The use of Viagra by gay menFindings from the QUICKIE project for HIV educators and other health professionals
may be highly valued because it protects men against the feelings of inadequacy
interviewed in 2007 and 2008 about a range
anxieties of performing sexually on demand.
of topics, including their use of licit and
Participants appeared to describe an erectile
illicit substances. During analysis of men’s
imperative—that they should be able to
sexual activity, it was noted that a number
required—and Viagra provided them with a
of men described using Viagra to maintain
condom use and/or counteract the adverse effects of illicit drugs on erectile function.
Viagra and similar drugs were also valued
for their ability to support condom use.
had been prescribed Viagra to treat erectile
using Viagra or similar drugs were therefore
‘recreational’ or non-prescribed use.
such as losing their erection when putting on a condom, reduction in sensitivity and
problems in maintaining an erection when wearing a condom. These problems may be
The majority of accounts of Viagra use by
participants were overwhelmingly positive.
are seldom acknowledged. Viagra therefore
In particular, men emphasised how useful
appeared to offer prophylactic certainty—the
it was in compensating for difficulties in
ability to sustain an erection when using a
condom—and therefore the ability to sustain
‘[Y]ou’re having to roll that bloody thing [condom] on, and a lot of times you
can’t stay hard by the time you’ve done
flaccidity associated with the use of alcohol
‘I think it [Viagra] means you can have sex
‘I think the use of Viagra and those sort
for much longer … very useful for safe
sex. You don’t have concern that you are
common than it used to be … and I think
not going to be able to keep the erection.’
there’s an acceptance also of using it in
terms of drugs, that in the past the drugs
Viagra was valued by these men because it
appeared to guarantee erectile performance
you don’t need to worry about it, just take
and because they felt it made it easier to
use condoms. For gay men, like heterosexual
men, the guarantee of erectile performance
National Centre in HIV Social Research, The University of New South Wales, 2009
Barclay suggests that it has become accepted to use
• Gay men’s descriptions of why they use Viagra reveal
Viagra to offset the erectile problems associated with
common problems with using condoms that may
illicit drugs. There is a neat, pharmaceutical logic to
this type of account: Why not take a drug like Viagra
• Gay men may be motivated to use Viagra to sustain
to solve the erectile problems caused by other drugs?
condom use but the situations under which Viagra
This makes perfect sense in a culture where drugs are
is used (e.g. when intoxicated or using illicit drugs)
increasingly seen as the ‘natural’ solution to diverse
may be less than ideal for making clear decisions
problems. However, others acknowledged that the
circumstances under which Viagra is used by gay men are not always ideal for making decisions about safe sex:
• Viagra is seen by some gay men as a simple,
pharmaceutical solution to the challenge of
‘[Y]ou take a Viagra, you are hard enough to fuck
sustaining condom use but it may in fact make
with a condom, there is not that temptation of
decisions about safe sex more complicated.
wanting to not have a condom, and you add drugs on top of that, and amphetamines are notorious for
• Gay men appear poorly informed about Viagra’s
killing erections, and plus your judgment becomes
potential side effects, contraindications and ability to
clouded on drugs, so you are now hard enough to
fuck, but you are not going to be tempted to do it without a condom …’
The Qualitative Interviews Concerning Key
Ben acknowledges that being able to have penetrative
Issues and Experiences (QUICKIE) project
sex while intoxicated (a situation enabled by Viagra) is
was a qualitative study that investigated key
a condition in which one’s ability to assess the safety
aspects of gay men’s lives in Sydney, including
or risk of that situation could be impaired and that, for
sex, relationships, community engagement and
various reasons including difficulties with condoms, men
HIV. The project provided a way to contextualise
may be ‘tempted’ to have unprotected sex. Rather than
issues identified in behavioural research and to
providing a neat, pharmaceutical solution, Viagra may
identify emergent issues of relevance to gay men.
in fact complicate the decisions gay men have to make
Participants were sexually active HIV-negative and
about sexual safety, or risk, by extending the period of
HIV-positive gay men living in Sydney, New South
time they can engage in penetrative sex, particularly
Wales. Thirty-one men aged between 20 and 71
when they use stamina-enhancing illicit drugs.
were interviewed in 2007 and 29 men aged between 21 and 73 took part in 2008. Twenty-four of the
men interviewed in 2007 were also interviewed in 2008. Sexual activity, condom use, safe-sex practice
• Gay men value Viagra because it appears to
and the use of licit and illicit substances were
guarantee erectile performance, assists in
topics covered in both years. All names attributed
maintaining condom use and offsets erectile
problems caused by alcohol and illicit drugs.
Thanks to all the men who participated in the study, the QUICKIE project reference group and NSW Health for For further information about the QUICKIE project, providing funding. The National Centre in HIV Social
contact Dr Martin Holt at the National Centre in HIV
Research receives core funding from the Australian
Social Research, The University of New South Wales
Government Department of Health and Ageing.
TMT Handbook: guidelines for treatment and long-term follow up of people exposed to radiation after a malevolent act Maria del Rosario Pérez*1, Zhanat Carr1, Makoto Akashi2, Robert N. Gent3, Patrick Gourmelon4, Siegfried Joussineau5, Volker List6, David Lloyd3, Nelson Valverde7, Albert Wiley8, Carlos Rojas-Palma9, Phil Kruse10 George Etherington3,Tua Rahola11, Maarit Muikku11, Astrid Li