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HIV Infection Is Linked To Higher Risk For Erectile Dysfunction In Men

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Published: May 19, 2011 2:24 pm
HIV Infection Is Linked To Higher Risk For Erectile Dysfunction In Men

Results from a recent study indicate that HIV-positive men who have sex with men are at an increased risk for erectile dysfunction compared to HIV-negative men who have sex with men. In particular, erectile dysfunction was significantly more prevalent in men with advanced HIV and AIDS who were between 40 and 59 years old.

HIV-positive men who have sex with men were also more likely to use prescription drugs to treat erectile dysfunction and more likely to engage in riskier sexual behavior. Men who had a steady partner were less likely to report problems with erectile dysfunction.

“Men with HIV, particularly men with HIV who develop AIDS, are more likely to develop erectile dysfunction than similarly aged men who are HIV negative. Sexual wellness is an important quality of life issue that deserves attention and should not be neglected,” said study authors Dr. Benjamin Breyer and Dr. Alan Shindel, urologists from the University of California at San Francisco and University of California at Davis, respectively, in correspondence with The AIDS Beacon.

“HIV-positive men should be aware that HIV may affect their erections, and that they should consult their physician if they start having problems,” they added.

Dr. Breyer and Dr. Shindel stated that follow-up studies would look into the cause for the higher risk in HIV-positive men.

“If we can learn what factors are most important (biological, psychological, etc), we can develop better interventions to help HIV-positive men maintain sexual wellness. We would be particularly interested in knowing if control of HIV infection with antiretroviral medications or attention to general health issues might help men maintain healthy sexual function,” they said.

Results from previous studies have suggested that HIV-positive men who have sex with men may have an increased risk of sexual problems, such as erectile dysfunction and decreased sexual desire, compared to the general population. Additionally, results from previous studies have indicated that HIV infection and AIDS increase the risk for declining sexual activity in men who have sex with men.

However, previous results have been conflicting due to small sample sizes, the survey methods used, and lack of an HIV-negative comparison group in some of the studies.

In this study, the researchers investigated the rates and risk factors for erectile dysfunction and premature ejaculation in HIV-positive men who have sex with men compared to HIV-negative men who have sex with men.

The study included 1,361 men, 236 of whom were HIV positive. The average age of participants was 42.6 years.

Study participants completed an Internet-based survey that included questions about their HIV status, demographic information such as age and race, drug use, sexual history, and sexual behavior and problems. Participants were also asked if they had ever seen a healthcare provider for any sexual problems or taken medications for erectile dysfunction, and if they had ever been treated for or diagnosed with health conditions such as diabetes, high blood pressure, and depression.

Since urinary tract problems are associated with sexual problems, participants completed an additional survey about lower urinary tract symptoms.

The authors only included completed surveys from participants 30 years or older in their analysis.

Results showed that HIV-positive men who have sex with men were about twice as likely to have erectile dysfunction compared to HIV-negative men who have sex with men, particularly in the 40 to 59 age group (about 12 percent of participants versus about 6 percent, respectively). Men with AIDS or a past history of AIDS were at greatest risk of erectile dysfunction.

The researchers also found a greater risk of premature ejaculation in men with advanced HIV between the ages of 30 and 39 (around 27 percent, compared to about 13 percent in HIV-negative men).

Men with HIV and AIDS reported higher rates of illicit drug use, depression, and severe lower urinary tract symptoms, compared to HIV-negative men. HIV-positive men were also significantly less likely to report a regular sexual partner and more likely to report risky sexual behavior and activity, such as sex with strangers or failure to use a condom.

Older age, diabetes, and severe lower urinary tract symptoms were associated with an increased risk for erectile dysfunction. Urinary tract symptoms were also associated with a higher risk for premature ejaculation.

The researchers found that men with a steady sexual partner had lower odds of reporting erectile dysfunction.

“It may be that men in a stable relationship have more regular sexual activity, or that men with stable partners don’t have as much anxiety about sexual activity,” suggested Dr. Breyer and Dr. Shindel.

“Partnered men may [also] be more likely to take care of their health (exercise, good diet, etc.) and might therefore have better erectile function due to better health. Since our study was just a survey, we can’t know for sure, but these are the leading theories,” they added

HIV-positive men younger than 60 years old were more likely to have sought help for sexual problems compared to HIV-negative men under 60. HIV-positive men were also more likely to use prescription drugs for erectile dysfunction (54 to 58 percent) compared to HIV-negative men (32 percent).

For more information, please see the study in AIDS Patient Care and STDs.

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