Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
Women's Health Research Institute, British Columbia (BC) Women's Hospital, Vancouver, Canada.
J Acquir Immune Defic Syndr. 2023 Aug 1;93(4):272-281. doi: 10.1097/QAI.0000000000003204.
Although sexual activity and function decline in older women living with HIV, positive dimensions of sexual health, such as satisfaction, are relatively unexplored. We evaluated the prevalence of sexual satisfaction for midlife women with HIV and assessed its relation to women's physical, mental, and sociostructural experiences.
We studied women in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) over 3 survey waves (2013-2018).
We included women living with HIV aged ≥45 years who reported ever having consensual sex. Sexual satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women and was dichotomized into satisfactory ("completely/very/reasonably satisfactory") and not satisfactory ("not very/not at all satisfactory"). Probable depression was based on CES-D ≥10. Multivariable logistic regression and fixed effects models determined correlates of sexual satisfaction. Reasons for sexual inactivity and alternate forms of sexual expression were also explored.
Among 508 midlife women, 61% were satisfied with their sexual lives at baseline. Women with probable depression had lower odds of sexual satisfaction than those without (aOR: 0.44; 95% CI: 0.27 to 0.71) and worsening depressive symptoms over time were associated with poorer sexual satisfaction ( P = 0.001). Increased sexual activity was associated with higher sexual satisfaction (aOR: 2.75; 95% CI: 1.54 to 4.91); however, 51% of women reporting sexual satisfaction were sexually inactive. Sexually inactive women engaged in alternate forms of sexual expression such as self-pleasure (37%) and intimate relationships without sex (13%).
Midlife women with HIV have high rates of sexual satisfaction, even in the absence of sexual activity. Depressive symptoms were closely associated with sexual dissatisfaction, alerting providers to the importance of screening for depression and sexual health together.
尽管感染艾滋病毒的老年女性的性行为和性功能下降，但性健康的积极方面，如满意度，相对来说还没有得到充分的研究。我们评估了感染艾滋病毒的中年女性的性满意度的流行率，并评估了其与女性的身体、心理和社会结构体验的关系。
我们研究了加拿大艾滋病毒女性性与生殖健康队列研究（CHIWOS）中的女性，该研究跨越了 3 个调查波（2013-2018 年）。
我们纳入了年龄≥45 岁且报告曾有过自愿性行为的感染艾滋病毒的女性。性满意度是通过女性性满意度量表中的一个项目来评估的，并分为满意（“完全/非常/相当满意”）和不满意（“不太满意/根本不满意”）。可能的抑郁是基于 CES-D≥10。多变量逻辑回归和固定效应模型确定了性满意度的相关因素。还探讨了性不活跃的原因和替代形式的性表达。
在 508 名中年女性中，61%的人在基线时对自己的性生活感到满意。有抑郁倾向的女性与没有抑郁倾向的女性相比，性满意度较低（优势比：0.44；95%置信区间：0.27 至 0.71），随着时间的推移，抑郁症状恶化与较差的性满意度相关（P=0.001）。性活动增加与性满意度提高相关（优势比：2.75；95%置信区间：1.54 至 4.91）；然而，51%报告性满意度的女性处于性不活跃状态。处于性不活跃状态的女性会采用替代形式的性表达，如自慰（37%）和没有性的亲密关系（13%）。
即使没有性行为，感染艾滋病毒的中年女性的性满意度也很高。抑郁症状与性不满密切相关，提醒医务人员一起筛查抑郁和性健康的重要性。
