Doctors who prescribe drugs for erectile dysfunction should also routinely offer counselling on safe sex, even to older men, advise the authors of a recent US study. In an analysis of health insurance claims for approximately 34 000 men aged over 40 years prescribed drugs for erectile dysfunction, the risk of sexually transmitted disease (STD) was increased threefold compared with controls. This was mainly driven by HIV infection, and also chlamydia. To see if the observed effect could be explained by changes in sexual activity or behaviour after starting the drug, they also assessed STD rates in the preceding year. They found no significant change, with high rates among the users during both time periods, suggesting that the observed increase in STDs was more likely to be due to the types of patients using the erectile dysfunction drugs than a direct effect of the drug’s availability.
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