Erectile Dysfunction Is More Common in Young to Middle‐Aged HIV‐Infected Men than in HIV‐Uninfected Men

Zona, Stefano; Guaraldi, Giovanni; Luzi, Kety; Beggi, Mattia; Santi, Daniele; Stentarelli, Chiara; Madeo, Bruno; Rochira, Vincenzo

doi:10.1111/j.1743-6109.2012.02750.x

Cited by 44 publications

(48 citation statements)

References 38 publications

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“…Erectile dysfunction agents PLWH use EDA more frequently than HIV-uninfected men [83,84], and several epidemiologic studies have reported that EDA are used recreationally, in the context of 'ChemSex', to sustain long-lasting sexual activity and reverse the impotence-inducing effects of other substances [8,85]. Data from the ASTRA study show that up to 21% of the PLWH recruited reported use of EDA in the previous 3 months [3].…”

Section: Benzodiazepinesmentioning

confidence: 95%

Increasing use of ‘party drugs’ in people living with HIV on antiretrovirals

Bracchi

Stuart

Castles

et al. 2015

Aids

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Use of 'party drugs', a particular set of recreational drugs used in the context of 'ChemSex', is frequent among MSM living with HIV. A recently published observational study showed that more than half of HIV-infected MSM interviewed reported use of illicit substances in the previous 3 months, with frequent concomitant use of three or more drugs. These substances are a combination of 'club drugs' (methylenedioxymethamphetamine, gamma-hydroxybutyrate, ketamine, benzodiazepine) and drugs that are more specifically used in a sexualized context (methamphetamine, mephedrone, poppers and erectile dysfunction agents). Although formal data on pharmacokinetic or pharmacodynamic interactions between recreational drugs and antiretroviral agents are lacking, information regarding potentially toxic interactions can be theorized or sometimes conclusions may be drawn from case studies and cohort observational studies. However, the risk of coadministering party drugs and antiretrovirals should not be overestimated. The major risk for a drug-drug interaction is when using ritonavir-boosting or cobicistat-boosting agents, and maybe some nonnucleoside reverse transcriptase inhibitors. Knowledge of the metabolic pathways of 'party drugs' may help in advising patients on which illicit substances have a high potential for drug-drug interactions, as this is not the case for all.

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Section: Benzodiazepinesmentioning

confidence: 95%

Increasing use of ‘party drugs’ in people living with HIV on antiretrovirals

Bracchi

Stuart

Castles

et al. 2015

Aids

View full text Add to dashboard Cite

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“…A few studies confirmed there is a significant trend for more ED in MLHIV relative to agematched HIV-negative men in all decades of age [10,11]. Recently Zona et al found a clear association between ED and HIV and considered the early onset of ED a sign of precocious aging in MLHIV [5].…”

Section: Erectile Dysfunction (Ed) In Men Living With Hiv (Mlhiv)mentioning

confidence: 98%

“…Recently Zona et al. found a clear association between ED and HIV and considered the early onset of ED a sign of precocious aging in MLHIV .…”

Section: Introductionmentioning

confidence: 99%

Erectile Dysfunction, Testosterone Deficiency, and Risk of Coronary Heart Disease in a Cohort of Men Living with HIV in Belgium

Ryck

Laeken

Apers

et al. 2013

The Journal of Sexual Medicine

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Introduction Erectile dysfunction (ED) is more prevalent in men living with HIV (MLHIV) when compared with age-matched HIV-negative men. This may be related to a premature decline in testosterone levels. In the general population, ED has been associated with an increased risk for coronary heart disease (CHD). Aim The aim of this study is to determine the prevalence of ED, testosterone deficiency, and risk of CHD in a cohort of young to middle-aged MLHIV in Belgium. Methods A cross-sectional, observational study among 244 MLHIV attending the outpatient clinic of the Institute of Tropical Medicine in Antwerp. Main Outcome Measures The short version of the international index of erectile function (IIEF-5) questionnaire diagnosed ED (cutoff score ≤21). The 10-year risk score for CHD was calculated. In a subset of men reporting ED, the calculated free testosterone (CFT) was determined using Vermeulen's formula. Testosterone deficiency was defined as CFT <0.22nmol/L. Results One hundred fifty-one men (61.9%) self-reported ED (median IIEF-5 score: 16 [interquartile range (IQR) 12–19]). In multivariate analysis, only increasing age, but none of the HIV-related parameters, nor any of the individual cardiovascular-risk related parameters, was statistically significantly associated with ED. Eighteen out of the 49 (36.7%) men with ED who received a blood test to assess testosterone levels were diagnosed with testosterone deficiency. The 10-year risk of CHD in the cohort was 4.3% (IQR 3.6–5.7) and was significantly higher in men with ED (5.1%, IQR 4.4–6.6) compared with men without ED (3.1%, IQR 2.5–4.2). Conclusions This study showed that ED and testosterone deficiency are highly prevalent in young to middle-aged MLHIV and that ED might be associated with an increased risk of CHD. Therefore, healthcare professionals should screen for clinical ED and should consider testing for underlying testosterone deficiency. A clinical diagnosis of ED should trigger a full evaluation of the patient's cardiovascular risk factors, even at younger age.

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“…En esencia, se trata de estimar el riesgo individual de sufrir un ECV con la mayor exactitud posible y de actuar sobre los FRCV modificables, con mayor o menor intensidad dependiendo del riesgo estimado [58][59][60][61][62][63] (algoritmo 3, fig. 3).…”

Section: Repercusión Cardiovascularunclassified