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The Use of Impotence Drugs and HIV Risks

November, 2006 - The Journal of Sexual Medicine –

Some of the recent researches suggested that the popular erectile dysfunction drugs may contribute to the increased risk of HIV transmission. In order to review and evaluate all the available data on this topic, National Institute of Mental Health (NIMH) initiated the multidisciplinary conference, which took place on September 27–28, 2005. In general, more than 100 representatives of public health agencies, regulatory and research agencies (FDA, CDC, NIMH and NIDA), and pharmaceutical companies participated in the conference to assess the current data on the biologic, epidemiologic, behavioral, and clinical management aspects of the possible link between impotence drugs and increased HIV risk.

Nowadays a certain class of medications, known as phosphodiesterase type 5 (PDE-5) inhibitors, is used to treat male erectile dysfunction, caused by spinal cord traumas, surgeries, diabetes, hypertension, or depression. There are three PDE-5 inhibitors for the time being: Viagra, Levitra and Cialis. Since the appearance of Viagra in late 1990th, PDE-5 inhibitors have proved to be effective and safe medications in treating erectile disorders in men. Nowadays, these drugs are available worldwide and are used by about 20 - 25 million men. Besides, along with improving sexual performance, PDE-5 inhibitors have potential in treating such diseases as pulmonary hypertension and benign prostatic hypertrophy.

Despite multiple benefits of the PDE-5 medications, some of the recent reports gave rise to the issue of possible link between the use of PDE-5 inhibitors and the increased risk of HIV transmission. It is known that impotence drugs are sometimes used as the “recreational drugs” or “party drugs” to enhance sexual performance of men without actual ED signs. Moreover, they are sometimes taken along with substances of abuse, such as methamphetamines, ecstasy, cocaine, and other stimulants. The misuse of anti-impotence drugs prevails among heterosexual or homosexual men and is associated with the practice of unprotected oral or anal sex, sex with multiple partners, which consequently may potentially lead to the increase of HIV transmission risks.

As the result of two-day discussion of the issue, the scientists, who participated in the above mentioned conference, found no sufficient evidences that would prove the fact that the PDE-5 inhibitors somehow increase the risk of HIV-transmission.

The data from several studies shows that in cases of associated use of PDE-5 drugs with illicit drugs (marijuana, cocaine, etc.) certain individuals may have the increased rate of risky sexual behavior, which may result in the increased HIV risks. However, scientists say that it is the substances of abuse along with certain psychological features of individuals, responsible for risky sexual behavior, and not PDE-5 inhibitors.

Finally, the conference participants concluded that more studies of the PDE-5 use are necessary. The scientists emphasized the importance of in-depth studying such issues, as the effect of PDE-5 inhibitors and other drugs (e.g., methamphetamines, cocaine, alcohol, steroids) on behavioral models; the impact of PDE-5 inhibitors on the quality of the sexual experience and on mental health; ethical "dilemmas" associated with the prescription of PDE-5 inhibitors to patients at high risk; the "black market" for PDE-5 inhibitors and their unregulated production; etc.

Nick

External resources
http://www.blackwell-synergy.com/doi/full/10.1111/j.1743-6109.2006.00323.x
http://www.medicalnewstoday.com/medicalnews.php?newsid=56731