Viagra Use in a Community-Recruited Sample of Men Who Have Sex With Men, San Francisco

Chu, Priscilla Lee; McFarland, Willi; Gibson, Steven J.; Weide, Darlene; Henne, Jeff; Miller, Paul; Partridge, Teddy; Schwarcz, Sandra

doi:10.1097/00126334-200306010-00012

Cited by 76 publications

(69 citation statements)

References 8 publications

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“…Although using sildenafil was positively associated with both risky sexual behavior and HIV-positive status, significantly fewer HIV-positive men participated in risky sexual behavior than HIV-negative men. Some studies have reported that risky sex is associated with sildenafil use when sildenafil is combined with club drugs such as ecstasy, methamphetamine, or amyl nitrate to enhance the sexual experience (Chu et al, 2003;Crosby & DiClemente, 2004;Kim et al, 2002). It is possible that the HIV-positive men in this sample were less likely to use sildenafil recreationally than the HIV-negative men.…”

Section: Discussionmentioning

confidence: 88%

“…For example, in a qualitative study of older MSM, erectile dysfunction was related to decreased desire to use condoms (Murray & Adam, 2007). However, sildenafil use allowed some men with erectile dysfunction to increase sexual activity (Murray & Adam, 2007), and several studies have shown that sildenafil use is correlated with HIV infection and risky sexual behavior (Chu et al, 2003;Kim, Kent, & Klausner, 2002;Sanchez & Gallagher, 2006;Sherr, Bolding, Maguire, & Elford, 2000).…”

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confidence: 99%

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Current Sexual Activity and Risky Sexual Behavior in Older Men With or At Risk for HIV Infection

Cooperman

Arnsten

Klein

2007

AIDS Education and Prevention

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In a cross-sectional analysis, we investigated frequency of sexual activity and factors associated with risky sexual behavior among 624 older men, aged 49−80, with or at risk for HIV infection. During the prior 6 months, 75% reported sexual activity with at least one partner, and one quarter of both the HIV-negative and HIV-positive men had more than one sexual partner. Only 18% of the HIVnegative men and 58% of the HIV-positive men always used condoms with their sexual partners. Factors independently and positively associated with risky sexual behavior included lack of HIV infection, any drug use in the past 6 months, greater importance of sex in one's life, weekly or more frequent sexual activity in the past 6 months, and ever taking sildenafil. These results suggest that older men with or at risk for HIV infection are sexually active, participate in risky sexual behavior, and need safer sex interventions.

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Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 99%

Current Sexual Activity and Risky Sexual Behavior in Older Men With or At Risk for HIV Infection

Cooperman

Arnsten

Klein

2007

AIDS Education and Prevention

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“…For example, in a study of MSM attendees of a sex resort in Georgia, Crosby and DiClemente [17] reported that Viagra was more implicated in substance abuse rather than sexual risk behavior. But in a community-based convenience sample of MSM in San Francisco, Chu et al, [18] found a strong relationship between Viagra use and risky sexual behavior as well as a significant association with combined and illicit drug use. This dual result is the more common finding among studies to date.…”

Section: Introductionmentioning

confidence: 95%

Recreational Viagra Use and Sexual Risk among Drug Abusing Men

Fisher¹,

Malow²,

Rosenberg³

et al. 2006

American J. of Infectious Diseases

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Until recently, the Viagra connection to HIV was anchored in older adults. However, CDC investigation showed stability in 50+ HIV diagnoses on the heels of upward trends in risk indicators among men who have sex with men (MSM) and substance abusing populations. Signs have increasingly pointed to recreational drug use among younger populations, to which Viagra is being added to the mix. Currently, the field is still locating the substance abuse, sexual risk and age-related dimensions of Viagra misuse. Recent studies identify it primarily as substance abuse, but the majority reports a combination of risky sex and risky drug use. At the very least, Viagra appears related to the enhancement of sexual experience or performance, even when it is used to compensate for erectile dysfunction caused by other drugs-either illicit or prescribed (e.g., antidepressants and highly active antiretroviral therapy or HAART). The populations studied, however, frequently have limited the generalizability of findings. This report analyzes the relationship among Viagra, Club Drugs and HIV sexual risk behavior in drug using men with a sample diverse in sexual orientation and demographic scope. Participants were 640 males recruited from three HIV prevention programs in Los Angeles County. Mean age was 43.97 years, ranging from 18.7 to 70.3 with almost 25% over 50. Sexual orientation was 79% heterosexual, 8% bisexual and 12% gay. Racial composition was 45% white, 35% black and 19% Hispanic. NIDA's Risk Behavior Assessment and a Club Drug/Viagra addendum were used to collect socio-demographic, substance use and sexual risk data. Multiple logistic regression models were constructed along with chi-square tests of association and some t-tests. White race was a major risk factor. No age effect was found. MSM were more likely to use Viagra. Insertive anal sex was a significant co-factor among heterosexual Viagra users involved in transactional sex with women. In the overall sample and the subsets of heterosexual, MSM, younger and older men, predictive models all identified club or designer drugs as significant co-factors in the use of Viagra. Different patterns of drug co-factors were observed for each subset. We detected consistent positive associations between the use of Viagra and the use of amphetamines immediately before or during sex. Viagra use has moved into a new generational context and now complicates the sexual risk and intervention equations for all men, particularly MSM as well as more hidden subgroups.

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“…In a longitudinal study of urban MSM, Koblin and her colleagues (Koblin et al 2006) reported that use of amphetamines nearly doubled a study participant's chance of HIV seroconversion (hazard ratio of 1.96), but use of marijuana, poppers, hallucinogens, or cocaine or crack were not associated with seroconversion in multivariate analyses. Research has highlighted the risk-augmenting roles of other substances among MSM, including amyl nitrates or ''poppers,'' and PDE-5 inhibitors such as Viagra Ò (Chu et al 2003;Kim et al 2002;Loeb 2004;Purcell et al 2005a, b;Paul et al 2005;Romanelli and Smith 2004;Swearingen and Klausner 2005).…”

Section: Introductionmentioning

confidence: 99%

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

et al. 2008

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We examined how drugs, high-risk sexual behaviors, and socio-demographic variables are associated with recent HIV infection among men who have sex with men (MSM) in a case-control study. Interviewers collected risk factor data among 111 cases with recent HIV infection, and 333 HIV-negative controls from Chicago and Los Angeles. Compared with controls, cases had more unprotected anal intercourse (UAI) with both HIV-positive and HIV-negative partners. MSM with lower income or prior sexually transmitted infections (STI) were more likely to be recently HIV infected. Substances associated with UAI included amyl nitrate ("poppers"), methamphetamine, Viagra (or similar PDE-5 inhibitors), ketamine, and gamma hydroxybutyrate (GHB). Cases more frequently used Viagra, poppers, and methamphetamine during UAI compared with controls. In multivariate analysis, income, UAI with HIV-positive partners, Viagra, and poppers remained associated with recent HIV seroconversion. Better methods are needed to prevent HIV among MSM who engage in high-risk sex with concurrent drug use.

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Viagra Use in a Community-Recruited Sample of Men Who Have Sex With Men, San Francisco

Cited by 76 publications

References 8 publications

Current Sexual Activity and Risky Sexual Behavior in Older Men With or At Risk for HIV Infection

Current Sexual Activity and Risky Sexual Behavior in Older Men With or At Risk for HIV Infection

Recreational Viagra Use and Sexual Risk among Drug Abusing Men

Drug Use, High-Risk Sex Behaviors, and Increased Risk for Recent HIV Infection among Men who Have Sex with Men in Chicago and Los Angeles

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