THE GAY COMMUNITY has a long history of alcohol and drug abuse above the rate that occurs in the heterosexual population. Research suggests that gay men use drugs in specific situations, such as during sex or during visits to specific “homosocial” venues like bars, clubs, sex parties or bathhouses. Thus, for many gay men, a unique aspect of gay culture is that drug use is very often specifically connected to seeking or having sex. When I was a young man in the 1970’s, the heyday of disco, there was something that we referred to as “the five D’s”: drugs, dancing, dick, dishing, and dining, which were all elements in the formation of an individual as well as a communal gay identity. The dance floors of the clubs—including such legendary ones as the Sanctuary, Tenth Floor, the Loft, Twelve West, Paradise Garage, Flamingo, and the Saint in Manhattan, Trocadero in San Francisco, Studio One in LA, the A House in Provincetown, the Ice Palace and Sandpiper on Fire Island, Warsaw in Miami—were venues where thousands of gay men created a celebratory, albeit sometimes self-destructive, tribal atmosphere. This spirit lives on in today’s circuit parties, which are late-night, and often multi-day, dance events attended by thousands of gay men, characterized by a high level of drug use and sexual activity—and a heightened risk of HIV transmission.