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Background: Ecstasy has become the drug of choice for many young adults across the United States. While ecstasy has been primarily a white suburban problem, it is now spreading rapidly in African-American (AA) inner-city communities as the new "it" drug. There are serious concerns that ecstasy use, which has been linked to sexual risk taking, will exacerbate the already high burden of HIV among AA’s. This study examined the motivations for using ecstasy among this understudied population.
Methods: In depth-interviews were conducted with 15 AA adults in an urban area of Southwest Florida from 2014-2015. Audiotapes of the interviews were transcribed, coded, and thematically analyzed using the NVivo software program. There were no pre-determined coding categories and themes were allowed to emerge from the data in a bottom up manner. Multiple coders were used to identify themes and inter-coder reliability was assessed.
Results: All participants reported poly-drug use and identified as heterosexual. Analysis revealed the strong perception of ecstasy as a sexual enhancer. The primary motivations for using ecstasy were very sexual in nature and included 1) “hooking up” with opposite sex, 2) making sex last longer, 3) enhancing sexual pleasure, and 4) getting their partner to do “freaky things” like engage in group or anal sex.
Conclusions: This is the first study to directly examine motivations for ecstasy use among heterosexual AA’s. The results suggest AA ecstasy users are a population at high risk for contracting HIV due to their engaging in high risk sexual behaviors like "hooking up," and group or anal sex. These findings contrast sharply with motivations reported in other groups of ecstasy users which suggest HIV prevention interventions tailored specifically for AA ecstasy users are needed. These data provide crucial insights to public health professionals and harm reduction workers in identifying how to intervene most efficaciously in this population.