The International Index of Erectile Function: Development of an Adapted Tool for Use in HIV-Positive Men Who Have Sex with Men

Abstract

Introduction Erectile dysfunction is common in HIV-positive men who have sex with men (MSM). A standardized scale is needed to assess erectile function in clinical practice and research studies. Aim The International Index of Erectile Function (IIEF) is a widely accepted tool for assessing erectile function designed for heterosexual men. We modified the tool for MSM. We present an analysis of internal consistency of the questionnaire in an HIV-positive cohort. Methods The adapted questionnaire included modified questions within each of the five domains of the IIEF: (i) erectile function, (ii) intercourse satisfaction, (iii) orgasmic function, (iv) sexual desire, and (v) overall satisfaction with sex. MSM at seven European HIV treatment centers completed the questionnaire. Main Outcome Measures Responses were analyzed for internal consistency using standardized Cronbach’s alpha values within each of the five domains. A factor analysis was performed to confirm the domain structure of the questionnaire. Results Data from 486 MSM were analyzed. The factor analysis supported the domain structure described. Questions about erectile function, orgasmic function, and sexual desire performed well, with Cronbach’s alpha values of 0.82, 0.83, and 0.89, respectively. Questions concerning intercourse satisfaction were less consistent (Cronbach’s alpha 0.55) because frequency of attempts at sexual intercourse did not correlate with other responses. Responses about satisfaction with sex with a regular partner diverged from satisfaction with overall sex life. Frequency of morning erections diverged from other aspects of erectile function, whereas erections with masturbation correlated better. Conclusions Internal consistency was high overall. This tool is suitable for HIV-positive MSM and can be used in screening, research, and monitoring treatment response.

Depression and Sexual Dysfunction Among HIV-Positive and HIV-Negative Men Who Have Sex With Men: Mediation by Use of Antidepressants and Recreational Stimulants

“…In this scale, higher scores characterize better functioning or satisfaction during sex. Erectile functioning was determined by the summed scores of a modified version of the IIEF-MSM (Coyne et al, 2010). The IIEF-MSM avoids assumptions in the original IIEF that all men engage in penetrative sexual intercourse during sexual activity.…”

Cognitive Schemas Activated in Sexual Context: A Comparative Study with Homosexual and Heterosexual Men and Women, With and Without Sexual Problems

“…However, differences were found between groups on marital status, v 2 (3) = 13.805, p = .003, with heterosexual men reporting higher rates of married/living together. Additionally, gay men with sexual problems scored significantly lower on the International Index of Erectile FunctionVersion for Men Who Have Sex with Men (IIEF-MSM; Coyne et al 2010), compared with gay men without sexual problems, t(45) = 4.467, p \ .001. Likewise, heterosexual men with sexual problems scored significantly lower on the International Index of Erectile Function (IIEF; Rosen et al 1997), compared with heterosexual men without sexual problems, t(60) = 3.369, p = .001.…”

“…The Portuguese version also presented good psychometric properties, with test-retest analysis indicated correlations between two administrations with a 2 weeks interval ranging from .69 and .90, and Cronbach's alpha values between .72 and .86 (Quinta-Gomes and Nobre 2012b). A modified version of the IIEF, for men who have sex with men was used with gay men (IIEF-MSM; Coyne et al 2010). The psychometric study suggested good reliability with Cronbach's alpha values of ranging from .82, .83, and .89 for erectile, orgasmic function and sexual desire function domains (Coyne et al 2010).…”

“…A modified version of the IIEF, for men who have sex with men was used with gay men (IIEF-MSM; Coyne et al 2010). The psychometric study suggested good reliability with Cronbach's alpha values of ranging from .82, .83, and .89 for erectile, orgasmic function and sexual desire function domains (Coyne et al 2010). …”

“…A hierarchical regression analysis was performed to explore the relationship between cognitive schemas activated in sexual context and male sexual functioning (assessed by the IIEF; Coyne et al 2010;Rosen et al 1997). Male sexual functioning was the criterion variable, age and marital status were entered in the first step, and sexual orientation (dummy variable: 0 = gay men; 1 = heterosexual men) was entered in the second step.…”