Sexual Risk Behaviors in Heterosexual Men Age 50 and Older Using Prescribed Erectile Dysfunction Drugs

Tuesday, 14 July 2009

Sande Gracia Jones, PhD, ARNP, ACRN, CS, FAAN1
Carol A. Patsdaughter, PhD, RN, ACRN, CNE1
Robert Malow, PhD2
Vicente Manuel Martinez Cardenas, RN, MSN1
Carlos Pardo, RN, BSN1
Luis Sanchez1
Vanessa Santiago1
1College of Nursing and Health Sciences, Florida International University, Miami, FL
2Stempel School of Public Health, Florida International University, Miami, FL

Learning Objective 1: describe current drug therapy for treatment of erectile dysfunction.

Learning Objective 2: discuss implications of sexual risk behaviors of heterosexual men age 50 and older for HIV prevention education.


Over 100 million men around the world are estimated to use some form of medication for treatment of erectile dysfunction (ED) (Kennard, 2008).  In 1998, the first ED drug, Viagra, received FDA approval; since then, approximately 1 billion Viagra tablets have been dispensed globally (Lyon, 2008).  Use of ED drugs (Viagra, Cialis, Levitra) has been implicated in the spread of HIV, but the 2006 NIH-funded Bolger Conference found no supporting evidence for heterosexual men.  The purpose of this study was to explore sexual risk behaviors of heterosexual men age 50 and older using prescribed ED drugs.


Participants were recruited by physician referral and community-based flyers.  Participants completed a one-time telephone interview and received a $25 gift card in appreciation of their participation.


Participants to date include 50 men who ranged in age from 50 to 78 (M = 61.9, SD = 8.3).  Most (62.%) were Hispanic, and 60.0% were born in the Caribbean or South America.  Eighty four percent reported that they have a spouse or primary partner. Of these men, 31.7% also reported sex outside the relationship within the past 12 months, and 16.7% did not use a condom in these encounters.  Three participants reported having sex with both men and women.  Six men in the sample (12%) reported a history of sexually transmitted disease, and one man (2.4%) reported being HIV-infected.


ED drugs have enabled men to potentially perform sexually throughout their lifespan. However, heterosexual men using ED drugs may inadvertently acquire HIV or STDs during unsafe sexual encounters and then transmit infection to their female primary partner. This new found sexual freedom must be tempered with HIV prevention education to promote responsible sexual behavior. From a global nursing perspective, HIV prevention education should be considered for all sexually active persons.