You can call it a hot beef injection, a needle prick in your dick, containing a concoction intended to create a hard-on that will last for hours.
Increasingly popular among men who suffer from crystal dick – when the use of crystal meth makes obtaining an erection difficult or impossible – the Triple Mix injection is available by prescription as well as on the street.
Though the idea of sticking a needle into your penis is enough to steer most men away from the practice, there’s at least one other reason why the Triple Mix can be risky: hepatitis C.
For a community that has long since accepted AIDS as part of its social fabric, hep C, which attacks the liver and can cause cirrhosis and death, can be an unexpected addition to the equation.
“I don’t generally encourage the use of injectable erectile drugs, since only a few of my patients truly need them and the potential for harm is very real,” says John Goodhew, a GP who serves many gay male patients.
The number of pharmaceuticals that promise to conquer erectile dysfunction (ED) is growing. Viagra, Levitra and Cialis are all available in pill form prescribed by medical doctors. Injectable erectile disjunction drugs, commonly known as Double or Triple Mix, have been around for a while and are available from family doctors, urologists and on the street. Gay men with prescriptions for Triple Mix are often tempted to share with partners – why should just one partner have a sustained erection?
“We want boners and we like to play with boners. We know how fast the party can die if everybody turns out bottom,” says Stan, a regular user who did not want his real name used for this story. “If you take too much you have a hard-on for 18 hours.”
Because of these erections that seem to last forever, some doctors believe abrasions and wear on the body can lead to an increased chance of disease transmission. There can be other problems with Triple Mix.
“Not only are they tricky to dose but can also lead to very serious problems,” says Goodhew. “Most of my patients are HIV-positive. They wear condoms but a needle puncture can cause problems.”
Even though the puncture is a small one, HIV and hepatitis C are two blood-borne viruses that can get through it. Men who might not otherwise share needles might be tempted to in hot and bothered circumstances and so infect each other.
“We were partying on drugs,” says Pete (not his real name), a gay man who contracted hep C from sharing Triple Mix needles. “There were three of us. One guy had the Triple Mix. We were already high on E and GHB, and had been up for way too long. It wasn’t the first time I’ve done it. I’d shot it twice before and both times the other people provided it and injected it. I don’t know if I used a new needle because I was high. I remember the guy asking if it mattered which one got shot first. We were in a group, all so excited and we were all HIV-positive so we didn’t think it mattered.”
Pete learned he had hep C shortly after sharing a needle.
“Every three months I get tested but not always for hep C. My doctor tests me for the standard things, liver function, T-count, viral load.” But this time his liver enzymes were extremely high so he was tested for hep C and found out he was positive.
Goodhew is not confident condoms will offset the risk of the needle prick.
“I’ll agree that in theory it is possible to use injections with condoms in a way that doesn’t increase HIV infection, HIV re-infection or hep C coinfection,” says Goodhew, “but we live in the real world where people sometimes forget to use condoms partway through a session or don’t plan on using them at all.”