title: Erectile dysfunction and hypogonadism among men with HIV.
abstract: Erectile dysfunction (ED) and hypogonadism are increasingly recognized conditions, however, the prevalence and etiologies of these conditions among HIV-infected men remain unclear. We studied 300 HIV-infected men who completed standardized questionnaires regarding sexual function and hypogonadal symptoms. An early morning testosterone test was performed; patients with a low serum testosterone level (defined by <300 ng/dL), underwent additional blood tests to determine the etiology of the hypogonadism. The participants' mean age was 39 years (range, 19-72); 61% were Caucasian; 24%, African American; 9%, Hispanic; and 5% other. Participants had been HIV-positive for a mean of 9 years (range, 0.5-20) with a mean CD4 count of 522 cells/mm(3) (range, 1-1531). Sixty percent were receiving antiretroviral therapy. ED was reported by 61.4%; of those with ED, 32% did not have a rigid enough erection for penetration, and 46% were unable to sustain an erection for the completion of intercourse. In the multivariate analysis, increasing age (odds ratio [OR] 1.4 for a 5-year increment, p < 0.001) and depression (OR 2.64, p < 0.0001) were associated with ED. A higher current CD4 count was protective (OR 0.80 for each 100 cells/mm(3), p = 0.004). Only 25% of patients with ED had utilized a phosphodiesterase-5-inhibitor for treatment. Seventeen percent of the 300 men were hypogonadal; there was no correlation between hypogonadism and ED. Increasing age and a higher body mass index (BMI) were positively associated with hypogonadism, while smoking was negatively associated (OR 0.44, p = 0.02). All patients with low testosterone had secondary hypogonadism. There was no association between ED or hypogonadism with the current, past, or cumulative use of HIV medications.
authors.affiliation: Tri-Service AIDS Clinical Consortium, Rockville, Maryland, USA. NRCrum@nmcsd.med.navy.mil
authors.forename: Nancy F
authors.initials: NF
authors.lastname: Crum-Cianflone
authors.forename: Mary
authors.initials: M
authors.lastname: Bavaro
authors.forename: Braden
authors.initials: B
authors.lastname: Hale
authors.forename: Christopher
authors.initials: C
authors.lastname: Amling
authors.forename: April
authors.initials: A
authors.lastname: Truett
authors.forename: Carolyn
authors.initials: C
authors.lastname: Brandt
authors.forename: Brandie
authors.initials: B
authors.lastname: Pope
authors.forename: Kari
authors.initials: K
authors.lastname: Furtek
authors.forename: Sheila
authors.initials: S
authors.lastname: Medina
authors.forename: Mark R
authors.initials: MR
authors.lastname: Wallace
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D015992:Body Mass Index; D018791:CD4 Lymphocyte Count; D003863:Depression; D007172:Erectile Dysfunction / Q000209:etiology*; D005006:Ethnicity; D015658:HIV Infections / Q000150:complications*; D006801:Humans; D007006:Hypogonadism / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012907:Smoking; D013223:Statistics as Topic; D011795:Surveys and Questionnaires; D013739:Testosterone / Q000097:blood
chemical_list: D019380:Anti-HIV Agents; D013739:Testosterone