Background: Sexual dysfunction (SD) has been reported to be more prevalent among HIV-positive patients in comparison with age-matched HIV-negative individuals. The aetiology of SD is multifactorial and includes endocrine alterations, peripheral and autonomic neuropathy, psychological aspects and vascular diseases.
Patients and Methods: In this cross-sectional study, we evaluated the prevalence of and risk factors for self-reported SD in a cohort of HIV-infected HAART-treated patients. SD evaluation was performed using the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men. All subjects were screened for anxiety by administering the Self Rating Anxiety State SAS 054.
Results: 152 patients were enrolled, 71.7% male, median age 45 (IQR 39-49) years. Median CD4+ T-cell count was 577 (IQR 373-842) cells/μl, HIV-1 RNA viral load was <50 copies/ml in 78.9% of patients. The median duration of HAART was 8.5 (IQR 4-13) years, 61.8% were taking a PI-based antiretroviral regimen, 36.2% a NNRTI-based one. 7% of women denied any sexual activity and were excluded from analysis. 58% of the remaining 141 subjects reported SD. SD was more frequent in men (65% vs 34%, p =0.0024, OR 3.5, 95% CI 1.6 to 8.2) and elderly subjects (≥50 years) (54% vs 28%, p =0.0029, OR 3.8, 95% CI 1.5 to 9.6). Of 71 men with erectile dysfunction (ED), 26.7% reported severe ED, 73.3% mild/moderate ED. 74 subjects (52.5%) had a z score ≥45 that was suggestive of anxiety. Logistic regression analysis confirmed that age (p =0.008) and male sex (p =0.0087) but not anxiety (p =0.068) were associated with SD.
Conclusions: SD was highly prevalent among HIV-positive patients and was associated with male sex and increasing age. A greater understanding of factors associated with SD may help developing focused intervention strategies to improve the quality of life of HIV-infected subjects.
To cite this article
Self-reported sexual dysfunction in HIV-positive subjects: a cross-sectional study
Infectious Diseases & Tropical Medicine 2015; 1 (2): e104
Published online: 15 Jul 2015
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