| Don’t
let me down
February 27, 2004
A trio of pills —
Cialis,
Levitra and Viagra — enable limp partiers
to have stiffer sex, but health researchers
warn of possible side effects
In gay dance events and circuit parties, gay
men and recreational drug use sometimes go hand-in-hand.
And since its introduction in 1998, Viagra
— and now its two rivals, Levitra and
Cialis — has found a home among gay men
looking to stay sexually
potent for hours on end and party-goers looking
to counteract the side-effects of drugs like
crystal meth.
But it doesn’t stop with recreationaluse:
Some men with HIV use the drugs, approved only
for treating erectile dysfunction, to overcome
the side effects of some HIV drugs.
For Keith Folger, living with HIV also means
coping with fatigue and the inability to maintain
an erection to have sex.
“ It’s a combination of me being
48 and the fatigue that HIV causes,” Folger
says. “I’m horny as hell but I’m
tired because I’m always fatigued from
HIV.”
Whether the HIV medications cause Folger’s
impotence or it’s the result of fatigue,
Folger says he won’t sit flaccidly by
and miss out on sex.
“I just use Viagra,” Folger says.
Health researchers, though, are concerned that
mixing erectile dysfunction drugs with HIV medications
or using them recreationally can cause complications.
Some studies show use of the drugs among gay
men can lead to riskier sex and higher rates
of HIV and STD infections.
The FDA approved Viagra for erectile dysfunction
in 1998. For the last few years, Folger has
refilled his prescription each month. But he
hasn’t tried Cialis or Levitra, competitors
to Viagra that gained FDA approval last year.
Crystal meth cocktail
Unlike Folger, some gay men obtain erectile
dysfunction drugs without a prescription to
combat the impotence that comes with using crystal
meth, according to Dr. Charlotte Kent, chief
of epidemiology in the STD prevention and control
division of the San Francisco Department of
Public Health.
Dubbed “crystal dick,” the meth-induced
impotence “provides motivation for people
to take something to compensate for the dysfunction
that occurs,” Kent says.
Charles, who asked that his last name not be
published, suffered from impotence during the
months he spent addicted to crystal meth, and
he took Viagra to compensate, he says.
The combination turned him into a veritable
sex machine.
“That’s part of what allowed me
to be able to just concentrate on having sex
with people,” Charles says. “With
the crystal I could stay up for three or four
days and have sex with 30 to 40 guys easily.”
Obtaining the pills was easy, he says.
“I called my own prescription in to pharmacies,”
Charles says. “Just pretended I was a
doctor’s office. Some people I know just
order from Web sites that provide a medical
consultation online.”
But gay men who take the crystal meth-Viagra
combination contract HIV and STDs at a higher
rate than men who take only Viagra, according
to a study to be released in March at the 2004
National STD Prevention Conference in Philadelphia.
“Where it is primarily a problem is when
people are using meth,” Kent says. “That’s
where we see the biggest risk factor.”
Specific results from the study weren’t
available because it has not yet been published.
But gay men who had sex while under the influence
of both crystal meth and Viagra were several
times more likely to contract syphilis and HIV,
Kent says.
A weekend of sex
One of the common places that gay men mix Viagra
with crystal meth, in addition to other party
drugs, is at circuit parties, according to a
three-year-old study by the federal Centers
for Disease Control & Prevention.
Gay men use erectile
dysfunction drugs to combine with common
party drugs such as crystal meth, amyl nitrates
(poppers), ketamine, gamma-hydroxybutyrate or
gamma-butyrolactone (GHB-GBL), and ecstasy,
according to a December 2001 study by the CDC.
The study, published in the Journal of AIDS,
examined the sex and drug habits of 295 gay
and bisexual men who attend circuit parties.
During one weekend of drug use, 80 percent
of study participants used ecstasy, 66 percent
used ketamine, 43 percent used crystal meth,
29 percent used GHB/GBL, 14 percent used Viagra
and 14 percent used poppers, according to the
study.
Poppers and Viagra, when used together, create
a potentially lethal combination that could
lead to heart failure, says Dr. Lee Golusinski,
a gay Atlanta doctor.
More than half of the circuit partiers used
four or more drugs during the course of the
weekend, according to the study, which concluded
that the use of the drugs increased the likelihood
of “high-risk behavior,” such as
unprotected anal sex.
The study points a finger at Viagra for the
increase.
“It is specifically associated with high-risk
sexual behavior,” according to the authors
of the study.
The study’s authors offered two explanations
for why Viagra was being taken: HIV-positive
men took erectile dysfunction drugs to combat
impotence caused by their medications or study
participants took Viagra to enable sex while
on party drugs.
The combination of party drugs and impotence
pills makes sense, Golusinski says.
“We’ve got one drug that makes
you want sex and the other gives you the ability
to have it,” Golusinski says.
But doctors cannot name Viagra as the problem
itself, says Dr. Jason Schneider, who serves
on the board of directors of the Gay & Lesbian
Medical Association.
“It depends on the individual person
and the setting in which it is used,”
Schneider says. “If you have a same-sex
couple who has been together 30 or 40 years,
then no, they won’t be at higher risk.
But contrast that with a single guy at a circuit
party using crystal meth. He is at a higher
risk. It’s not because of Viagra, but
of other drugs he’s doing and the setting
he’s in.”
Feds ‘drag their feet’
Advertisements and consumer information put
out by the makers of Cialis, Levitra and Viagra
warn prospective users that the pills don’t
provide protection from sexually transmitted
diseases.
Officials with Eli Lilly & Company, which
manufactures Cialis, and Bayer Pharmaceuticals
and GlaxoSmithKline, which produces Levitra,
maintain their literature includes warnings
against using the drugs for other than their
prescribed purposes. Disclaimers also say the
drugs do provide protection against HIV and
other STDs.
“It would be very clear to consumers
what this product is for and to help avoid any
confusion they include HIV/STD information,”
says Carol Copeland, communication specialist
for Levitra.
Pfizer, which manufactures Viagra, did not
respond to repeated inquiries. But the company
has long warned against the use of the drug
for nonapproved purposes, and has educated doctors
about the dangers of combining it with both
legal and illegal nitrates.
But the FDA should step in and require the
companies to do more, according to Dr. Jeff
Klausner, director of the STD/HIV prevention
unit of the San Francisco Department of Public
Health. Warnings on the drugs should also make
it clear that it may increase the chance of
contracting STDs, he says.
“The FDA has been dragging its feet on
this issue,” Klausner says. “They
have not moved on the issue and it is completely
in their authority and responsibility to make
physicians and users of their product aware.”
In 2002, the San Francisco Department of Public
Health asked the FDA to place a more thorough
warning on Viagra to make it clear that sexual
risks are associated with the drug, Klausner
says.
According to a July 2002 study in AIDS, Viagra
users reported greater numbers of recent sex
partners, higher levels of unprotected anal
sex with an HIV-positive partner and higher
rates of STDs than non-users.
But the FDA did not follow the recommendation,
according to an FDA spokesperson.
With the launch of Levitra and Cialis late
last year, the number of new users of erectile
dysfunction drugs increased, according to data
from NDCHealth, which tracks the numbers of
new and refilled prescriptions in pharmacies
across the country.
Of the three pills, Cialis remains in a user’s
system the longest — up to 36 hours —
making it the perfect pill for impotent men
to take on a Friday afternoon so they can remain
sexually active for most of the weekend, Golusinski
says.
source:-http://www.southernvoice.com
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