Toorabally Nasreen, Mercer Catherine H, Mitchell Kirstin R, Blell Mwenza, Burns Fiona, Gilson Richard, McGregor-Read Janine, Allan Sris, De Ruiter Annemiek, Dhairyawan Rageshri, Fox Julie, Gilleece Yvonne, Jones Rachael, Mackie Nicola, Obeyesekera Sharmin, Post Frank, Reeves Iain, Rosenvinge Melanie, Ross Jonathan, Sarner Liat, Sullivan Ann, Tariq Anjum, Ustianowski Andrew, Sabin Caroline A, Tariq Shema
Institute for Global Health, University College London, London, UK.
NIHR Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections, University College London, London, UK.
AIDS Care. 2020 Mar;32(3):286-295. doi: 10.1080/09540121.2019.1653436. Epub 2019 Aug 14.
Increasing numbers of women living with HIV are reaching their midlife. We explore the association of HIV status with sexual function (SF) in women aged 45-60 using two national cross-sectional surveys: the third British National Survey of Sexual Attitudes and Lifestyles ("Natsal-3") and "PRIME", a survey of women living with HIV attending HIV clinics across England. Both studies asked the same questions about SF that take account not only sexual difficulties but also the relationship context and overall level of satisfaction, which collectively allowed an overall SF score to be derived. We undertook analyses of sexually-active women aged 45-60 from Natsal-3 (= 1228, presumed HIV-negative given the low estimated prevalence of HIV in Britain) and PRIME (= 386 women living with HIV). Women living with HIV were compared to Natsal-3 participants using multivariable logistic regression (adjusting for key confounders identified : ethnicity, ongoing relationship status, depression and number of chronic conditions) and propensity scoring. Relative to Natsal-3 participants, women living with HIV were more likely to: have low overall SF (adjusted odds ratio (AOR) 3.75 [2.15-6.56]), report ≥1 sexual problem(s) lasting ≥3 months (AOR 2.44 [1.49-4.00]), and report almost all 8 sexual problems asked about (AORs all ≥2.30). The association between HIV status and low SF remained statistically significant when using propensity scoring (AOR 2.43 [1.68-3.51]). Among women living with HIV (only), low SF was more common in those who were postmenopausal vs. Premenopausal (55.6% vs. 40.4%). This study suggests a negative association between HIV status and sexual function in women aged 45-60. We recommend routine assessment of SF in women living with HIV.
感染艾滋病毒的女性数量日益增多，她们正步入中年。我们利用两项全国性横断面调查，探究了45至60岁女性的艾滋病毒感染状况与性功能（SF）之间的关联：第三次英国全国性态度和生活方式调查（“Natsal - 3”）以及“PRIME”，这是一项针对在英格兰各地艾滋病毒诊所就诊的感染艾滋病毒女性的调查。两项研究都询问了关于性功能的相同问题，这些问题不仅考虑了性方面的困难，还包括关系背景和总体满意度，综合这些因素得出了一个总体性功能得分。我们对Natsal - 3中45至60岁的性活跃女性（= 1228人，鉴于英国艾滋病毒估计患病率较低，假定为艾滋病毒阴性）和PRIME（= 386名感染艾滋病毒的女性）进行了分析。通过多变量逻辑回归（对已确定的关键混杂因素进行调整：种族、恋爱关系状况、抑郁和慢性病数量）和倾向评分，将感染艾滋病毒的女性与Natsal - 3参与者进行比较。相对于Natsal - 3参与者，感染艾滋病毒的女性更有可能：总体性功能较低（调整后的优势比（AOR）为3.75 [2.15 - 6.56]），报告有≥1个持续≥3个月的性问题（AOR为2.44 [1.49 - 4.00]），并且报告几乎所有被问及的8个性问题（所有AOR均≥2.30）。使用倾向评分时，艾滋病毒感染状况与低性功能之间的关联在统计学上仍然显著（AOR为2.43 [1.68 - 3.51]）。在仅感染艾滋病毒的女性中，绝经后女性的低性功能比绝经前女性更为常见（55.6%对40.4%）。这项研究表明，45至60岁女性的艾滋病毒感染状况与性功能之间存在负相关。我们建议对感染艾滋病毒的女性进行性功能的常规评估。
