GOOGLE and Yahoo! respond to community and public health feedback and cease sponsored ads for poppers.  08/25/08   MSN responded to complaints in December 2007 and ceased sponsored ads for poppers. 

GOOGLE, Yahoo!, and MSN continue to list websites selling poppers violating their policy of not listing websites selling illegal drugs. 

The results of a 2006 Seattle online community survey underscore that gay men seek information about poppers by searching the internet, with Google and Yahoo named as the most popular search engines.

Here are the results of a recent Seattle ( www.homohealth.org ) community survey used to assess what guys felt about poppers:

2006 Poppers Survey
Gay Men, Drug Use and HIV Workgroup

Total Respondents = 276

Demographics
Age	Ethnicity	Sexual Identity	Location	HIV Status
19-25 12%	White 82%	Gay 90%	Seattle 71%	HIV+ 19%
26-35 28%	Latino 7%	Bi 7%	In WA 16%	HIV- 72%
36-45 36%	Afr-Am 5%	Hetero 3%	Out WA 13%	HIV? 9%
46-55 16%	Asian 5%	--	--	--
56+ 8%	Pac Is 2%	--	--	--

What is your personal opinion about poppers?
Nearly half (48%) of guys had a favorable attitude towards popper. Either they liked using them, or thought it was okay for others to use. One-third (35%) felt negatively. 16% had neutral opinions.

They're great	16%
I think they're OK to use now and then	32%
Don't like them	35%
Never used, so don't really know	8%
Don't care	8%
Other	1%

• Very few men don’t know what poppers are.
• Neutrality about poppers decreases as men age. Greatest shift from neutral to either pro- or anti-poppers happens from ages 26-35 to ages 36-45. Men age 46-55 have the most favorable attitude towards poppers.
• HIV-positive men have slightly more favorable attitudes than HIV-negative men (55% vs. 46%), and are less neutral about poppers. Is this also a function of age?
• Attitudes are often discordant with actual use. many men who expressed favorable attitudes had never themselves used or had stopped using after going into recovery. Several men said they “hated” poppers but still used them (and expressed anger that they did). Many men said poppers were OK for others to use although they themselves chose not to.
  

I feel that I know the facts about poppers.
This was pretty much divided evenly. One-third feels unknowledgeable or uncertain. One-third feels somewhat knowledgeable. One-third feels knowledgeable.

Yes	34%
Some, but would like more	36%
Not sure	17%
No	14%

• HIV-positive men and men age 46-55 feel most knowledgeable (52% and 49%, total average 34%).
• Confidence in knowledge about poppers increases steadily with age. Nearly one-half of men 19-25 said they don’t know the facts or feel uncertain about them (highest percentage of all age groups).
• Confidence in knowledge about poppers increases with use of poppers. The more men use poppers, the more they feel they know about them.

I think poppers are associated with:

* - correct answer	Yes	No	Not sure
Kaposi's Sarcoma	12%	36%*	48%
Increased risky sex	70%*	14%	16%
Increased HIV risk	59%*	20%	21%
Rectal tearing	34%*	29%	37%
Erectile dysfunction/impotence	32%	27%	41%*
Suppressed immune system	42%*	20%	38%
Dangerous with ED drugs	71%*	6%	22%
Blindness	14%	42%	44%*

The majority of men correctly know that popper are associated with increased risky sex (70%), HIV risk (59%) and that they are dangerous to use with erectile dysfunction drugs (71%).

• The risks with the least consensus (no clear majority opinion) include rectal tearing, erectile dysfunction, and suppressed immune system.
• The risks men feel least certain about include Kaposi’s sarcoma (48%), blindness (44%), and erectile dysfunction (41%). None of these are associated with poppers use (blindness was a “red herring”), so uncertainty is reasonable.
• Which sub-group is most accurate in its knowledge? Difficult to say as it depends on the risk and the sub-group’s familiarity with that risk.
• Non-users and men age 19-25 feel the most unsure about associated risks.
• Users, HIV-positive men, and men age 36-45 are least likely to agree with risks (same groups that said they felt the most confident about their knowledge).
• Kaposi’s sarcoma
  o HIV-positive men are twice as likely to think this is a risk
  o Almost one-half are not sure about KS, or what it actually is?
• Increased risky sex
  o Users are more likely to disagree
• HIV risk
  o Non-users, men age 19-25, and men age 46-55 agree with this risk
  o Users are twice as likely to disagree that this is a risk
• Rectal tearing
  o Users almost twice as likely disagree with this risk
• Erectile dysfunction
  o Not much variance
• Suppressed immune system
  o HIV-positive men are more likely to agree this is a risk
• Dangerous with erectile dysfunction drugs
  o Men age 19-25 are less likely to agree this is a risk (maybe because they don’t use ED drugs as much?)
• Blindness
  o Most groups disagree or are unsure about this as a risk (this question was a “red herring”)

Do you think it’s possible to become dependent on poppers for sex? A greater number of men think dependence is possible.

Yes	41%
Maybe	32%
No	15%
Not sure	12%

• Non-users (50%) and men age 36-45 (46%) are more likely to agree.
• Users (28%), HIV-positive men (23%), and men 36-45 (23%) are more likely to disagree.
• Non-users are the most unsure of dependence (22% vs. 12%)
• Men who think dependency is possible are 2 – 3 times less likely to be using poppers.
• Men who don’t think dependency is possible are 4 – 5 times more likely to be using poppers.

If I wanted more info about poppers, I would go to:

Internet	82%
Doctor	42%
Gay/HIV organization	39%
Friends	25%
Gay mag/news	15%
Baths resource	11%
Other	4%

The overwhelming majority of men would use the Internet to find information; this is consistent across all sub-groups. A portion of this was an online survey.

• Doctors, healthcare providers, and gay/HIV organizations are important sources of information.
• Gay print media and the resource areas at bathhouses are not effective sources of information. Users are slightly more likely to utilize baths resources (18% vs. 11%)

Which websites would you use? The majority of men would do a general search on Google or Yahoo.

Google or Yahoo	55%
Don't know	12%
Web MD	7%
The Body.com or other HIV site	4%
Gay.com	4%
Other	10%

• HIV-positive men would use HIV related or medical sites more than other men (21% vs. 4%)
• Outside Google or Yahoo, there is no clear site preference.

Do you think gay men need better info about poppers and their risks? The overwhelming majority think men need better information. This is consistent across all sub-groups.

Yes	72%
Maybe	20%
No	5%
Not sure	3%

• 100% of men age 19-25 said yes or maybe.

How often do you use poppers? Most men don’t use poppers.

Daily	2%
Weekly	13%
Monthly	11%
Every few months	18%
Never	40%
Quit using	16%	Why: Side effects/health problems	42%
		In recovery	21%
		Tired of them	13%
		Fear of consequences	11%
		Only experimented	8%
		Other	8%

• Poppers use is more prevalent among men ages 26-45 than other ages.
• Frequency of poppers use varies somewhat evenly from weekly to monthly to every few months.
• HIV-positive men are only slightly more likely than HIV-negative men to be currently using (48% vs. 42%), especially among men ages 36-45 (64%) and ages 46-55 (55%). HIV-positive men are more likely to quit using poppers due to personal recovery from all drug use (38%) than HIV-negative men (17%) or men in general (21%).

Do you use poppers for:

	Always	Sometimes	Rarely	Never
Topping	10%	28%	16%	46%
Being a bottom	20%	29%	16%	35%
Oral sex	7%	24%	13%	56%
Vaginal sex	1%	1%	1%	97%
Dancing		4%	8%	88%
Other	7%	12%	14%	67%

• More men use poppers to be a bottom than to top.
• About one-half of men chose a combination of bottom/top/oral.

What do you like about poppers? Men like the head rush from poppers more so than any one sexual effect. This is especially true for men ages 19-25 (88% vs. 64%).

Head rush	64%
Easier/less painful to get fucked	46%
Better ograsm	46%
Less inhibited sex	40%
More connected w/partner	22%
Better erection	17%
Easier to use condoms	3%
Other (get aroused, sex more exciting, fisting)	17%

• The most enjoyed sexual effects include better orgasm (46%), easier or less painful to be fucked (46%), and reduced inhibitions (40%). Enhanced erection is not a primary sexual benefit for most men.

What other drugs do you sue before, with, or right after poppers? The vast majority of men using poppers are not using them regularly or even occasionally with other drugs or alcohol.

	Always	Sometimes	Rarely	Never
Alcohol	4%	38%	13%	45%
Viagra/Cialis	3%	18%	5%	74%
Crystal meth	1%	8%	9%	82%
Ecstasy	1%	7%	8%	84%
Cocaine	--	6%	2%	92%
GHB	1%	1%	3%	95%
Ketamine	--	1%	1%	98%
Heroin	--	1%	--	99%

• The drugs most likely to be always or sometimes used with popper are alcohol (4% always, 38% sometimes) and ED drugs (3% always, 18% sometimes).
• Co-use of crystal meth, cocaine, or ecstasy is far less common. There is almost no co-use of GHB, ketamine or heroin.
• Prevalence of other drugs use increases with age, especially Viagra. Co-use of alcohol peaks during ages 36045; crystal meth use is most prevalent in men ages 26-35 and 46055 (similar levels); cocaine and ecstasy use is most prevalent in men ages 19-25.
• Cocaine use is not more prevalent among African-American men as might be expected.
• HIV-positive men are more likely to be co-using drugs with poppers. Although prevalence of alcohol use is similar, HIV-positive men are 2 times more likely to be co-using ED drugs and 2-3 times more likely to be co-using with crystal meth.
• Among men who said they alwas co-use ED drugs with poppers, 3 say they know it is dangerous to use them together. Among men who say they sometimes co-use ED drugs with poppers, 19 say they know it is dangerous to use them together, and 2 are not sure.