Erectile dysfunction in men with human immunodeficiency virus: prevalence and associated factors

Male sexuality plays a crucial role in determining the overall quality of life, and it involves complex interactions between physical systems and psychosocial dimensions. Erectile dysfunction (ED) has a particularly notable impact on men's well-being, especially among those living with human immunodeficiency virus (HIV). This study's aim was to explore the prevalence of ED and its associated factors in men with HIV.

Cross-sectional research was conducted in a specialized care unit in Paraná, involving 120 adult men living with HIV. Data collection occurred from March 2021 to December 2023, and ED was assessed using the 6-item version of International Index of Erectile Function (IIEF-6) questionnaire. Psychological factors were assessed using the Depression, Anxiety and Stress Scales-21 (DASS-21). The primary outcome was ED.

The prevalence of ED was 37.5% [95% confidence interval (CI): 28.8% to 46.2%]. A significant association was observed between advanced age and ED. Regarding the type of antiretroviral therapy (ART), the data revealed a significant association with ED, the differences were particularly notable when comparing the therapeutic regimens of nucleoside reverse transcriptase inhibitor (NRTI) + Integrase inhibitor (INI) vs. NRTI + protease inhibitor (PI) and NRTI + NRTI. Furthermore, mental health factors were analyzed, with anxiety demonstrating a significant association with ED [odds ratio (OR) =2.35; 95% CI: 1.02 to 5.43; P=0.046].

The findings highlight the urgent need for an integrated approach to clinical management that considers both medical and emotional aspects in men living with HIV. It has also a potential to subside further investigations, particularly those adopting a longitudinal design to capture casual mechanisms of ED in men with HIV.