The use of erection enhancing medication and party drugs among men living with HIV in Europe

Abstract

Studies have shown more erectile dysfunction (ED) in men living with HIV (MLHIV), relative to age matched HIV-negative men. Erection enhancing medication (EEM) is more frequently used by HIV-positive men than in the general male population. Increased sexually transmitted infection has been described in HIV-positive men with ED using EEM. This study investigated the use of EEM and party drugs (methyleendioxymethamfetamine (XTC), gammahydroxybutyrate (GHB) “fluid XTC” and alkyl nitrites “poppers”) among MLHIV. Self-administered questionnaires were distributed consecutively to all patients attending 17 European HIV treatment centers. The sample included 1118 HIV-positive men, among whom 74.5% men having sex with men (MSM). The use of EEM was more frequent in MSM than in heterosexual men (odds ratio (OR) 3.33, p<0.001) and was associated with increased sexual risk behavior (OR 3.27, p<0.001). Nonmedically indicated use of EEM was linked to increased use of party drugs (OR 2.30, p=0.01). Physicians taking care of MLHIV need to be aware of the high prevalence of (nonmedical) use of EEM and party drugs. Medical provision of EEM should be combined with a discussion on safer sex behavior and the risk related to concomitant use of party drugs and illegal EEM.

Keywords:

• erection enhancing medication (EEM)
• HIV/AIDS
• sexual risk behavior
• party drugs

Acknowledgements

We are grateful to all study participants for contributing to this study and to the investigators at the participating centers: Birgit Mumelter (University of Innsbruck), Gabriele Schmied (European Centre, Vienna), Ruth Borms (Sensoa, Antwerp), Ivo Prochazka (University of Prague), Johannes Bogner, Matthias Müller (Ludwig Maximilians University, Munich), Werner Becker, Ramona Volkert (Private Practice, Munich), Andreas Niedermeier (University Clinic for Dermatology, Munich), Martin Karwat (Private Practice, Munich), Nikos Dedes (Synthesis, Athens), Peter Csépe (Semmelweis University, Budapest), Gloriana Bartoli, Carlo Giaquinto (University of Padua, Padua); Caterina Uberti-Foppa, Giulia Galotta (HSR Ospedale, Milan), Anda Vaisla (Latvian Family Planning Association, Riga), Michal Pozdal, Zbigniew Izdebski (University of Zielona Góra), Luis Caldeira (Hospital Santa Maria, Lisbon), Victoria Gordillo (University Complutense of Madrid), Ed Wilkins, Cinthia Murphy (Pennine Acute Hospitals NHS Trust, Manchester). Our thanks also go to the Swiss National Science Foundation and the Swiss HIV Cohort Study for funding, support, and cooperation. EUROSUPPORT V received funding from the European Commission, SANCO/Public Health, grant agreement nr. 2004314. The Commission is not responsible for any use that may be made of the information contained in this publication.