Angle of the Dangle - The WSJ, of all places, has a page-one article about the connection between Viagra and sexually transmitted disease for gay men. It focuses on the campaign by Jeffrey Klausner, San Francisco's director of sexually-transmitted-disease prevention. The latest target of Klausner's never-ending campaign is Pfizer, the impotence drug's maker. He is demanding that they change Viagra's label so that it explicitly warns about sexually transmitted disease and promotes the use of condoms. He also wants Pfizer to send letters to doctors, pharmacists and consumers acknowledging the risk of disease in Viagra users, rewrite its advertisements to mention those risks and to fund an education campaign tailored to gay men. So what's the connection? As the Journal puts it,

[Men] who take Viagra are especially at risk for sexually transmitted disease 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.

The paper also mentions that Viagra can greatly increased the duration of sexual experience. "Hours of intercourse [!] can contribute to the transmission of the AIDS virus because the friction can cause micro abrasions." That's about as close as they get to a certain queasy subject of what gay men do in bed, and they complete leavely out an entire other major risk factor. Viagra can turn bottoms into tops -- sort of like anti-poppers. Although it may not be P.C. to say so, bottoming bareback is more dangerous than topping without a condom. The fear is that habitual bottoms, who are more likely to be HIV-positive yet less likely to spread the disease, become infectors when they suddenly take the active role. Any thoughts, Ben?