Skip to main content

Advertisement

Log in

Recreational Use of Erectile Dysfunction Medications in Undergraduate Men in the United States: Characteristics and Associated Risk Factors

  • Original Paper
  • Published:
Archives of Sexual Behavior Aims and scope Submit manuscript

Abstract

Mounting evidence indicates that erectile dysfunction medications (EDMs) have become increasingly used as a sexual enhancement aid among men without a medical indication. Recreational EDM use has been associated with increased sexual risk behaviors, an increased risk for STIs, including incident HIV infection, and high rates of concomitant illicit drug use. The aim of the present study was to investigate the characteristics and associated risk factors for recreational EDM use among young, healthy, undergraduate men. A cross-sectional sample of 1,944 men were recruited from 497 undergraduate institutions within the Unites States between January 2006 and May 2007. The survey assessed patterns of EDM use, as well as demographic, substance use, and sexual behavior characteristics. Four percent of participants had recreationally used an EDM at some point in their lives, with 1.4% reporting current use. The majority of recreational EDM users reported mixing EDMs with illicit drugs and particularly during risky sexual behaviors. Recreational EDM use was independently associated with increased age, gay, or bisexual sexual orientation, drug abuse, lifetime number of sex partners, and lifetime number of “one-night stands.” Recreational EDM users also reported a 2.5-fold rate of erectile difficulties compared to nonusers. Overall, recreational use of EDMs was associated with sexual risk behaviors and substance abuse; however, a relatively small proportion of undergraduates reported using EDMs. Results also suggest that a sizable portion of recreational EDM users are heterosexual men, and that use does not solely occur within the environments of venues that cater to men having sex with men.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Benotsch, E. G., Seeley, S., Mikytuck, J. J., Pinkerton, S. D., Nettles, C. D., & Ragsdale, K. (2006). Substance use, medications for sexual facilitation, and sexual risk behavior among traveling men who have sex with men. Sexually Transmitted Diseases, 33, 706–711.

    Article  PubMed  Google Scholar 

  • Cachey, E., Mar-Tang, M., & Mathews, W. (2004). Screening for potentially transmitting sexual risk behaviors, urethral sexually transmitted infection, and sildenafil use among males entering care for HIV infection. AIDS Patient Care and STDs, 18, 349–354.

    Article  Google Scholar 

  • Cappelleri, J. C., Rosen, R. C., Smith, M. D., Mishra, A., & Osterloh, I. H. (1999). Diagnostic evaluation of the erectile function domain of the International Index of Erectile Function. Urology, 54, 346–351.

    Article  PubMed  Google Scholar 

  • Chu, P. L., McFarland, W., Gibson, S., Weide, D., Henne, J., Miller, P., et al. (2003). Viagra use in a community-recruited sample of men who have sex with men, San Francisco. Journal of Acquired Immune Deficiency Syndromes, 33, 191–193.

    Article  PubMed  Google Scholar 

  • Colfax, G., Mansergh, G., Guzman, R., Vittinghoff, E., Marks, G., Rader, M., et al. (2001). Drug use and sexual risk behavior among gay and bisexual men who attend circuit parties: A venue-based comparison. Journal of Acquired Immune Deficiency Syndromes, 28, 373–379.

    PubMed  Google Scholar 

  • Cooper, M. L. (2002). Alcohol use and risky sexual behavior among college students and youth: Evaluating the evidence. Journal of Studies on Alcohol Supplement, 14, 101–117.

    PubMed  Google Scholar 

  • de Freitas, V. M., de Menezes, F. G., Antonialli, M. M., & Nascimento, J. W. (2008). Use of phosphodiesterase-5 inhibitors by college students. Revista de Saude Publica, 42, 965–967.

    Article  PubMed  Google Scholar 

  • Delate, T., Simmons, V. A., & Motheral, B. R. (2004). Patterns of use of sildenafil among commercially insured adults in the United States: 1998–2002. International Journal of Impotence Research, 16, 313–318.

    Article  PubMed  Google Scholar 

  • Fisher, D. G., Malow, R., Rosenberg, R., Reynolds, G., Farrell, N., & Jaffe, A. (2006). Recreational Viagra use and sexual risk among drug abusing men. American Journal of Infectious Diseases, 2, 107–114.

    Article  PubMed  Google Scholar 

  • Gledhill-Hoyt, J., Lee, H., Strote, J., & Wechsler, H. (2000). Increased use of marijuana and other illicit drugs at US colleges in the 1990s: Results of three national surveys. Addiction, 95, 1655–1667.

    Article  PubMed  Google Scholar 

  • Goldstein, I., Lue, T. F., Padma-Nathan, H., Rosen, R. C., Steers, W. D., & Wicker, P. A. (1998). Oral sildenafil in the treatment of erectile dysfunction. New England Journal of Medicine, 338, 1397–1404.

    Article  PubMed  Google Scholar 

  • Hirshfield, S., Remien, R. H., Humberstone, M., Walavalkar, I., & Chiasson, M. A. (2004). Substance use and high-risk sex among men who have sex with men: A national online survey. AIDS Care, 16, 1036–1047.

    Article  PubMed  Google Scholar 

  • Ishikura, F., Beppu, S., Hamada, T., Khandheria, B. K., Seward, J. B., & Nehra, A. (2000). Effects of sildenafil citrate (Viagra) combined with nitrate on the heart. Circulation, 102, 2516–2521.

    PubMed  Google Scholar 

  • Jackson, G. (2005). PDE 5 inhibitors and HIV risk: Current concepts and controversies. International Journal of Clinical Practice, 59, 1247–1252.

    Article  PubMed  Google Scholar 

  • Kim, A. A., Kent, C. K., & Klausner, J. D. (2002). Increased risk of HIV and sexually transmitted disease transmission among gay or bisexual men who use Viagra, San Francisco 2000–2001. AIDS, 16, 1425–1428.

    Article  PubMed  Google Scholar 

  • Kinsey, A. C., Pomeroy, W. B., & Martin, C. E. (1948). Sexual behavior in the human male. Philadelphia, PA: W. B. Saunders.

    Google Scholar 

  • Korkes, F., Costa-Matos, A., Gasperini, R., Reginato, P. V., & Perez, M. D. (2008). Recreational use of PDE5 inhibitors by young healthy men: Recognizing this issue among medical students. Journal of Sexual Medicine, 5, 2414–2418.

    PubMed  Google Scholar 

  • Laumann, E. O., Paik, A., & Rosen, R. C. (1999). Sexual dysfunction in the United States: Prevalence and predictors. Journal of the American Medical Association, 281, 537–544.

    Article  PubMed  Google Scholar 

  • Loeb, L. (2004). Viagra: The science and politics of drugs, sex, and risk. Focus, 19, 4–7.

    PubMed  Google Scholar 

  • McCambridge, J., Mitcheson, L., Hunt, N., & Winstock, A. (2006). The rise of Viagra among British illicit drug users: 5-year survey data. Drug and Alcohol Review, 25, 111–113.

    Article  PubMed  Google Scholar 

  • Mondaini, N., Ponchietti, R., Muir, G. H., Montorsi, F., Di Loro, F., Lombardi, G., et al. (2003). Sildenafil does not improve sexual function in men without erectile dysfunction but does reduce the postorgasmic refractory time. International Journal of Impotence Research, 15, 225–228.

    Article  PubMed  Google Scholar 

  • Musacchio, N. S., Hartrich, M., & Garofalo, R. (2006). Erectile dysfunction and Viagra use: What’s up with college-age males? Journal of Adolescent Health, 39, 452–454.

    Article  PubMed  Google Scholar 

  • Pfizer Inc. Viagra Web site. Available at http://www.viagra.com/content/viagra-sample-pack.jsp?setShowOn=../content/getting-viagra-prescription.jsp&setShowHighlightOn=../content/viagra-sample-pack.jsp. Accessed January 10, 2009.

  • Rosen, R. C., Cappelleri, J. C., Smith, M. D., Lipsky, J., & Pena, B. M. (1999). Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. International Journal of Impotence Research, 11, 319–326.

    Article  PubMed  Google Scholar 

  • Rosen, R. C., & Kostis, J. B. (2003). Overview of phosphodiesterase 5 inhibition in erectile dysfunction. American Journal of Cardiology, 92(Suppl. 9A), 9M–15M.

    Article  PubMed  Google Scholar 

  • Rosen, R. C., Riley, A., Wagner, G., Osterloh, I. H., Kirkpatrick, J., & Mishra, A. (1997). The international index of erectile function (IIEF): A multidimensional scale for assessment of erectile dysfunction. Urology, 49, 822–830.

    Article  PubMed  Google Scholar 

  • Santtila, P., Sandnabba, N., Jern, P., Varjonen, M., Witting, K., & von der Pahlen, B. (2007). Recreational use of erectile dysfunction medication may decrease confidence in ability to gain and hold erections in young males. International Journal of Impotence Research, 19, 591–596.

    Article  PubMed  Google Scholar 

  • Selvin, E., Burnett, E., & Platz, E. (2007). Prevalence and risk factors for erectile dysfunction in the U.S. American Journal of Medicine, 120, 151–157.

    Article  PubMed  Google Scholar 

  • Sherr, L., Bolding, G., Maguire, M., & Elford, J. (2000). Viagra use and sexual risk behavior among gay men in London. AIDS, 14, 2051–2053.

    Article  PubMed  Google Scholar 

  • Swearingen, S. G., & Klausner, J. D. (2005). Sildenafil use, sexual risk behavior, and risk for sexually transmitted diseases, including HIV infection. American Journal of Medicine, 118, 571–577.

    Article  PubMed  Google Scholar 

  • U.S. Bureau of the Census. (2000). Native resident population estimates of the United States by sex, race, and Hispanic origin: April 1, 1990 to July 1, 1999. Washington, DC: Author. Retrieved February 5, 2010, from http://www.census.gov/population/estimates/nation/nativity/nbtab003.txt.

  • Wiederman, M. W. (1999). Volunteer bias in sexuality research using college student participants. Journal of Sex Research, 36, 59–66.

    Article  Google Scholar 

Download references

Acknowledgments

This study was supported by Grant 5 RO1 AT00224-02 from the National Center for Complementary and Alternative Medicine to Cindy Meston. The NCCAM had no further role in study design; in the collection, analysis, and interpretation of data; in preparation and the writing of the report; or in the decision to submit the paper for publication. The authors thank Alison Marks for help with online data management and data acquisition.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Cindy M. Meston.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Harte, C.B., Meston, C.M. Recreational Use of Erectile Dysfunction Medications in Undergraduate Men in the United States: Characteristics and Associated Risk Factors. Arch Sex Behav 40, 597–606 (2011). https://doi.org/10.1007/s10508-010-9619-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10508-010-9619-y

Keywords

Navigation