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Associations between HIV-status and sexual dysfunction in homosexual men – findings from the German male sex-study

Schneider-Wirth, S1; Kron, M2; Schulwitz, HS1; Dinkel, A3; Arsov, C4; Hadaschik, B5; Imkamp, F6; Gschwend, JE1; Herkommer, K1

1: Department of Urology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; 2: Institute of Epidemiology and Medical Biometrics, University of Ulm, Ulm, Germany ; 3: Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany; 4: University Dusseldorf, Medical Faculty, Department of Urology, Dusseldorf, Germany; 5: Department of Urology, University Hospital Heidelberg, Heidelberg, Germany; 6: Clinic for Urology and Urological Oncology, Hannover Medical School, Hannover, Germany

Objectives: Studies, mostly conducted on high risk samples, have shown that HIV-positive (HIV+) men are significantly more often affected by the most common sexual dysfunctions (erectile dysfunction (ED), premature ejaculation (PE), low sexual desire) than HIV-negative (HIV-) men. This study investigated associations between HIV-status and sexual dysfunctions in a community-based sample of 45-year old homosexual German men.

Material and Methods: Within the German Male Sex-Study, a project related to the German prostate cancer screening-trial PROBASE, 45-year-old men were asked about, lifestyle and sexual behaviors using self-report questionnaires in four study centers (Dusseldorf, Hannover, Heidelberg, TU Munich) between April 2014 and April 2016. In addition, medical history was taken and a short physical examination was performed. Inclusion criterion was self-reported homosexual sexual identity. Data was analyzed using chi square test.

Results: Of 471 homosexual men, 54 self-disclosed as HIV+ (11.5%). Of those, 84.5% had been sexually active in the past three months. ED was more common in HIV+ men than in HIV- men (63.2% vs. 50.2%, p=0.130). PE was more often found HIV+ men than in HIV- men (12.1% vs. 6.7%, p=0.280). Low sexual desire was reported almost equally often by HIV+ and HIV- men (5.5% vs. 5.9%, p=1.000). Significantly fewer HIV+ men were in a partnership than HIV- men (p=0.023). There was a significant association of higher risk of HIV-infection in men with lower education (61.1% vs. 35.4%, p<0.001). HIV+ men smoked more often than HIV- men (p=0.014). No association could be shown between HIV-infection and alcohol consumption, physical activity, obesity, and overall health. Furthermore, HIV-infection was not associated with comorbidities (e.g. depression, diabetes, hypertension, circumcision, benign prostate symptoms, HBV/HCV infection).

Conclusions: In contrast to studies with high-risk samples, HIV-status was not associated with sexual dysfunction in this community sample of middle-aged homosexual men. Few differences were found between HIV+ and HIV- men. Only partnership status, education level, and smoking were clearly associated with HIV status.


Work supported by industry: no.

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