Luzi Kety, Guaraldi Giovanni, Murri Rita, De Paola Maria, Orlando Gabriella, Squillace Nicola, Esposito Roberto, Rochira Vincenzo, Zirilli Lucia, Martinez Esteban
Universita di Modena e Reggio Emilia, Modena, Italy.
Antivir Ther. 2009;14(1):85-92.
Prevalence and factors associated with sexual dysfunction in HIV-positive women are poorly known.
This was a cross-sectional study in a cohort of HIV-infected women. Clinically stable women were invited to participate in a female sexual dysfunction (FSD) evaluation with Female Sexual Function Index (FSFI) exploring desire, arousal, lubrication, orgasm, pain and satisfaction. An FSFI score <23 was used for defining FSD. Variables evaluated included body appearance satisfaction, interference of body changes with habits, social life and attitudinal aspects of body image, health-related quality of life, hormonal assessment, menopause, cumulative exposure to antiretroviral drug classes and immune-virological parameters. Lipodystrophy was defined according to the HIV Outpatient Study definition.
A total of 185 women completed the FSFI. The mean (+/-SD) age was 42 years (+/-5), 27% had CDC stage C, the mean (+/-SD) CD4+ T-cell count was 508 cells/microl (+/-251) and median HIV RNA was 1.7 log10 copies/ml (interquartile range 1.7-2.6). Among 161 evaluable patients, 59 (32%) reported FSD. In a multiple linear regression analysis, desire, arousal and satisfaction domains were associated with interference of body changes with habits, social life and attitudinal aspects of body image (beta = 0.22, 95% confidence interval [CI] 0.06-0.37; beta = 0.29, 95% CI 0.10-0.48; and beta = 0.20, 95% CI 0.02-0.38, respectively). Lubrication and orgasm domains were associated with body image satisfaction (beta = -0.49, 95% CI -0.88 - -0.10 and beta = -0.58, 95% CI -1.00 - -0.16, respectively). No significant associations with sex hormones, CDC stage, CD4+ T-cell count, HIV RNA viral load and cumulative exposure to antiretroviral drug classes were found. In women with FSD, severity of self-perceived abdominal fat accumulation showed a trend towards lower FSFI scores (ANOVA P = 0.02).
FSD was highly prevalent in this cohort. Self-perceived body changes was identified as its major determinant.
HIV 阳性女性性功能障碍的患病率及相关因素鲜为人知。
这是一项针对感染 HIV 女性队列的横断面研究。邀请临床状况稳定的女性参与一项使用女性性功能指数（FSFI）进行的女性性功能障碍（FSD）评估，该指数用于探究性欲、性唤起、润滑、性高潮、疼痛和满意度。FSFI 评分<23 被用于定义 FSD。评估的变量包括对身体外观的满意度、身体变化对习惯、社交生活及身体形象态度方面的干扰、健康相关生活质量、激素评估、绝经情况、抗逆转录病毒药物类别累积暴露情况以及免疫病毒学参数。脂肪代谢障碍根据 HIV 门诊研究定义进行界定。
共有 185 名女性完成了 FSFI 评估。平均（±标准差）年龄为 42 岁（±5），27%处于 CDC C 期，平均（±标准差）CD4 + T 细胞计数为 508 个/微升（±251），HIV RNA 中位数为 1.7 log10 拷贝/毫升（四分位间距 1.7 - 2.6）。在 161 名可评估患者中，59 名（32%）报告存在 FSD。在多元线性回归分析中，性欲、性唤起和满意度领域与身体变化对习惯、社交生活及身体形象态度方面的干扰相关（β = 0.22，95%置信区间[CI]0.06 - 0.37；β = 0.29，95%CI 0.10 - 0.48；以及β = 0.20，95%CI 0.02 - 0.38，分别）。润滑和性高潮领域与身体形象满意度相关（β = -0.49，95%CI -0.88 - -0.10 和β = -0.58，95%CI -1.00 - -0.16，分别）。未发现与性激素、CDC 分期、CD4 + T 细胞计数、HIV RNA 病毒载量及抗逆转录病毒药物类别累积暴露有显著关联。在患有 FSD 的女性中，自我感知的腹部脂肪堆积严重程度显示出 FSFI 评分较低的趋势（方差分析 P = 0.02）。
FSD 在该队列中高度流行。自我感知的身体变化被确定为其主要决定因素。
