Use Of Erectile Dysfunction Drugs Research Articles

Effects of Erectile Dysfunction Drugs Use on T-Cells and Immune Markers on Men Who Have Sex with Men

Objective Examine prospective relationships between erectile dysfunction (ED) drugs and CD4 and CD8 T-cells, and immune markers among men who have sex with men (MSM). Methods Data from Multicenter AIDS Cohort Study, an observational prospective cohort study, with semiannual follow-ups conducted in four U.S. centers from 1998 onwards was used. Marginal structural models using g-computation were fitted to estimate the mean differences for the effects of self-reported ED drug use on CD4 and CD8 T-cell outcomes and immune biomarkers. Results Total of 1,391 men with HIV (MWH) and 307 men without HIV (MWOH) was included. Baseline mean CD4 cell count among MWH and MWOH was 499.9 and 966.7 cells/μL, respectively. At baseline, 41.8% of MWH were virally suppressed. ED drug users reported a mean of 44.4 months of exposure to ED drugs. ED drug use was associated with increased CD4 cell outcomes among MWH but not MWOH. Mean differences in CD4 cell counts after 1 year of ED drug use was 57.6 cells/μL and increased to 117.7 after 10 years among MWH. CD8 counts were higher in ED drug users among MWH over 10 years than non-users; no consistent differences were found among MWOH. ED drug use appeared to reduce immune marker levels, such as IL-6 and increase markers, such as IL-10. We observed similar effects of ED drug use on biomarker levels among MWOH. Conclusion Long-term use of ED drugs do not adversely affect immune function among MWH or MWOH. Future studies on the relationships between different types of ED drugs and effects on T-cell subtypes are warranted.

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

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.

A latent class analysis of sexual and romantic relationships among HIV-positive and HIV-negative gay and bisexual men in Vancouver

Quantitative studies of gay and bisexual men have often reduced relational experiences to single dimensions and explored linkages with sexual risk behaviours. We sought to document the intersection of multiple relationship dimensions among 218 HIV-positive and 556 HIV-negative gay and bisexual men, and estimate associations with love and affection as well as various health and social covariates. We performed latent class analysis of relationships, employing five indicators: relationship status, sexual agreement (monogamous/open), and number of recent sex partners, sex parties, and anonymous sex encounters. We assessed differences in love and affection, and identified covariates using multinomial logistic regression. Two latent classes involved single men: ‘single, less sex partners’ (45% of sample) and ‘single, more sex partners’ (17%), differentiated by number of partners (52% vs. 92% of each class had ≥5 partners, respectively), party sex (3% vs. 57%), and anonymous sex (2% vs. 58%). Three involved regular partners: ‘monogamish’ (15%) (78% were monogamous yet 50% reported ≥1 recent sex partner); ‘open, less sex partners’ (15%) (100% open, 43% ≥5 partners, 10% party sex, 4% anonymous sex); and ‘open, more sex partners’ (9%) (96% open, 92% ≥5 partners, 47% party sex, 69% anonymous sex). Love and affection were common across classes, although more prevalent among partnered (85–91%) versus single (48–51%) men. Relative to ‘single/less partners,’ the study demonstrated that higher sexual sensation seeking scores were associated with membership in every class except ‘monogamish’; erectile dysfunction drug use was associated with being in the ‘more partners’ (single and open) classes; anxiety and older age were associated with the ‘open/less partners’ class; and loneliness was associated with reduced odds of membership in all three partnered classes. We uncovered considerable relational diversity among gay and bisexual men and complex associations with love and wellbeing. Findings are relevant for sex researchers, educators, and therapists.

A Multi-Group Latent Class Analysis of Chronic Medical Conditions Among Men Who Have Sex with Men.

Until recently, research on the health of gay and other men who have sex with men (MSM) has focused on risk for and the health consequences of HIV and other sexually transmitted infections. A multigroup latent class analysis examined a range of lifetime chronic medical conditions (CMCs) among MSM. Covariates included sociodemographics, substance use, psychological distress, and HIV serostatus. A two-class model best fit the medical condition data: a low probabilities class for most CMCs and a moderate to high probabilities (MHP) class. HIV serostatus was associated with increased within-class probabilities for some CMCs, particularly gastrointestinal and skin disorders. Only increasing age and use of erectile dysfunction drugs were directly associated with increased odds of being in the MHP class whereas methamphetamine use, identifying as gay, and lower alcohol use were indirectly associated. Implications of the findings for future research and the health care needs of MSM are discussed.

Longitudinal analysis of key HIV-risk behavior patterns and predictors in men who have sex with men, Bangkok, Thailand.

The HIV incidence among Thai men who have sex with men (MSM) enrolled in the Bangkok MSM Cohort Study (BMCS) has remained high since its inception in 2006. The purpose of this BMCS analysis was to determine: (1) changes in three HIV-risk behaviors (unprotected anal intercourse (UAI), recreational drug use, and multiple sexual partners i.e., more than four male/transgender partner) over time; and (2) factors associated with each one separately. Thai MSM aged 18years or older and living in Bangkok were eligible to participate in the BMCS. At each follow-up visit, participants were asked to report their sexual and drug behaviors in the previous 4months. We conducted a longitudinal analysis using generalized estimating equations logistic regression that included 1,569 MSM who were enrolled from 2006 to 2010 and contributed at least one follow-up visit. For each four-month visit increase, we found a 2, 1, and 1% decrease in odds for reported UAI, recreational drug use, and multiple sexual partners, respectively. We found significant predictors associated with three HIV-risk behaviors such as binge drinking, participation in group sex, and use of erectile dysfunction drugs. The statistically significant decrease in odds of HIV-risk behaviors among the participants is encouraging; however, continued vigilance is required to address the factors associated with HIV-risk behaviors through currently available interventions reaching MSM.

Drug use, sexual risk behaviour and sexually transmitted infections among swingers: a cross-sectional study in The Netherlands

ObjectivesRecreational drug use has been found to be associated with high-risk sexual behaviour and with sexually transmitted infections (STI). This study is the first to assess the prevalence of drug...

Complex drug use patterns and associated HIV transmission risk behaviors in an Internet sample of U.S. men who have sex with men.

Although the relationship between drug use and HIV risk among men who have sex with men (MSM) is well described, relatively few studies have employed empirical methods to assess underlying classes of drug use that may better predict the risk of HIV or sexually transmitted infections (STIs) among MSM. The aim of this study was to determine whether latent class analysis (LCA) would identify underlying drug classes reported prior to sex, as well as predict unprotected anal intercourse (UAI) in the last sexual encounter among MSM. From 2004 to 2005, an anonymous online survey was conducted among 8,717 sexually active MSM recruited from gay-affiliated U.S. websites. LCA clustered participants into six distinct drug use classes based on the specific types and number of drugs used: (1) low/no drug use, (2) recreational drug use, (3) poppers with prescription erectile dysfunction (ED) drug use, (4) poppers with both prescription and non-prescription ED drug use, (5) recreational, club, and ED drug use, and (6) high polydrug use. Compared with men in Class 1, men in the highest drug use class were 4.84 times more likely to report UAI in their last sexual encounter and 3.78 times more likely to report an STI in the past year (both ps<.001). Younger MSM aged 18-29 were significantly more likely to report an STI than men aged 50 and above (p<.001). There is a need to better understand the complex relationship between a diverse set of drugs used among MSM and how polydrug use impacts sexual negotiation over time.

Drug prescription for erectile dysfunction before and after diagnosis of localized prostate cancer.

Despite the high prevalence of erectile dysfunction (ED) in men with prostate cancer, little is known about the use of ED drugs. Also, the possible influence of socioeconomic factors on ED drug use has not been studied previously. The aim of this study was to examine determinants and patterns of ED drug use before and after diagnosis in men with localized prostate cancer. Using a nationwide population-based cohort, 25,390 men with localized prostate cancer diagnosed between 2006 and 2009 and 126,944 control men were identified and followed for filled ED drug prescriptions over a 3-year period, ranging from 1 year before and up to 2 years after diagnosis. The main outcome measure was the proportion of men with at least one filled ED drug prescription after diagnosis. The number of men using ED drugs increased markedly following diagnosis. Men who underwent radical prostatectomy had the strongest increase, with a cumulative proportion of 74% for at least one filled prescription within the first 2 years after diagnosis. The corresponding proportion was 33% in men treated with radiotherapy, 21% in men on active surveillance, 10% in men on watchful waiting, and 8% in control men. Among men who underwent prostatectomy, usage attenuated over time. Determinants of postdiagnostic use were young age at diagnosis, high income, high education, and a low- or intermediate-risk cancer. Although drugs for ED are commonly prescribed after diagnosis, use among most men is transient and influenced by socioeconomic status. Posttreatment counseling and affordable ED drugs are likely to reduce treatment dropout and disparities in use and help improve sexual health and quality of life in men with prostate cancer.

Characteristics of online pharmacy users in a nationally representative sample

ObjectiveTo identify health care–related factors associated with online pharmacy use by considering patients’ prescription drug insurance coverage, number of prescriptions, health care expenditures, types of medications purchased, and health status. MethodsData were obtained from the Agency for Healthcare Research and Quality's 2002–2010 Medical Expenditure Panel Survey. Online pharmacy users were compared with nonusers across study variables in unadjusted and adjusted comparisons using logistic regression. Survey weights were applied to generate nationally representative estimates. ResultsA total of 443 online pharmacy users were identified, representing an average of 1.5 million individuals per year. Online users were found to be older and to have more prescriptions compared with nonusers, as well as to have higher health care expenditures and higher Charlson comorbidity index scores. Online users were also more likely to be privately insured, white, and married, and to be more educated. In logistic regression models, higher prescription expenditures (odds ratio [OR] 1.17 [1.05–1.32]), higher number of prescriptions (OR 5.13 [1.4–19]), medium to high income (OR 1.82 (1.3–2.5)], and use of erectile dysfunction drugs (OR 2.09 [1.06–4.10]) were associated with greater odds of online pharmacy use. Black race (OR 0.47 [0.3–0.72]), Medicaid insurance coverage (OR 0.23 [0.1–0.5]), and use of narcotic medications (OR 0.72 [0.53–0.97]) were associated with decreased odds of online pharmacy use. ConclusionThis study showed that age, race, income level, insurance coverage, high health care expenditures, and higher number of prescriptions are predictors for online pharmacy use.

Substance use and drinking outcomes in Personalized Cognitive Counseling randomized trial for episodic substance-using men who have sex with men

BackgroundNon-dependent alcohol and substance use patterns are prevalent among men who have sex with men (MSM), yet few effective interventions to reduce their substance use are available for these men. We evaluated whether an adapted brief counseling intervention aimed at reducing HIV risk behavior was associated with secondary benefits of reducing substance use among episodic substance-using MSM (SUMSM). Methods326 episodic SUMSM were randomized to brief Personalized Cognitive Counseling (PCC) intervention with rapid HIV testing or to rapid HIV testing only control. Both arms followed over 6 months. Trends in substance use were examined using GEE Poisson models with robust standard errors by arm. Reductions in frequency of use were examined using ordered logistic regression. ResultsIn intent-to-treat analyses, compared to men who received rapid HIV testing only, we found men randomized to PCC with rapid HIV testing were more likely to report abstaining from alcohol consumption (RR=0.93; 95% CI=0.89–0.97), marijuana use (RR=0.84; 95% CI=0.73–0.98), and erectile dysfunction drug use (EDD; RR=0.51; 95% CI=0.33–0.79) over the 6-month follow-up. PCC was also significantly associated with reductions in frequency of alcohol intoxication (OR=0.58; 95% CI=0.36–0.90) over follow-up. Furthermore, we found PCC was associated with significant reductions in number of unprotected anal intercourse events while under the influence of methamphetamine (RR=0.26; 95% CI=0.08–0.84). ConclusionThe addition of adapted PCC to rapid HIV testing may have benefits in increasing abstinence from certain classes of substances previously associated with HIV risk, including alcohol and EDD; and reducing alcohol intoxication frequency and high-risk sexual behaviors concurrent with methamphetamine use.

Factors Influencing Distress Toward Erectile Dysfunction and Attitude Toward Erectile Dysfunction Drugs Among Middle-Aged and Elderly Chinese Women and Men in Hong Kong

This study aims to explain distress toward erectile dysfunction (ED), attitude toward ED drugs, and experiences with ED drug use in terms of sexual attitudes, relationship satisfaction, and sociodemographic factors among the middle-aged and elderly Chinese population. Studies show that a significant number of middle-aged and elderly men in Asia suffer from ED. However, people's attitudes toward ED drugs are not positive. Few studies have sought to reveal the influencing factors of this negative attitude. Nine hundred forty-six Hong Kong women and men aged 36-80 with stable partners were administered a structured questionnaire through face-to-face street-intercept survey. Self-reporting on single-item questions using a five-point Likert scale was adopted for most of the variables, including attitude toward sex, relationship satisfaction, distress toward ED, and attitude toward ED drugs. Perceived importance of sex in an intimate relationship and attitude toward sex were assessed through three items. Respondents were asked to report whether they had taken ED drugs or bought ED drugs for their partners. While perceived importance of sex in an intimate relationship and distress toward ED both contributed to the estimation of attitudes toward ED drugs for both genders, relationship satisfaction was only associated with men's attitude, while women's attitude was related to two other factors: relationship status and income level. Both age and attitude toward ED drugs influenced experiences with ED drug use for women and men. Men's experience with ED drug use was further related to the perceived importance of sex and to men's self-esteem and relationship status. Results of this study could help identify people who are disturbed by ED but reluctant to seek treatment. Clinicians and public health policy makers could make use of the findings to encourage proper understanding of ED.

Alexithymia and Circumcision Trauma: A Preliminary Investigation

This preliminary study investigates what role early trauma might have in alexithymia acquisition for adults by controlling for male circumcision. Three hundred self-selected men were administered the Toronto Twenty-Item Alexithymia Scale checklist and a personal history questionnaire. The circumcised men had age-adjusted alexithymia scores 19.9 percent higher than the intact men; were 1.57 times more likely to have high alexithymia scores; were 2.30 times less likely to have low alexithymia scores; had higher prevalence of two of the three alexithymia factors (difficulty identifying feelings and difficulty describing feelings); and were 4.53 times more likely to use an erectile dysfunction drug. Alexithymia in this population of adult men is statistically significant for having experienced circumcision trauma and for erectile dysfunction drug use.

Sexually Transmitted Diseases Among Users of Erectile Dysfunction Drugs

Pharmacologic treatments for erectile dysfunction (ED) have gained widespread popularity among middle-aged and older males in recent years. Driven largely by the high prevalence of erectile difficulties in this population1–8, rates of sildenafil use reportedly reached 1.4% in the commercially insured population by 2002.9 This is perhaps not surprising, since nearly 40% of men aged 57 to 85 have some degree of erectile dysfunction.8 While their clinical efficacy has been well documented, little is known about the relationship between ED treatments and the prevalence of sexually transmitted diseases (STDs). In light of growing evidence for rising STD cases, including AIDS cases, at older ages10–14, ED drugs have received attention for their possible contribution to these trends.13, 14 In fact, a recent study found that widowhood in older men, but not older women, was associated with higher rates of STDs, especially after the introduction of sildenafil (Viagra) in 1998.15 Although middle-aged and older adults generally take fewer risks with their health, their decreased need for contraception may imply less than optimal safe sexual practices compared to younger populations.16 For example, prior research suggests that condom use declines with age16, 17 and, among at-risk populations, individuals older than 50 years are one sixth as likely to use condoms during sex and one-fifth as likely to have been tested for HIV compared to individuals in their twenties.18 Moreover, a survey of primary care physicians revealed that most physicians rarely or never discuss sexual risk factor reduction with their middle-age and older patients.19 These facts are particularly important in light of the emergence of ED drugs, which have improved sexual function among older adult males. Several small studies in the MSM (men who have sex with men) community have investigated the connection between pharmacologic ED treatments and STDs.20–24 In this community, ED drug use is associated with high-risk sexual behavior, such as unprotected anal sex.20–22 ED drug users also report a greater number of recent sex partners and higher rates of STDs than non-users.21–23 While the measured outcomes of these studies likely reflect selection bias among users rather than the effect of ED drugs per se, these studies nonetheless highlight a group of individuals within the MSM community who are at high risk of contracting STDs. In light of these findings and the growing use of pharmacologic treatments for ED, we investigated the relationship between STDs and ED drug use in a comprehensive, large sample of privately insured, middle-age and older adult male beneficiaries. Large datasets are required to examine STD patterns since in the general population itself, STDs are still quite rare, and even more so among middle-age and older adults.15 For men above 40, we compared STD rates between users and non-users of ED drugs, adjusting for pre-existing STDs and other co-morbidities. We also compared STD rates within users before and after initiation of an ED drug. We hypothesized that users of ED drugs would have higher rates of STDs compared to non-users and that users of ED drugs would have higher rates of STDs in the months after initiating an ED drug compared to the months prior. A confirmation of this hypothesis would suggest two things. At a minimum, men requesting ED drugs would be at higher risk of contracting or already having sexually transmitted disease and may therefore benefit from closer monitoring of risky sexual behavior and renewed discussions about safe sexual practices. Second, the availability of ED drugs could in theory directly lead to higher rates of STDs by facilitating sexual activity among those previously less sexually active.

Does erectile dysfunction drug use contribute to risky sexual behavior?

Erectile dysfunction (ED) is a common sexual problem affecting up to one-third of men throughout their lives. According to the Massachusetts Male Aging Study (MMAS), ED affects an estimated 52% of men between the ages of 40 and 70. With the approval of sildenafil (USA in March 1998), the first phosphodiesterase type 5 (PDE-5) inhibitor to be made available for treatment of ED, and the subsequent approval of vardenafil (USA in August 2003) and tadalafil (USA in November 2003), the PDE-5 inhibitor class of drugs has rapidly become the first-line therapy for ED of varying etiologies and severities.

Sexually Transmitted Diseases Among Users of Erectile Dysfunction Drugs: Analysis of Claims Data

Pharmacologic treatments for erectile dysfunction (ED) have gained popularity among middle-aged and older men. Increased sexual activity among those who use these drugs raises concerns about sexually transmitted diseases (STDs). To examine the rates of STDs in men who use and do not use ED drugs. Retrospective cohort study. Database of claims from 1997 to 2006 for 1,410,806 men older than age 40 years with private, employer-based insurance from 44 large companies. 33,968 men with at least 1 filled prescription for an ED drug and 1,376,838 patients with no prescription. STD prevalence among users and nonusers of ED drugs. Users of ED drugs had higher rates of STDs than nonusers the year before initiating ED drug therapy (214 vs. 106 annually per 100,000 persons; P = 0.003) and the year after (105 vs. 65; P = 0.004). After adjustment for age and other comorbid conditions, users of ED drugs had an odds ratio (OR) for an STD of 2.80 (95% CI, 2.10 to 3.75) in the year before initiating drug therapy; the OR was 2.65 (CI, 1.84 to 3.81) in the year after. These differences were largely due to infections with HIV. The OR for HIV infection was 3.32 (CI, 2.38 to 4.36) in the year before and 3.19 (CI, 2.11 to 4.83) in the year after an ED drug prescription was filled. Significant changes in STD rates from the year before to the year after the first ED drug prescription was filled were not documented (adjusted OR for STD for users before vs. after the first ED drug prescription was filled, 0.96 [CI, 0.87 to 1.06]). Selection bias precludes conclusions about whether use of ED treatments directly leads to increases in STDs. Men who use ED drugs have higher rates of STDs, particularly HIV infection, both in the year before and after use of these drugs. The observed association between ED drug use and STDs may have more to do with the types of patients using ED drugs rather than a direct effect of ED drug availability on STD rates. Counseling about safe sexual practices and screening for STDs should accompany the prescription of ED drugs. RAND Roybal Center, National Institutes of Health, and Agency for Healthcare Research and Quality.

Community Reactions to a Syphilis Prevention Campaign for Gay and Bisexual Men in Los Angeles County

“Stop the Sores” (STS), a humor-based syphilis prevention campaign, was implemented in response to increasing syphilis prevalence among gay and bisexual men in Los Angeles County. In 2004, 564 men completed surveys measuring exposure and reactions to the campaign and syphilis testing. Mean age was 39, and men of color comprised a significant proportion of the sample (46.8%). Most men reported being HIV-negative (79.3%). Overall, 7.8% of the sample reported ever having syphilis; HIV-positive men were six times more likely to report this. Over one half of the sample (58.5%) reported exposure to the campaign. Men reporting any recent unprotected anal sex were twice more likely (than those who did not) to see the campaign. Men of color were twice more likely than White men to report wanting to speak to their friends about it. Finally, 39.1% of men exposed to the campaign reported being tested for syphilis as a result. Factors related to higher likelihood to test for syphilis included HIV seropositive status, any recent unprotected anal insertive sex, recent use of methamphetamine, recent use of “poppers,” and recent use of erectile dysfunction drugs. Although STS was somewhat effective, outreach efforts to particular subgroups may need to increase.

Specific Sex Drug Combinations Contribute to the Majority of Recent HIV Seroconversions Among MSM in the MACS

New HIV infections are being observed among men who have sex with men (MSM). Understanding the fusion of risky sexual behaviors, stimulant and erectile dysfunction drug use with HIV seroconversion may provide direction for focused intervention. During the follow-up period (1998-2008), we identified 57 HIV seroconverters among 1667 initially HIV-seronegative men. Time to seroconversion was modeled using Cox proportional hazards regression analysis for 7 combinations of sex drugs (inhaled nitrites or "poppers", stimulants, and erectile dysfunction drugs) used at the current or previous semiannual visit, adjusting for other risk factors including sexual behavior, alcohol and other drugs used, and depression. Model-based adjusted attributable risks were then calculated. The risk of seroconversion increased linearly with the number of unprotected receptive anal sex partners (URASP), with hazard ratios ranging from 1.73 [95% confidence interval (CI): 0.75 to 4.01] for 1 partner, to 4.23 (95% CI: 1.76 to 10.17) for 2-4 partners, and to 14.21 (95% CI: 6.27 to 32.20) for 5+ partners, independent of other risk factors. After adjustment, risks for seroconversion increased from 2.99 (95% CI: 1.02 to 8.76) for men who reported using stimulants only (1 drug) to 8.45 (95% CI: 2.67 to 26.71) for men who reported using all 3 sex drugs. The use of any of the 7 possible sex drug combinations accounted for 63% of the 9-year HIV seroincidence in the Multicenter AIDS Cohort Study. When contributions of increased URASP and combination drug use were analyzed together, the total attributable risk for HIV seroconversion was 74%, with 41% attributable to URASP alone and a residual of 33% due to other direct or indirect effects of sex drug use. Use of poppers, stimulants, and erectile dysfunction drugs increased risk for HIV seroconversion significantly in this cohort. These data reinforce the importance of implementing interventions that target drug reduction as part of comprehensive and efficacious HIV prevention strategies.

Lack of Information Underlies Women's Perceptions of Erectile Dysfunction (ED) Drugs in Japan

Some Japanese women are known to have negative attitudes toward erectile dysfunction (ED) drugs, but the environment underlying these perceptions is unclear. To reveal the underlying environment that shapes women's perceptions of ED drugs in Japan. A web-based questionnaire was conducted through an Internet-based market research company. A total of 2,593 women in five age groups (20s, 30s, 40s, 50s, and 60s or older) were randomly invited to participate in this study, with an almost equal number in each age group. The questionnaire contained 30 items related to individual background and sexual information, concerns about the image of ED drugs, ED drug-related perceptions, and attitude toward sexual information media. The women's attitude and the independent predictors that affect their partner's use of ED drugs were clarified. Answers were obtained from 1,077 women, of whom 35.4% (n=381) had a negative image of ED drugs. Although 69.5% (n=749) agreed that a sexual relationship with a male partner was important, only 26.7% (n=288) agreed that this remained important if ED drugs were used. However, 56.7% (n=611) and 57.7% (n=621) of respondents, respectively, answered that they would allow their partner's use of ED drugs if they imagined that they understood the safety and effectiveness of ED drugs and that their quality of life was improved by their partner's use of the drugs. Lack of information about ED drugs was a significant predictor for acceptance of a partner's use of ED drugs among women with a negative image of ED drugs, since they were more likely to accept the use of these drugs if they were convinced about their safety and effectiveness or positive effect on quality of life. Lack of information about ED drugs may influence the perception of women in Japan regarding these drugs.