San Antonio Military Medical Center, San Antonio, TX, USA.
Department of Sociology, University of Texas San Antonio, San Antonio, TX, USA.
HIV Med. 2021 Aug;22(7):617-622. doi: 10.1111/hiv.13107. Epub 2021 Apr 25.
HIV infection is associated with increased risk of erectile dysfunction (ED); however, factors associated with ED remain unclear. We evaluated the prevalence of ED among men living with HIV and factors associated with ED diagnosis in the US Military HIV Natural History Study (NHS).
A retrospective cohort study evaluated participants in the NHS, a cohort of HIV-positive active duty members and beneficiaries with HIV infection. Men with a diagnosis of ED after HIV diagnosis were included. Cohort controls without ED diagnosis were matched 2:1 by age at HIV diagnosis and duration of follow-up. Multivariate logistic regression models were used to identify factors associated with ED.
A total of 543 of 5682 male participants (9.6% prevalence) had a diagnosis of ED, of whom 488 were included in the analysis. The median (interquartile range, IQR) age at ED diagnosis was 43 (37.0-49.0) years and the time from HIV diagnosis to antiretroviral therapy (ART) start was longer for cases (5.0 years, IQR: 2.0-9.0) than for controls (3.0 years, 1.0-6.0; P < 0.01). Cases had higher proportions of multiple comorbid conditions, including depression (33.4% vs. 21.7%), tobacco use (19.7% vs. 9.0%) and sleep apnoea (14.8% vs. 4.2%) compared with controls (P < 0.01 for all). Logistic regression showed increased odds of ED for delayed ART initiation > 4 years [odds ratio (OR) = 2.05, 95% confidence interval (CI): 1.56-2.71], protease inhibitor use ≥ 1 year (OR = 1.81, 95% CI: 1.38-2.38) and sleep apnoea (OR = 2.60, 95% CI: 1.68-4.01).
Erectile dysfunction was common in men with HIV and associated factors included both HIV-related and traditional factors.
HIV 感染与勃起功能障碍（ED）风险增加相关；然而，与 ED 相关的因素仍不清楚。我们评估了美国军事 HIV 自然史研究（NHS）中 HIV 感染者中 ED 的患病率以及与 ED 诊断相关的因素。
一项回顾性队列研究评估了 NHS 中的参与者，这是一组 HIV 阳性现役成员和 HIV 感染者的队列。在 HIV 诊断后被诊断为 ED 的男性被纳入研究。未被诊断为 ED 的队列对照者按照 HIV 诊断时的年龄和随访时间进行 2:1 匹配。多变量逻辑回归模型用于确定与 ED 相关的因素。
在 5682 名男性参与者中，共有 543 名（9.6%的患病率）被诊断为 ED，其中 488 名被纳入分析。ED 诊断时的中位（四分位间距，IQR）年龄为 43（37.0-49.0）岁，从 HIV 诊断到开始抗逆转录病毒治疗（ART）的时间对于病例（5.0 年，IQR：2.0-9.0）比对照组（3.0 年，1.0-6.0；P<0.01）更长。与对照组相比，病例组有更高比例的多种合并症，包括抑郁（33.4%比 21.7%）、吸烟（19.7%比 9.0%）和睡眠呼吸暂停（14.8%比 4.2%）（所有 P<0.01）。逻辑回归显示，ART 延迟启动>4 年（比值比[OR] = 2.05，95%置信区间[CI]：1.56-2.71）、使用蛋白酶抑制剂≥1 年（OR = 1.81，95% CI：1.38-2.38）和睡眠呼吸暂停（OR = 2.60，95% CI：1.68-4.01）与 ED 的发生几率增加相关。
HIV 感染者中 ED 很常见，相关因素包括与 HIV 相关的因素和传统因素。
