Methamphetamine and sildenafil (Viagra) use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of men who have sex with men

Abstract

Objectives: There is evidence that methamphetamine and sildenafil (Viagra) use are associated with sexual risk behaviour among men who have sex with men (MSM). We investigated the association of methamphetamine, sildenafil, and other substance use with unprotected receptive and insertive anal sex among MSM by conducting an encounter specific analysis. Methods: Data were from a cross sectional, community based survey of MSM in San Francisco regarding behaviour during their most recent anal sex encounter. Mulitvariate regression analysed independent associations of specific substance use and demographic variables with unprotected anal sex behaviours. Results: The sample (n = 388) was diverse in race/ethnicity, age, income, education, HIV status, and homosexual/bisexual identification. More than half (53%) reported unprotected anal sex, including insertive (29%) and receptive (37%) during their most recent anal sex encounter; 12% reported unprotected insertive and 17% reported unprotected receptive anal sex with an HIV discordant or unknown partner. Methamphetamine was used by 15% and sildenafil was used by 6% of the men before or during the encounter; 2% used both drugs. In multivariate analysis controlling for demographic factors and other substance use, methamphetamine use was associated with unprotected receptive (odds ratio (OR), 2.03; 95% confidence interval (CI), 1.09 to 3.76) and sildenafil use was associated with unprotected insertive (OR, 6.51; CI, 2.46 to 17.24) anal sex. Effects were stronger with HIV discordant or unknown sex partners specifically. Conclusion: Encounter specific associations of methamphetamine and sildenafil use with unprotected receptive and insertive anal sex, respectively, indicate the importance of assessment specificity and tailoring risk reduction efforts to address certain drugs and sexual behavioural roles among MSM.

Alcohol, drugs, and condom use among drug offenders: An event-based analysis

“…For example, crack cocaine has been associated with trading sex for drugs (Edlin et al, 1994;Marx et al, 1991), and among MSM, nitrites (Ostrow et al, 1990;Ostrow et al, 1993) and methamphetamine (Colfax et al, 2004;Mansergh et al, 2006) may serve as triggers for risky sex. Heroin may reduce sexual interest and ability, while methamphetamine and cocaine are associated with increased sex drive (Zule and Desmond, 1999;Rhodes and Quirk, 1998).…”

“…In a sample of female drug users, condom use at a recent sexual encounter was not significantly associated with use of alcohol, injection drugs, crack, or noninjection drugs before sex (Tortu et al, 2000), while a study of drug injectors suggested decreased condom use when both sexual partners were using crack with sex (Friedman et al, 1999). Event-level studies of MSM have found more unprotected receptive anal intercourse among men who used stimulants before sex (Colfax et al, 2004;Mansergh et al, 2006), as well as no effects for drugs other than alcohol (Vanable et al, 2004).…”

Abuse of Prescription and Over-the-Counter Medications

“…27 Methamphetamine and Sildenafil use are linked to unprotected receptive and insertive anal sex, respectively, in a sample of gay men. 28 Sildenafil use appears to have become a stable fixture of the sexual culture of gay men and is associated with a general behavioral risk patter for transmission of HIV and other sexually transmitted diseases. 29 The concomitant use of Viagra, testosterone, and antidepressants among HIV-seropositive gay and bisexual men has been associated with unintended negative effects because of the additive risk of side effects.…”

Dietary supplement adverse events: Report of a one-year poison center surveillance project

“…JOURNAL OF MEDICAL TOXICOLOGY I VOLUME 4, NUMBER 2 I JUNE 2008 methamphetamine induce short-term erectile dysfunction due to vasoconstriction, and self-treatment with sildenafil and similar drugs has been reported [11]. It may be that use of yohimbe as a sexual enhancer is popularly promoted among illicit stimulant users, and represents a potentially risky drug-supplement combination.…”