A reader writes:

Mine is a cautionary tale of the pernicious nature of meth, especially in relationship to the transmission of HIV.

By the time I was 17 in 1984, I had been having sex for several years. Whether as a result of luck or the grace of God (I say this as a Catholic agnostic), I did not contract HIV despite quite a number of sexual partners. However, during the summer of 1984, I was about to engage in potentially dangerous sexual behavior when my older sexual partner scolded me and taught me what was and wasn't safer sexual practice. I cried from humiliation, but that gentleman probably saved my life.

When I moved to NYC in the early 1990s, I volunteered for ACT UP, interned for alternate gay magazines, and became a buddy for Gay Men's Health Crisis, helping to take care of men dying from AIDS. I saw firsthand HIV's and AIDS's physical and emotional devastation. I am a smart, Ivy League educated guy (I think I might have been at Harvard as an undergraduate when you were a graduate student) and knew what needed to be done to prevent my contracting the virus.

Unfortunately, I also have always had a strain of self-destructiveness. However, despite my impulse to undermine myself, I had always been able to prevent myself from doing irreparable harm to myself. A suburban kid at heart, I flirted with more marginal behavior but made sure to separate, even compartmentalize, such behavior from my more respectable veneer of a life, which included work on Wall Street. All that changed when I decided - despite my full knowledge of its dangerous nature - to try meth.

During my 20s, I smoked pot every so often. I took Ecstasy maybe one to three times a year. I hated snorting coke. People would use it around me and I would avoid it because I didn't like how it made me feel and I hated losing my erection. Up until about my 30th birthday, I refused to try meth or smoke coke. Unfortunately, during a very emotionally vulnerable time in my life, I stupidly smoked coke. My biochemical wiring was immediately altered. For the first time in my life, I craved a drug. Within a few weeks, I got myself to 12 step meetings because I knew where such use could lead me. I was a binge user who would use once every few months. I won't say I had it under control but I was able to hold down a job, despite these occasional relapses.

I might have continued this way for several years but I eventually added meth into the mix. Eventually, I partied with nothing but meth. I lost my job on Wall Street and used my severance package to live a life of meth and sex. Meth gave me the artificial delusion that I was deeply and passionately connected to my sexual partners - a feeling I found nearly impossible to feel when I was sober. And even if I got rejected while on meth, I didn't feel it. I could move on to my next partner and any rejection was a distant memory. Meth freed me from those nagging feelings of self-doubt and self-hatred I had suffered since I was a child. It was far more powerful and seemingly effective than years of therapy and anti-depressants.

However, along with losing my crippling self-consciousness, I also lost my impulse for self-preservation. Despite years of being a top, I found myself wanting to bottom and to do so without a condom. In the summer of 2004 - 20 years after learning what I needed to do to prevent my contracting HIV - I seroconverted.  I had for years been nearly a hypochondriac when it came to feeling shitty, suspecting it might be my having contracting HIV. I was so strung out on meth that I didn't even realize that the fever and sore throat, which wouldn't respond to antibiotics, were indications of my having contracted the disease.

Five and a half years later, I am healthy as a result of a great physician and anti-viral regiment. I still battle my addiction and find myself still feeling unsure of myself on a daily basis. I have struggled to not live in isolation and remain a productive part of society. I battle the overwhelming desire to not use meth and know that the recidivism rate of meth users is high because, unlike other drugs (including cocaine), the brain does not naturally start producing dopamine and serotonin after meth use. I try not to live in regret and try my best to treat myself with compassion, if for no other reason than my knowing that beating myself over the head will not make my life any better.

I lived a charmed life and felt that I would not fall victim to the dangers of meth as others around me had. Such feelings of invincibility led to where I am today.