Party & Play – “PNP”

There are a variety of reasons queer individuals, and often gbmsms participate in PnP. Some use PnP to:

• increase their sexual confidence and help them overcome their self-doubt, body image issues and sexual insecurities.
• increase their libido or sexual desire, which may have changed as they age.
• create a sense of community through participation.
• increase feelings of intimacy and sexual connection with sex partners — some men describe very intense feelings of intimacy and being in touch with their own senses and the desires of their partner when they PnP.
• increase their sexual longevity, allowing them to have sex for longer periods of time without ejaculating or to be ready to have sex again soon after ejaculating — this can also allow for sex with more partners over the same length of time.
• participate in a more diverse range of sexual activities because of a loss of inhibition.

For some HIV-positive individuals, including gbMSM, PnP may help them to deal with negative feelings arising from stigma and discrimination related to their HIV status and/or sexuality.

The drugs most commonly associated with PnP in Canada are crystal methamphetamine (crystal meth), gamma-hydroxybutyrate (GHB) and ketamine. This is often referred to as GMK. These drugs are used because they increase sexual arousal and performance, while encouraging disinhibition.

Crystal meth

Crystal meth (Tina, T, crystal, ice, meth, speed) can be swallowed, smoked in a glass pipe, snorted, inserted into the rectum (“booty bump”) or mixed with water and injected into a vein (“slamming”). The effects of crystal meth can last up to 24 hours, although doses are usually repeated every few hours to enhance energy or to remain high. The effects of crystal meth include euphoria (experiencing intense pleasure or excitement), increased energy, enhanced confidence, impulsivity, reduced experience of pain, intense sexual stimulation and lowered inhibitions.

Gamma-hydroxybutyrate/gamma-butyrolactone

Gamma-hydroxybutyrate (GHB, G, Gina) and gamma-butyrolactone (GBL) are taken in very small doses diluted with water or other liquids such as a soft drink. Doses of GHB/GBL are usually repeated every two hours or so, depending on the potency. The effects of GHB/GBL include euphoria, lowered inhibitions and an increased sex drive. Some men have stronger erections and more intense orgasms when they take GHB/GBL. It has relaxant effects so can make receptive anal sex easier or more pleasurable.

GHB/GBL are considered “date-rape” drugs because although a person may be agreeable to sexual activities, their ability to set and assert sexual boundaries is decreased. This means they may not be able to meaningfully consent to sex.

Ketamine

Ketamine (K, Special K, cereal) is an anaesthetic. It can be snorted, injected into muscle, swallowed, or smoked mixed with tobacco or cannabis. The effects of ketamine last between 40 and 90 minutes after it is snorted and up to three hours after it is swallowed or injected. How often doses are repeated depends on the way it is taken. Ketamine numbs physical pain. In small doses it can give a minor energy boost. Moderate doses can induce feelings of relaxation and disconnection or disassociation from the body. Higher amounts induce psychedelic journeys (“K hole”) and hallucinations. Ketamine increases the desire for sex but makes it harder to keep an erection. It also helps relax the anus, which, combined with the drug’s numbing effects, makes it easier for men to have rough sex and be fisted (having a fist inserted into the rectum).

Poppers
Poppers, or Amyl Nitrate, is a medication originally utilized for angina in the early 1900’s, and has become one of the most popular ‘PNP’ drugs utilized by individuals. Because of it’s vasodilating effects, it causes a euphoric state, increased bloodflow and physical sensation, and often temporarily lowers inhibitions. The chemical belongs to a family of those that have similar effects, but because amyl nitrate is illegal to produce or sell within Canada, international companies will often produce cheaper varieties which can increase the negative effects, often including a headache, body aches, and temporary dysphoria. The effects of poppers are enhanced when combined with other drugs, so it is often combined with GHB, meth, or other drugs, which can cause dangerous compounding effects. For example, mixing poppers and Viagra can cause a dangerous drop in blood pressure, which can lead to fainting, a stroke or a heart attack.

Other drugs
Men who PnP may also use other substances, such as cocaine, MDMA (ecstasy), cannabis and alcohol before, during or after a PnP session. Erectile dysfunction drugs (such as Viagra) are used by some men to counter the effects of crystal meth or ketamine, which may make it difficult to get or keep an erection. Mixing different drugs can be dangerous as it can lead to drug interactions or potential overdose.

Engaging in PNP increases your risk of getting HIV and other STIs, and it can also have a negative impact on things like your work, your social life and relationships, as well as your mental health and well being.

Increases in Riskier Sexual Practices

International research also shows that participation in PnP is associated with different sexual practices associated with passing HIV, hepatitis C and STIs.

Compared with those who do not participate in PnP, HIV-negative individuals who do participate in PnP are more likely to:

• participate in condomless anal sex with one or more partners
• participate in more frequent receptive anal sex
• participate in condomless anal sex with HIV-positive or unknown-status partners
• participate in receptive condomless anal sex with an unknown-status partner
• report having 11 or more new sexual partners in the past year
• participate in group sex

Research suggests that some individuals are open to exploring activities during PnP that they have no intention of engaging in when sober.

Given that the use of drugs during PnP sessions can reduce inhibitions, increase sexual adventurism and extend sex sessions, it can also increase the likelihood of participation in activities that can cause damage to the rectal lining. This can increase the risk of passing HIV, hepatitis C and other STIs. Damage to the rectal lining can be caused by participation in rougher sex and sexual acts such as fisting because of decreased sensitivity to pain, especially when using crystal meth and/or ketamine.

Men injecting crystal meth may also pass HIV or hepatitis C if they share injecting equipment. Although men who PnP may be aware of the risks of injecting, they may not be as vigilant as usual when they share equipment during extended PnP sessions. Care also needs to be taken to keep the equipment used for injecting and the area of skin to be injected sterile to prevent skin infections that can lead to sores or abscesses.

STI’s such as HIV, Gonorrhea, and Chlamydia

A systematic review of sexualized drug use among queer men found an increased prevalence of gonorrhea and chlamydia, especially in men who used crystal meth. Men who used crystal meth or injected drugs were more likely to get hepatitis C than men who didn’t use crystal meth or inject.

A variety of studies from Europe and North America have found that queer individuals who participate in PnP are more likely to have bacterial STIs (chlamydia, gonorrhea and syphilis) than those who do not participate in PnP. A variety of studies from European and other high-income countries have found that queer men who participate in PnP are more likely to get HIV.

Impact on mental health

There is some evidence that men who have experienced depression or anxiety at some point in their lives may be more likely to take part in PnP. Taking PnP drugs is also linked to short-term and longer term mental health issues, such as depression, anxiety and psychosis, which in some cases can lead to suicide.

PnP is also linked to other drug use and addiction issues. For example, crystal meth can be highly addictive, especially if it is smoked or injected. It can be extremely difficult to stop using crystal meth after prolonged use because the brain stops producing the chemical dopamine, which helps control the brain’s reward and pleasure centres. Lack of dopamine means a person may have difficulty feeling happy or good about themselves. This may make them want to take more crystal meth to feel better about themselves.

It may seem like something that should be obvious, but it is easy for people to be taking part in PNP without necessarily knowing. Some people first get introduced to PNP through their partners, and eventually will begin to take part. Others may go to a party that they found through a hook-up app or social networking, and then discover it is actually a PNP party, which is commonly called a chill out.

However it has happened, it is important that you feel safe, and in control of what drugs you take, and the sex you have.

Be Assertive

A lot of times, especially with the gay male, or gbmsm community, people may ask you to bareback, and this puts you at high risk of getting HIV and STIs. It may also be something you don’t feel comfortable doing when sober as you know it will make you worry, but when you engage in PNP, you agree to it because of the influence the drugs are having. It is important to always be assertive in what you want, and what you don’t want to do, and set some ground rules before you start, so that people know what you do and do not want to do.

There are a number of other strategies for those engaged with PnP that may help reduce HIV, hepatitis C and STI transmissions:

• If those with penises are using condoms during extended sex sessions with one partner, the condoms should be replaced regularly and lube should be regularly applied to reduce the risk of condom breaks. A new condom should be used with each new partner.
• If condoms are not used, lube should be plentifully and regularly applied to help reduce irritation of the rectal lining, vagina, and penis.
• Lube should also be plentifully and regularly applied for fisting. A new glove should be used for each fisting partner.
• HIV-negative queer individuals who PnP may be good candidates for PrEP.
• HIV-negative queer individuals who PnP may be good candidates for post-exposure prophylaxis (PEP) after a potential exposure to HIV.
• Those on PrEP and HIV-positive men on HIV treatment can set alarms or program text message reminders on their mobile phones to remind them to take their pills on time. Also it is a good idea for individuals to take more than enough pills in a pill box to ensure they have a sufficient supply if a PnP session goes on longer than anticipated.
• For those who inject drugs, it is important to always use new needles and other injecting equipment.
• In the context of the ongoing overdose crisis in Canada, individuals may want to use drug checking services to determine what is in their drugs and to check if the drugs have not been cut with fentanyl, which may lead to an overdose.

Regular HIV, hepatitis C and STI testing is recommended, especially for those having sex with multiple partners. See our page on STIs, HIV, and Testing Services for more information.

There also exists an excellent guide on providing first aid support for those engaged with PNP, found for free here. Consider keeping a digital or printed copy on hand for when you are engaging in PNP with others , as it contains detailed information on what to do in various situations.

Remember that engaging in PNP is not morally wrong. People engage in various activities for a number of reasons. What is important is making sure you approach activities, including PNP, in a way that minimizes the risks so that you can enjoy them while remaining healthy.