Erectile Dysfunction Drug Receipt, Risky Sexual Behavior and Sexually Transmitted Diseases in HIV-infected and HIV-uninfected Men

Abstract

BACKGROUND: Health care providers may be concerned that prescribing erectile dysfunction drugs (EDD) will contribute to risky sexual behavior.OBJECTIVES: To identify characteristics of men who received EDD prescriptions, determine whether EDD receipt is associated with risky sexual behavior and sexually transmitted diseases (STDs), and determine whether these relationships vary for certain sub-groups. DESIGN:Cross-sectional study. PARTICIPANTS:Two thousand seven hundred and eighty-seven sexually-active, HIV-infected and HIV-uninfected men recruited from eight Veterans Health Affairs outpatient clinics. Data were obtained from participant surveys, electronic medical records, and administrative pharmacy data.MEASURES: EDD receipt was defined as two or more prescriptions for an EDD, risky sex as having unprotected sex with a partner of serodiscordant or unknown HIV status, and STDs, according to self-report. RESULTS:Overall, 28% of men received EDD in the previous year. Eleven percent of men reported unprotected sex with a serodiscordant/unknown partner in the past year (HIV-infected 15%, HIV-uninfected 6%, P< 0.001). Compared to men who did not receive EDD, men who received EDD were equally likely to report risky sexual behavior (11% vs. 10%, p=0.9) and STDs (7% vs 7%, p=0.7). In multivariate analyses, EDD receipt was not significantly associated with risky sexual behavior or STDs in the entire sample or in subgroups of substance users or men who had sex with men.CONCLUSION: EDD receipt was common but not associated with risky sexual behavior or STDs in this sample of HIV-infected and uninfected men. However, risky sexual behaviors persist in a minority of HIVinfected men, indicating ongoing need for prevention interventions.KEY WORDS: HIV infection; risky sexual behavior; STDs; men; phosphodiesterase inhibitors.

Perceptions, Attitudes, and Experience Regarding mHealth Among Homeless Persons in New York City Shelters

“…They also face discrimination in the health care system which dissuades them from seeking care (Wen et al 2007; Cooper, Roter, Carson et al 2012; Hausmann, Hannon, Kresevic et al, 2011). Providers may have prejudice and biases against the medical needs and priorities of minorities and focus largely on addressing their acute care needs rather than chronic disease management, risk reduction and risky behaviors and preventive care (Hausmann et al 2011; Teal, Shada, Gill et al 2010). Strategies to address biases among providers have been proposed (Devine, Forscher, Austin et al 2012; Peek, Wilson, Bussey-Jones et al 2012), and mHealth strategies may help reduce missed opportunities for health education and counseling by providing a more consistent approach and improve connectivity (Post et al 2013).…”

Human Papillomavirus Knowledge and Attitude among Homeless Women of New York City Shelters

“…Providers’ education and preparation to address biases and stigma along with cultural competency and communication skills building (Devine, 2012; Peek et al, 2012; Teal, et al, 2010), with emphasis on offering health counseling to all patients irrespective of their social conditions, may help minimize missed opportunities to provide HPV health education to the homeless. Electronic medical record reminders could also help improve targeted health education regarding STIs and HPV for high-risk populations including the homeless and with discussions on cancer control and screening during clinical encounters that may otherwise be overlooked (Loo et al, 2011).…”

Does erectile dysfunction drug use contribute to risky sexual behavior?

“…The authors astutely point out that selection bias precludes this claim. Another recent cross-sectional study by Cook et al [5] failed to show a significant association between the use of ED drugs and risky sexual behavior or STDs; however, the number of participants enrolled in that study (2 700) was significantly less than that of the study by Jena and colleagues (1 410 806). Many aspects of the ED treatment cohort need to be further delineated to determine the cause of differences in STD prevalence, including psycho-npg logical profiles, sexual practices, and personality inclinations.…”