The use of erection enhancing medication and party drugs among men living with HIV in Europe

Abstract

Studies have shown more erectile dysfunction (ED) in men living with HIV (MLHIV), relative to age matched HIV-negative men. Erection enhancing medication (EEM) is more frequently used by HIV-positive men than in the general male population. Increased sexually transmitted infection has been described in HIV-positive men with ED using EEM. This study investigated the use of EEM and party drugs (methyleendioxymethamfetamine (XTC), gammahydroxybutyrate (GHB) "fluid XTC" and alkyl nitrites "poppers") among MLHIV. Self-administered questionnaires were distributed consecutively to all patients attending 17 European HIV treatment centers. The sample included 1118 HIV-positive men, among whom 74.5% men having sex with men (MSM). The use of EEM was more frequent in MSM than in heterosexual men (odds ratio (OR) 3.33, p<0.001) and was associated with increased sexual risk behavior (OR 3.27, p<0.001). Nonmedically indicated use of EEM was linked to increased use of party drugs (OR 2.30, p=0.01). Physicians taking care of MLHIV need to be aware of the high prevalence of (nonmedical) use of EEM and party drugs. Medical provision of EEM should be combined with a discussion on safer sex behavior and the risk related to concomitant use of party drugs and illegal EEM.

Recreational drug use among individuals living with HIV in Europe: review of the prevalence, comparison with the general population and HIV guidelines recommendations

“…With respect to the use of antiretroviral treatment, only two studies focused on individuals with HIV who were under treatment (Faggian et al, 2005 ; Peretti-Watel et al, 2006 ), while others reported treatment prevalence between 60 and 85%, or provided no information. Only one study included patients from 17 European countries (De Ryck et al, 2013 ). Apart from this article, data for recreational drugs were only available in six European countries.…”

Increasing use of ‘party drugs’ in people living with HIV on antiretrovirals

“…Erectile dysfunction agents PLWH use EDA more frequently than HIV-uninfected men [83,84], and several epidemiologic studies have reported that EDA are used recreationally, in the context of 'ChemSex', to sustain long-lasting sexual activity and reverse the impotence-inducing effects of other substances [8,85]. Data from the ASTRA study show that up to 21% of the PLWH recruited reported use of EDA in the previous 3 months [3].…”

“…About a quarter of them reported use of at least three types of drugs during that time period. Importantly, numerous studies have shown that MSM living with HIV are more likely to use different substances at the same time, and use the whole variety of recreational drugs, compared with MSM without HIV [3,[8][9][10].…”

Poly drug use, chemsex drug use, and associations with sexual risk behaviour in HIV-negative men who have sex with men attending sexual health clinics

“…Gay, bisexual, and other men who have sex with men (MSM) continue to be one of the highest risk groups for HIV in the UK and globally , and experience a significant burden of ill health and harm through the use of alcohol, recreational drugs and tobacco (PHE, 2015). Recreational drug use in MSM and the associations with sexual-risk behaviour has been documented on an international level (Heiligenberg , 2012;Prestage, 2009, Pappas, 2011, Santos, 2013Colfax, 2006;De Ryck, 2013;Drumright, 2007;McCarty-Caplan, 2014) and is an important public health consideration in Western Europe (EMIS, 2010), particularly the UK (Kirby, 2013;Hunter, 2014;Daskalopoulou , 2014;Bolding, 2006;Home Office, 2013/14), where transmission of HIV and other sexually transmitted infections (STIs), remain high (Public Health England, 2014a). A 2014 report described the use of psychoactive drugs in sexual settings among MSM in London (Bourne, 2014).…”