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Impaired Sexual Function Is Common among Women with HIV

SUMMARY: HIV positive women are more likely to experience sexual problems than their HIV negative counterparts, especially if they are older, have more advanced immune deficiency, or have symptoms of depression, according to a study published in the February 20, 2010 advance online edition of the Journal of Acquired Immune Deficiency Syndromes.

By Liz Highleyman

Impaired sexual function is common among people with chronic diseases; physical disability, psychological distress, and medication side effects can all play a role. While there has been some study of sexual function among HIV positive men, there is less information about this condition in HIV positive women.

Tracey Wilson from the State University of New York Downstate Medical Center and colleagues conducted a study to compare impaired sexual function among women with and without HIV, and to describe clinical and psychosocial factors associated with these problems. They looked at aspects of sexual function including sexual desire, physiological arousal, difficult or painful intercourse, ability to achieve orgasm, and satisfaction with sex.

The analysis included more than 1800 participants in the Women's Interagency HIV Study (WIHS), an ongoing observational study of HIV positive and at-risk HIV negative women in the U.S.

Between October 2006 and March 2007, a total of 1279 HIV positive women and 526 HIV negative women completed a study visit that included administration of the Female Sexual Function Index (FSFI), physical and gynecological examinations, and blood sample collection.


HIV positive women reported more sexual problems than HIV negative women.
The average FSFI score among HIV positive women was significantly lower than that of the HIV negative group (13.8 vs 18.0, respectively, on a scale of 0-36).
Other factors that independently predicted poorer sexual function included:
Being menopausal;
Having symptoms of depression;
Not being in a relationship with a spouse or regular partner.
CD4 cell count was independently associated with FSFI scores.
Women with CD4 counts of 199 cells/mm3 or lower reported significantly poorer sexual functioning than those with 200 cells/mm3 or higher.
About one-third of HIV positive women and about one-quarter of HIV negative women reported not having vaginal, anal, or oral sex since their last WIHS study visit (conducted every 6 months).
Women who reported better sexual function had a higher average number of sexual partners.

Based on these findings, the researchers concluded that the study "shows a clear link between HIV infection and sexual problems among women."

"Given research documenting relationships between self-reported sexual problems and both clinical diagnoses of sexual dysfunction and women's quality of life, greater attention to this issue as a potential component of women's overall HIV care is warranted," they wrote.

Departments of Community Health Sciences, Medicine, and Neurology, State University of New York, Downstate Medical Center, Brooklyn, NY; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Department of Medicine, Stroger Hospital and Rush University, Chicago, IL; Departments of Psychiatry and Psychology, Obstetrics and Gynecology, and Medicine-Geriatrics, University of Illinois at Chicago, Chicago, IL; Departments of Clinical Pharmacy, Medicine and Epidemiology, and Biostatistics, University of California, San Francisco, CA; Division of Gynecologic Oncology, Washington University School of Medicine, St. Louis, MO; Department of Medicine, Montefiore Medical Center, Bronx, NY; Department of Medicine, Georgetown University, Washington, DC.


TE Wilson, G Jean-Louis, R Schwartz, and others. HIV Infection and Women's Sexual Functioning. Journal of Acquired Immune Deficiency Syndromes (Abstract). February 20, 2010 (Epub ahead of print).
















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