Increasing incidence and importance of HIV/AIDS and gonorrhea among men aged ≥50 years in the US in the era of erectile dysfunction therapy

Abstract

The past decade saw rises in heterosexual transmission of HIV and i.v. drug use, especially in the population aged >50 years. The CDC reports that the incidence of new HIV infection is stabilizing in men aged 30-39 years and even falling in men aged 20-29 years. Gonorrhea is well known to increase infectivity for HIV and other STDs. Although the rates of gonorrhea infection fell throughout the early 1990s, they increased by 9% between 1997 and 1999. The number of sildenafil prescriptions has increased by almost 80% over the last few years. Although there may be multiple contributory factors for these findings, to our knowledge this is the first paper in the urologic literature to examine such trends in the older male population, especially in the light of newly available medications for erectile dysfunction.

Urologic complications of HIV and AIDS

“…100 Effective treatment of ED can increase the risk of spreading HIV. 101 Benotschet al 102 have shown that men who took phosphodiesterase-5 inhibitors had higher rates of sexually risky behavior. This observation means that there might be an ethical dilemma in treating ED in HIV-positive patients.…”

Condom Attitudes of Heterosexual Men Ages 50 and Older Using Prescribed Drugs (Viagra, Cialis, Levitra) to Treat Erectile Dysfunction

“…The use of oral phosphodiesterase type 5 (PDE5) inhibitor medications, such as sildenafil (Viagra ® ), has changed the medical management of ED and allowed men with ED to resume and once again enjoy sexual activity (Dorsey, Keel, Klavens, & Hellstrom, 2010;Karlovsky, Lebed, & Mydlo, 2004).…”

HIV After Age 55

“…Older adults are as at risk or at higher risk for contracting HIV/AIDS as younger populations when they engage in risky behaviors such as unprotected sex and alcohol and drug use [2,7,16]. In fact, the major reasons for exposure to AIDS in those older than 50 years of age who are living with AIDS are: male homosexual transmission (46%), intravenous drug use (29%), heterosexual transmission (18%), and unknown factors (7%) [2,3].…”