Older Viagra patients 'should be given safe sex advice'

3rd February 2012 - Men over 50 who are prescribed erectile dysfunctionmedication should be offered advice on safe sex to curb the growing numbers of older people with sexually transmitted infections (STIs), says an editorial in Student BMJ.

The authors, Rachel von Simson, a final year medical student at King’s College London, and Ranjababu Kulasegaram, consultant genitourinary physician at St Thomas’ Hospital, London, argue that GPs should target older men being prescribed drugs like Viagra because they have a high risk of contracting an STI.

More STIs

A study in 2010 in the Annals of Internal Medicine found that in men with prescriptions for erectile dysfunction medication, sexually transmitted infections were higher during the year before beginning treatment and the year immediately after, compared to men without a prescription.

"I think it is very important that GPs discuss safe sex with men asking for erectile dysfunction drugs," Rachel von Simson tells BootsWebMD. "This is a group that has been shown in the US to be at increased risk both before and after getting these medications and if they are otherwise well, this may be their only contact with health care providers for some time - as men tend to visit their doctors less frequently than women."

She adds: "Patients may be seeking these medications because they are starting a new relationship and it is a good time to bring up safe sex issues."

Doubling of cases

The authors say that in England, between 2000 and 2009, diagnoses of sexually transmitted infections in over 45s doubled, to almost 13,000 cases. Also, a recently published Human Protection Agency report on HIV in the UK showed that 20% of adults accessing HIV care are older than 50, up from 11% in 2001.

Rachel von Simson says the increases cannot be fully explained by the boost in the number of older people in the population. Also, there is no evidence that this generation is more promiscuous than ones in the past.

"Sadly there is very little research in this area and what scant research has been done has only been done because there are more STIs now," she says.

Safe sex

Commenting on the editorial, Natika Halil, director of information at sexual health charity the FPA, said in a statement: "Too many people in that age group coming out of long-term relationships don’t think safer sex applies to them. But the truth is STIs will find you just as attractive whatever your age.

"The message is if you’re starting a new relationship, remember to use a condom and protect yourself."

Jason Warriner, clinical director at Terrence Higgins Trust, says when people seek help for erectile dysfunction GPs and practice nurses should seize the chance to get across a safe sex message.  "If somebody's had problems for a number of years, and are then moving on to something like Viagra, it's an opportunity to include it in the conversation because a person then will become sexually active," he tells us. "So it's about looking after themselves and their sexual partners."