Having HIV is associated with reduced erectile function in men who have sex with men (MSM) age 45 and older, the National AIDS Treatment Advocacy Project (NATAP) reports. Additionally, a recent study of this population found that having taken Kaletra (lopinavir/ritonavir) was associated with erectile dysfunction.

Researchers studied a group of 399 HIV-positive MSM and 366 HIV-negative MSM in the AGEhIV cohort, giving them a standardized questionnaire to assess their erectile function along with questions about their satisfaction with their sex life and worries about having minimal sexual desire.

Findings were presented at the 9th International AIDS Society Conference on HIV Science in Paris (IAS 2017).

The median age in the HIV-positive group was 53.6; the median age in the HIV-negative group was 52.3 Ninety-five percent of the men living with HIV were on antiretroviral (ARV) treatment, and 97 percent of that group had an undetectable viral load.

Eighteen percent of the HIV-positive men had decreased sexual satisfaction, compared with 12 percent of the HIV-negative men. The respective rates of decreased sexual desire in the HIV-positive and -negative groups were 7 percent and 4 percent, and the respective rates of decreased erectile function were 13 percent and 4 percent.

After adjusting the data for age and ethnicity, the researchers found that having HIV was associated with a 4.1-fold increased likelihood of having decreased erectile function. In another model, the researchers adjusted for age, ethnicity, waist-to-hip ratio, number of age-related health conditions, depression, frailty and use of antidepressants or high blood pressure medications. Under this model, having HIV raised the risk of having decreased erectile function by 2.5-fold.

In a series of other models, the researchers adjusted various factors and found that having taken Kaletra was associated with a 4.3- to 5.6-fold increased likelihood of having decreased sexual function, depending on which factors the researchers put into the model.

The study authors concluded that HIV is independently associated with decreased erectile function in MSM who are 45 and older.