More than half of the men at a Spanish HIV Clinic had erectile dysfunction (ED), according to a study published online November 30 in AIDS and reported by aidsmap. Older age and the use of protease inhibitors (PIs), the authors report, were most strongly associated with an increased risk for ED.

Several studies have indicated that ED might be more common in HIV-positive men, and at a younger age, compared with their HIV-negative counterparts. Given that HIV-positive men are more likely to have common ED risk factors, such as cardiovascular disease and low testosterone, it will be important to determine exactly which ED risk factors are most common and troublesome in HIV-positive men.

To explore the prevalence and risk factors of ED, Oscar Moreno-Pérez, MD, from the Universitario de Alicante, in Alicante, Spain, and his colleagues examined 90 HIV-positive men from their clinic. All of the men completed a survey about their sexual functioning. Researchers also tested the participants' testosterone and checked their medical records to determine whether or not they were receiving antiretroviral (ARV) therapy, whether they had treatment-related side effects, and whether they were experiencing depression. The participants' average age was 42, and most were taking ARV therapy.

More than half, 53.4 percent, were found to have ED, based on the score from a standard set of questions. The two strongest factors associated with having ED were older age and having been on treatment with a regimen containing a PI for more than 79 weeks. Depression and the presence of lipodystrophy also increased the likelihood that a person would have ED. There were no significant differences in testosterone between those who had ED and those who did not. All of the men with low testosterone, however, also had ED.

No HIV-negative control group was used in the study, thus it was no possible to conclude that ED is necessarily more common among HIV-positive men. Instead, the authors call for additional research to better understand erectile dysfunction in HIV-positive men, including its possible association with more serious diseases.