title: Use of crystal methamphetamine, Viagra, and sexual behavior.
abstract: OBJECTIVE
  Methamphetamine (meth) use has been shown in the literature to be associated with high-risk sexual behavior for both homosexual (MSM) and heterosexual samples for over a decade. The use of Viagra has also been shown to be associated with high-risk sexual behavior. The purpose of this review is to update the record on Viagra and on the combination of Viagra and meth use.
  
  
  RESULTS
  There is now strong evidence that the use of Viagra is associated with HIV seroconversion in MSM. The combination of taking both meth and Viagra is strongly associated with much higher sexually transmitted disease and HIV rates. There is some evidence that Viagra is associated with insertive and meth is associated with receptive anal intercourse by men.
  
  
  CONCLUSIONS
  The evidence is strong to support the relationship between Viagra use and HIV seroconversion now that more sophisticated analyses have been done. The meth-Viagra recreational drug combination is of very high risk. More research is needed to generate longitudinal and event-level data that are necessary to answer fine-grained questions about drug combinations and the relationship with sexual behavior.
authors.affiliation: California State University, Long Beach, California, USA. dfisher@csulb.edu
authors.forename: Dennis G
authors.initials: DG
authors.lastname: Fisher
authors.forename: Grace L
authors.initials: GL
authors.lastname: Reynolds
authors.forename: Lucy E
authors.initials: LE
authors.lastname: Napper
mesh_terms: D015658:HIV Infections / Q000635:transmission*; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008694:Methamphetamine; D010879:Piperazines; D011687:Purines; D012309:Risk-Taking; D012725:Sexual Behavior / Q000187:drug effects* / Q000523:psychology; D012749:Sexually Transmitted Diseases / Q000635:transmission*; D000068677:Sildenafil Citrate; D013450:Sulfones
chemical_list: D010879:Piperazines; D011687:Purines; D013450:Sulfones; D008694:Methamphetamine; D000068677:Sildenafil Citrate