**Background:** The global dietary supplement market is large and growing, with sexual enhancement supplements (SES) representing a significant segment. Many SES are adulterated with phosphodiesterase type 5 (PDE-5) inhibitors or other undeclared pharmaceuticals, leading to variable dosing, increased adverse effects, and drug–drug interactions. Despite regulatory warnings, SES remain widely available online and in stores. In the UAE, no adverse events from SES had been publicly reported to authorities, suggesting under-reporting. This study aimed to evaluate risk awareness, prevalence of use, and associated factors among university personnel in the UAE.
**Methods:** A descriptive-analytical cross-sectional study was conducted at Ajman University, UAE, from May 10 to August 5, 2020. Male students and staff aged ≥18 years were included; females and those under 18 were excluded. A self-administered, validated questionnaire (17 items, four sections) was distributed via a web-based electronic link. Content validity was confirmed (CVI = 0.88), and internal consistency was acceptable (Cronbach's α = 0.72). A pilot study of 300 respondents informed sample size calculation. Of 1,280 questionnaires distributed, 1,101 were completed (response rate = 86%). Risk awareness was scored from 0–7; a median score ≥4 defined “good awareness.” Univariate and multivariate logistic regression identified factors associated with SES use and risk awareness.
**Key Results:** Among 1,101 male participants, 433 (39.3%) [95% CI: 33.2–44.5] reported using SES. The most common ingredients were zinc and other minerals (37.0%), ginseng (25.4%), L-arginine (15.9%), and yohimbe (10.6%). Of the 433 users, 137 (31.6%) [95% CI: 28.6–37.2] experienced adverse effects, most frequently palpitation or shortness of breath (36.5%), gastrointestinal symptoms (24.1%), and cutaneous symptoms (16.8%). SES use was significantly higher among participants aged 60–69 years (OR: 2.94; 95% CI: 1.63–5.28; p < .001), diabetic patients (OR: 2.61; 95% CI: 1.75–3.90; p < .001), hypertensive patients (OR: 2.12; 95% CI: 1.45–3.10; p < .001), and overweight/obese participants (OR: 1.84; 95% CI: 1.44–2.35; p < .001). Regarding risk awareness, 60.2% did not know that SES products should be registered with regulatory authorities, and 61.3% were unaware that SES may be adulterated with prescription drugs. In multivariate analysis, higher risk awareness scores were significantly associated with age 60–69 years (OR: 1.30; 95% CI: 1.03–1.65; p = .029) and diabetes (OR: 1.27; 95% CI: 1.06–1.52; p = .01).
**Clinical Implications:** SES use is common among male university staff and students in the UAE, particularly among older men and those with chronic conditions such as diabetes, hypertension, and obesity. Nearly one-third of users experienced adverse effects, yet awareness of regulatory oversight and potential adulteration is low. These findings underscore an urgent need for public health campaigns targeting at-risk populations, especially older men and those with comorbidities, to educate about the risks of SES. Regulatory bodies should strengthen monitoring, enforce post-market surveillance, and encourage adverse event reporting to protect public health.