Sexual dysfunction in HIV-infected men: role of antiretroviral therapy, hypogonadism and lipodystrophy.
BACKGROUND
Both psychological and organic factors have been recognized to be associated with sexual dysfunction in HIV-infected individuals.


METHODS
In this cross-sectional study we evaluated the prevalence and factors associated with sexual dysfunction in a cohort of HIV-infected adult men. Evaluation tools included: the International Index of Erectile Function (erectile dysfunction [ED], desire, orgasm, intercourse satisfaction, overall satisfaction), the Assessment of Body Change and Distress (body image satisfaction), the Medical Outcomes Study HIV Health Survey (mental and physical health-related quality of life), and plasma free and total testosterone level (hypogonadism).


RESULTS
Three-hundred and fifty-seven men were enrolled. Among 336 patients reporting sexual activities in the 4 weeks before, 94 (29.6%) had mild, 30 (9.4%) moderate and 34 (10.1%) severe dysfunction. The Mental Health Summary score was 2.28 units (95% confidence interval [CI] 1.51, 3.06) lower for each unit higher of body image dissatisfaction and 0.31 units (95% CI 0.27, 0.36) higher for each unit higher of the score for body change interference with habits. At regression analysis, ED was independently related to the body mass index (B = 0.31, 95% CI 0.08, 0.62). Desire, orgasm and overall satisfaction domains were associated with mental health score (B = 0.87, 95% CI 0.47, 1.27; B = 0.75, 95% CI 0.23, 1.26; B = 0.86, 95% CI 0.45, 1.28, respectively). An improved intercourse satisfaction domain was associated with a lower interference of body changes with habits and social life (B = 0.39, 95% CI 0.05, 0.73). Testosterone, metabolic alterations and HAART were not associated with sexual function domains.


CONCLUSIONS
Body image and mental health but not HAART or hypogonadism were associated with sexual function domains.
Guaraldi
Giovanni
G
Università di Modena e Reggio Emilia, Modena, Italy. g.guaraldi@unimo.it
Luzi
Kety
K
Murri
Rita
R
Granata
Antonio
A
De Paola
Maria
M
Orlando
Gabriella
G
Squillace
Nicola
N
Malmusi
Davide
D
Carani
Cesare
C
Comelli
Dante
D
Esposito
Roberto
R
Martinez
Esteban
E
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001828:Body Image; D003430:Cross-Sectional Studies; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D039682:HIV-Associated Lipodystrophy Syndrome / Q000150:complications* / Q000188:drug therapy / Q000523:psychology; D006801:Humans; D007006:Hypogonadism / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D020018:Sexual Dysfunctions, Psychological / Q000453:epidemiology / Q000209:etiology*; D013739:Testosterone / Q000097:blood
D013739:Testosterone