Physicians who prescribe erectile dysfunction drugs for their male patients should be sure to discuss the importance of safer sex practices, even with older patients: that is an important implication of a report in the July 6 issue of Annals of Internal Medicine. The analysis of insurance records of more than 1.4 million U.S. men over 40 found that those who used ED drugs were more likely to have sexually transmitted diseases than were non-users.
"Anyone who does not practice safer sex, no matter their age, can contract an STD," says Anupam B. Jena, MD, PhD, of the Massachusetts General Hospital (MGH) Department of Medicine, the study's lead author. "Even though STDs are quite rare among older men – on the order of 1 per 1,000 individuals – we found that STD rates in men who used ED drugs were two to three times higher, both before and after they filled their first prescription."
Jena and his co-authors note that ED drugs have become popular since sildenafil (Viagra) was first introduced in 1998. As early as 2002 it was estimated that up to 20 percent of U.S. men over 40 had tried an ED drug. Studies have shown both that rates of STDs, including HIV/AIDS, are rising in older individuals as well as the general public and that people over 50 are much less likely than those in their 20s to use condoms during sex or be tested for HIV infection. A survey of primary care physicians found that they rarely if ever discussed reducing sexual risk factors with middle aged or older patients.
Small studies of men who have sex with men had associated the use of ED drugs with higher-risk behaviors and increased rates of STDs. But no previous study had examined the relationship between ED drugs and STD risk in a large, representative sample of privately insured older men. For the current study, the researchers examined health insurance claims records covering 1997 though 2006 from 44 large U.S. employers. For male beneficiaries over 40 who used ED drugs, the researchers collected data covering one year before and one year after the first prescription was filled. Each ED drug user was matched with five non-users randomly selected from the database, for whom claims data covering the same two-year periods was collected.
The final study group included about 40,000 men who used ED drugs and nearly 1.37 million who did not. In both the year before and the year after the first ED drug prescription, users had significantly higher rates of STDs than non-users did in matching time periods. HIV/AIDS was the most frequently reported STD in both groups, followed by chlamydia. Since the prevalence of STDs did not markedly change after ED drug therapy began, the authors note that the difference between groups probably reflects higher-risk sexual practices among users of the drugs. The data gathered could not indicate whether ED drug use itself increased STD risk, but the authors are investigating that question in a further study.
"Health care providers need to recognize that their older adult patients who are on ED drugs are already at a higher risk of having or acquiring an STD," says Dana Goldman, PhD, director of the Schaeffer Center for Health Policy and Economics at the University of Southern California (USC), the study's senior author. "Both the physicians who prescribe these drugs and the pharmacists who fill those prescriptions should counsel all patients on the importance of safer sexual practices."
Co-authors of the Annals of Internal Medicine report are Amee Kamdar, PhD, University of Chicago; Darius Lakdawalla, PhD, Schaeffer Center at USC; and Yang Lu, PhD, RAND Corporation. The study was supported by grants from the RAND Roybal Center for Health Policy Simulation, the National Institutes of Health, the Agency for Healthcare Research and Quality, and the Bing Center for Health Economics.
Massachusetts General Hospital
Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of more than $600 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, systems biology, transplantation biology and photomedicine.
Schaeffer Center for Health Policy and Economics
The Schaeffer Center at the University of Southern California is distinguished by a staff strategically recruited for its research and policy expertise. The center uses a novel, interdisciplinary approach to advance economic, health services and policy research and to train a new generation of global health policy leaders. Currently, the center conducts research and policy analysis to support evidence-based health care reform. Studies underway focus on critical health policy issues related to health care spending and value, the impacts of public policy on pharmaceutical innovation, insurance design, the macroeconomic consequences of US health care costs and comparative effectiveness and outcomes research.
Sue McGreevey | EurekAlert!
Multi-year study finds 'hotspots' of ammonia over world's major agricultural areas
17.03.2017 | University of Maryland
Diabetes Drug May Improve Bone Fat-induced Defects of Fracture Healing
17.03.2017 | Deutsches Institut für Ernährungsforschung Potsdam-Rehbrücke
Astronomers from Bonn and Tautenburg in Thuringia (Germany) used the 100-m radio telescope at Effelsberg to observe several galaxy clusters. At the edges of these large accumulations of dark matter, stellar systems (galaxies), hot gas, and charged particles, they found magnetic fields that are exceptionally ordered over distances of many million light years. This makes them the most extended magnetic fields in the universe known so far.
The results will be published on March 22 in the journal „Astronomy & Astrophysics“.
Galaxy clusters are the largest gravitationally bound structures in the universe. With a typical extent of about 10 million light years, i.e. 100 times the...
Researchers at the Goethe University Frankfurt, together with partners from the University of Tübingen in Germany and Queen Mary University as well as Francis Crick Institute from London (UK) have developed a novel technology to decipher the secret ubiquitin code.
Ubiquitin is a small protein that can be linked to other cellular proteins, thereby controlling and modulating their functions. The attachment occurs in many...
In the eternal search for next generation high-efficiency solar cells and LEDs, scientists at Los Alamos National Laboratory and their partners are creating...
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are less stable. Now researchers at the Technical University of Munich (TUM) have, for the first time ever, produced a composite material combining silicon nanosheets and a polymer that is both UV-resistant and easy to process. This brings the scientists a significant step closer to industrial applications like flexible displays and photosensors.
Silicon nanosheets are thin, two-dimensional layers with exceptional optoelectronic properties very similar to those of graphene. Albeit, the nanosheets are...
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to simulate these confined natural conditions in artificial vesicles for the first time. As reported in the academic journal Small, the results are offering better insight into the development of nanoreactors and artificial organelles.
Enzymes behave differently in a test tube compared with the molecular scrum of a living cell. Chemists from the University of Basel have now been able to...
20.03.2017 | Event News
14.03.2017 | Event News
07.03.2017 | Event News
24.03.2017 | Materials Sciences
24.03.2017 | Physics and Astronomy
24.03.2017 | Physics and Astronomy