Hart Trevor A, Mustanski Brian, Ryan Daniel T, Gorbach Pamina M, Stall Ron D, Surkan Pamela J, Plankey Michael
Department of Psychology, Ryerson University, 350 Victoria St., Toronto, ON, M5B 2K3, Canada,
Arch Sex Behav. 2015 Feb;44(2):399-409. doi: 10.1007/s10508-014-0279-1. Epub 2014 Mar 27.
Erectile dysfunction and other forms of sexual dysfunction are highly prevalent among HIV+ men who have sex with men (MSM). Research has not previously identified the mechanisms by which depression may be associated with sexual dysfunction among HIV-positive and HIV-seronegative (HIV-negative) MSM. The present study examined the role of antidepressant use, stimulant use, and smoking as mediators of the relation between depression and sexual dysfunction among HIV-positive and HIV-negative MSM. Participants enrolled in the Multicenter AIDS Cohort Study, an ongoing prospective study of the natural and treated histories of HIV infection among MSM in the United States, completed a modified version of the International Index of Erectile Function for MSM. The study sample included 1,363 participants, with 619 HIV-positive men and 744 HIV-negative men. A structural equation model examined depression as a predictor of subsequent sexual dysfunction, mediated by antidepressant use, stimulant use, and smoking. Depression predicted subsequent sexual function among both HIV-negative and HIV-positive MSM. This effect appeared to be both a direct effect and an indirect effect via antidepressant use. Findings suggest that antidepressant medication use may partially explain sexual dysfunction among MSM.
勃起功能障碍及其他形式的性功能障碍在男男性接触者（MSM）且感染HIV的人群中极为普遍。此前的研究尚未确定在HIV阳性及HIV血清阴性（HIV阴性）的男男性接触者中，抑郁症可能与性功能障碍相关的机制。本研究探讨了使用抗抑郁药、兴奋剂和吸烟作为HIV阳性和HIV阴性男男性接触者中抑郁症与性功能障碍之间关系的中介因素的作用。参与多中心艾滋病队列研究的参与者完成了一份针对男男性接触者的国际勃起功能指数修订版，该研究是一项正在进行的关于美国男男性接触者中HIV感染自然史和治疗史的前瞻性研究。研究样本包括1363名参与者，其中619名HIV阳性男性和744名HIV阴性男性。一个结构方程模型将抑郁症作为后续性功能障碍的预测因素，由使用抗抑郁药、兴奋剂和吸烟介导。抑郁症可预测HIV阴性和HIV阳性男男性接触者的后续性功能。这种影响似乎既是直接影响，也是通过使用抗抑郁药产生的间接影响。研究结果表明，使用抗抑郁药物可能部分解释了男男性接触者中的性功能障碍。
