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Erectile Dysfunction Drugs Like Viagra Linked to Higher Rates of STDs Featured

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Researchers at Massachusetts General Hospital and the University of Southern California say the fault lies not with the erectile dysfunction (ED) drugs but rather the high risk behaviors of the men who request erectile dysfunction (ED) drugs. And doctors should counsel these patients about safe sex practices, wrote the researchers.

Small studies of men who have sex with men have associated the use of erectile dysfunction (ED)  drugs with higher risk behaviors and increased rates of STDs, but this report is said to be the first to examine the relationship between ED drugs and STD risk in a large, representative sample of privately insured older men, not a targeted group of homosexual or bisexual men.

"Primary care doctors don't usually talk to older men about safe sexual practices, and that's partly because rates of STDs are much lower in this group than in younger men, on the order of one per 1,000 individuals," said study author Dr. Anupam B. Jena, an internal medicine resident at Massachusetts General. "But what our findings suggest is that just by virtue of asking for an erectile dysfunction (ED) drug, these men are identifying themselves as being at two to three times higher risk of STDs."

The researchers examined health insurance claims records covering 1997 though 2006 from 44 large U.S. employers. The study group included about 34,000 male beneficiaries over 40 who used erectile dysfunction (ED) drugs, for whom the researchers collected data covering one year before and one year after the first prescription was filled, and nearly 1.37 million men over 40 who were non-users, for whom claims data was also collected. The researchers had no way of knowing how many of the men were bisexual vs. homosexual.

Men who had been prescribed an ED drug were two to three times more likely than non-users to have sexually transmitted diseases, and this was true both in the year before and after the first prescription was filled. The most frequently reported STD was HIV/AIDS, followed by chlamydia. The data gathered could not indicate whether erectile dysfunction (ED)  drug use itself increased STD risk, but Jena said he and his colleagues are investigating that question in a separate study.

Jena speculated that HIV/AIDS was the most frequently reported STD because "the symptoms that are associated with a primary HIV infection are the kinds of things that make men more likely to show up to a doctor, rather than go to a free clinic where they know they can get tested for an STD anonymously."

Use of erectile dysfunction (ED) drugs has grown significantly since the introduction of sildenafil (Viagra) in 1998, and earlier research has found that men over 50 are much less likely than young men to use condoms, according to background information in the study.

"This study confirms what we've suspected for a while, which is that the men who are using these [erectile dysfunction] drugs aren't just those who have erectile dysfunction, but they're also men in high risk groups who take it to enhance sexual activity," said Dr. Peter Leone, a professor of medicine at the University of North Carolina and board chair of the National Coalition of STD Directors. "So it's not that the erectile dysfunction drug is leading to the behavior. It's really the other way around."

The findings regarding erectile dysfunction (ED) and STD suggest a need for greater responsibility in prescribing ED medications, added Leone. "Doctors need to realize that unless these patients are always using condoms or are in mutually monogamous relationships, they need routine STD screening with repeated follow-ups."

SOURCES:

July 6, 2010, Annals of Internal Medicine

Anupam B. Jena, M.D., Ph.D., resident, department of internal medicine, Massachusetts General Hospital, Boston;

Peter Leone, M.D., professor, medicine, University of North Carolina, Chapel Hill;

Last modified on Wednesday, 25 May 2011 19:42
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