Body image is a major determinant of sexual dysfunction in stable HIV-infected women

Abstract

Background Prevalence and factors associated with sexual dysfunction in HIV-positive women are poorly known. Methods This was a cross-sectional study in a cohort of HIV-infected women. Clinically stable women were invited to participate in a female sexual dysfunction (FSD) evaluation with Female Sexual Function Index (FSFI) exploring desire, arousal, lubrication, orgasm, pain and satisfaction. An FSFI score <23 was used for defining FSD. Variables evaluated included body appearance satisfaction, interference of body changes with habits, social life and attitudinal aspects of body image, health-related quality of life, hormonal assessment, menopause, cumulative exposure to antiretroviral drug classes and immune-virological parameters. Lipodystrophy was defined according to the HIV Outpatient Study definition. Results A total of 185 women completed the FSFI. The mean (±sd) age was 42 years (±5), 27% had CDC stage C, the mean (±sd) CD4+ T-cell count was 508 cells/μl (±251) and median HIV RNA was 1.7 log10 copies/ ml (interquartile range 1.7–2.6). Among 161 evaluable patients, 59 (32%) reported FSD. In a multiple linear regression analysis, desire, arousal and satisfaction domains were associated with interference of body changes with habits, social life and attitudinal aspects of body image (β=0.22, 95% confidence interval [CI] 0.06–0.37; β=0.29, 95% CI 0.10–0.48; and β=0.20, 95% CI 0.02–0.38, respectively). Lubrication and orgasm domains were associated with body image satisfaction (β=-0.49, 95% CI -0.88— 0.10 and β=-0.58, 95% CI -1.00—0.16, respectively). No significant associations with sex hormones, CDC stage, CD4+ T-cell count, HIV RNA viral load and cumulative exposure to antiretroviral drug classes were found. In women with FSD, severity of self-perceived abdominal fat accumulation showed a trend towards lower FSFI scores (ANOVA P=0.02). Conclusions FSD was highly prevalent in this cohort. Self-perceived body changes was identified as its major determinant.

Prevalence and correlates of sexual concerns and associated distress among women living with HIV in Canada

“…Most research has focused on sexual dysfunction, using varied definitions and questions, and usually without measuring distress. 52–55 Thus, it is difficult to compare prevalence estimates with other HIV cohorts. Previous population health research suggests a fairly high prevalence of sexual difficulties in the general population, ranging between 22% and 59%, depending on the domain measured and sample characteristics (e.g.…”

“…Most research has focused on sexual dysfunction, using varied definitions and questions, and usually without measuring distress. [52][53][54][55] status). [56][57][58] Distress about sexuality among women in the general population also varies, from 24% to 51%.…”

Low sexual function is associated with menopausal status in mid-aged women with human immunodeficiency virus infection

“…In this population, the limited access to sexual and reproductive health services could partly explain this situation 9 . Furthermore, some factors associated with low sexual functioning in HIV-infected women are depression, irritability, anxiety, body image, obesity, stigma, and alcohol use, among others 10-14 . In this scenario, evaluating the role of the menopausal status on female sexuality could be relevant since it is a critical stage of life.…”

“…Nevertheless, a systematic review highlighted evidence gaps in the knowledge of the HIV infection in terms of age at menopause 20 . Although there are publications on sexuality in middle-aged women with HIV, these are scarce in Peru 7,10,11,13,14,21 …”

“…20 Although there are publications on sexuality in middle-aged women with HIV, these are scarce in Peru. 7,10,11,13,14,21 In this context, it is challenging to evaluate sexual behaviors in Peruvian women under highly active antiretroviral therapy (HAART) since this has been somewhat a taboo hitherto. 22 Our study aimed to evaluate the association between menopausal status and sexual function in sexually active heterosexual mid-aged women infected with HIV controlled by clinical and demographic variables.…”