Marseille 2007
| Abstract #176 - SEXUAL DYSFUNCTION IN HAART-TREATED PERSONS: PREVALENCE, DETERMINANTS AND RELATIONSHIP WITH ADHERENCE | ||||
|
Session: 30.4: Sex and sexuality (Parallel) on Tuesday @ 11.00-12.30 in CP Chaired by Peter Weatherburn, Linda Pride Authors: Presenting Author: Dr Maria Paola Trotta - INMI "L. Spallanzani", Italy |
||||
| Additional Authors: MD Maria Paola Trotta, MD Adriana Ammassari, MD Patrizia Marconi, MD Rita Murri, MD Antonella d'Arminio Monforte, MD Andrea Antinori, | ||||
| Aim: Increased occurrence of sexual dysfunction (SD) among patients treated with highly active antiretroviral therapy (HAART) has been reported. This study was carried out to assess the prevalence of self-reported SD in a large cohort of HIV-infected persons taking HAART and to identify factors related to this alteration. Furthermore, we wanted to investigate the relationship between sexual dysfunction and HAART adherence behaviour. | ||||
| Method / Issue: Inter-cohort analysis among Italian HIV-infected persons treated with HAART. By an anonymous self-reported questionnaire, patients were asked to report the occurrence of any dysfunction in sexual activity and of other 23 common HAART-related symptoms over the past four weeks, using a 4-grade intensity scale (absent, mild, moderate, severe). Patient-reported non-adherence to HAART was also investigated in the questionnaire and was defined as missing at least one dose of HAART in the last week. Questionnaire evaluated also the Global Health Status (GHS) in a visual analogue scale rating from 0 to 100 (with the higher score representing the better health status), and the Mental Health Index-5 (MHI-5) to assess psychological well-being. | ||||
| Results / Comments: Among 612 participants, 125 persons (21%) reported some degree of SD; moderate or severe SD were recorded in 36 (6%) of individuals, with no significant difference in frequency among the two genders (6% in both). At univariate analysis, patients complaining of SD were more likely to be non-adherent to HAART (OR 3.37; 95%CI 1.69-6.69; P=0.0001) and to have HIV RNA >500 copies/ml at the time of questionnaire (OR 2.36; 95%CI 1.11-5.01; P=0.03). Moreover, self-reported moderate/severe SD was significantly associated with perceived worsening of viro-immunological parameters in respect to previous determinations, with patients satisfaction with social or family support and with several symptoms as well as with some reasons for missing/discontinuation of antiretrovirals. In particular, patients complaining of SD showed a higher mean overall symptom score (18.6+8.58 versus 7.86+6.39; P=0.0001) and medication side effect score (3.11+2.15 versus 1.72+1.62; P=0.0001). Both mean GSH (45.6+20.3 versus 59.1+24.2; P=0.0001) and MHI-5 scores (48.1+20.4 versus 61.6+20.2; P=0.0001) were significantly lower among individuals reporting SD when compared to those who did not. No significant association was found with socio-demographic, clinical and immunological characteristics, as well as with treatment history or specific drug classes. At multivariate analysis, participants who reported worsening of viro-immunological parameters (OR 3.90; 95%CI 1.08-14.18; P=0.04), higher symptom score (OR 1.13; 95%CI 1.05-1.22; P=0.001) and abnormal fat distribution (OR 4.33; 95%CI 1.55-12.11; P=0.005) were more likely to have impairment in sexual activity. Individuals self-reporting non-adherence to HAART had a more then 3-fold increased risk of complaining about sexual dysfunction (OR 3.44; 95%CI 1.30-9.08; P=0.04). | ||||
| Discussion: Patients perceived sexual dysfunction represents a relevant problem for HIV-infected persons treated with antiretrovirals and is associated with patient perceived worsening of viro-immunological markers, suboptimal HAART adherence, and self-perceived body alteration. In the light of clinicians need to optimise treatment adherence and to ensure an adequate quality of life to HIV-infected persons, identification and treatment of sexual dysfunction together with close risk-reduction counselling and stressed messages to promote safe sex should be encouraged. | ||||
| Go Back | ||||
