Sen Mahadev Singh, Chattopadhyay Ankita, Chawla Nishtha, Ganesh Ragul, Verma Suraj, Sarkar Siddharth, Ambekar Atul
Department of Psychiatry, Institute of Human Behaviour and Allied Sciences (IHBAS), Delhi, India.
Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India.
Indian J Psychiatry. 2023 Jan;65(1):75-82. doi: 10.4103/indianjpsychiatry.indianjpsychiatry_395_22. Epub 2023 Jan 13.
Association between opioid use and sexual functioning is well-known. However, data evaluating the influence of treatment on different aspects of sexuality are lacking.
To compare sexual behavior, functioning, relationship, satisfaction, and sexual quality of life (sQoL) among treatment naïve patients (GROUP-I) with Opioid (heroin) dependence syndrome (ODS-H) with those maintained on buprenorphine (GROUP-II).
Married adult males diagnosed with ODS-H, currently sexually active, and living with their partner were recruited. They were assessed for their sexual practices and high-risk sexual behavior (HRSB) through a semi-structured questionnaire and sexual functioning, relationships, satisfaction, and sQoL through structured questionnaires.
A total of 112 individuals (GROUP-I: 63; GROUP-II: 49) were recruited from the outpatient settings. Mean age and employment in GROUP-II were higher ( < 0.05) than in GROUP-I (37 vs 32 years; 94% vs 70%, respectively). Other sociodemographic variables and the age of onset of heroin use were comparable. The current practice of HRSB (e.g., engaging in casual partner sex, sex with commercial sex workers, and sex under intoxication) was higher in GROUP-I while almost no differences were seen in lifetime HRSB. The frequency of erectile dysfunction and premature ejaculation in the two groups were: 78% vs 39% ( < 0.001), and 30% vs 6% ( = 0.001), respectively. GROUP-II had significantly higher scores in all the scales ( < 0.05) as compared to GROUP-I, indicating better sexual satisfaction, quality of life, and sexual relationship.
Heroin use is associated with HRSB, poorer sexual functioning, overall satisfaction, and sQoL. Maintenance of Buprenorphine helps with improvement in all these parameters. Comprehensive management for substance use should target sexual problems as well.
阿片类药物使用与性功能之间的关联已广为人知。然而，评估治疗对性方面不同维度影响的数据尚缺。
比较初治的阿片类药物（海洛因）依赖综合征（ODS-H）患者（第一组）与接受丁丙诺啡维持治疗的患者（第二组）之间的性行为、性功能、性关系、性满意度及性生活质量（sQoL）。
招募确诊为ODS-H、目前有性行为且与伴侣同住的已婚成年男性。通过半结构化问卷评估其性行为及高危性行为（HRSB），并通过结构化问卷评估其性功能、性关系、性满意度及sQoL。
共从门诊招募了112名个体（第一组：63名；第二组：49名）。第二组的平均年龄和就业比例高于第一组（P<0.05）（分别为37岁对32岁；94%对70%）。其他社会人口学变量及海洛因使用起始年龄具有可比性。第一组当前的HRSB行为（如与临时伴侣发生性行为、与性工作者发生性行为及在醉酒状态下发生性行为）发生率更高，而终生HRSB行为发生率两组间几乎无差异。两组勃起功能障碍和早泄的发生率分别为：78%对39%（P<0.001），以及30%对6%（P=0.001）。与第一组相比，第二组在所有量表上的得分均显著更高（P<0.05），表明其性满意度、生活质量及性关系更佳。
海洛因使用与HRSB、较差的性功能、总体满意度及sQoL相关。丁丙诺啡维持治疗有助于改善所有这些参数。物质使用的综合管理也应针对性问题。
