title: Antiretroviral therapy is associated with sexual dysfunction and with increased serum oestradiol levels in men.
abstract: Our objective was to determine the relationship between highly active antiretroviral therapy (HAART), serum total oestradiol and sexual dysfunction in HIV-infected men. Sexual difficulties were recorded prospectively in a cohort of HIV-negative (or unknown status) gay/bisexual men (MSM) and a cohort of HIV-infected men. The HIV-infected men were divided into those on and not on HAART and by sexuality. Serum total oestradiol and testosterone levels were evaluated where possible. One hundred HIV-negative MSM and 73 HIV-infected men (88% MSM) were analysed. Low libido and erectile dysfunction (ED) were reported in the control group in 2% and 10% respectively. This compared to a prevalence of 26% for both problems in HIV-infected MSM not taking HAART. In those MSM on HAART reduced libido was noted in 48% and ED in 25%. In the group of men taking HAART the mean oestradiol level was 228 pmol/L and was significantly above normal limits. Low libido and ED are more commonly reported in HIV-infected men compared to gay men of negative or unknown status. HAART is associated with a higher prevalence of lack of sexual desire and raised serum oestradiol levels.
authors.affiliation: Department of HIV Medicine & Sexual Health, St Mary's Hospital, Paddington, London W2 INY, UK. harpal.lamba@st-marys.nhs.uk
authors.forename: Harpal
authors.initials: H
authors.lastname: Lamba
authors.forename: David
authors.initials: D
authors.lastname: Goldmeier
authors.forename: Nicola E
authors.initials: NE
authors.lastname: Mackie
authors.forename: George
authors.initials: G
authors.lastname: Scullard
mesh_terms: D000328:Adult; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects*; D016022:Case-Control Studies; D007172:Erectile Dysfunction / Q000139:chemically induced*; D004958:Estradiol / Q000097:blood*; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy*; D020010:Heterosexuality / Q000706:statistics & numerical data; D018451:Homosexuality, Male / Q000706:statistics & numerical data; D006801:Humans; D007989:Libido; D008297:Male; D011446:Prospective Studies; D012016:Reference Values; D011795:Surveys and Questionnaires
chemical_list: D004958:Estradiol