LACK OF AN ASSOCIATION BETWEEN PROTEASE INHIBITORS USE AND SEXUAL DYSFUNCTION IN PATIENTS WITH HIV INFECTION

L McGregor¹, JB Angel^2,3, JJ Clinch³, P Giguère^1
1Department of Pharmacy and ²Department of Medicine, Ottawa Hospital; ³Ottawa Health Research Institute, Ottawa, Ontario

Introduction: Sexual dysfunction (SD) is common in HIV infection and one potential contributing factor is antiretroviral therapy. The objective of this study was to determine the prevalence of SD in persons with HIV infection and to evaluate if SD is associated with the use of protease inhibitor (PI) based therapy.
Methods: Consecutive HIV infected patients attending the outpatient immunodeficiency clinic at the Ottawa Hospital over a one-month period were invited to participate in this cross-sectional study, by completing a questionnaire. SD was assessed using the Arizona Sexual Experiences ScaleÓ, a validated, self-reported measure composed of five Likert-scale questions. Relationships between categorical variables were examined using chi-squared or Fisher’s exact test while means of continuous variables were examined using the t-test. Logistic regression was conducted to establish a multivariate model.
Results: Of 248 patients screened, 165 (135 men and 30 women) were included in the analysis. 106 patients were taking PIs. 52 participants (32%) were experiencing SD. SD was not reported more often by patients taking PI containing regimens (31/106, 29%), compared to those not taking PIs (21/57, 37%), (p=0.3210). Multivariate analysis including the following variables: age, gender, plasma HIV RNA, current PI therapy and antidepressant medications use determined the following factors to be associated with SD: greater age (p=0.0053), female gender (p=0.0004) and antidepressant use (p<0.001). Although no association was found with PI usage in the multivariate model (p=0.5603), an association between any specific PI based regimen could not be excluded.
Conclusion: These data suggests that the use of a PI based regimen is not associated with a greater prevalence of SD. The observation that only greater age, female gender and antidepressant use are associated with SD illustrate the importance on HIV-independent factors. Further study may be warranted to determine if specific antiretroviral agents may be associated with SD.