title: Dyspareunia in HIV-positive and HIV-negative middle-aged women: a cross-sectional study.
abstract: OBJECTIVE
  To evaluate whether dyspareunia is associated with HIV status in menopausal women and also to assess which factors are associated with dyspareunia in a group of HIV-positive menopausal women.
  
  
  METHODS
  A cross-sectional study was conducted with 178 HIV-negative and 128 HIV-positive women aged 40-60 years. The Short Personal Experiences Questionnaire (SPEQ) was used to collect data. Sociodemographic, clinical, behavioural and reproductive factors were evaluated, as well as factors related to the HIV infection. Dyspareunia was defined as pain during intercourse. A bivariate analysis and Poisson multiple regression analysis were performed.
  
  
  RESULTS
  Overall, 41.4% of the HIV-positive women reported dyspareunia compared with 34.8% of the HIV-negative women (p=0.242). In the HIV-positive women, bivariate analysis revealed an association between dyspareunia and having a steady partner (p=0.047); the woman's partner having undergone HIV testing (p=0.020); vaginal dryness (p<0.001); muscle/joint pain (p=0.021); physical/emotional violence (p=0.049); urinary incontinence (p=0.004); and the use of lamivudine/zidovudine (p=0.048). The Poisson multiple regression analysis found an association between dyspareunia and vaginal dryness (prevalence ratio (PR)=1.96, 95% CI 1.10 to 3.50, p=0.023) and urinary incontinence (PR=1.86, 95% CI 1.06 to 3.27, p=0.031).
  
  
  CONCLUSIONS
  Dyspareunia was common in this group of HIV-positive women and was associated principally with vaginal dryness and urinary incontinence. The importance of treating dyspareunia within the context of sexual health in this group of women should be emphasised and appropriate management of this issue may reduce the likelihood of lesions on the vaginal wall, which may act as a portal of entry for other infections.
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Ana L R
authors.initials: AL
authors.lastname: Valadares
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Aarão M
authors.initials: AM
authors.lastname: Pinto-Neto
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Debora de C
authors.initials: Dde C
authors.lastname: Gomes
authors.affiliation: Department of Obstetrics and Gynecology, Graduated Student of Medicine of School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Walquíria C
authors.initials: WC
authors.lastname: D'Avanzo
authors.affiliation: Department of Municipal Health Division, Infectious Disease Reference Center, CTR/DIP Orestes Diniz, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors.forename: Alexandre S
authors.initials: AS
authors.lastname: Moura
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Lúcia
authors.initials: L
authors.lastname: Costa-Paiva
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Maria Helena
authors.initials: MH
authors.lastname: de Sousa
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004414:Dyspareunia / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D018023:HIV Seronegativity; D006679:HIV Seropositivity / Q000150:complications*; D006801:Humans; D008875:Middle Aged
keywords: PAIN MANAGEMENT; SEXUAL MEDICINE