Antiretroviral therapy is associated with sexual dysfunction and with increased serum oestradiol levels in men

Abstract

Our objective was to determine the relationship between highly active antiretroviral therapy (HAART), serum total oestradiol and sexual dysfunction in HIV-infected men. Sexual difficulties were recorded prospectively in a cohort of HIV-negative (or unknown status) gay/bisexual men (MSM) and a cohort of HIV-infected men. The HIV-infected men were divided into those on and not on HAART and by sexuality. Serum total oestradiol and testosterone levels were evaluated where possible. One hundred HIV-negative MSM and 73 HIV-infected men (88% MSM) were analysed. Low libido and erectile dysfunction (ED) were reported in the control group in 2% and 10% respectively. This compared to a prevalence of 26% for both problems in HIV-infected MSM not taking HAART. In those MSM on HAART reduced libido was noted in 48% and ED in 25%. In the group of men taking HAART the mean oestradiol level was 228 pmol/L and was significantly above normal limits. Low libido and ED are more commonly reported in HIV-infected men compared to gay men of negative or unknown status. HAART is associated with a higher prevalence of lack of sexual desire and raised serum oestradiol levels.

Sexual Satisfaction Among Men Living with HIV in Europe

“…Patients lost to follow-up were not reached, which may have lead to a potential overestimation of the correlation between ART and sexual dissatisfaction (as one could hypothesize that people who are lost to follow-up are more likely to feel depressed, since not caring about health is a core symptom of depression). The role of ART in the onset of sexual problems in MLHIV remains unclear, also because of the inconsistency of the results obtained in other studies [6,[15][16][17][18][19][20][21][22]. The lack of a gold standard to define sexual dissatisfaction necessitated defining an arbitrary cutoff point without proven clinical relevance.…”

Diminished Sexual Activity, Interest, and Feelings of Attractiveness Among HIV-Infected Women in Two Eras of the AIDS Epidemic

“…Currently, little is known about whether the impact of being HIV-positive on sexuality has changed with the availability of HAART and the subsequent reconceptualization of HIV as a chronic disease rather than an acute life-threatening illness. HAART use has been linked to higher prevalence of sexual dysfunction among HIVinfected men (Collazos, Martinez, Mayo, & Ibarra, 2002;Colson et al, 2002;Lamba et al, 2004;Schrooten et al, 2001). Although the relationship between HAART and sexual functioning remains far less examined among HIV-positive women, the little research that has been done has found few differences.…”

HIV Treatment Adherence and Sexual Functioning

“…For men, low libido and erectile dysfunction have been reported as side effects associated with HAART, but are poorly discussed in the literature and with patients (Gordillo, Amo, Soriano, & Gonzalez-Lahoz, 1999;Lallemand et al, 2002;Lamba et al, 2004). Prevalence of sexual dysfunction is widespread with most (89%) HIV positive homosexual and bisexual men reporting a decrease or loss of libido, 86% having erectile dysfunction, 68% reporting orgasmic perturbation, and 59% reporting ejaculation difficulties (Lallemand et al, 2002).…”