HIV/AIDS InfoGram May, 2007

UPDATE ON POPPERS KEY MESSAGES

Although poppers have been around for decades, information • Be cautious about about their health risks has not always been consistent or information on the accurate. Urban myths, deceptive retail ads and outdated Internet. Websites that research may confuse individuals about the actual facts. sell poppers are not In a recent local survey of men who have sex with men, nearly accurate sources of three-quarters (72%) said gay men need better information health information. about poppers, and 42% would go to their health care provider for that information. • The best choice for your overall health is to This fact sheet summarizes the latest clinical and behavioral not use poppers, research on poppers. Public Health encourages providers to especially if you have talk openly with their patients and clients about sex and drug HIV. They are not use, including poppers, and to use this fact sheet to inform and approved for any human guide those conversations. use or regulated for What are poppers? purity. Poppers are a liquid form of nitrites. They are widely sold as If you use poppers: “video head cleaner” or “leather cleaner” on the Internet and in sex shops. Although men sometimes use poppers for dancing • Try using less or less or other activities, they most often use them during sex, often to reduce harmful inhaling the fumes to enhance orgasm, prolong sex, or relax effects. anal muscles for easier penetration. After a quick rush, they may feel light headed, nauseous, or flushed. The high and • Pace yourself. Don’t intensified sexual effects last only a few minutes, which take whiffs more often leads some men to sniff poppers frequently or repeatedly than every few minutes. during sex. • Do not use poppers Can you get addicted to poppers? with erectile Poppers are not physically addictive, but people can develop dysfunction drugs or tolerance. After frequent use, however, some men feel party drugs like GHB, psychologically dependent on poppers to have or enjoy sex. ecstasy or crystal.

• If poppers trigger you to Health Impacts of Poppers have unprotected sex,

Moderate use Chronic use put a strategy in place before you take the first y severe headache As use y weight loss whiff. Have condoms and y throat irritation increases, y mouth or nasal y nose bleed short-term sores lube handy to use. y nausea effects y impaired smell y faintness may get worse y lung damage • Think about your use. y reduced breathing or last longer. y anemia How bad are the side & heart rate y impaired ability to effects? How do you feel y burns or blistering think about the role of poppers

Poppers can increase internal eye pressure and should not in your sex life? Do you be used by people with glaucoma. wish it could be different? If you want to make a change, talk with Can you overdose on poppers? someone you trust. Fatal overdoses are rare. But, inhaling too much or too often can lower blood pressure and cause unconsciousness or heart attack. This risk increases significantly when poppers are used with erectile dysfunction (ED) drugs. Together, these drugs can For more information on cause a severe drop in blood pressure and heart failure. alcohol, drugs and Several deaths have occurred from co-using poppers and community resources, go to Viagra. www.homohealth.org

Continued on back . . . In rare cases, large doses of poppers can cause methemobloginemia, a potentially fatal reduction in the blood’s What Should ability to carry oxygen. Swallowing poppers can be lethal. Providers Do?

Do poppers damage the immune system? Some research has shown that poppers weaken parts of the 1. Correct misinformation. immune system. However, many of these results are Ask patients/clients what controversial since studies: they know about poppers. 1. only tested mice or cells outside the body, 2. often administered poppers at higher doses and for “This week I’m talking longer periods than typical human use, and with all of my patients/ 3. failed to control for other factors in the study design. clients about poppers. Some of these same studies also found that immune function What have you heard improved within days of stopping use. Therefore the short- about how poppers affect and long-term immune impacts are still a matter of scientific health?” debate. 2. Talk openly with patients Do poppers cause Kaposi’s sarcoma (KS) or and clients about their other cancers? use. Poppers do not cause KS. This theory from the early AIDS epidemic has long been disproved. KS is caused by the “What’s your use been HHV-8 virus (human herpesvirus, type 8, also known as like over the last few Kaposi’s sarcoma virus). Using poppers, however, may months?” facilitate the sexual transmission of HHV-8 through unprotected sex. “How do feel about your poppers use?” Poppers do not cause any cancers, but animal studies suggest they may be linked to faster growth of tumor cells. “What do you like about Rather than stimulating cancer cells directly, poppers may poppers? What don’t you suppress certain immune functions that help kill tumor cells like?” and slow cancer growth. 3. Reinforce the How do poppers affect HIV disease? Key Messages. Poppers do not seem to impact viral replication or interact with HIV anti-retroviral medications. Chronic poppers use, however, may affect one’s ability to adhere to drug regimens and thus 4. Educate about the risks promote drug resistance. Protease inhibitors increase blood of using poppers with levels of erectile dysfunction drugs. So it’s even more erectile dysfunction dangerous for people on protease inhibitors to use ED drugs – especially HIV- drugs and poppers at the same time. positive men who take protease inhibitors. Are you more likely to get HIV if you use poppers? Research studies consistently find poppers use to be independently associated with acquiring HIV or an STD. Not all men who use poppers have unprotected sex. But for some, For more information on poppers may lower sexual inhibition, impair judgment or make alcohol, drugs and it more difficult to feel small tears in anal tissue during longer, community resources, go to rougher sex. www.homohealth.org

www.kingcounty.gov/health/hiv Available in alternate formats. 206-296-4649