Guaraldi Giovanni, Luzi Kety, Murri Rita, Granata Antonio, De Paola Maria, Orlando Gabriella, Squillace Nicola, Malmusi Davide, Carani Cesare, Comelli Dante, Esposito Roberto, Martinez Esteban
Università di Modena e Reggio Emilia, Modena, Italy.
Antivir Ther. 2007;12(7):1059-65. doi: 10.1177/135965350701200713.
Both psychological and organic factors have been recognized to be associated with sexual dysfunction in HIV-infected individuals.
In this cross-sectional study we evaluated the prevalence and factors associated with sexual dysfunction in a cohort of HIV-infected adult men. Evaluation tools included: the International Index of Erectile Function (erectile dysfunction [ED], desire, orgasm, intercourse satisfaction, overall satisfaction), the Assessment of Body Change and Distress (body image satisfaction), the Medical Outcomes Study HIV Health Survey (mental and physical health-related quality of life), and plasma free and total testosterone level (hypogonadism).
Three-hundred and fifty-seven men were enrolled. Among 336 patients reporting sexual activities in the 4 weeks before, 94 (29.6%) had mild, 30 (9.4%) moderate and 34 (10.1%) severe dysfunction. The Mental Health Summary score was 2.28 units (95% confidence interval [CI] 1.51, 3.06) lower for each unit higher of body image dissatisfaction and 0.31 units (95% CI 0.27, 0.36) higher for each unit higher of the score for body change interference with habits. At regression analysis, ED was independently related to the body mass index (B = 0.31, 95% CI 0.08, 0.62). Desire, orgasm and overall satisfaction domains were associated with mental health score (B = 0.87, 95% CI 0.47, 1.27; B = 0.75, 95% CI 0.23, 1.26; B = 0.86, 95% CI 0.45, 1.28, respectively). An improved intercourse satisfaction domain was associated with a lower interference of body changes with habits and social life (B = 0.39, 95% CI 0.05, 0.73). Testosterone, metabolic alterations and HAART were not associated with sexual function domains.
Body image and mental health but not HAART or hypogonadism were associated with sexual function domains.
心理因素和器质性因素均被认为与HIV感染者的性功能障碍有关。
在这项横断面研究中，我们评估了一组HIV感染成年男性中性功能障碍的患病率及相关因素。评估工具包括：国际勃起功能指数（勃起功能障碍[ED]、性欲、性高潮、性交满意度、总体满意度）、身体变化与痛苦评估（身体形象满意度）、医学结局研究HIV健康调查（与心理和身体健康相关的生活质量）以及血浆游离睾酮和总睾酮水平（性腺功能减退）。
共纳入357名男性。在336名报告在之前4周内有性活动的患者中，94名（29.6%）有轻度性功能障碍，30名（9.4%）有中度性功能障碍，34名（10.1%）有重度性功能障碍。身体形象不满程度每升高一个单位，心理健康总结评分降低2.28分（95%置信区间[CI] 1.51, 3.06）；身体变化对习惯的干扰评分每升高一个单位，心理健康总结评分升高0.31分（95% CI 0.27, 0.36）。回归分析显示，ED与体重指数独立相关（B = 0.31, 95% CI 0.08, 0.62）。性欲、性高潮和总体满意度领域与心理健康评分相关（分别为B = 0.87, 95% CI 0.47, 1.27；B = 0.75, 95% CI 0.23, 1.26；B = 0.86, 95% CI 0.45, 1.28）。性交满意度提高与身体变化对习惯和社交生活的干扰降低相关（B = 0.39, 95% CI 0.05, 0.73）。睾酮、代谢改变和高效抗逆转录病毒治疗与性功能领域无关。
身体形象和心理健康与性功能领域相关，而高效抗逆转录病毒治疗或性腺功能减退与之无关。
