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Background: Erectile dysfunction (ED) remains an important aspect of medical care, with up to 20-50% of adult men affected. The FDA approved sildenafil in 1998 providing a non-invasive, effective therapy for ED, which quickly became widely used. This has led to concerns of possible increased sexual risk taking and sexually transmitted infections (STIs).
Objectives: We evaluated sexual history taking and STI screening in a population of Veterans receiving an initial ED medication prescription in an outpatient setting.
Methods: Utilizing a standardized data extraction tool, charts of patients were reviewed. Patient and clinic demographics were determined, along with rates of sexual history taking and STI screening and diagnoses.
Results: 252 patients who received initial ED therapy from October 1st-December 31st, 2009 were identified and included in the analysis. Overall, approximately 3% of patients were asked any aspect of a sexual history in the 24 months surrounding initial ED medication prescription. STI screening was 9.9% for syphilis, 4.8% for HIV, and 4.3% for gonorrhea/chlamydia prior to prescription, with only a slight increase in HIV screening after. Four incident STIs were found; however, two represented diagnosis rather than from screening.
Conclusions: Little sexual history taking and STI screening were identified in a cohort of Veterans during the 24 months surrounding a new ED medication prescription. Only four incident STIs were found.
Implications for Programs, Policy, and Research: Determining provider and patient barriers to discussion of sexual health, as well as STI screening, in patients seeking treatment for ED is a research priority.