Sexual Dysfunction in 156 Ambulatory HIV-Infected Men Receiving Highly Active Antiretroviral Therapy Combinations With and Without Protease Inhibitors

Abstract

We conducted a cross-sectional study of 156 ambulatory HIV-infected homosexual or bisexual men to assess and compare the prevalence and characteristics of sexual dysfunction according to treatment combinations (group A, protease inhibitor [PI] treatment; group B, no PI treatment; and C, PI treatment interrupted >1 month previously). The study was based on a self-administered 163-item questionnaire that included a French translation of the International Index of Erectile Function, five sections of the Derogatis Sexual Functioning Inventory, and open questions. Data analysis was performed using Mann-Whitney and Kruskal-Wallis H nonparametric tests (quantitative values) and chi2 tests (qualitative values) using SPSS software (SPSS, Chicago, IL, U.S.A.). One hundred fifty-six patients completed the study. The median age +/- SD of the patients was 40.5 +/- 7.7 years, and the median CD4+ cell count +/- SD was 415 +/- 236/mm3. One hundred eleven (71%) of 156 patients reported some degree of sexual dysfunction since the beginning of their treatment (65 [71%] of 91 group A patients; 15 [65%] of 23 group B patients; and 31 [74%] of 42 group C patients), with no significant difference among the groups. Of the 111 patients, 99 (89%) reported decrease or loss of libido, 76 (68%) reported orgasmic perturbation, 96 (86%) reported erectile dysfunction, and 65 (59%) reported ejaculation perturbation, with no significant difference among the three groups. There were no significant differences among the three groups regarding the International Index of Erectile Function and Derogatis Sexual Functioning Inventory scores. These data suggest that PI-based therapy does not seem to increase sexual dysfunction in this patient population.

Sexual dysfunction in HIV-positive men is multi-factorial: A study of prevalence and associated factors

“…While several studies have demonstrated an association with PIs (1,2,3,5) it is interesting that neither of the two groups that utilised the IIEF found a link with a particular class of medications (4,6).…”

“…Deleted: There have been numerous reports of sexual dysfunction in HIV positive men with prevalence rates of up to 70% being described (1)(2)(3)(4)(5)(6) The primary objectives of this study therefore are to establish the prevalence of erectile dysfunction (EDF) and low sexual desire (LSD) in both ARV naïve and experienced HIV positive men attending HIV outpatient centres across Europe and to define the variables associated with sexual dysfunction. Due to the large number of variables that are potentially contributors to dysfunction a large amount of data relating to these variables was collected.…”

Sexual Health, HIV, and Sexually Transmitted Infections among Gay, Bisexual, and Other Men Who Have Sex with Men in the United States

“…Sexual compulsivity and other measures of sexual dysfunction have also been linked to sexual risk behavior among MSM [34,87,[92][93][94][95][96]. MSM living with HIV experience especially high rates of sexual dysfunction [87,91,[97][98][99][100], and sexual dysfunction in this population has been associated with poorer adherence to HIV treatment [101] and HIV/STI transmission risk behavior [87,91]. Taken as a whole, these findings suggest the possibility that better understanding and addressing underlying psychological and physical causes of sexual dysfunction among MSM might improve sexual health, reduce high-risk sexual behavior, and help reduce STI and HIV infections.…”

Urologic complications of HIV and AIDS

“…Studies both support and oppose the occurrence of sexual dysfunction in HIV-positive men taking HAART. 92,93,94,95 Men who are HIV positive are more likely to have symptoms of depression than are men without HIV. 96,97 This correlation might be associated with low libido and ED; however, common antidepressant medications such as selective serotonin reuptake inhibitors can also decrease libido and sexual performance.…”