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The practice has been credited with the emergence of a new, more virulent form of HIV.The strain has been described as having the ability to produce AIDS symptoms in as little as four months.

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For some PNP participants, substance use may facilitate a process of "cognitive disengagement" from the fears and stipulations associated with sex in the time of HIV/AIDS.

Popular discourses of "disinhibition" provide a commonly accepted alibi for activities engaged in when under the influence of substances.

Aside from the inherent risks involved with drug use, health officials have found a strong correlation between drug use and unsafe sex practices.