602. Factors Associated with Erectile Dysfunction Diagnosis in HIV-infected Individuals: A Case-control Study
Session: Poster Abstract Session: HIV: Management and Clinical Outcomes
Thursday, October 4, 2018
Room: S Poster Hall
Posters
  • ID Week Poster HIV and ED Sep 25.pdf (113.6 kB)
  • Background:

    HIV-infected men have increased incidence of erectile dysfunction (ED) compared to men without HIV infection. Risk factors for ED among HIV-positive individuals have not been widely described.

    Methods:

    A retrospective cohort study was completed evaluating participants in the US Military HIV Natural History Study, a cohort of HIV-infected active duty members and beneficiaries. Men with a diagnosis of ED after HIV diagnosis were included (n=488). Cohort controls (n=976) without ED diagnosis were matched 2:1 by age at HIV diagnosis. Multivariate logistic regression model was used to identify risk factors for ED.

    Results:

    At HIV diagnosis, the median CD4 count was similar for cases (523 cells/uL, IQR 396-675) and controls (508 cells/uL, IQR 366-673; p=0.310) and the overall median age was 32 years. At ED diagnosis, cases had a median age of 43 years (IQR 37.0-49.0) and 445 (92.3%) were on antiretroviral therapy (ART). The median time from HIV diagnosis to ART start was longer for cases (5.0 years, IQR 2.0-9.0) compared with controls (3.0 years, IQR 1.0-6.0;p<0.001). Cases had a higher proportion of the following diagnoses compared to controls (p<0.001 for all): depression (33.4% vs 21.7%), hypertension (37.9% vs 20.4%), hyperlipidemia (54.3% vs 32.4%), tobacco use (31.1% vs 23.1%), sleep apnea (14.8% vs 4.2%) and diabetes/cardiovascular disease (CVD)(10.5% vs 4.7%). Multivariate logistic regression model is reported below (table).  

    Logistic Regression Model to Predict ED

    Characteristic

    Odds Ratio

    95% CI

    p-value

    Sleep apnea

    2.62

    1.69-4.05

    <0.001

    Time from HIV diagnosis to ART start  > mean

    2.07

    1.58-2.71

    <0.001

    African American race

    1.76

    0.90-3.42

    0.096

    Diabetes/cardiovascular disease

    1.61

    1.01-2.58

    0.048

    Tobacco use

    1.42

    0.99-2.04

     0.057

    Hypertension

    1.36

    1.02-1.82

     0.034

    Hyperlipidemia

    1.26

    0.96-1.64

     0.092

    Depression

    1.24

    0.94-1.63

    0.130

    CD4 count <200 cells/uL at HIV diagnosis

    0.63

    0.32-1.25

    0.184

    Prior protease inhibitor use

    0.43

    0.31-0.60

    <0.001

    Conclusion:

    Delay in ART initiation as well as risk factors for and presence of CVD were associated with ED in HIV-infected persons. Mitigating risk factors and optimizing comorbidities is important to improve sexual health and reduce ED in HIV-infected persons.

    Nathan Jansen, DO1, Colton Daniels, MS2, T.S. Sunil, PhD, MPS3, Xiaohe Xu, PhD, MPS4, Jason M. Cota, PharmD, MSc5, Morgan Byrne, MPH6, Anuradha Ganesan, MD, MPH7, Robert Deiss, MD8, Brian Agan, MD7 and Jason Okulicz, MD9, (1)Infectious Disease, San Antonio Military Medical Center, Ft Sam Houston, TX, (2)University of San Antonio/Department of Sociology, San Antonio, TX, (3)University of Texas San Antonio, Department of Sociology, San Antonio, TX, (4)University of Texas San Antonio/Department of Sociology, San Antonio, TX, (5)University of the Incarnate Word, San Antonio, TX, (6)Infectious Disease Clinical Research Program, Uniformed Services Unifersity of Health Sciences, Rockville, MD, (7)Infectious Disease Clinical Research Program, Uniformed Services University of the Health Sciences, Bethesda, MD, (8)Infectious Diseases Clinical Research Program, Uniformed Services University, Bethesda, MD, (9)Infectious Disease, San Antonio Military Medical Center, Fort Sam Houston, TX

    Disclosures:

    N. Jansen, None

    C. Daniels, None

    T. S. Sunil, None

    X. Xu, None

    J. M. Cota, None

    M. Byrne, None

    A. Ganesan, None

    R. Deiss, None

    B. Agan, None

    J. Okulicz, None

    Findings in the abstracts are embargoed until 12:01 a.m. PDT, Wednesday Oct. 3rd with the exception of research findings presented at the IDWeek press conferences.