title: Erectile dysfunction is more common in young to middle-aged HIV-infected men than in HIV-uninfected men.
abstract: BACKGROUND
  Erectile dysfunction (ED) is common among elderly men and patients suffering from chronic diseases, the latter probably including also HIV infection. No studies, however, compared the prevalence of ED in HIV-infected and HIV-uninfected individuals using the international index of erectile function (IIEF-15).
  
  
  OBJECTIVE
  The aim of this study is to compare ED prevalence in young to middle-aged men with and without HIV infection using the IIEF-15 questionnaire.
  
  
  METHODS
  We conducted a cross-sectional, observational, controlled study on 444 HIV-infected men and 71 HIV-uninfected men.
  
  
  METHODS
  The IIEF-15 questionnaire was used to assess ED. A cutoff score of ≤25 of the erectile domain was used to diagnose ED. Serum testosterone, demographic, and anthropometric (weight, height, and body mass index [BMI]) characteristics were obtained from all participants. Statistics included the T-test, the Fisher's test, univariable and multivariable logistic regression, and univariate and multivariate Spearman's correlation analysis.
  
  
  RESULTS
  The HIV-uninfected group was significantly younger than the HIV-infected group and presented a higher BMI (P < 0.001). The prevalence of mild, moderate, and severe ED was higher in HIV-infected men than in HIV-uninfected men of all decades of age. In univariate analysis, HIV infection was associated with ED (odds ratio [OR] = 34.19, P < 0.001). In multivariable logistic regression analysis, HIV infection remained the strongest predictors of ED (OR = 42.26, P < 0.001) followed by hypogonadism, after adjusting for age and BMI.
  
  
  CONCLUSIONS
  This study demonstrates a clear association between ED and HIV infection, after adjusting for age and BMI. Other than HIV infection, hypogonadism was associated with ED. In addition, the prevalence of ED was higher in HIV-infected men than in HIV-uninfected men, in all decades of age. The early onset of ED in HIV-infected men could be considered a peculiar clinical hallmark of HIV and confirms precocious aging in these patients. ED should be of concern to clinicians when managing HIV-infected men even if the latter are young or middle aged.
authors.affiliation: Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Zona
authors.forename: Giovanni
authors.initials: G
authors.lastname: Guaraldi
authors.forename: Kety
authors.initials: K
authors.lastname: Luzi
authors.forename: Mattia
authors.initials: M
authors.lastname: Beggi
authors.forename: Daniele
authors.initials: D
authors.lastname: Santi
authors.forename: Chiara
authors.initials: C
authors.lastname: Stentarelli
authors.forename: Bruno
authors.initials: B
authors.lastname: Madeo
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Rochira
mesh_terms: D000328:Adult; D000367:Age Factors; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D007172:Erectile Dysfunction / Q000453:epidemiology / Q000209:etiology*; D015658:HIV Infections / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D011795:Surveys and Questionnaires