Drugs for erectile dysfunction (ED) have become commonly used among middle-aged and older men. This population may be less inclined to consider the need for safe sex practices than younger men. A retrospective cohort study using insurance records from 1997-2006, investigated the relationship between ED drug prescriptions and diagnosis of sexually transmitted diseases (STDs) in 1,410,806 men > 40 years old. ED drugs were used by 2.4%. The annual rate of STDs per 1,000 men was 1.05 for ED drug users compared to 0.65 for nonusers during the first year after starting drug therapy (p = 0.004) (level 2 [mid-level] evidence). The largest differences were in the rates of HIV infection and chlamydia. Rates of STDs were also significantly higher in the ED drug group during the year prior to starting the drugs, suggesting that the increase in STD rates might reflect lifestyle differences in those seeking the drugs rather than an effect of the drugs themselves. Based on these findings, the authors suggest providing advice about safe sex practices and STD screening when prescribing ED drugs (Ann Intern Med 2010 Jul 6;153(1):1).
