Gay men who experience erection loss are less likely to use condoms during anal sex and less likely to use them in the future, says a new Dutch report. According to Aidsmap, Condom Induced Erectile Dysfunction (COINED) was much more of an independent factor of unprotected sex than thought before.

Of the 435 men surveyed (6 percent were HIV positive), 10 percent claimed to experience COINED with casual partners and 7 percent with steady partners. The study also found that COINED made it 2.71 times more likely for a man to engage in risky sex six months later.

While researchers believe that traditional prevention methods may not work with addressing this issue, they do believe that Viagra might be a solution for “men who need it simply to be ‘tops.'”