Stimulant-Induced Enhanced Sexual Desire as a Potential Contributing Factor in HIV Transmission

National Institute on Drug Abuse, 6001 Executive Blvd., Rm. 5274, Bethesda, MD 20892, USA.
American Journal of Psychiatry (Impact Factor: 12.3). 02/2007; 164(1):157-60. DOI: 10.1176/appi.ajp.164.1.157
Source: PubMed


Stimulant abuse is associated with an increased risk of contracting human immunodeficiency virus (HIV). Although sharing of contaminated needles is one of the routes by which HIV is spread, noninjection abusers are also at high risk. The authors investigated the effect of the stimulant drug methylphenidate (given intravenously) on sexual desire as a possible contributing factor to risky sexual behavior associated with the contraction of HIV.
The effects of intravenous methylphenidate (0.5 mg/kg) on self-reports of sexual desire (rated from 0-10) were evaluated in 39 comparison subjects and 39 cocaine abusers.
Intravenous methylphenidate significantly increased self-reports of sexual desire in comparison subjects (1.4 versus 3.7) and cocaine abusers (2.8 versus 4.8).
Stimulant-induced enhancement of sexual desire could be one mechanism by which stimulant drugs such as cocaine and methamphetamine increase the risk for HIV transmission even when they are not injected.

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    • "Sexual motivation level predicts greater sexual risk intentions (Ariely and Loewenstein, 2006). In fact, sexual motivation levels predict people's intentions to engage in risky sexual behaviors better than the amount of alcohol consumed in replicated laboratory studies (George et al., 2009; Prause et al., 2011) and has been suggested to be the primary mechanism by which drugs promote sexual risk behaviors (Volkow et al., 2007). "
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    ABSTRACT: Risky sexual behaviors typically occur when a person is sexually motivated by potent, sexual reward cues. Yet, individual differences in sensitivity to sexual cues have not been examined with respect to sexual risk behaviors. A greater responsiveness to sexual cues might provide greater motivation for a person to act sexually; a lower responsiveness to sexual cues might lead a person to seek more intense, novel, possibly risky, sexual acts. In this study, event-related potentials were recorded in 64 men and women while they viewed a series of emotional, including explicit sexual, photographs. The motivational salience of the sexual cues was varied by including more and less explicit sexual images. Indeed, the more explicit sexual stimuli resulted in enhanced late positive potentials (LPP) relative to the less explicit sexual images. Participants with fewer sexual intercourse partners in the last year had reduced LPP amplitude to the less explicit sexual images than the more explicit sexual images, whereas participants with more partners responded similarly to the more and less explicit sexual images. This pattern of results is consistent with a greater responsivity model. Those who engage in more sexual behaviors consistent with risk are also more responsive to less explicit sexual cues.
    Social Cognitive and Affective Neuroscience 12/2014; DOI:10.1093/scan/nsu024 · 7.37 Impact Factor
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    • "In particular, intravenous administration of methylphenidate at a high dose of 0.5 mg/kg body weight has been shown to enhance self-reported sexual desire (Volkow et al., 2007) while administration of a moderate oral dose of methylphenidate (20 mg) had no effects (Volkow et al., 2007). Finally, to our knowledge there are no experimental data on the effects of MDMA on sexual perception and arousal. "
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    ABSTRACT: Methylphenidate mainly enhances dopamine neurotransmission whereas 3,4-methylenedioxymethamphetamine (MDMA, "ecstasy") mainly enhances serotonin neurotransmission. However, both drugs also induce a weaker increase of cerebral noradrenaline exerting sympathomimetic properties. Dopaminergic psychostimulants are reported to increase sexual drive, while serotonergic drugs typically impair sexual arousal and functions. Additionally, serotonin has also been shown to modulate cognitive perception of romantic relationships. Whether methylphenidate or MDMA alter sexual arousal or cognitive appraisal of intimate relationships is not known. Thus, we evaluated effects of methylphenidate (40mg) and MDMA (75mg) on subjective sexual arousal by viewing erotic pictures and on perception of romantic relationships of unknown couples in a double-blind, randomized, placebo-controlled, crossover study in 30 healthy adults. Methylphenidate, but not MDMA, increased ratings of sexual arousal for explicit sexual stimuli. The participants also sought to increase the presentation time of implicit sexual stimuli by button press after methylphenidate treatment compared with placebo. Plasma levels of testosterone, estrogen, and progesterone were not associated with sexual arousal ratings. Neither MDMA nor methylphenidate altered appraisal of romantic relationships of others. The findings indicate that pharmacological stimulation of dopaminergic but not of serotonergic neurotransmission enhances sexual drive. Whether sexual perception is altered in subjects misusing methylphenidate e.g., for cognitive enhancement or as treatment for attention deficit hyperactivity disorder is of high interest and warrants further investigation. Copyright © 2014 Elsevier B.V. and ECNP. All rights reserved.
    European neuropsychopharmacology: the journal of the European College of Neuropsychopharmacology 12/2014; 25(1). DOI:10.1016/j.euroneuro.2014.11.020 · 4.37 Impact Factor
    • "The mechanisms underlying increased sexual arousal following administration of psychoactive substances have only partly been elucidated. It has been proposed that DA is responsible for the increase in sexual arousal following administration of methylphenidate or methamphetamine by disrupting conditioned inhibition of sexual arousal and behaviour (Volkow et al., 2007) although these drugs also enhance NE in addition to DA. MDMA did not enhance subjective sexual arousal ratings in response to visual stimuli in the present study. However, MDMA, similar to methylphenidate, significantly increased the number of clicks to potentially prolong the presentation of the implicit but not of the explicit sexual stimuli compared with placebo. "

    European Neuropsychopharmacology; 10/2014
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