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Matt has never had sex sober. Not while he was using, and not since his most recent attempt to get clean more than a year ago.
"I'm just nervous that I'm going to have sex and it's not going to be good, or I'm just going to be like, 'Well, I'm never going to do that again, I'm just going to go use,'" he says. "For three years, I did nothing but have sex and use meth for sex. Having sex on meth, it's nothing compared to any kind of sex on [MDMA] or anything like that. So when I would think of fucking, which happened daily because I'm a human being, meth would be right there with it."
His drug use, he says, intensified his sexual fantasies, sometimes to a dangerous extent.
"It's fast, you can't really focus on everything, all your inhibitions are lower," Matt says. "You're just this thing that wants everything. It got crazier to where I had to keep one-upping whatever it was. My mind just went to different places."
Sometimes he'd add to his meth frenzy GHB, the anti-sleep date-rape drug that affects the central nervous system. "I'd turn blue for hours," he says. "People would leave me. I'd wake up by myself. I was used plenty of times."
When he woke up, Matt would get back on Grindr to find his next high.
"That's how I did everything," Matt says.
He rarely used condoms and didn't know if his partners were taking PrEP, a pre-exposure drug that lowers the chances of HIV transmission. Matt certainly wasn't. He thought he had the virus. He specified on Grindr that he'd only hook up with HIV-positive men for that reason. But he hadn't been tested. He just assumed.
Matt got lucky – he escaped with just a curable case of syphilis.
"I have absolutely no idea how," he says.
Not everyone in the MSM community is as fortunate. A 2016 study published in the Journal of Acquired Immune Deficiency Syndromes that followed the same group of MSM individuals over several years found that individuals who start using meth tend to engage in riskier sexual behavior than they had previously, providing "the strongest evidence that initiation of methamphetamine use increases sexual risk behavior among HIV-uninfected MSM."
"Part of the reason why I am HIV-positive is because of drugs," says Graper, who sits on the Central Florida HIV Planning Council. "If you're using drugs, that's risky. Let's be honest. It doesn't matter which drug it is. And then you add on to that a layer of multiple sex partners ...."
Graper describes it as a "wheelhouse of risky behavior." The combination of using drugs with multiple sex partners is infrequent at first – once a year becomes every six months, which then narrows down to every three months, every month, every week, every day. At first you're regularly using condoms, then you're not.
"Then all of a sudden whatever goes is whatever goes," Graper says. "It is a perfect storm, if you will, of different circumstances. I think it's one of the reasons that allows our HIV rates to remain high."
In February 2016, CDC researchers estimated that if current HIV rates continue as is, roughly one in two MSM African Americans and one in four MSM Latinos in the U.S. will be infected with the virus.
In 2015, Florida had the second-highest rate of new HIV diagnoses among adults and adolescents, with 27.9 new cases per 100,000 people, nearly double the national rate, according to the CDC. The Orlando metro area ranked sixth among U.S. cities for the highest rate of new HIV diagnoses.
In Central Florida that year, new diagnoses peaked at 25.7 cases per 100,000 people – adding 614 new diagnoses to the state total of 4,849 cases.
According to data from the Florida Department of Health, Orange County had the state's third-highest rate of MSM-specific HIV transmissions in 2017, with 345 out of more than 3,000 measured statewide, behind Broward (444) and Miami-Dade (798.)
Matt says the Health Department is aware of the risk, too. He says he's been asked by health managers how best to approach the situation, and if they can drop by and test people for HIV during sex parties. Officials are sometimes seen outside of local bathhouses and clubs, like Club Orlando and Parliament House.
"Our statement is that we have no knowledge of this," says a Parliament House manager when asked for comment on possible drug abuse at the club.
Club Orlando and Southern Nights did not respond to requests for comment.
Meth users describe the high as akin to Adderall, the prescription amphetamine used to treat attention deficit disorders, except it's stronger and looks like tiny shards of broken glass. You can crush it and snort it and feel a sudden burst of pain. You can smoke it in a glass pipe – it smells like vinegar and ammonia. Or you can shoot up, like Matt did.
Use enough and you're almost guaranteed to get hooked – you'll compulsively look at your phone, you'll compulsively clean your house, you'll compulsively seek out casual sex. You'll fixate. You'll crave. You'll lose your mind.
"Gay men fixate on sex," Matt says. "The whole entire time there's a preoccupation with sex until you get that. Some people take apart dishwashers and put them back together. I've met people who take apart a TV when they're in a hotel and put it back together – they'll do that for hours. So I guess it's wherever your mind is."
Sometimes Matt's mind would be stuck on his appearances. Because meth use can lead to extensive tooth decay, he would brush his teeth 20 times a day. He'd also wash his face at an almost fanatical level, to keep it from getting oily when he'd sweat and not shower. He'd wear charcoal masks, as if he were at a day spa and not a seedy motel.
In part, Matt says, it's this sense of vanity that led him to using in the first place.
"[Meth] gives people who feel insecure confidence, especially people who grew up not feeling a part of the gay community, including myself," Matt says. "So all of a sudden you have this drug and now you're part of the gay community, but you're a part of this part of the community. Because in your mind, when you think of the gay community you think of sex, parties – that's what comes to mind. If you're an average guy and you don't categorize yourself as really, really fit or just really skinny or a bear, then you're kind of just like – I don't know – in limbo. You have all these ideas off what you think it's supposed to be like to be a gay man. You just can't be yourself."
Meth helped Matt feel strong and confident, like he thought the other men in the room felt when he'd walk into a club. It helped him feel uninhibited during sex. It helped him feel not like Matt.
But his life was unmanageable, unraveling – from the nights he spent getting high with a random man who induced himself into psychosis and started throwing things at Matt to the cyst he developed on his arm after missing his vein with a needle.
He won't talk about the exact moment that convinced him to try to get clean.
"It was just something that scared me," he says. "It's something I don't want to talk about. It just scared me because I knew that if I continued with what I was doing, knowing the way my mind was going, I believed that I could do something ..."
His voice trails off.
For meth, there is no generally accepted detox or treatments. That's why most insurance carriers require meth addiction to be treated at the outpatient level, says Orlando Recovery Center executive director Katie Reeley.
"That is something that's contested in the industry," Reeley says. "There's no generally accepted medical-assisted treatment to use for them. So if someone comes in on methamphetamine primarily, usually we're not going to accept them as a patient because we know that there isn't a medically assisted treatment. It's like going to a hospital and not having something that they're actually going to be able to treat you with."
In late 2017, Matt began attending Narcotics Anonymous meetings and working the 12 steps. It was hit and miss. He relapsed a couple of times but found his way back, most recently a couple of months ago. He rejoined dating apps but edited his preferences to weed out drug dealers. It worked until it didn't.
"Hey," he texted last week. "I've relapsed and am still active."