A Doctor Fights for New Warnings on Viagra Labels
March 7, 2003
In his fight against the spread of AIDS, Dr. Jeffrey Klausner, director of the San Francisco Department of Health STD Prevention and Control has taken on some powerful corporate foes. Now he is taking on Pfizer, which sells some $1.7 billion a year of its popular impotence drug, Viagra.Adapted from:
Klausner is demanding that Pfizer change Viagra's label so that it explicitly warns about STDs and promotes the use of condoms. In a flurry of letters to the drug company and the Food and Drug Administration, he has asked that Pfizer be required to send letters to doctors, pharmacists and consumers acknowledging the risk of disease in Viagra users. He also wants Pfizer to rewrite its advertisements to mention those risks and to fund an education campaign tailored to gay men. Both the drug maker and the FDA contend that the current label on Viagra is sufficient. It warns that the drug does not prevent STDs.
Klausner and other public health officials believe that men who take Viagra are especially at risk for STDs because it allows them to have multiple erections, with a minimal recovery period in between. That means that at sex clubs and in party settings, Viagra users can have several sex partners, increasing the possibility that disease will spread. Epidemiologists call this "the multiplier effect." There are other factors at play as well. The street drug crystal methamphetamine is popular in some gay sex clubs. A form of speed, the drug impairs judgment -- and erections. So it is often taken along with Viagra. Under those conditions, safe sex and condoms are sometimes forgotten.
CDC has begun studying Viagra's role in STDs in an effort to help "address possible increased risk of HIV from Viagra use," said Dr. Harold Jaffe, director of CDC's National Center for HIV, STD and TB Prevention. Last month CDC reported that diagnoses of HIV rose 8 percent between 1999 and 2001. Among gay and bisexual men, HIV diagnoses increased 14 percent. Syphilis rates rose in 2001 for the first time since 1990.
Pfizer says it sees no connection between use of Viagra, a prescription drug, and a higher incidence of disease. "We've said this is a product for men with erectile dysfunction, and have opposed recreational use from day one," says Pfizer spokesperson Mariann Caprino. She points out that people who are using Viagra without physician supervision or who are buying it on the Internet or engage in high-risk behavior are not going to read labels or heed warnings. "We don't believe there's credible medical evidence" that Viagra use increases the risk of AIDS infection.
Klausner complains that Pfizer and the FDA's inaction puts the burden of studying and preventing the problem on local health officials. "They're suggesting public health can pick up the pieces," he said.
Wall Street Journal
03.07.03; Marilyn Chase
This article was provided by CDC National Prevention Information Network. It is a part of the publication CDC HIV/Hepatitis/STD/TB Prevention News Update.