Sexual dysfunction in gay and bisexual men with HIV infection: evaluation,treatment and implications

Sexual dysfunction problems are common in people with HIV infection, but th eir relevance has been recently highlighted in response to the increased su rvival shown by many individuals with HIV, and the publicity surrounding th e development of new treatments for male sexual dysfunction. Thirty-four ga y/bisexual men with HIV infection presenting with sexual dysfunction were a ssessed. Antiretroviral combination therapy including protease inhibitors w as taken by 44% other combinations not including protease inhibitors by 24% , while 32% were not taking any antiretrovirals. Primarily psychogenic sexu al dysfunction was thought to be present in 44%, primarily organic dysfunct ion in 22% and a mixed aetiology in 34%. Treatments offered included psycho logical interventions and physical methods of treatment, alone or in combin ation. Treatment was effective, with 76% reporting resolution of the proble ms, 14% reporting improvement and only 10% reporting no change. Practical a nd ethical issues raised by the findings are discussed.