Characteristics and Longitudinal Patterns of Erectile Dysfunction Drug Use Among Men Who Have Sex with Men in the U.S.

Eric C. Seaberg,Ken S. Ho,Roger Detels,Adrian S. Dobs,Frank J. Palella,Jee Won Park,Robert E. Weiss

doi:10.1007/s10508-021-02065-x

Abstract

We investigated the longitudinal relationship between erectile dysfunction (ED) drug use with behavioral factors, including substance use and sexual activities in men who have sex with men from the Multicenter AIDS Cohort Study during 1998–2016 (n = 1636). We used a bivariate random-intercept model to evaluate ED drug use along with other behavioral factors to assess relationships between the two outcomes over time on a population level and also at the individual level. Average ED drug use among men who have sex with men (MSM) with HIV was positively correlated with average use of marijuana (r = .19), poppers (r = .27), and stimulants (r = .25). In this group, testosterone use (r = .32), multiple partners (r = .41), insertive anal intercourse with condom (r = .40), and insertive anal intercourse without condom (r = .43) all showed moderate correlations over time with average ED use (p < .001). Associations among MSM without HIV were similar, with average marijuana use (r = .19) and stimulant use (r = .22) being positively correlated with average ED drug use, and were also correlated with having multiple partners (r = .36), insertive anal intercourse with condom (r = .22), and insertive anal intercourse without condom (r = .18) over time. Positive within-individual associations between ED drug use and multiple partners and insertive anal intercourse with and without condom were observed regardless of HIV serostatus. This study showed that MSM who reported use of ED drugs were also, on average, more likely to use recreational drugs and engage in sexual activities, such as having multiple partners and insertive anal intercourse. Within individuals, average ED drug use was also positively correlated with sexual behaviors.

Highlights

Erectile dysfunction (ED) is common among men with HIV (MWH) (Romero-Velez et al, 2014) and is associated with positive HIV serostatus among men who have sex with men (MSM) (Dijkstra et al, 2018)
To examine the patterns of ED drug use in MWH and men without HIV (MWOH), we set our study initiation year to 1998, which was the year when the first ED drugs were available in the U.S for the purposes of our study, we examined data from a total of 1,636 MSM who had been enrolled in the Multicenter AIDS Cohort Study (MACS) study since 1998
From a total of 1,636 participants in this study, there were 62 men who seroconverted during the period of our study and contributed data to both the MWH and MWOH groups

Summary

Introduction

Erectile dysfunction (ED) is common among men with HIV (MWH) (Romero-Velez et al, 2014) and is associated with positive HIV serostatus among men who have sex with men (MSM) (Dijkstra et al, 2018). Archives of Sexual Behavior (2021) 50:2887–2896 and information, the use of recreational drugs is common among MSM regardless of age and socioeconomic status (Colfax et al, 2005; Mansergh et al, 2006; Purcell et al, 2005a, b), and these drugs include marijuana, cocaine, ecstasy, and ED drugs (Halkitis et al, 2005; Purcell et al, 2005a, b; Ruf et al, 2006). The majority of MSM from an Australian community cohort study reported that use of recreational drugs was part of their lifestyle (Ruf et al, 2006). In another cross-sectional study of young heterosexual, bisexual, and gay men in the U.S, 5% of the participants reported using ED drugs, the majority were for recreational purposes (Harte & Meston, 2011). Slightly less than half of the men who had reported using ED drugs had combined the drugs together with marijuana and other substances such as ecstasy, methamphetamines, and cocaine

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