Because Viagra has the potential to increase friction during sex (due to the increased size of the erection) and to lead to prolonged sex, its recreational use warrants study in the context of STD risk. The researchers conducted an exploratory study to identify bivariate correlates of non-prescription, recreational use of Viagra among men who have sex with men. Subjects were recruited at a popular sex resort for men in the southern United States. Ninety-one percent of 164 men approached completed a self-administered questionnaire that assessed behavior, including use of Viagra, for a three-month recall period.

The average age of subjects was 40. Ninety-three percent self-identified as white. Subjects came from 14 states; most lived in the U.S. South. Median annual income interval of subjects was $25,000-$50,000.

One-sixth (16.7 percent) of subjects reported being HIV-positive. Sixteen percent reported non-prescription Viagra use. Age, income and HIV status were not associated with Viagra use. Thirty-five percent of men recently using ecstasy during sex reported Viagra use, compared to 13 percent of non-ecstasy users. Thirty-seven percent of men recently using cocaine during sex reported Viagra use, compared to 13 percent of non-cocaine users. Recent frequency of unprotected anal sex, fisting, rimming, and having five or more sex partners were not associated with Viagra use. The use of "poppers" approached but stopped short of achieving statistical significance as a correlate of Viagra use.

The researchers found that regardless of age or HIV status, recreational use of Viagra was "relatively common" among the men. "Viagra use was associated with men's substance abuse behaviours rather than their sexual risk behaviours," the authors concluded.

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