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Affiliation(s)
- Ali Mohamed Ali Ismail
- Department of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics, Faculty of Physical Therapy, Cairo University, Giza, Egypt
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De Vincentis S, Tartaro G, Rochira V, Santi D. HIV and Sexual Dysfunction in Men. J Clin Med 2021; 10:jcm10051088. [PMID: 33807833 PMCID: PMC7961513 DOI: 10.3390/jcm10051088] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) management, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.
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Affiliation(s)
- Sara De Vincentis
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Giulia Tartaro
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Correspondence: ; Tel.: +39-059-396-2453; Fax: +39-059-396-1335
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
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Hirshfield S, Schrimshaw EW, Stall RD, Margolis AD, Downing MJ, Chiasson MA. Drug Use, Sexual Risk, and Syndemic Production Among Men Who Have Sex With Men Who Engage in Group Sexual Encounters. Am J Public Health 2015; 105:1849-58. [PMID: 25713951 DOI: 10.2105/ajph.2014.302346] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We surveyed men who have sex with men (MSM) to determine whether sexual risk behaviors, recent drug use, and other psychosocial problems differed between men who engaged in one-on-one and group sexual encounters. METHODS We conducted an Internet-based cross-sectional survey of 7158 MSM aged 18 years or older in the United States recruited from a gay-oriented sexual networking Web site in 2008. Among MSM who engaged in group sexual encounters, we compared their past-60-day sexual behaviors in one-on-one encounters and group sexual encounters. We also compared risk profiles and syndemic production between men who did and did not participate in group sex. RESULTS Men reporting a group-sex encounter had significantly higher polydrug use and sexual risk than did the men not reporting group sex in the past 60 days. The odds of engaging in group sex with 4 or more sexual partners significantly increased with the number of psychosocial problems, supporting evidence of syndemic production. CONCLUSIONS We identified a particularly high-risk subgroup in the MSM population with considerable psychosocial problems that may be reached online. Research is needed on how to engage these high-risk men in combination prevention interventions.
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Affiliation(s)
- Sabina Hirshfield
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Eric W Schrimshaw
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Ronald D Stall
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Andrew D Margolis
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Martin J Downing
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
| | - Mary Ann Chiasson
- Sabina Hirshfield, Martin J. Downing Jr, and Mary Ann Chiasson are with Public Health Solutions, Research and Evaluation Unit, New York, NY. Eric W. Schrimshaw is with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York. Ronald D. Stall is with the Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA. Andrew D. Margolis is with the Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of HIV/AIDS Prevention, Prevention Research Branch, Atlanta, GA
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Prestage G, Jin F, Bavinton B, Grulich A, Brown G, Pitts M, Hurley M. Australian Gay and Bisexual Men's Use of Erectile Dysfunction Medications During Recent Sexual Encounters. J Sex Med 2014; 11:809-19. [DOI: 10.1111/jsm.12407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Santi D, Brigante G, Zona S, Guaraldi G, Rochira V. Male sexual dysfunction and HIV--a clinical perspective. Nat Rev Urol 2014; 11:99-109. [PMID: 24394405 DOI: 10.1038/nrurol.2013.314] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Sexual dysfunction in men with HIV is often overlooked by clinicians owing to many factors, including the taboo of sexuality. The improved life expectancy of patients with HIV requires physicians to consider their general wellbeing and sexual health with a renewed interest. However, data on sexual dysfunction in those with HIV are scarce. Erectile dysfunction (ED) is the most common sexual dysfunction in men, with a prevalence of ∼30-50% and is frequent even in men <40 years of age. HIV infection itself is the strongest predictor of ED, and many factors related to the infection-fear of virus transmission, changes in body image, HIV-related comorbidities, infection stigma, obligatory condom use-all impair erectile function. The diagnosis and treatment of sexual dysfunction is based on a multidisciplinary approach, which involves specialists in both infectious diseases and sexual medicine. Particular attention should be paid to the promotion of safer sex in these patients. This Review, describes the issues surrounding sexual dysfunction in men with HIV and aims to provide clinical advice for the physician treating these patients.
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Affiliation(s)
- Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Giulia Brigante
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
| | - Stefano Zona
- Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medicine and Medical Specialties, University of Modena & Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy
| | - Giovanni Guaraldi
- Metabolic Clinic, Infectious and Tropical Disease Unit, Department of Medicine and Medical Specialties, University of Modena & Reggio Emilia, Via del Pozzo 71, 41124 Modena, Italy
| | - Vincenzo Rochira
- Department of Biomedical, Metabolic and Neural Sciences, Section of Endocrinology, University of Modena & Reggio Emilia, Via Campi 287, 41125 Modena, Italy
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Jones SG, Fenkl EA, Patsdaughter CA(, Chadwell K. Condom Attitudes of Heterosexual Men Ages 50 and Older Using Prescribed Drugs (Viagra, Cialis, Levitra) to Treat Erectile Dysfunction. Am J Mens Health 2013; 7:504-15. [DOI: 10.1177/1557988313486172] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The purpose of this study was to explore attitudes about condoms that may affect condom use by heterosexual men ages 50 and older who were sexually active and currently using prescribed oral phosphodiesterase type 5 inhibitor medications (Viagra®, Cialis®, or Levitra®) for treatment of erectile dysfunction. The study was part of a larger study that explored the need for safer-sex health promotion and education for these men. Fifty men completed factor subscales of the Condom Attitude Scale. Subscales were scored and analyzed. Positive factors were found with regard to the Interpersonal Impact, Inhibition, Perceived Risk, Perceived Seriousness, and Global Attitudes subscales. Factors with negative or neutral responses included the Effect on Sexual Experience, Relationship Safety, and Promiscuity subscales. Independent t tests revealed no differences between married and nonmarried men for the mean score on any of the subscales, but there was a difference on the Global Attitude Scale, with younger men having a more positive global attitude than older men. Study findings can be used in the development of health promotion educational activities on condom use as a safer-sex practice.
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Goltz HH, Coon DW, Catania JA, Latini DM. A pilot study of HIV/STI risk among men having sex with men using erectile dysfunction medications: challenges and opportunities for sexual medicine physicians. J Sex Med 2012; 9:3189-97. [PMID: 23035896 DOI: 10.1111/j.1743-6109.2012.02943.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION A growing literature suggests relationships between erectile dysfunction medications (EDM) and riskier sexual behavior among men who have sex with men (MSM). Questions remain concerning EDM use and related HIV/sexually transmitted infections (STI) risk among older MSM, particularly those 40 years and over, for whom EDM may be medically warranted. AIM This exploratory pilot study explores the relationship between EDM and risky sexual behavior in a convenience sample of MSM using EDM and attending historic sex-on-premises venues. METHODS We examined anonymous surveys from 139 MSM. Bivariate relationships were examined. We then fit a multiple logistic regression model to determine predictors of engaging in unprotected anal intercourse (UAI) at last EDM, using variables identified as being significantly related to UAI in the bivariate analyses. Potential predictors entered the model in a stepwise fashion. MAIN OUTCOME MEASURES The primary outcome measure was engaging in UAI at last EDM use. RESULTS MSM participating in the study ranged from 27 to 77 years and averaged 52.0 years (standard deviation = 10.73 years). These participants were primarily older MSM; fewer were younger MSM (12.12%), under age 40. Participants reporting UAI at last EDM use (N = 41) were significantly younger (P < 0.01). Men visiting bars within the last 6 months reported less UAI (P < 0.01). Both variables were independent predictors of UAI in the logistic regression model (P < 0.01). CONCLUSIONS Similar to reports from younger MSM, our findings suggest older MSM using EDM and reporting UAI are also recreational drug users. We include recommendations for urologists and other sexual medicine physicians treating MSM who may be at elevated risk for HIV/STI infection because of joint EDM and club drug use.
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Affiliation(s)
- Heather Honoré Goltz
- VA HSR&D Center of Excellence, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
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Graham CA. Condom use in the context of sex research: a commentary. Sex Health 2012; 9:103-8. [DOI: 10.1071/sh11103] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Accepted: 10/21/2011] [Indexed: 02/04/2023]
Abstract
This commentary highlights some recent trends in sex research that have particular relevance for research on condom use, including studies investigating the meaning of sexual arousal, desire and pleasure; a focus on couple-level investigations; and the relevance of individual differences and personality characteristics to sexual risk-taking. Although historically, sexuality-related issues have received little systematic attention in the field of public health, researchers are now paying more attention to the role of pleasure and sexual arousal in condom use. It is argued that a better integration of findings from the area of sex research into the HIV and sexually transmissible infection (STI) field is needed to develop and improve programs to reduce the risk of STIs and unintended pregnancy.
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Sexual Dysfunctions of HIV-Positive Men: Associated Factors, Pathophysiology Issues, and Clinical Management. Adv Urol 2011; 2011:854792. [PMID: 22046183 PMCID: PMC3199204 DOI: 10.1155/2011/854792] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 08/21/2011] [Indexed: 11/17/2022] Open
Abstract
Sexual dysfunctions in HIV-positive men are associated with an increase in risky sexual behavior and decreased adherence to antiretroviral drug regimens. Because of these important public health issues, we reviewed the literature on the pathophysiology, associated factors and clinical management of sexual dysfunction in HIV-positive men. The goal was to investigate the current research on these issues. Literature searches were performed in June 2011 on PubMed, Web of Science, and PsycInfo databases with the keywords “AIDS” and “sexual dysfunction” and “HIV” and “sexual dysfunction”, resulting in 54 papers. Several researchers have investigated the factors associated with sexual dysfunction in HIV-positive men. The association between sexual dysfunction and antiretroviral drugs, particularly protease inhibitors, has been reported in many studies. The lack of standardized measures in many studies and the varying study designs are the main reasons that explain the controversial results. Despite some important findings, the pathophysiology of sexual dysfunction in the HAART era still not completely understood. Clinical trials of testosterone replacement therapy have shown the treatment to be beneficial to the improvement of sexual dysfunctions related to hypogonadism. However, there are not enough psychological intervention studies to make conclusions regarding the therapeutic effects of psychotherapy.
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Wolitski RJ, Fenton KA. Sexual health, HIV, and sexually transmitted infections among gay, bisexual, and other men who have sex with men in the United States. AIDS Behav 2011; 15 Suppl 1:S9-17. [PMID: 21331797 DOI: 10.1007/s10461-011-9901-6] [Citation(s) in RCA: 96] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The sexual health of gay, bisexual, and other men who have sex with men (MSM) in the United States is not getting better despite considerable social, political and human rights advances. Instead of improving, HIV and sexually transmitted infections (STIs) remain disproportionately high among MSM and have been increasing for almost two decades. The disproportionate and worsening burden of HIV and other STIs among MSM requires an urgent re-assessment of what we have been doing as a nation to reduce these infections, how we have been doing it, and the scale of our efforts. A sexual health approach has the potential to improve our understanding of MSM's sexual behavior and relationships, reduce HIV and STI incidence, and improve the health and well-being of MSM.
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Affiliation(s)
- Richard J Wolitski
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton RD NE (E-35), Atlanta, GA 30333, USA.
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Jones SG, Pat Patsdaughter CA, Martinez Cardenas VM. Lessons from the viagra study: methodological challenges in recruitment of older and minority heterosexual men for research on sexual practices and risk behaviors. J Assoc Nurses AIDS Care 2011; 22:320-9. [PMID: 21216626 DOI: 10.1016/j.jana.2010.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2010] [Accepted: 10/26/2010] [Indexed: 11/30/2022]
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Sadeghi-Nejad H, Wasserman M, Weidner W, Richardson D, Goldmeier D. Sexually Transmitted Diseases and Sexual Function. J Sex Med 2010; 7:389-413. [DOI: 10.1111/j.1743-6109.2009.01622.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Nettles CD, Benotsch EG, Uban KA. Sexual risk behaviors among men who have sex with men using erectile dysfunction medications. AIDS Patient Care STDS 2009; 23:1017-23. [PMID: 19909171 DOI: 10.1089/apc.2009.0029] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This study examined relationships between use of the phosphodiesterase type-5 (PDE-5) inhibitors (erectile dysfunction medications) sildenafil (Viagra), Pfizer, New York, NY), tadalafil (Cialis), Eli Lily, Indianapolis, IN), and/or vardenafil (Levitra), Bayer, Berlin, Germany), substance use, perceptions of risk, and sexual behavior in men who have sex with men (MSM). MSM (N = 342) attending a gay pride festival completed a brief survey assessing sexual behavior, risk perceptions, and substance use, including the use and the source of PDE-5 inhibitors. More than a quarter of the sample (26.3%, n = 89) reported having ever used a PDE-5 inhibitor. Those reporting use of PDE-5 inhibitors had higher rates of sexual risk behaviors and differed in their assessment of the risk of HIV transmission for unprotected anal sex. Users who received PDE-5 inhibitors from their doctors did not report sexual behaviors that differed significantly from those who received PDE-5 inhibitors from nonphysician sources. In a sequential logistic regression analysis, recent PDE-5 inhibitor use was associated with unprotected anal sex after accounting for the influence of age, education, ethnic identity, and substance use. Many MSM users of erectile dysfunction drugs report behaviors that may place their and others' health at risk. Interventions to reduce risk among MSM PDE-5 inhibitor users should be explored.
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Affiliation(s)
| | - Eric G. Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Kristina A. Uban
- Department of Pyschology, University of British Columbia, Vancouver, British Columbia
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Carey JW, Mejia R, Bingham T, Ciesielski C, Gelaude D, Herbst JH, Sinunu M, Sey E, Prachand N, Jenkins RA, Stall R. Drug use, high-risk sex behaviors, and increased risk for recent HIV infection among men who have sex with men in Chicago and Los Angeles. AIDS Behav 2009; 13:1084-96. [PMID: 18498049 DOI: 10.1007/s10461-008-9403-3] [Citation(s) in RCA: 127] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2007] [Accepted: 04/28/2008] [Indexed: 11/26/2022]
Abstract
We examined how drugs, high-risk sexual behaviors, and socio-demographic variables are associated with recent HIV infection among men who have sex with men (MSM) in a case-control study. Interviewers collected risk factor data among 111 cases with recent HIV infection, and 333 HIV-negative controls from Chicago and Los Angeles. Compared with controls, cases had more unprotected anal intercourse (UAI) with both HIV-positive and HIV-negative partners. MSM with lower income or prior sexually transmitted infections (STI) were more likely to be recently HIV infected. Substances associated with UAI included amyl nitrate ("poppers"), methamphetamine, Viagra (or similar PDE-5 inhibitors), ketamine, and gamma hydroxybutyrate (GHB). Cases more frequently used Viagra, poppers, and methamphetamine during UAI compared with controls. In multivariate analysis, income, UAI with HIV-positive partners, Viagra, and poppers remained associated with recent HIV seroconversion. Better methods are needed to prevent HIV among MSM who engage in high-risk sex with concurrent drug use.
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Affiliation(s)
- James W Carey
- Prevention Research Branch, Division of HIV/AIDS Prevention, Centers for Disease Control & Prevention, Atlanta, GA, 30333, USA.
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Semple SJ, Zians J, Strathdee SA, Patterson TL. Sexual marathons and methamphetamine use among HIV-positive men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2009; 38:583-90. [PMID: 18185990 PMCID: PMC2695846 DOI: 10.1007/s10508-007-9292-y] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2007] [Revised: 06/21/2007] [Accepted: 08/19/2007] [Indexed: 05/16/2023]
Abstract
A sexual marathon is defined as prolonged sexual activity over hours and even days. This exploratory study examined the phenomenon of sexual marathons in a sample of 341 HIV-positive methamphetamine-using men who have sex with men (MSM). Eighty-four percent of the men reported engaging in marathon sex while high on methamphetamine. MSM who engaged in sexual marathons and those who did not were compared in terms of background characteristics, methamphetamine use variables, alcohol and illicit drug use, sexual risk behaviors, and psychosocial factors. Men who engaged in marathon sex used significantly more illicit drugs, were more likely to use sildenafil (Viagra) and amyl nitrates, and scored higher on a sexual compulsivity scale compared to men who did not engage in marathon sex. In multivariate analyses, use of sildenafil in the past two months was significantly correlated with participation in sexual marathons. Findings are discussed in terms of their implications for HIV/STI prevention and intervention.
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Affiliation(s)
- Shirley J. Semple
- Department of Psychiatry, University of California–San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, U.S.A
| | - Jim Zians
- Department of Psychiatry, University of California–San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, U.S.A
| | - Steffanie A. Strathdee
- Department of Family and Preventive Medicine, University of California–San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0622, U.S.A
| | - Thomas L. Patterson
- Department of Psychiatry, University of California–San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0680, U.S.A
- Department of Veterans Affairs Medical Center, Research Service V116A, 3350 La Jolla Village Drive, San Diego CA 92161 U.S.A
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Sanders SA, Milhausen RR, Crosby RA, Graham CA, Yarber WL. ORIGINAL RESEARCH–ED PHARMACOTHERAPY: Do Phosphodiesterase Type 5 Inhibitors Protect Against Condom-Associated Erection Loss and Condom Slippage? J Sex Med 2009; 6:1451-6. [DOI: 10.1111/j.1743-6109.2009.01267.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Abstract
INTRODUCTION Homosexuality is a topic that needs to be integrated into the knowledge base of the practitioner of sexual medicine. AIM To present to the reader a summary of the current literature on homosexuality and sexual orientation and address specifically issues that pertain to the relationship sexual orientation and sexual medicine practice. MAIN OUTCOME MEASURES The information is presented in a continued medical education format, with a series of evaluation questions at the end of the activity. Methods. A review of the literature is presented and organized according to the authors' judgment of the value of the information as to provide the reader with an inclusive panorama of the issues covered. RESULTS Current concepts, debates, and need for further research are presented. CONCLUSIONS The professional of sexual medicine needs to be aware of the various topics reviewed in this article as his or her involvement in the area of sexuality can create the expectation on the part of the patients of knowingness of all aspects of human sexuality. Sexual orientation is a complex area but considerable understanding has fortunately been achieved in many issues in reference to homosexuality and heterosexuality.
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Dibble SL, Eliason MJ, Christiansen MA. Chronic Illness Care for Lesbian, Gay, & Bisexual Individuals. Nurs Clin North Am 2007; 42:655-74; viii. [DOI: 10.1016/j.cnur.2007.08.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Spindler HH, Scheer S, Chen SY, Klausner JD, Katz MH, Valleroy LA, Schwarcz SK. Viagra, methamphetamine, and HIV risk: results from a probability sample of MSM, San Francisco. Sex Transm Dis 2007; 34:586-91. [PMID: 17334264 DOI: 10.1097/01.olq.0000258339.17325.93] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To determine the prevalence and factors of Viagra use in combination with crystal methamphetamine and its association with HIV risk behavior in a probability sample of men who have sex with men (MSM). STUDY DESIGN A cross-sectional, random-digit dial telephone survey of MSM in San Francisco conducted between June 2002 and January 2003. RESULTS Of the 1976 MSM, 13.5% used Viagra alone, 7.1% used methamphetamine without Viagra, 9.6% used Viagra with a mood-altering substance (excluding methamphetamine), and 5.1% used Viagra with methamphetamine. Of the MSM using Viagra with methamphetamine, 57% were HIV-infected and 24% of these men reported serodiscordant unprotected insertive intercourse. Viagra used with methamphetamine was independently associated with a higher risk of serodiscordant unprotected insertive intercourse, serodiscordant unprotected receptive intercourse, and a recent diagnosis of a sexually transmitted disease. CONCLUSION MSM who use Viagra with crystal methamphetamine have high prevalence rates of HIV and engage in HIV risk behaviors.
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Affiliation(s)
- Hilary H Spindler
- San Francisco Department of Public Health, San Francisco, California, USA.
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Richardson D, Goldmeier D, Bell C, Lamba H. Do phosphodiesterase 5 inhibitors promote onward transmission of HIV in men who have sex with men? Sex Transm Infect 2007; 83:250. [PMID: 17569725 PMCID: PMC2659105 DOI: 10.1136/sti.2006.024166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Abstract
HIV infection starts as an acute, systemic infection, followed by a chronic period of clinical latency, usually lasting 3 to 10 years, which precedes the eventual collapse of the immune system. It is increasingly recognized that events occurring during acute HIV infection may determine the natural course of the disease. The very dynamic events of acute HIV infection provide multiple opportunities for biologic interventions, such as anti-retroviral or immune-based therapies. Similarly, the implementation of public health measures during acute HIV infection could help control epidemics or outbreaks. Many of the dramatic possibilities for intervention in acute HIV infection remain unproved, not the least because of traditional difficulty of diagnosing patients during this early period. This article reviews the natural history, pathogenesis and clinical presentation of acute HIV infection, and suggests a diagnostic and therapeutic approach to guide clinicians dealing with patients with suspected or confirmed acute HIV infection.
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Affiliation(s)
- Nicola M Zetola
- Division of Infectious Diseases, University of California-San Francisco, San Francisco, CA 94103, USA
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Goldstein I. EDITORIAL: The Journal of Sexual Medicine in 2007: The Electronic Age. J Sex Med 2007; 4:1-3. [PMID: 17233771 DOI: 10.1111/j.1743-6109.2007.00392.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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