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Erectile Dysfunction Is More Common in Young to Middle-Aged HIV-Infected Men than in HIV-Uninfected Men

Authors

  • Stefano Zona MD,

    1. Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy
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  • Giovanni Guaraldi MD,

    1. Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy
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  • Kety Luzi MD,

    1. Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy
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  • Mattia Beggi MD,

    1. Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy
    2. Health Science Research Centre, Department of Life Sciences, Roehampton University, London, UK
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  • Daniele Santi MD,

    1. Chair and Unit of Endocrinology & Metabolism, Department of Medicine, Endocrinology & Metabolism, Geriatrics, University of Modena and Reggio Emilia, Azienda AUSL of Modena-NOCSAE of Baggiovara, Modena, Italy
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  • Chiara Stentarelli MD,

    1. Metabolic Clinic, Infectious Diseases Unit, Department of Medicine and Medical Specialities, University of Modena and Reggio Emilia, Modena, Italy
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  • Bruno Madeo MD, PhD,

    1. Chair and Unit of Endocrinology & Metabolism, Department of Medicine, Endocrinology & Metabolism, Geriatrics, University of Modena and Reggio Emilia, Azienda AUSL of Modena-NOCSAE of Baggiovara, Modena, Italy
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  • Vincenzo Rochira MD, PhD

    Corresponding author
    1. Chair and Unit of Endocrinology & Metabolism, Department of Medicine, Endocrinology & Metabolism, Geriatrics, University of Modena and Reggio Emilia, Azienda AUSL of Modena-NOCSAE of Baggiovara, Modena, Italy
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Vincenzo Rochira, MD, PhD, Unit and Chair of Endocrinology, Department of Medicine, Endocrinology and Metabolism, Geriatrics, University of Modena and Reggio Emilia, Azienda AUSL of Modena-NOCSAE of Baggiovara, Via Giardini 1355, Baggiovara, Modena 41126, Italy. Tel: +39-(0)59-422 45 29; Fax: +39-(0)59-422 25 28; E-mail: rochira.vincenzo@unimore.it

ABSTRACT

Introduction.  Erectile dysfunction (ED) is common among elderly men and patients suffering from chronic diseases, the latter probably including also HIV infection. No studies, however, compared the prevalence of ED in HIV-infected and HIV-uninfected individuals using the International Index of Erectile Function (IIEF-15).

Aim.  The aim of this study is to compare ED prevalence in young to middle-aged men with and without HIV infection using the IIEF-15 questionnaire.

Methods.  We conducted a cross-sectional, observational, controlled study on 444 HIV-infected men and 71 HIV-uninfected men.

Main Outcomes Measures.  The IIEF-15 questionnaire was used to assess ED. A cutoff score of ≤25 of the erectile domain was used to diagnose ED. Serum testosterone, demographic, and anthropometric (weight, height, and body mass index [BMI]) characteristics were obtained from all participants. Statistics included the T-test, the Fisher's test, univariable and multivariable logistic regression, and univariate and multivariate Spearman's correlation analysis.

Results.  The HIV-uninfected group was significantly younger than the HIV-infected group and presented a higher BMI (P < 0.001). The prevalence of mild, moderate, and severe ED was higher in HIV-infected men than in HIV-uninfected men of all decades of age. In univariate analysis, HIV infection was associated with ED (odds ratio [OR] = 34.19, P < 0.001). In multivariable logistic regression analysis, HIV infection remained the strongest predictors of ED (OR = 42.26, P < 0.001) followed by hypogonadism, after adjusting for age and BMI.

Conclusions.  This study demonstrates a clear association between ED and HIV infection, after adjusting for age and BMI. Other than HIV infection, hypogonadism was associated with ED. In addition, the prevalence of ED was higher in HIV-infected men than in HIV-uninfected men, in all decades of age. The early onset of ED in HIV-infected men could be considered a peculiar clinical hallmark of HIV and confirms precocious aging in these patients. ED should be of concern to clinicians when managing HIV-infected men even if the latter are young or middle aged. Zona S, Guaraldi G, Luzi K, Beggi M, Santi D, Stentarelli C, Madeo B, and Rochira V. Erectile dysfunction is more common in young, middle-aged HIV-infected men than in HIV-uninfected men. J Sex Med 2012;9:1940–1947.

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