequent and heavy use of recreational drugs can impact on the immune system [1]. So, if you’re out getting wasted every weekend then your immune system may not be as strong as it could be. If you’re regularly taking E, coke, speed, crystal, ketamine, GHB or whatever your favourite cocktail is, then you’re also probably missing sleep and not eating enough. This lifestyle would eventually make anyone feel run down, whether HIV positive or not. When you are run down, your immune system probably won’t be as effective in fighting infections. If you already have a suppressed immune system because of HIV then it follows that loads of clubbing and drug taking could leave you more open to HIV-related illnesses.

In general it’s better for your health to be sensible about how hard and how often you party. Try to avoid heavy sessions when you’re not feeling well, and make sure you give your body time to recover properly from a big night out.

It’s good to eat slow energy release foods, such as pasta, rice or potatoes, before you go out if you are planning on having a big night. Afterwards, make sure you rest well, eat plenty of good food, such as fresh fruit and veg, and drink plenty of filtered water. This will give your body the things it needs to recover as quickly as possible.

It’s also worth remembering that some recreational drugs, such as crystal meth, can cause you to lose your inhibitions, and can be highly addictive. If you are looking for ‘chem sex’ (sex whilst on drugs, especially crystal meth), it’s possible you could find yourself in a situation where you don’t have as safe sex as you would normally like, possibly leaving yourself open to picking up another STI or hepatitis. Also, crystal meth can increase the levels of HIV in your system, and it can also inhibit the immune response of men who are uninfected. This means that it is more likely you could infect your partner if you are have risky sex whilst doing crystal than it would be normally. Therefore, try to remember the reasons why you’d want to use condoms even when you are off your head.

You can read more about using condoms and your sexual partners in the section on Sex.

If you take drugs by snorting them, try not to share snorting straws or banknotes with anyone. It’s possible to pass on or pick up Hepatitis C through sharing snorting straws or banknotes as tiny specks of blood can get onto the end of them during use. If the specks of blood have come from the nose of someone with Hep C those specks will contain the Hep C virus. Therefore, if you then put that straw or banknote up your nose you could get Hep C.

You can read more about Hep C and protecting yourself in the section on STIs and in the Sex section.

Injecting drugs
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If you are injecting drugs then it’s vital that you always use clean and sterilised injecting equipment. If you share a needle with someone else, then you could become infected with hepatitis or any other blood borne disease he may be carrying. It’s also possible that you could pass on HIV to someone you share a needle with, so it’s important to never share injecting equipment with anyone.
Getting advice
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You could talk to your HIV doctor or health adviser in complete confidence about what recreational drugs you take and how often. If you are concerned about confidentiality you can always ask them not to put anything about this into your notes before you talk to them about it. They should be able to give you advice about this without being judgmental. When it comes to monitoring your HIV, and also when considering treatment options, you’ll be better placed to get the right care and advice if your doctor or health adviser know that you take recreational drugs.
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There’s no evidence to show that cannabis use can make HIV progress any faster, or affect how well anti-HIV drugs work. However there are other health risks involved with using cannabis. Smoking cannabis, whether with or without tobacco, carries with it many of the health risks associated with smoking tobacco such as emphysema and heart disease. Some people experience problems with their memory and attention span with long-term cannabis use. It has also been shown that heavy usage of cannabis in young people can increase the risk of them developing other mental health problems such as depression and even schizophrenia in later life [2].
Poppers and Viagra
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There’s no solid evidence to show that poppers can speed up the progression of HIV, or that they interact with anti-HIV drugs, although poppers should always be avoided by anyone with heart or lung problems. However, poppers should never be taken at the same time as the anti-impotence drugs Viagra or Cialis. Both of these drugs work by dilating the blood vessels allowing blood to flow to the penis more easily. Poppers also work by dilating the blood vessels, and so if taken when using Viagra or Cialis can cause a sudden drop in blood pressure which can prove fatal.
CD4 counts and recreational drugs
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If you’re going for your regular CD4 and viral load tests very soon after a heavy drug session, then remember that your immune system may be suppressed more than usual. If it is, your CD4 cell count could be lower that it normally is, and it may be worth remembering this when discussing your results with your doctor.

"I went on a big night out just before I went for my bloods 6 months ago and I was a bit shocked when I got the results back - my CD4 count dropped from 750 to 450. My doctor didn't seem overly concerned because I'd been stable before then and he talked about CD4 to white blood cell percentages staying the same, meaning it was affecting my whole immune system rather than a fall in only my CD4 cells and therefore not necessarily HIV-related. I've just got the results from my latest blood test (no big nights out this time) and my CD4 count has risen up to 680. So I'm well pleased with that. It's a good reminder to treat myself with a little more care, and not just before blood tests." (Martin, 39)
Interactions with anti-HIV drugs
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Some recreational drugs interact with some anti-HIV drugs, so it’s a good idea to make sure you know what the possible risks are before mixing the two. Your HIV doctor should ask you about your recreational drug use before you start treatment. If you are already on treatment and haven’t talked about this with your HIV doctor or health adviser then it’s probably a good idea to do so next time you are there.

You’ll need to be careful if you are taking anti-HIV drugs known as protease inhibitors, and especially one called ritonavir (which is used to boost most other protease inhibitors, so it would be likely that you are taking ritonavir if you are taking a protease inhibitor). Protease inhibitors are processed through the liver in a similar way to many recreational drugs. As such, protease inhibitors can increase the levels of many recreational drugs in your blood. This can in turn increase the effects of the recreational drugs to what could be dangerous levels.

NAM’s website, Aidsmap, provides some very in-depth information about recreational drugs and their interactions with anti-HIV drugs at
Remembering to take your anti-HIV drugs
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If you are on HIV treatment, and you are taking recreational drugs, it’s important to remember that when you are off your head it’s easy to lose track of time, and even to forget to take your anti-HIV drugs. Think about this before you take any recreational drugs and how you’ll go about remembering to take your anti-HIV drugs. You could set an alarm on your watch or phone to remind you, or carry a pill box with an alarm. If your friends know you need to take your meds at a certain time then they may be able to remind you when it’s time to take them.

If you do forget to take one of your doses of anti-HIV drugs, take them as soon as you remember. Even if you missed a dose at night and remembered in the morning, take the dose you missed as soon as you can. Then continue to take your doses at your normal times, even if this means that you will be taking two doses fairly close together.
Using more than you’d like

Being diagnosed and living with HIV can be very difficult to deal with, and using drugs or alcohol as a means of escape from this is not unusual. Some men feel that there’s no point in looking after themselves any more so start drinking more or taking more drugs. Remember though that treatments these days mean that there’s usually no reason for not having a long and full life, and in looking after yourself you’re giving yourself the best chance of achieving this.

If you are using more drugs that you want to, or you feel you have a problem with recreational drugs, then it’s always a good idea to get some help. We talk about this later on this page.

"After I was diagnosed, I didn't always put my health at the top of my priorities. I often lived for the moment, partied too hard, and ran my body down. Then combination therapy came along, the prospect of a long and full life opened up, and my attitude began to change. One or two of the habits that I picked up in my 'living for the moment' period that are no good for my health remained with me though, and it's taken real effort to break out of them. At the time, you don't realise quite how ingrained some hedonistic behaviours can become; but they can." (Daniel, 38)
Drug advice and support
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If you are concerned about your recreational drug use, you could start by talking to your HIV doctor or a health adviser at your clinic. They will be able to talk things through with you and give you advice about what to do next and what services may be available through your clinic.

There is also a specialist service in Soho called Antidote LGBT. They offer information and support exclusively to lesbian, gay, bisexual or transgendered people about drugs and alcohol. Their website is and you can also call them on 020 7437 3523 to arrange an appointment to talk to them in complete confidence.

There may also be a local service near where you live. There’s a list of drug support agencies in the section on Help and Support.
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1 Recreational Drug Use. AIDSMAP, 2010
2 T. Moore, S. Zammit, A. Lingford-Hughes, T. Barnes, P. Jones, M. Burke, G. Lewis. Cannabis use and risk of psychotic or affective mental health outcomes: a systematic review. The Lancet, Volume 370, Issue 9584, Pages 319-328, 28 July 2007.