title: Motivations for the recreational use of erectile enhancing medications in urban gay and bisexual men.
abstract: OBJECTIVE
  Recreational erectile enhancing medication (EEM) use has been associated with a number of health risk behaviours among gay and bisexual men. This study aims to extend previous findings about the associations between recent EEM use and illegal drug use, incident sexually transmitted infections (STIs) and unprotected sex, as well as to report on motivations for EEM use.
  
  
  METHODS
  A cross-sectional, street-intercept survey method was used to collect data from 912 gay/bisexual men at two large lesbian, gay and bisexual community events in New York City in 2006.
  
  
  RESULTS
  Lifetime EEM use was reported by 28.0% of the men; 17.4% used EEM in the past 3 months. EEM users were more likely to be white and HIV positive. EEM users were more likely to engage in unprotected anal insertive sex with seroconcordant and serodiscordant partners. EEM users who were HIV negative were more likely to report using alcohol and other drugs before and during sex, especially crystal methamphetamine (AOR 18.66; 95% CI 6.82 to 51.02) as well as to endorse incident STIs. The most frequent responses for EEM use were to "add to the fun", "maintain an erection while using a condom" and "to have sex for hours". Men with HIV were 2.93 times (95% CI 1.24 to 6.88) more likely to endorse using EEMs to bareback.
  
  
  CONCLUSIONS
  Gay and bisexual men use EEMs to enhance their sexual experiences among other motives. Different motives and correlates emerged by HIV status. Overall, EEM use was correlated with multiple health risk behaviours. EEM users who were HIV negative appear to be at particularly high risk of acquiring HIV.
authors.affiliation: Center for HIV/AIDS Educational Studies and Training, Hunter College & The Graduate Center, City University of New York, 250 West 26th Street, Suite 300, New York, NY 10001, USA.
authors.forename: D W
authors.initials: DW
authors.lastname: Pantalone
authors.forename: D S
authors.initials: DS
authors.lastname: Bimbi
authors.forename: J T
authors.initials: JT
authors.lastname: Parsons
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001727:Bisexuality / Q000523:psychology*; D003430:Cross-Sectional Studies; D018451:Homosexuality, Male / Q000523:psychology*; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010410:Penile Erection / Q000187:drug effects*; D019966:Substance-Related Disorders / Q000523:psychology*; D047568:Unsafe Sex / Q000523:psychology; D014504:Urban Health; D055815:Young Adult
chemical_list: D013287:Illicit Drugs