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Toorabally N, Mercer CH, Mitchell KR, Blell M, Burns F, Gilson R, McGregor-Read J, Allan S, De Ruiter A, Dhairyawan R, Fox J, Gilleece Y, Jones R, Mackie N, Obeyesekera S, Post F, Reeves I, Rosenvinge M, Ross J, Sarner L, Sullivan A, Tariq A, Ustianowski A, Sabin CA, Tariq S. Association of HIV status with sexual function in women aged 45-60 in England: results from two national surveys. AIDS Care 2020; 32:286-295. [PMID: 31411046 PMCID: PMC7034538 DOI: 10.1080/09540121.2019.1653436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 08/02/2019] [Indexed: 01/23/2023]
Abstract
Increasing numbers of women living with HIV are reaching their midlife. We explore the association of HIV status with sexual function (SF) in women aged 45-60 using two national cross-sectional surveys: the third British National Survey of Sexual Attitudes and Lifestyles ("Natsal-3") and "PRIME", a survey of women living with HIV attending HIV clinics across England. Both studies asked the same questions about SF that take account not only sexual difficulties but also the relationship context and overall level of satisfaction, which collectively allowed an overall SF score to be derived. We undertook analyses of sexually-active women aged 45-60 from Natsal-3 (N = 1228, presumed HIV-negative given the low estimated prevalence of HIV in Britain) and PRIME (N = 386 women living with HIV). Women living with HIV were compared to Natsal-3 participants using multivariable logistic regression (adjusting for key confounders identified a priori: ethnicity, ongoing relationship status, depression and number of chronic conditions) and propensity scoring. Relative to Natsal-3 participants, women living with HIV were more likely to: have low overall SF (adjusted odds ratio (AOR) 3.75 [2.15-6.56]), report ≥1 sexual problem(s) lasting ≥3 months (AOR 2.44 [1.49-4.00]), and report almost all 8 sexual problems asked about (AORs all ≥2.30). The association between HIV status and low SF remained statistically significant when using propensity scoring (AOR 2.43 [1.68-3.51]). Among women living with HIV (only), low SF was more common in those who were postmenopausal vs. Premenopausal (55.6% vs. 40.4%). This study suggests a negative association between HIV status and sexual function in women aged 45-60. We recommend routine assessment of SF in women living with HIV.
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Affiliation(s)
| | - Catherine H. Mercer
- Institute for Global Health, University College London, London, UK
- NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - Kirstin R. Mitchell
- MRC/CSO Social and Public Health Sciences Unit, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Mwenza Blell
- The Policy Ethics and Life Sciences (PEALS) Research Centre, School of Geography, Politics, and Sociology, Newcastle University, Newcastle, UK
| | - Fiona Burns
- Institute for Global Health, University College London, London, UK
- Ian Charleson Day Centre, Royal Free London NHS Foundation Trust, London, UK
| | - Richard Gilson
- Institute for Global Health, University College London, London, UK
| | | | - Sris Allan
- City of Coventry Health Centre (Integrated Sexual Health Services), Coventry and Warwickshire Partnership NHS Trust, Coventry, UK
| | - Annemiek De Ruiter
- Harrison Wing, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
- ViiV Healthcare, London, UK
| | | | - Julie Fox
- Harrison Wing, Guy’s & St Thomas’ NHS Foundation Trust, London, UK
| | - Yvonne Gilleece
- Lawson Unit, Brighton & Sussex University Hospitals NHS Trust, Brighton, UK
| | - Rachael Jones
- Kobler Outpatient Clinic, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Nicola Mackie
- The Wharfside Clinic, Imperial College Healthcare NHS Trust, London, UK
| | | | - Frank Post
- Caldecot Centre, King's College Hospital NHS Foundation Trust, London, UK
| | - Iain Reeves
- Jonathan Mann Clinic, Homerton University Hospital Foundation Trust, London, UK
| | | | - Jonathan Ross
- Queen Elizabeth Hospital Birmingham HIV Clinic, University Hospital Birmingham NHS Foundation Trust, Birmingham, UK
| | - Liat Sarner
- Grahame Hayton Unit, Barts NHS Trust, London, UK
| | - Ann Sullivan
- Kobler Outpatient Clinic, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Anjum Tariq
- Wolverhampton Sexual Health Service, The Royal Wolverhampton NHS Trust, Wolverhampton, UK
| | - Andrew Ustianowski
- Department of Infectious Diseases, North Manchester General Hospital, Penine Acute Hospitals NHS Trust, Manchester, UK
| | - Caroline A. Sabin
- Institute for Global Health, University College London, London, UK
- NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK
| | - Shema Tariq
- Institute for Global Health, University College London, London, UK
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