1
|
Tiecco G, Salvi M, Delbarba A, Di Gregorio M, Colangelo C, Castelli F, Quiros-Roldan E. Sexual dysfunction in women living with HIV: an updated narrative review. Sex Med Rev 2024:qeae061. [PMID: 39183169 DOI: 10.1093/sxmrev/qeae061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 07/16/2024] [Accepted: 07/26/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION Female sexual dysfunction is a significant concern for many women worldwide, with chronic health conditions such as HIV infection contributing to its prevalence. However, there is a paucity of studies focusing this subject in the available literature. OBJECTIVES This narrative review aimed to provide a comprehensive and updated overview of the current state of knowledge regarding sexual dysfunction in women living with HIV (WLWH). METHODS References for this review were identified from MEDLINE, Embase, and Cochrane databases using the search terms "sexual dysfunction" AND "HIV" AND "female" OR "woman." The final reference list was generated based on the timeline, originality, and relevance to the scope of this narrative review. RESULTS In the general population, female sexual function is influenced by various factors, including biological, psychological, physiological, sociocultural, and relational ones. In WLWH, the role of antiretroviral therapy in female sexual dysfunction is controversial. Although current international guidelines recommend collecting a thorough sexual life anamnesis during routine outpatient visits, sexual difficulties are often inadequately addressed. CONCLUSION A tailored clinical approach that focuses on the multidimensional domains of sexual dysfunction may improve the sexual health and quality of life in WLWH.
Collapse
Affiliation(s)
- Giorgio Tiecco
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Martina Salvi
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Andrea Delbarba
- Unit of Endocrinology and Metabolism, Department of Medicine, ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Marco Di Gregorio
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Cosimo Colangelo
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Francesco Castelli
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| | - Eugenia Quiros-Roldan
- Unit of Infectious and Tropical Diseases, Department of Clinical and Experimental Sciences, University of Brescia and ASST Spedali Civili di Brescia, 25123 Brescia, Italy
| |
Collapse
|
2
|
Etemadi F, Bessonneau P, Yaya I, Dara A, Eriksson L, Rodriguez S, Lona Juraskova, Henrique M, Réjean T, Griffith W, Thonon F, Chassany O, Duracinsky M. Factors associated with sexual quality of life among men living with HIV. Int J STD AIDS 2024; 35:352-364. [PMID: 38146622 DOI: 10.1177/09564624231217324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
INTRODUCTION This study aims to assess the prevalence of sexual difficulties and identify factors associated with the Sexual Quality of Life (SQoL) among people living with HIV (PLWHA). METHODS The study included 107 heterosexual men and 474 men who have sex with men (MSM) from five countries. Participants self-reported variables related to physical and mental health, as well as HIV-related parameters. Erectile or ejaculation difficulty, as well as low sexual desire, were investigated. SQoL was measured using the PROQOL-SexLife questionnaire. RESULTS Most of participants reported low sexual desire, predominantly among MSM. Among MSM, living with a partner and healthcare satisfaction were associated with SQoL scores in POP dimension, while consistent condom use, cardiovascular complications, and being single were associated with SQoL scores in STI dimension. Viagra use, anti-cholesterol treatment, and living with a partner were associated with SQoL scores in DIS dimension. Among heterosexual men, employment and African origin were associated with SQoL scores in the POP dimension. Alcohol consumption was associated with SQoL scores in STI dimension. CONCLUSION This study underscores the importance of non-clinical determinants when assessing SQoL among PLWHA, emphasizing psychological factors and the perceived quality of healthcare. Tailored interventions should incorporate these findings to enhance overall SQoL outcomes.
Collapse
Affiliation(s)
- Fatima Etemadi
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Pascal Bessonneau
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Issifou Yaya
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Aichata Dara
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Lars Eriksson
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Solna, Sweden
| | - Sarah Rodriguez
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Lona Juraskova
- School of Psychology, University of Sydney, Sydney, Australia
| | | | | | | | - Frédérique Thonon
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Olivier Chassany
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
| | - Martin Duracinsky
- Unité de Méthodologie des critères d'évaluation (Patient- Centered Outcomes Research), Hopital Hotel-Dieu de Paris, Paris, France
- Patient-Centered Outcomes Research, University Paris-Diderot, Paris, France
- Internal Medicine and Clinical Immunology Department, AP-HP, Bicetre Hospital, Kremlin-Bicêtre, France
| |
Collapse
|
3
|
Abdu Z, Dule A, Habib S. The Frequency and Predictors of Sexual Dysfunction Among People Living with HIV/AIDS. HIV AIDS (Auckl) 2023; 15:729-737. [PMID: 38149002 PMCID: PMC10749793 DOI: 10.2147/hiv.s436966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/18/2023] [Indexed: 12/28/2023] Open
Abstract
Background The frequency of sexual dysfunctions reported by HIV/AIDS patients is significantly higher than that of their peers. Sexual dysfunction and its predictors may result in increased viral loads, worsening HIV infection, and infectivity. To mitigate its consequences, appropriate evaluation and intervention are required. Methods A cross-sectional study design was conducted among 336 HIV/AIDS-positive individuals at one hospital in southwest Ethiopia. To assess sexual dysfunctions, a tool called the Changes in Sexual Functioning Questionnaire (CSFQ-14) was used. Data analysis was done with SPSS version 20. Bivariate and multivariable logistic regressions were used to identify independent predictor variables, and statistical significance was declared at a p-value of <0.05. Results 98.53% of the sample completed the questionnaire accordingly. The frequency of SD was 72.0% (95% CI = 67.4-77.0). The frequency of SD was reported to be more prevalent among males (76.8% (95% CI = 70.6-81.6)) than that of females (66.2% (95% CI = 59.5-73.5)). Among the domains of sexual dysfunction, sexual pleasure problems (96.70%, (95% CI: 94.60-98.50)) were the higher figure of SD, and sexual desire problems (82.40%, (95% CI: 78.60-86.60)); were the least prevalent sexual dysfunctions. Predictors of the SD were age, social anxiety, nicotine use, poor sleep quality, and time of resuming ART medication. Conclusion The frequency of SD was 72.0%. Predictors of the SD were age, social anxiety, nicotine use, poor sleep quality, and time of resuming ART medication.
Collapse
Affiliation(s)
- Zakir Abdu
- Department of Psychiatry, Mattu University, Mattu, Oromia, Ethiopia
| | - Aman Dule
- Department of Psychiatry, Mattu University, Mattu, Oromia, Ethiopia
| | - Sadik Habib
- Department of Family Health, Mattu Health Science College, Mattu, Oromia, Ethiopia
| |
Collapse
|
4
|
Atalay S, Ucak HA, Caglayan D, Arkali E, Abakay H, Koc G. Erectile dysfunction prevalence and associated factors in men living with HIV from Western Turkey: A cross-sectional study. Int J STD AIDS 2023; 34:914-920. [PMID: 37401573 DOI: 10.1177/09564624231173029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
BACKGROUND The majority of people living with HIV in our country are younger men. However, limited data exist for the sexual health of these patients. Knowledge of the epidemiology in this population may improve health outcomes across the continuum of HIV care. The aim of this study was to determine the prevalence of erectile dysfunction (ED) and its association with some clinical and laboratory factors. METHODS A cross-sectional study was conducted using random sampling in men living with HIV (MLWH) at a tertiary hospital in Turkey. Patients were asked to fill out the five-item International Index of Erectile Function (IIEF-5), and blood was collected for HIV viral load, CD4+ T lymphocyte count, lipids and hormone levels to assess biological aspects at the same clinical visit. RESULTS A total of 107 MLWH were recruited. Mean age was 40.4 ± 12.4 years. ED was found in 73.8% (n = 79) of the participants. Severe ED was found in 6.3%, moderate in 5.1%, mild-moderate 35.4%, mild 53.2% of the participants, respectively. The mean age of men with erectile dysfunction was 42.5 ± 12.5 years, while those without erectile dysfunction were 34.5 ± 10 years (p:0.00). ED was detected more frequently in cases with high Low Density Lipoprotein (LDL) levels (p:0.003). There was no statistically significant difference between ED presence and having hormone abnormality. There was a moderate, negative correlation between age and ED score (r: -0.440, p < 0.001). A negative and low correlation was found between triglyceride level and ED score (r: -0.233, p:0.02). The only predictive variable was age in the multivariate analysis [B: -0.155 (95% CI -0.232 to -0.078), p: <0.001]. CONCLUSIONS Our study revealed a high prevalence of ED in the MLWH cohort. Age was found to be the only factor associated with ED. HIV clinicians should consider routine ED screening with validated measures as a part of the follow-up scheme to improve integrated wellbeing in MLWH.
Collapse
Affiliation(s)
- Sabri Atalay
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hazal Albayrak Ucak
- Department of Infectious Diseases and Clinical Microbiology, Ankara City Hospital, Ankara, Turkey
| | - Derya Caglayan
- Department of Public Health, Division of Epidemiology, Dokuz Eylül University Faculty of Medicine, Izmir, Turkey
| | - Eren Arkali
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Hilal Abakay
- Department of Infectious Diseases and Clinical Microbiology, University of Health Sciences, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Gokhan Koc
- Department of Urology, University of Health Sciences, Izmir Tepecik Training and Research Hospital, Izmir, Turkey
| |
Collapse
|
5
|
Milewska-Buzun M, Cybulski M, Baranowska A, Krajewska-Kułak E, Kózka M, Paradowska-Stankiewicz I. Satisfaction with sex life and its impact on the quality of life in people living with HIV in Poland treated in the city of Bialystok: a cross-sectional study. Front Psychiatry 2023; 14:1270441. [PMID: 37772065 PMCID: PMC10524601 DOI: 10.3389/fpsyt.2023.1270441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 08/28/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction Sex life is an important element contributing to the overall quality of life. It is also a particularly sensitive dimension of quality of life for HIV-positive patients. Objective The aim of the study was to assess the sexual life of people living with HIV in Poland treated in the Observation and Infection Clinic with the Subunit for HIV/AIDS Patients of the University Clinical Hospital in Bialystok, and its impact on the quality of life, life satisfaction, HIV status acceptance, general health status and depressive symptoms among the respondents. Methods A total of 147 participants, including 104 men (70.7%) and 43 women (29.3%), took part in the research. The study was conducted between May 2019 and January 2020. The study used a diagnostic survey method with a modified questionnaire "Psychosocial situation of people living with HIV/AIDS" by Dr. Magdalena Ankiersztejn-Bartczak and the following standardised psychometric tools: the World Health Organization Quality of Life (WHOQOL-BREF), Short Form Health Survey (SF-36), Acceptance of Illness Scale (AIS), Satisfaction with Life Scale (SWLS), General Health Questionnaire (GHQ-28) and Beck Depression Inventory (BDI). Results One-third of patients rated their sex life as poor or very poor. Almost half of respondents always informed sexual partners of their HIV status (49.7%). The sex life of respondents was highly correlated with almost all psychometric measures used in the study. Those indicating sexual contact as a possible source of HIV infection had a lower quality of life in the domain of general health compared to other respondents, but the difference was relatively small (about 5.5 points). Discussion In conclusion, the overall satisfaction with the sex life of people living with HIV was moderate with a tendency to poor. The quality of life of people living with HIV was determined by their sex life. Better quality of life was presented by those with good self-reported sex life.
Collapse
Affiliation(s)
- Marta Milewska-Buzun
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Mateusz Cybulski
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Anna Baranowska
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Elżbieta Krajewska-Kułak
- Department of Integrated Medical Care, Faculty of Health Sciences, Medical University of Bialystok, Bialystok, Poland
| | - Maria Kózka
- Department of Clinical Nursing, Institute of Nursing and Midwifery, Faculty of Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Iwona Paradowska-Stankiewicz
- Department of Epidemiology of Infectious Diseases and Surveillance, National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| |
Collapse
|
6
|
De Vincentis S, Decaroli MC, Milic J, Fanelli F, Tartaro G, Diazzi C, Mezzullo M, De Santis MC, Roli L, Trenti T, Santi D, Pagotto U, Guaraldi G, Rochira V. Determinants of sexual function in men living with HIV younger than 50 years old: Focus on organic, relational, and psychological issues. Andrology 2023; 11:954-969. [PMID: 36585963 DOI: 10.1111/andr.13372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Revised: 12/09/2022] [Accepted: 12/19/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Sexual dysfunctions, particularly erectile dysfunction, are common in men living with HIV, whose organic and psychological components remain to be clarified. The aim of the study is to investigate the impact of risk factors of sexual dysfunctions, including organic, relational, and psychological determinants of erectile function, in men living with HIV younger than 50 years old. METHODS A cross-sectional, observational study was conducted in men living with HIV < 50 years. The questionnaire International Index of Erectile Function-15 was used to assess the prevalence and degree of erectile dysfunction. The structured interview of erectile dysfunction was used to explore the organic (Scale 1), relational (Scale 2), and psychological (Scale 3) components of erectile dysfunction. Total testosterone, estradiol, and dihydrotestosterone were measured by liquid chromatography-tandem-mass spectrometry; free testosterone was calculated by the Vermeulen equation. RESULTS A total of 313 consecutive men living with HIV were prospectively enrolled (median age 47.0 years; median HIV-infection duration 16.2 years). 187 patients (59.7%) had erectile dysfunction, with a higher prevalence of non-heterosexual (138 out of 187, 73.8%) than heterosexual patients (p = 0.003). Patients with erectile dysfunction showed a worse score of structured interview of erectile dysfunction scale 3 compared to patients without erectile dysfunction (p = 0.025); the International Index of Erectile Function-15 was inversely related to structured interview of erectile dysfunction scale 3 (p = 0.042). No difference was found for sex steroids (total testosterone, estradiol, free testosterone, and dihydrotestosterone) between men living with HIV with and without erectile dysfunction. In the multivariate analysis sexual orientation, and lack of stable relationships were major determinants for erectile dysfunction. Only 35 of 187 patients with erectile dysfunction (18.7%) reported the use of erectile dysfunction medications. CONCLUSIONS Within the multidimensional network of erectile dysfunction in men living with HIV, the psychological component is predominant, highlighting the contribution of peculiar factors related to HIV distress (e.g., fear of virus transmission, stigma) rather than gonadal status and other classical risk factors. In contrast to the high prevalence, only a few patients reported the use of erectile dysfunction medications suggesting a general under-management of such issues.
Collapse
Affiliation(s)
- Sara De Vincentis
- Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medical Specialties, Unit of Endocrinology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Chiara Decaroli
- Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medical Specialties, Unit of Endocrinology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Jovana Milic
- Multidisciplinary Metabolic Clinic, Unit of Infectious Diseases, University of Modena and Reggio Emilia, Italy
| | - Flaminia Fanelli
- Department of Medical and Surgical Sciences, Center for Applied Biomedical Research, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Giulia Tartaro
- Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medical Specialties, Unit of Endocrinology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Chiara Diazzi
- Department of Medical Specialties, Unit of Endocrinology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Marco Mezzullo
- Department of Medical and Surgical Sciences, Center for Applied Biomedical Research, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | | | - Laura Roli
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - Tommaso Trenti
- Department of Laboratory Medicine and Pathology, Azienda USL of Modena, Modena, Italy
| | - Daniele Santi
- Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medical Specialties, Unit of Endocrinology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| | - Uberto Pagotto
- Department of Medical and Surgical Sciences, Center for Applied Biomedical Research, Alma Mater Studiorum University of Bologna, Bologna, Italy
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giovanni Guaraldi
- Multidisciplinary Metabolic Clinic, Unit of Infectious Diseases, University of Modena and Reggio Emilia, Italy
| | - Vincenzo Rochira
- Department of Biomedical, Metabolic and Neural Sciences, Unit of Endocrinology, University of Modena and Reggio Emilia, Modena, Italy
- Department of Medical Specialties, Unit of Endocrinology, Azienda Ospedaliero-Universitaria di Modena, Modena, Italy
| |
Collapse
|
7
|
Dadgar F, Moshfeghy Z, Janghorban R, Doostfatemeh M. Predictors of sexual dysfunction in HIV-infected men. ACTA FACULTATIS MEDICAE NAISSENSIS 2022. [DOI: 10.5937/afmnai39-34461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Aims: The prevalence of sexual dysfunction in people infected with human immunodeficiency virus (HIV) is higher than in those without this infection. Sexual dysfunction in HIV-infected people is associated with adverse outcomes. This study aimed to investigate the predictors of sexual function in people infected with HIV. Material and Methods: This cross-sectional study was done at Behavioral disease counseling centers. Samples were taken from 186 HIV-infected men. Demographic variables were recorded. Sexual function and psychological status were assessed by the International Index of Erectile Function Questionnaire, the DASS-21 (Depression, Anxiety, Stress Scales), and the Domestic Violence Questionnaire. To examine the CD4 cells and hormonal profiles, blood samples were taken from each patient. The data were analyzed using the SPSS18 software. Results: A multivariate analysis showed that hepatitis B infection (P = 0.034, OR = 9.6), smoking (P = 0.026, OR = 2.5), severe stress (P = 0.04, OR = 0.32) and severe depression (P = 0.042, OR = 6.9) were the predictors of sexual dysfunction in HIV-infected men. Conclusion: This study showed that smoking, hepatitis B infection, severe depression, and severe stress could be predictors of sexual dysfunction in those men.
Collapse
|
8
|
De Vincentis S, Tartaro G, Rochira V, Santi D. HIV and Sexual Dysfunction in Men. J Clin Med 2021; 10:jcm10051088. [PMID: 33807833 PMCID: PMC7961513 DOI: 10.3390/jcm10051088] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 12/12/2022] Open
Abstract
Sexual issues tend to go unaddressed in human immunodeficiency virus (HIV) management, although overt sexual dysfunctions are more prevalent in people living with HIV than uninfected people. Erectile dysfunction is the most frequent sexual problem, with a prevalence of 30–50% even in men <40 years of age, but other issues such as loss of libido and ejaculatory disorders should not be overlooked. Peculiar factors related to HIV infection (e.g., fear of virus transmission, changes in body image, HIV-related comorbidities, HIV distress and stigma), alongside classical factors non-related to HIV, should be considered when approaching sexual problems in HIV patients. For this reason, the diagnostic and therapeutic workout of sexual dysfunction in the context of HIV requires a multidisciplinary approach, involving specialists in both infectious diseases and sexual medicine. This narrative review presents an overview of current knowledge on sexual dysfunction in HIV men, deepening the factors driving and taking part in these issues, providing advice for the clinical approach, and underlining the importance of caring for sexual health to improve the quality of life of HIV patients.
Collapse
Affiliation(s)
- Sara De Vincentis
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Giulia Tartaro
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| | - Vincenzo Rochira
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
- Correspondence: ; Tel.: +39-059-396-2453; Fax: +39-059-396-1335
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Via Giardini 1355, 41126 Modena, Italy; (S.D.V.); (G.T.); (D.S.)
- Unit of Endocrinology, Department of Medical Specialties, Azienda Ospedaliero-Universitaria of Modena, 41126 Modena, Italy
| |
Collapse
|
9
|
Huntingdon B, Muscat DM, de Wit J, Duracinsky M, Juraskova I. Factors Associated with General Sexual Functioning and Sexual Satisfaction among People Living with HIV: A Systematic Review. JOURNAL OF SEX RESEARCH 2020; 57:824-835. [PMID: 31755793 DOI: 10.1080/00224499.2019.1689379] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Sexual difficulties, experienced by half of the people living with HIV (PLWH), not only affect quality of life but have been associated with lower adherence to antiretroviral medication. This systematic review synthesizes studies published since 1997 which used statistical methods to investigate factors associated with general sexual functioning or sexual satisfaction of PLWH. We searched Medline, PsycINFO, Embase, Cinahl and Scopus with terms: HIV AND sexual dysfunction AND factors. Of 5552 records, 26 studies met selection criteria. Twenty-one studies on general sexual function, and five studies on sexual satisfaction. Two researchers separately extracted data and applied standardized quality assessment criteria. (Registration: CRD42018094146.) Regarding general sexual dysfunction, older age, general physical health, depression, body image and psychological distress were the most relevant factors. There was inconsistent evidence for: CD4, viral load, HIV symptom severity, HIV disease progression and time since diagnosis. From limited available evidence on sexual satisfaction, age, unemployment, and psychosocial factors were significant. Overall, anxiety and relational factors were under-researched, treatment center studies were over-represented and non-validated measurement of outcomes was common. Future research is required to build theoretical models of sexual well-being specific to PLWH to guide effective research and intervention to promote sexual quality of life of PLWH.
Collapse
Affiliation(s)
- Ben Huntingdon
- Clinical Psychology Unit, School of Psychology, The University of Sydney
| | - Danielle Marie Muscat
- Faculty of Medicine and Health, School of Public Health, Sydney Health Literacy Lab, The University of Sydney
| | - John de Wit
- Centre for Social Research in Health, UNSW Sydney
- Department of Interdisciplinary Social Science, Utrecht University
| | - Martin Duracinsky
- Patient-Centered Outcomes Research, Université Paris-Diderot, Sorbonne Paris Cité
- Service de Médecine Interne et d'Immunologie Clinique, Hospital Bicetre , France
- Unité de Recherche Clinique (URC-ECO), Hospital Hotel-Dieu
| | - Ilona Juraskova
- Clinical Psychology Unit, School of Psychology, The University of Sydney
- Centre for Medical Psychology and Evidence-based Decision-making (CeMPED), The University of Sydney
| |
Collapse
|