Erectile dysfunction (ED) medications known as Phosphodiesterase type 5 (PDE-5) inhibitors have been used by millions of men as safe and effective management options associated with high rates of patient and partner satisfaction. Recent reports have appeared, however, that some individuals have misused this class of drug, combining them with narcotics such as methamphetamines. These reports further note that such individuals may be, in particular, at an increased risk for HIV. If such claims of a large and expanding use of PDE-5 inhibitors are correct, this would signify an important public health concern.

A comprehensive, multi-disciplinary conference funded by the National Institutes of Health sought to determine whether the drug class of PDE-5 inhibitors was contributing to an overall increase in HIV infection. The results of this conference appear in the latest issue of The Journal of Sexual Medicine.

Convincing evidence was not found to support the conclusion that PDE-5 inhibitor use is a risk factor for HIV infection. For the large majority of men, PDE-5 inhibitor use is conducted in a stable, committed partner relationship. Under such circumstances, the risk of HIV infection is relatively small. Clinicians and educators did emphasize, however, the importance of safe sex practices for those engaging in risky sexual relations.

“It’s impressive how responsible most men are who use ED drugs, and the benefits they and their partners achieve with them, but there is a potential for abuse that needs to be recognized,” says Raymond C. Rosen, PhD, lead author of the report. “I would not like to see Viagra, Cialis or Levitra being used as performance enhancement drugs—that’s not why these drugs were approved or why physicians prescribe them.”

Irwin Goldstein, Editor-in-Chief of The Journal of Sexual Medicine , noted that this paper is especially important to the field. “Health care providers should be reminded that individuals infected with HIV frequently have ED from their disease or from pharmacologic agents commonly used in its treatment. Positive clinical benefits have been reported in the HIV population when using PDE-5 inhibitor drugs as indicated.”