The fiftysomething GWM’s AIDS war stories are typical enough: He has lost his partner of many years and an entire network of friends. He has taken antiretrovirals since the AZT-only days and suffered with the typical side effects. And until recently, he had acquired the typical medicine Rx cabinet: a morphine patch; Marinol, a pill version of marijuana; testosterone; Viagra; painkillers; and Xanax, an anti-anxiety med. “I had so many pills and problems, it got so I couldn’t tell if I was taking them for my pain or to get high,” he sighed. But his green eyes twinkled as he recalled the day when he first developed nausea, months after being prescribed Marinol by his doctor. “I thought, ’Wow, it really does work for nausea!’” he said with a laugh, allowing that a simple fib was all it took to originally get a hold of the happy pills.

Another Rx-rich HIVer hosts barebacking events in a midtown Manhattan hotel that start with Viagra (to counter the erection-inhibiting main course of crystal meth) and that wind down with the tranquilizer Valium. And a third, who describes his body as a battleground between gym-pumped muscle mass and HIV-related wasting, doubled his daily dose of testosterone to prep for summer.

It’s no secret that many GWMs use pills and powders for fun. What’s new and alarming is that this tendency, combined with easy access to meds, may turn the self-empowered HIVer into the self-medicated. “People with HIV are using an enormous number of substances, many psychoactive,” said Walt Odets, PhD, a psychologist in Berkeley, California. “In addition to the obvious reasons that many suffer mood problems, antivirals can depress mood and raise anxiety. Some respond with prescription antidepressants, while others resort to ’recreational’ solutions.”

While no one is calling HIV specialists Dr. Feel-Goods, Howard Grossman, MD, a New York City AIDS doc, acknowledges that many HIVer prescriptions tend to be automatic. “Often doctors prescribe these extra drugs without discussing all the pros and cons with their patients,” he said, adding that in the protease age, he has tightened his protocol for prescribing not only such drugs as tranquilizers but even steroids. “I used to tell patients I’d send them to Betty Ford once they were cured, but until then they had other things to worry about,” he said.

Our anonymous source, who kicked his habit when a new regimen made stomaching so many pills impossible, concluded, “I was so sick on the meds, and these made it nice. I felt guilty and lucky at the same time.”