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Klitzman RL, Pope HG Jr, Hudson JI. 
“MDMA ('Ecstasy') abuse and high-risk sexual behaviors among 169 gay and bisexual men”. 
Am J Psychiatry. 2000;157(7):1162-4.
OBJECTIVE: The authors explored the association between abuse of 3, 4-methylenedioxymethamphetamine (MDMA, or 'Ecstasy') and high-risk sexual behaviors among gay and bisexual men.

METHODS: An anonymous questionnaire was completed by 169 gay and bisexual men at three New York City dance clubs. The questionnaire covered demographic indices, use of MDMA and other drugs, and history of high-risk sexual behaviors.

RESULTS: About one-third of the respondents reported MDMA use at least monthly. MDMA use was strongly and significantly associated with a history of recent unprotected anal intercourse. This association remained equally strong even after controlling for age, ethnicity, and all other forms of drug use, including alcohol. CONCLUSIONS: MDMA abuse, and its strong association with high-risk sexual behaviors, appears to represent important unexplored public health problems among some gay or bisexual men.
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