title: Sexual dysfunction in HIV-infected men: role of antiretroviral therapy, hypogonadism and lipodystrophy.
abstract: 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.
authors.affiliation: Università di Modena e Reggio Emilia, Modena, Italy. g.guaraldi@unimo.it
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Kety
authors.initials: K
authors.lastname: Luzi
authors.forename: Rita
authors.initials: R
authors.lastname: Murri
authors.forename: Antonio
authors.initials: A
authors.lastname: Granata
authors.forename: Maria
authors.initials: M
authors.lastname: De Paola
authors.forename: Gabriella
authors.initials: G
authors.lastname: Orlando
authors.forename: Nicola
authors.initials: N
authors.lastname: Squillace
authors.forename: Davide
authors.initials: D
authors.lastname: Malmusi
authors.forename: Cesare
authors.initials: C
authors.lastname: Carani
authors.forename: Dante
authors.initials: D
authors.lastname: Comelli
authors.forename: Roberto
authors.initials: R
authors.lastname: Esposito
authors.forename: Esteban
authors.initials: E
authors.lastname: Martinez
mesh_terms: 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
chemical_list: D013739:Testosterone