Health Canada statistics show that about 12 percent of people who tested positive for HIV in the first six months of 2003 were 50 or older. "I have no doubt that Viagra and similar drugs have dramatically changed the sex lives of some older people and that is going to be reflected in higher rates of HIV/AIDS," said Dr. Réjean Thomas, director of Clinique Médicale L'Actuel.

Paul Lapierre, of the Canadian AIDS Society, said the disease's prevalence among older people, younger women, aboriginals and intravenous drug users reflects the growth and complexity of the epidemic. "Clearly, we have to do a better job of targeting our message," he said.

Lapierre said older Canadians with HIV/AIDS are difficult to reach because of taboos about talking about sex, attitudes toward condom use, and reluctance to get tested. Thomas stressed that contrary to popular belief, Viagra and its new competitor, Cialis, are not used solely by older men. The drugs, he said, have become part of the rave scene, and he noted dramatic rises in chlamydia, gonorrhea, syphilis and herpes in recent years at his STD clinic.

Dr. Jeffrey Klausner, head of STD prevention and control for the San Francisco Department of Public Health, published a study, "Increased Risk of HIV and Sexually Transmitted Disease Transmission Among Gay or Bisexual Men Who Use Viagra, San Francisco 2000-2001" in AIDS (2002;16(10):1425-1428), showing that Viagra users had about 35 percent more sexual partners and 35 percent more STDs than non-users. The average age of users was 32.

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