Risk-taking behavior of the gay party male as seen by doctors

Here are a few choice excerpts from Dr. Frank Spinelli about gay men's propensity for drinking, drugs, and unsafe sex:

Over the years I have monitored and treated gay men with curiosity. I’ve concluded that some of the most telling insights into the gay mind come from watching my own (presumably) heterosexual nephews. At age 15 and 16, they don’t always listen to their parents, they’re eager to push the limits set by their teachers, and when confronted about their risk-taking behavior, they invariably roll their eyes to show their disinterest in having a rational conversation. That’s because teenagers, like gay men, are a conundrum, baffling to scientists and doctors.

...

As doctors, we do our best. I counsel my patients about drugs and sexually transmitted diseases, including HIV. Although I feel confident in my abilities, I still picture my nephews’ eyes rolling into the back of their heads when I try to instill some sense of caution in my patients before a circuit event. I don’t judge, or at least that is what I tell myself. But I suppose I do. I stopped going out years ago when it became a never-ending merry-go-round of witnessing overdoses and re-treating STDs. I tell myself I’m getting older. When I was younger, I didn’t listen either, but the age of the modern-day party boy is well beyond the age when any of us should be referring to each other as “boy.” I’ve read that the average age of an Atlantis cruise ship passenger is 41.

The trouble with gay men is that, like teenagers, they fall prey to the rush of hormones that drive the reward-system network. Although dopamine affects many parts of the brain and body, the effect is most important on two brain sites: the nucleus accumbens and the ventral tegmentum. These two brain sites are connected by a bundle of cells called the mesolimbic pathway, or the brain-reward center. This is the area of the brain that is most powerfully associated with pleasure and addiction. Stimulating this pathway makes a person want to repeat this behavior in order to feel the reward it brings. Unfortunately, that reward is never truly like the first time — no matter how much sex you have or how many bumps you take.

Of course, the obvious culprit is that we are fueled by our desires, whether these are sexual or drug-fueled escapes, especially when these desires have been liberated after years of confusion and confinement. Who wouldn’t want to go on a sex, drug, and alcohol binge while drifting through the Caribbean on a gay cruise where there
are no judgmental eyes watching your every move?

...

When I read the article online [about the drug bust aboard the Atlantis cruise] and spoke to passengers upon their return, I felt angry. In a time when gay men and women want to be taken seriously so that we can serve openly in the military and have the legal right to marry, isn’t counterproductive to read about the drug busts and overdoses on a floating circuit party? Or maybe we just want it all — the rights we deserve and the option to choose which, if any, fit into our particular circumstances and plans.