By Gabriel Olawale
A NEW government-funded study by Johns Hopkins investigators on healthy regular cocaine users has pointed to “impatience” as a clear barrier to condom use in those who are sexually aroused because of the drug.
It is no longer news that cocaine use has long been tied anedoctally to higher-than-usual rates of impulsive behaviour, including risky sex, but the tie-in has been difficult to study with any scientifically controlled rigor.
Now, the research team knew that people who regularly use cocaine are more likely to have HIV or other sexually transmitted infections, STIs, and the study authors say their findings, published in Psychopharmacology, suggest “sexual impatience” as a likely explanation for the increased risk.
According to the Associate Professor of Psychiatry and Behavioral Sciences at the Johns Hopkins University School of Medicine, Matthew Johnson, the study affirms and may help explain why people who regularly use cocaine are more willing to partake in risky sex when under the influence of cocaine, and underscores why public health officials and physicians should be ensuring that cocaine users are supplied with condoms to prevent the spread of sexually transmitted disease.
Cocaine is a stimulant whose use creates feelings of euphoria, high energy and hyperalertness.
For the study, potential participants were excluded if they were seeking help to quit their cocaine habit and were provided with resources and contacts to get them treatment. Twelve participants completed the study. Eight participants were male, eight were white, two were African-American, and two were bi- or multiracial. Participants were an average age of 27, and all had some education beyond high school.
For 24 hours prior to each study session, participants abstained from use of drugs, including alcohol. The researchers tested the participants each day before the session when they arrived at the Behavioral Biology Research Unit at the Johns Hopkins Bayview Medical Center. Each participant took a pill in one of three study sessions with either no cocaine, 125 milligrams per 70 kilograms of body weight of cocaine or 250 milligrams per 70 kilograms of body weight of cocaine in the presence of a research assistant. They then stayed in the controlled setting for approximately 4.5 hours until their blood pressure dropped below 150 over 100 millimeters of mercury, a measure that their cocaine “high” had worn off.
Every 10 minutes during the session, the participants rated the effect of the drug on a four-point scale, with zero meaning no effect and four being a strong effect, and their sexual desire on a 100-point scale with zero being no sexual desire and 100 being intense. They performed the rating using a computer scale.
Results showed that sexual desire and drug effect rose together and peaked around 45 minutes after taking cocaine, with the larger dose of the drug resulting in a greater response to both drug effect and sexual desire.
The researchers found that people had a similarly high likelihood of condom use if one was immediately available and 80 to 87 percent whether they were on cocaine or not. But the longer a participant on cocaine had to wait to use a condom, the more willing they were to have sex without one.
This increased likelihood of unprotected sex due to waiting was greater when they were on cocaine compared to no cocaine. For example, participants on the highest dose of cocaine were on average 40 percent likely to wait an hour to use a condom, but the same participants were 60 percent likely to wait that long when given the zero-dose pill.