"The meth moms trade sex for drugs, and contraception and prenatal care are not always the highest priority," says the state employee. "There's a bit of a baby boom among women using meth."
As reports of HIV infections increase in Maricopa County, local health officials say widespread meth use is to blame. The meth problem in the Valley's gay community, where most of Arizona's HIV-positive cases have been reported, has been pervasive for years.
Yet even with more than 40 percent of local HIV patients reporting that they are also meth users -- significant because tweakers are much less likely to use protection, HIV-positive or not -- there's been no significant public health campaign in Maricopa County warning of the dangers of having sex while tweaking.
There certainly hasn't been an effort like that made in other major metropolitan cities like New York, Chicago, Boston, or San Francisco, where city leaders and nonprofit agencies are pre-emptively targeting gay men before they use meth for the first time. The Stop AIDS Project credits a series of public health awareness campaigns coordinated in part by the agency for a nearly 50 percent drop in meth use among gay and bisexual men in San Francisco.
That's not the case in Phoenix, where health officials admit they've done little, if anything, to address what a huge problem meth and sex present.
"It just hasn't been on our radar screen," says Bruce Porter, the HIV/AIDS coordinator for the Arizona Department of Health Services. "Should it have been? Absolutely."
That's an understatement, according to Steven Varnadore, an investigator in Maricopa County's Department of Public Health, who administers HIV tests at local gay bathhouses.
"We're dropping grains of sand to fill up a hole," says Varnadore, a former "recreational" meth user. "And it's enormous."
For the sex-addicted tweakers, if they manage to be sober long enough to get into recovery and therapy -- like Theresa, Randy and Robert -- there is a lifetime of sexual reprogramming, somehow learning to disassociate sex from the act of using meth.
"I know I'm not gay," says Randy, who once so obsessively sought "to get a nut" while high on meth that he had unprotected sex with a transsexual while his girlfriend waited for him at home. "I've never seen some guy's hairy ass and said, 'Oh, I gotta have that.' I'm not dealing with my sexual identity.
"My biggest problem," says Randy, "is that I don't know how to have a healthy sex life."
Crystal meth has an almost instant attraction to dopamine receptors -- commonly referred to as the human brain's "pleasure system" -- more so than other narcotics, according to Brough Stewart, the chemical dependency program director for Banner Behavioral Health in Scottsdale.
"It's a euphoric drug," says Stewart. "It allows us to work more, to eat less, but most often to have more sex."
"If you talk to the users," says Richard Rawson, the UCLA researcher, "meth becomes sex. It actually stimulates the same part of the brain [the dopamine receptors] that controls sexual arousal. The chemistry of sexual arousal and the chemistry of meth become the same. That's why it's so uniquely different from these other drugs we associate with sex."
Which explains why Don Sherrard, who supervises the Phoenix Police Department unit that focuses on searching out and shutting down meth labs, finds "stacks and stacks" of porn at almost every meth house he busts.
"When these guys aren't cooking up the meth or tweaking, they're masturbating or having sex with multiple partners," Sherrard says. "There's pornography everywhere. Sex toys everywhere. These people have contraptions hooked up all over the bedroom."
Robert, one of the ex-tweakers now in recovery, is familiar with what happens in a meth lab.
He says he was once referred to simply as "The Doorman," guarding local meth labs run by biker gangs, protecting both the house and the cooks inside from cops and psychotic tweakers alike. But for willing teenage "sex toys," there was plenty of meth, if not access inside the meth house, for the price of orally satisfying The Doorman.
Robert wasn't initially into meth for the sex. He was only in the seventh grade when he was first exposed to it, weighing cocaine for a friend who happened to have a pocket full of "white crosses."
But over the years, working for biker gangs like "The Dozen" and "The Spartans," he was exposed to more women -- more women looking for drugs.
"You wanted meth? You had to go through me," Robert says. "So I had all these little 18- and 19-year-old sex toys at my feet."
Robert and a fellow tweaker buddy decided it wasn't enough to have their way with young girls who were totally uninhibited on meth; they wanted to film it. They bought a stolen professional-grade video camera, recruited the girls, and then spent hours at a time choreographing the scenes, like big-shot porn directors in the San Fernando Valley.