POVEZANOST UPOTREBE LEKOVA ZA EREKTILNU DIFUNKCIJU SA SEKSUALNIM  PONAŠANJEM I POLNO PRENOSIVIM INFEKCIJAMA KOD MUŠKARACA KOJI IMAJU  SEKSUALNE ODNOSE SA MUŠKARCIMA U BEOGRADU

Milan Bjekić; Dubravka  Salemović; Hristina Vlajinac; Jelena Marinković

doi:10.5937/zdravzast52-44488

Milan Bjekić Gradski zavod za kožne i veneričnebolesti, Beograd, Republika Srbija
Dubravka Salemović Klinika za infektivne i tropskebolesti, Klinički centar Srbije, Beograd, Republika Srbija
Hristina Vlajinac Institut za epidemiologiju, Medicinski fakultet Univerzitet u Beogradu, Beograd, Republika Srbija
Jelena Marinković Institut za statistiku i informatiku, Medicinski fakultet, Univerzitet u Beogradu, Republika Srbija

DOI: https://doi.org/10.5937/zdravzast52-44488

Ključne reči: lekovi, erektilna disfunkcija, muškarci koji imaju seksualne odnose sa muškarcima, seksualno ponašanje, polno prenosive infekcije

Sažetak

Uvod/Cilj: Lekovi za erektilnu disfunkciju (ED) se sve više koriste u rekreativne svrhe i poboljšanje seksualnih performansi. Oralni inhibitori fosfodiesteraze 5 su najpopularniji tip lekova za ED među muškarcima koji imaju seksualne odnose sa muškarcima (MSM). Cilj ovog istraživanja bio je da se proceni prevalencija upotrebe lekova za ED među MSM populacijom u Beogradu i njena povezanost sa njihovim ponašanjem i polno prenosivim infekcijama.

Metod: Studija preseka je sprovedena u dve zdravstvene ustanove u Beogradu i obuhvatila je 469 MSM osoba. Anonimnim upitnikom prikupljeni su od svih ispitanika podaci o demografskim karakteristikama, seksualnom ponašanju i polno prenosivim infekcijama, upotrebi lekova za ED i drugih rekreativnih droga u prethodnih šest meseci.

Rezultati: Od svih 469 ispitanika 16,2% je koristilo lekove za ED. Prema rezultatima multivarijantne logističke regresione analize ispitanici koji su koristili lekove za ED u odnosu na one koji ih nisu koristili bili su stariji (Unakrsni odnos -UO=2,60, 95% Interval poverenja – 95%IP 2,77–3,84, p<0,001), imali su veći broj seksualnih partnera u poslednjih šest meseci (UO=1,83; 95%IP 1,53–2,18; p<0,001), češće su upotrebljavali marihuanu (UO= 2,55; 95%IP 1,31–4,93; p=0,006) i praktikovali hemseks (seksualni odnos pod uticajem droga koje olakšavaju i poboljšavaju seks) tokom poslednjih šest meseci (UO=3,33; 95%IP 1,69–6,67; p<0,001).

Zaključak: Upotreba lekova za ED među MSM populacijom udružena je sa većim stepenom upotrebe rekreativnih droga i visokorizičnim seksualnim ponašanjem. Neophodne su edukativne poruke o rizicima i posledicama upotrebe lekova za ED.

Reference

1. Bechara A, Casaba A, De Bonis W, Helien A, Bertolino MV. Recreative use of phosphodiesterase type 5 inhibitors by healthy young men. J Sex Med 2010; 7(11): 3736-3742. doi: 10.1111/j.1743-6109.2010.01965.x.

2. Park JW, Dobs AS, Ho KS, Palella FJ, Seaberg EC, Weiss RE, et al. Characteristics and longitudinal patterns of erectile dysfunction drug use among men who have sex with men in the U.S. Arch Sex Behav 2021; 50(7): 2887-2896. doi: 10.1007/s10508-021-02065-x.

3. Romero-Velez G, Lisker-Cervantes A, Villeda-Sandoval CI, Sotomayor de Zavaleta M, Olvera-Posada D, Sierra-Madero JG, et al. Erectile dysfunction among HIV patients undergoing highly active antiretroviral therapy: Dyslipidemia as a main risk factor. Sex Med 2014; 2(1):24-30. doi:10.1002/sm2.25.

4. Hammoud MA, Jin F, Lea T, Maher L, Grierson J, Prestage G. Off-label use of phosphodiesterase type 5 inhibitor Erectile Dysfunction Medication to Enhance Sex among Gay and Bisexual Men in Australia: results from the FLUX Study. J Sex Med. 2017;14(6):774-84. doi: 10.1016/j.jsxm.2017.04.670.

5. Halkitis PN, Green KA. Sildenafil (Viagra) and club drug use in gay and bisexual men: The role of drug combinations and context. Am J Mens Health 2007, 1(2), 139-147. doi: 10.1177/1557988307300450.

6. Swearingen SG, Klausner JD. Sildenafil use, sexual risk behavior, and risk for sexually transmitted diseases, including HIV infection. Am J Med 2005, 118(6), 571-577.doi: 10.1016/j.amjmed.2005.01.042.

7. Fisher DG, Reynolds GL, Ware MR, Napper LE. Methamphetamine and Viagra use: Relationship to sexual risk behavior. Arch Sex Behav 2011;40(2):273-9. doi: 10.1007/s10508-009-9495-5.

8. Goltz HH, Coon DW, Catania JA, Latini DM. A pilot study of HIV/STI risk among men having sex with men using erectile dysfunction medications: Challenges and opportunities for sexual medicine physicians. J Sex Med 2012;9(12):3189-97. doi: 10.1111/j.1743-6109.2012.02943.x.

9. Ishikura F, Beppu S, Hamada T, Khandheria BK, Seward JB, Nehra A. Effects of sildenafil citrate (Viagra) combined with nitrate on the heart. Circulation. 2000; 102(20):2516-2521.doi 10.1161/01.cir.102.20.2516.

10. Babor T, Higgins-Biddle JC, Sounders JB, Monteiro MG. The alcohol use disorder identification test. Guidelines for use in primary care. Department of Mental Health and Substance Dependence, World Health Organization, 2001.

11. Prestage G, Jin FY, Bavinton B, Grulich A, Brown G, Pitts M, et al. Australian gay and bisexual men’s use of erectile dysfunction medications during recent sexual encounters. J Sex Med 2014;11(3):809-819. doi: 10.1111/jsm.12407.

12. Chu PL, McFarland W, Gibson S, Weide D, Henne J, Miller P, et al. Viagra use in a community-recruited sample of men who have sex with men, San Francisco. J AcquirImmune DeficSyndr 2003;33(2):191-3.doi: 10.1097/00126334-200306010-00012.

13. Kim A, Kent C, Klausner J. Increased risk of HIV and sexually transmitted disease transmission among gay or bisexual men who use Viagra, San Francisco 2000–2001. AIDS 2002; 16(10):142-158. doi: 10.1097/00002030-200207050-00017.

14. Paul JP, Pollack L, Osmond D, Catania J. Viagra (Sildenafil) use in a population-based sample of U. S. men who have sex with men. Sex Transm Dis 2005; 32(9): 531-533.doi: 10.1097/01.olq.0000175294.76494.77.

15. Bjekić M, Šipetić-Grujičić S, Begović-Vuksanović B, Rafailović N, Vlajinac H. Syphilis resurgence in Belgrade, Serbia in the new millennium: an outbreak in 2014. Centr Eur J Public Health. 2017; 25(4): 277-81.doi: 10.21101/cejph.a4525.

16. Prestage GP, Grierson J, Bradley J, Hurley M, Hudson J. The role of drugs during group sex among gay men in Australia. Sex Health 2009;6(4):310-317. doi: 10.1071/SH09014.

17. Tomkins A, George R, KlinerM. Sexualized drug taking among men who have sex with men: a systematic review. Perspect Public Health 2019; 139(1): 23-33. doi: 10.1177/1757913918778872.

18. McCarty-Caplan D, Jantz I, Swartz J. MSM and drug use a latent class analysis of drug use and related sexual risk behaviors. Aids Behav2014; 18(7): 1339-1351. doi: 10.1007/s10461-013-0622-x.

19. Fisher DG, Reynolds GL, Ware MR, Napper LE. Methamphetamine and Viagra use: Relationship to sexual risk behaviors. Arch Sex Behavior 2011; 40(2): 27-–279. doi: 10.1007/s10508-009-9495-5.

20. Crosby R, DiClemente RJ. Use of recreational Viagra among men having sex with men. Sex Transm Infect 2004; 80(6): 466-468. doi: 10.1136/sti.2004.010496.

21. European Monitoring Centre for Drugs and Drug Addiction. Serbia, National Drug Report 2017, Publications Office of the European Union, Luxembourg, 2017.