Goggin K, Engelson E S, Rabkin J G, Kotler D P
Aaron Diamond Foundation, New York State Psychiatric Institute, Cornell Medical College, USA.
Psychosom Med. 1998 Jan-Feb;60(1):11-6. doi: 10.1097/00006842-199801000-00003.
This exploratory study assessed the prevalence of mood disorders, sexual disorders, and endocrine abnormalities, and explored the relationship between these parameters in a sample of HIV+ women.
Fifty-four HIV+ women were evaluated with the Structured Clinical Interview for DSM-III-R (SCID) and measures of psychiatric symptom severity, psychological well-being, and sexual problems. Women also provided blood to establish CD4 cell count, serum total testosterone, and dehydroepiandrosterone sulfate (DHEAS) levels.
Although overall levels of current Axis I diagnosis were low, Hypoactive Sexual Desire Disorder (HSDD) was diagnosed in 39% of the women. Forty-eight percent of the sample had deficient testosterone levels (below 20.0 ng/dl) and 27% had deficient DHEAS levels (below 35.0 microg/dl). We found no significant relationship between diminished sexual desire and deficient levels of testosterone, DHEAS, or mood disorder diagnoses. However, HSDD was significantly related to more depressive symptoms and lower life satisfaction. Women whose perceived risk factor for HIV infection included sexual contact were more than five times more likely to be diagnosed with a new onset HSDD than women who reported intravenous drug use (IVDU) as their only risk factor (47% vs. 9%, respectively).
We observed what seems to be high rates of HSDD and endocrine abnormalities with very low rates of mood disorders. Interestingly, endocrine abnormalities were not associated with low sexual desire. Our findings suggest that there is a significant unmet need for treatment of Hypoactive Sexual Desire Disorder among urban HIV+ women.
本探索性研究评估了情绪障碍、性功能障碍和内分泌异常的患病率，并在感染人类免疫缺陷病毒（HIV）的女性样本中探讨了这些参数之间的关系。
对54名感染HIV的女性进行了《精神障碍诊断与统计手册》第三版修订本（DSM-III-R）结构化临床访谈以及精神症状严重程度、心理健康状况和性问题的测量。这些女性还提供了血液样本以测定CD4细胞计数、血清总睾酮和硫酸脱氢表雄酮（DHEAS）水平。
虽然当前轴I诊断的总体水平较低，但39%的女性被诊断为性欲减退障碍（HSDD）。48%的样本睾酮水平不足（低于20.0 ng/dl），27%的样本DHEAS水平不足（低于35.0 μg/dl）。我们发现性欲减退与睾酮水平不足、DHEAS水平不足或情绪障碍诊断之间没有显著关系。然而，HSDD与更多的抑郁症状和更低的生活满意度显著相关。认为HIV感染危险因素包括性接触的女性被诊断为新发HSDD的可能性是那些报告静脉吸毒（IVDU）为唯一危险因素的女性的五倍多（分别为47%和9%）。
我们观察到性欲减退障碍和内分泌异常的发生率似乎较高，而情绪障碍的发生率很低。有趣的是，内分泌异常与性欲低下无关。我们的研究结果表明，城市中感染HIV的女性对性欲减退障碍的治疗存在重大未满足需求。
