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Sexual dysfunction in HIV-infected men: prevalence and associated factors
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Abstracts presented at the 7th International Workshop on Adverse Drug Reactions and Lipodystrophy in HIV 13-16 November 2005, Dublin, Ireland
D Malmusi1, G Guaraldi 2, E Martinez3, E de Lazzari 3, K Luzi 2, A Granata2, JL Blanco3, G Orlando2, R Murri4 and JM Gatell3
1Institut Municipal d'Assistencia Sanitaria, Barcelona, Spain; 2Universita di Modena e Reggio Emilia, Modena, Italy; 3Hospital Clinic i Provincial, Barcelona, Spain; 4Universita Cattolica Sacro Cuore, Roma, Italy.
ABSTRACT 97
Antiviral Therapy 2005; 10:L58
Background: In the HAART era, few clinical studies evaluated prevalence and risk factors of sexual dysfunctions (SD) in HIV-positive men. SD prevalence has been described in up to 74% of this population, but no standardized and validated methods for detection of SD have ever been used. Protease inhibitors and hypogonadism have been inconsistently associated with SD.
Aims: Cross-sectional study to evaluate the prevalence and risk factors of sexual dysfunctions in HIV-infected men.
Methods: Clinically stable, consecutive HIV-infected men undergoing medical assessment were offered to participate in a sexual dysfunction evaluation in two
referral HIV clinics in Barcelona (Spain) and Modena (Italy). Sexual dysfunction was assessed with the following tools: International Index of Erectile Function
(IIEF), Hospital Anxiety and Depression scale, blood analysis for laboratory diagnosis of hypogonadism. Other clinical and lifestyle data were collected from
interview and medical records.
Results: Consent was offered by 161 men, who were recruited and completed the IIEF. Of these, 94 (60%) were in CDC stage C (median CD4 was 503 [IQR 393;659] and median VL 50 [IQR 50;1000]), 121 (75%) were on HAART, 32 (19%) were on treatment interruption and eight (5%) were drug naives. Eleven patients referring having had no sexual activity in the past month were
excluded from the analysis.
--IIEF documented erectile dysfunction (ED) in 76 men (51%); 48 (30%) had insufficient sexual desire, 33 (22%) had orgasmic problems and 69 (46%) were unsatisfied with their sexual life.
--Most frequently perceived obstacles of sexual function were: the fear to infect the partner, HAART and condom use.
--Patients with ED were older (P=0.002), were more often men having sex with men (P=0.029), had anxiety (P=0.007), depression (P<0.001), high level of glycosilated haemoglobin (P=0.002) and lipid-lowering therapy (P=0.040).
--Lipodystrophy was more often reported in the SD population (P=0.089). Antiretroviral treatments and hormonal levels did not show significant associations with ED and other sexual problems.
Discussion: Sexual dysfunctions, and particularly ED, were common in sexually active HIV-infected southern European men. High prevalence of SD suggests a routine evaluation of sexual function in the clinical evaluation of HIV disease. In our population, HAART and hypogonadism were not associated with SD or ED.
Questionnaires to assess SD need to be validated in this particular population.
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