Combination Use of Viagra, Illegal Drugs Among Gay Men May Lead to Increase in Unprotected Sex, HIV Transmission

The increased use of Viagra for recreational purposes among gay men, coupled with the use of illegal drugs, could lead to an increase in unprotected anal intercourse and new HIV infections, the New York Times reports. Although many gay men take Viagra for its prescribed purpose of erectile dysfunction, often a side effect of antiretroviral drugs or HIV infection, some gay men have begun to use the drug recreationally along with Ecstasy and other illegal drugs. A recent survey of 800 men attending an STD clinic conducted by the San Francisco Department of Public Health found that 32% of gay respondents reported having used Viagra in the previous year compared to 7% of heterosexual respondents, and many of the gay men said they had taken the drug in combination with Ecstasy, methamphetamine or poppers, a nitrate-based liquid that may be inhaled during sex to relax and increase sensation. Health officials are particularly concerned about the combination of Viagra and poppers because both drugs cause blood vessels to dilate, which could lead to strokes or heart attacks. Several deaths have occurred among Viagra users who also took nitrate-based heart medication. The gay men who reported using Viagra in the survey also reported having greater numbers of recent sexual partners and were more likely to have a current STD, compared to gay men who did not use the drug.

Educating the Public
It is unclear whether the use of Viagra leads to risky sexual behavior or whether risk takers are more likely to use Viagra, but public health officials are concerned about the effects of the drug in the gay population. Dr. Jeffrey Klausner, head of the San Francisco health department's STD division, said he would like to see Pfizer, the maker of Viagra, create an educational campaign aimed at gay men and their physicians about the dangers of recreational Viagra use. Information could be placed in gay magazines and at doctors' offices, he added. Pfizer spokesperson Geoff Cook said that the company has "long warned against the use of Viagra for nonapproved purposes" and did not know if the company would pursue a gay-specific campaign. "Our position to not use Viagra for recreational purposes is well-known, but any pharmaceutical product can be abused," Cook said, adding that using the drug while taking protease inhibitors could also lead to complications by causing priapism -- prolonged erection that can cause permanent damage -- in addition to headaches and heart-related complications (Tuller, New York Times, 10/16).