ReviewSildenafil use, sexual risk behavior, and risk for sexually transmitted diseases, including HIV infection
Section snippets
Methods
To begin our review, we searched for available articles in the National Center for Biotechnology Information PubMed2 using a variety of terms to maximize article return, including “Viagra and use,” “Viagra and human immunodeficiency virus,” and “Viagra and sexually transmitted disease.” Similar searches were done using the terms Cialis and Levitra, as well as with generic drug terminology and abbreviated terms (sildenafil, tadalafil, vardenafil, HIV, STD). The search was limited to articles
Results
Our initial search of PubMed returned 1543 articles for “Viagra and use,” 38 articles for “Viagra and HIV,” and 4 articles for “Viagra and STD.” Similar searches using the other ED treatment drugs returned 18 articles for “Cialis and use,” 88 articles for “Levitra and use,” 1 identical article for both “Cialis and HIV” and “Levitra and HIV,” and no articles for both “Cialis and STD” and “Levitra and STD.” Numerous duplicates were found among the various search terms. Of these, 7 publications3, 4
Discussion
In several geographical locations, the reviewed studies establish a substantial level of sildenafil use among a variety of samples of men who have sex with men. In these studies, sildenafil was often obtained without a prescription, and use of sildenafil was often combined with other recreational drugs, including methamphetamines and ecstasy. Numerous studies established an association between sildenafil use and increased sexual risk behavior, including unprotected anal sex with a partner of
Acknowledgment
The authors thank Devon Brewer, PhD, Sabina Hirshfield, PhD, Samuel Mitchell, MD, PhD, David Purcell, JD, PhD, Frank Romanelli, PharmD, BCPS, and William Wong, MD, for their assistance in the review of their studies and for providing additional data and information when necessary. We also thank Charlotte Kent, MPH, and Kate Scott, MPH, for their critical review of the manuscript.
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This study was funded by the City and County of San Francisco, Calif.