Raymond C Rosen1, Joseph A Catania2, Anke A Ehrhardt3, Arthur L Burnett4, Tom F Lue5, Kevin McKenna6, Julia R Heiman7, Sandy Schwarcz8, David G Ostrow9, Sabina Hirshfield10, David W Purcell11, William A Fisher12, Ron Stall13, Perry N Halkitis14, David M Latini15, Jonathan Elford16, Edward O Laumann17, Freya L Sonenstein18, David J Greenblatt19, Robert A Kloner20, Jay Lee21, David Malebranche22, Erick Janssen7, Rafael Diaz23, Jeffrey D Klausner24, Arthur L Caplan25, Graham Jackson26, Ridwan Shabsigh27, Jag H Khalsa28, David M Stoff29. 1. Department of Psychiatry, Robert Wood Johnson Medical School, Piscataway, NJ, and New England Research Institutes, Watertown, MA. Electronic address: rrosen@neriscience.com. 2. Center for AIDS Prevention Studies, Department of Medicine, San Francisco, CA. 3. HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, New York, NY. 4. Department of Urology, The Johns Hopkins Hospital, Baltimore, MD. 5. Department of Urology, University of California, San Francisco, CA. 6. Departments of Physiology and Urology, Northwestern University Medical School, Chicago, IL. 7. Kinsey Institute for Research in Sex, Gender and Reproduction, Indiana University, Bloomington, IN. 8. HIV/AIDS Statistics and Epidemiology, San Francisco Public Health Department, San Francisco, CA. 9. David Ostrow & Associates, Lakewood, IL. 10. Medical and Health Research Association, New York, NY. 11. Prevention Research Branch, Division of HIV/AIDS Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. 12. Departments of Psychology and Obstetrics and Gynecology, University of Western Ontario, London, Ontario, Canada. 13. Department of Behavioral and Community Health Sciences, University of Pittsburgh, Pittsburgh, PA. 14. Center for Health, Identity, Behavior and Prevention Studies (CHIBPS), New York University, New York, NY. 15. Scott Department of Urology, Baylor College of Medicine, Houston, TX, USA. 16. City University, Institute of Health Sciences, UK. 17. Department of Sociology, University of Chicago, Chicago, IL. 18. Center for Adolescent Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 19. Department of Pharmacology & Experimental Therapeutics, Tufts University, Boston, MA. 20. Keck School of Medicine, University of Southern California, Los Angeles, CA, USA. 21. Private Practice, Calgary Alberta, Canada. 22. Department of Medicine, Emory University, Atlanta, GA. 23. Cesar Chavez Institute, San Francisco State University, San Francisco, CA. 24. STD Prevention and Control Services, San Francisco Department of Public Health, San Francisco, CA. 25. Center for Bioethics, University of Pennsylvania, Philadelphia, PA, USA. 26. Saint Thomas Hospital, London, UK. 27. Department of Urology, Columbia Presbyterian Medical Center, Columbia University, New York, NY. 28. Medical Consequences Branch, National Institute on Drug Abuse, Bethesda, MD. 29. Center for Mental Health Research on AIDS, National Institute of Mental Health, Bethesda, MD, USA.
Abstract
INTRODUCTION: Recent reports have linked the use of phosphodiesterase type 5 (PDE-5) inhibitors with increased rates of high-risk sexual behavior and HIV transmission in some individuals. AIM: A National Institute of Mental Health (NIMH)-funded, multidisciplinary conference was convened to evaluate scientific research, clinical and ethical considerations, and public policy implications of this topic. MAIN OUTCOME MEASURES: Published and unpublished findings on effects of PDE-5 inhibitors on sexual behavior; published guidelines and management recommendations. METHODS: Leading investigators in relevant disciplines (e.g., public health, epidemiology, medical ethics, urology, psychology) participated in a 2-day meeting, including representatives of government, scientific, and regulatory agencies (the Centers for Disease Control, Food and Drug Administration, NIMH, and the National Institute on Drug Abuse). Panelists provided critical reviews of substantive areas of research, followed by question and answer sessions on each topic. On the second day, working groups were convened to identify critical gaps and priorities in three major areas: (i) research and evaluation needs; (ii) prevention strategies and clinical management issues; and (iii) policy and prevention implications. RESULTS: Research needs and priorities were categorized into four specific areas: (i) basic and clinical/laboratory research; (ii) epidemiology and risk factors; (iii) social-behavioral processes and interventions; and (iv) prevention/policy and educational needs. Identified gaps in the available data include populations at risk (e.g., risk among heterosexuals, risk profiles among subpopulations of men who have sex with men) and the specific role of PDE-5 inhibitors in HIV seroconversion. Specific areas of emphasis were the need for safer sex counseling, comprehensive sexually transmitted infection (STI) screening and follow-up when indicated, avoidance of potentially dangerous drug interactions, and potential benefits of testosterone replacement for HIV-positive men with decreased androgen and other symptoms of hypogonadism. Conclusions. A conference was convened on the topic of PDE-5 inhibition and HIV risk. This "white paper" summarizes the findings of the conference and recommendations for future research.
INTRODUCTION: Recent reports have linked the use of phosphodiesterase type 5 (PDE-5) inhibitors with increased rates of high-risk sexual behavior and HIV transmission in some individuals. AIM: A National Institute of Mental Health (NIMH)-funded, multidisciplinary conference was convened to evaluate scientific research, clinical and ethical considerations, and public policy implications of this topic. MAIN OUTCOME MEASURES: Published and unpublished findings on effects of PDE-5 inhibitors on sexual behavior; published guidelines and management recommendations. METHODS: Leading investigators in relevant disciplines (e.g., public health, epidemiology, medical ethics, urology, psychology) participated in a 2-day meeting, including representatives of government, scientific, and regulatory agencies (the Centers for Disease Control, Food and Drug Administration, NIMH, and the National Institute on Drug Abuse). Panelists provided critical reviews of substantive areas of research, followed by question and answer sessions on each topic. On the second day, working groups were convened to identify critical gaps and priorities in three major areas: (i) research and evaluation needs; (ii) prevention strategies and clinical management issues; and (iii) policy and prevention implications. RESULTS: Research needs and priorities were categorized into four specific areas: (i) basic and clinical/laboratory research; (ii) epidemiology and risk factors; (iii) social-behavioral processes and interventions; and (iv) prevention/policy and educational needs. Identified gaps in the available data include populations at risk (e.g., risk among heterosexuals, risk profiles among subpopulations of men who have sex with men) and the specific role of PDE-5 inhibitors in HIV seroconversion. Specific areas of emphasis were the need for safer sex counseling, comprehensive sexually transmitted infection (STI) screening and follow-up when indicated, avoidance of potentially dangerous drug interactions, and potential benefits of testosterone replacement for HIV-positive men with decreased androgen and other symptoms of hypogonadism. Conclusions. A conference was convened on the topic of PDE-5 inhibition and HIV risk. This "white paper" summarizes the findings of the conference and recommendations for future research.
Authors: Sande Gracia Jones; Carol A Pat Patsdaughter; Vicente Manuel Martinez Cardenas Journal: J Assoc Nurses AIDS Care Date: 2011-01-08 Impact factor: 1.354
Authors: Sabina Hirshfield; Eric W Schrimshaw; Ronald D Stall; Andrew D Margolis; Martin J Downing; Mary Ann Chiasson Journal: Am J Public Health Date: 2015-02-25 Impact factor: 9.308