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16th International AIDS Conference
Toronto, Canada - August 13 - 18, 2006
VIAGRA, METHAMPHETAMINE AND HIV RISK: RESULTS FROM A PROBABILITY
SAMPLE OF MSM, SAN FRANCISCO
Int Conf AIDS. 2006 Aug 13-18;16 Abstract No. MoPE0342
H. Spindler1, S. Scheer1, S. Chen1, J. Klausner1, L. Valleroy2, S. Schwarcz1 1 San Francisco Department of Public Health, San Francisco, United States, 2 Centers for Disease Control and Prevention, Atlanta, United States BACKGROUND: Viagra has been associated with high risk sexual and drug using behavior and HIV
infection among men who have sex with men (MSM). Crystal methamphetamine may be used by MSM
in conjunction with Viagra to prolong sexual activity and to counteract erectile dysfunction that may
occur from use of crystal methamphetamine. We compared the prevalence and sexual and drug using
behaviors of MSM who did not use Viagra, used Viagra without other mood-altering substances, used
Viagra with methamphetamine, and used crystal methamphetamine without Viagra. We compared the
independent risk of unprotected serodiscordant insertive and receptive anal intercourse associated with
use of Viagra without other drugs, use of crystal methamphetamine without Viagra, and the use of
Viagra combined with crystal methamphetamine.
METHODS: A random digit dial telephone survey of MSM in San Francisco (June 2002 - January
2003) that ascertained sexual and drug use behaviors in the past 12 months.
RESULTS: Of the 1,976 MSM, 1388 (84%) did not use Viagra, 266 (16%) used Viagra without other
mood-altering drugs, 100 (5%) used Viagra combined with crystal methamphetamine, and 139 (7%)
used crystal methamphetamine without Viagra. Of the MSM using Viagra with crystal
methamphetamine 57% were HIV-infected and 42% of these reported serodiscordant unprotected
insertive intercourse. The adjusted odds ratio (95% confidence limits) of unprotected serodiscordant
insertive anal intercourse associated with use of Viagra alone was 1.6 (1.1, 2.5), associated with crystal
methamphetamine use without Viagra was 1.4 (0.8, 2.4), and associated Viagra combined with crystal
methamphetamine was 2.8 (1.6, 5.0). The adjusted odds ratio (95% confidence limits) of unprotected
serodiscordant receptive anal intercourse associated with use of Viagra alone was 1.1 (0.7, 1.8),
associated with crystal methamphetamine use without Viagra was 1.4 (0.7, 2.6), and associated Viagra
combined with crystal methamphetamine was 2.6 (1.4, 4.7).
CONCLUSIONS: Viagra use is associated with high risk.
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