Incidence of erectile dysfunction among middle-aged and aging sexual minority men living with or without HIV.
Aishat Mustapha, Brittanny M Polanka, Mansi Maini, Deanna P Ware, Xiuhong Li, Trevor A Hart, Todd Brown, Frank Palella, Pamina M Gorbach, Ken Ho, Michael Plankey
Author Information
Aishat Mustapha: Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.
Brittanny M Polanka: Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, United States.
Mansi Maini: School of Medicine, Georgetown University, Washington, DC, United States.
Deanna P Ware: Department of Medicine, Georgetown University Medical Center, Washington, DC, United States.
Xiuhong Li: Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States.
Trevor A Hart: Department of Psychology, Ryerson University, Toronto, ON, Canada.
Todd Brown: Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, United States.
Frank Palella: Division of Infectious Diseases, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
Pamina M Gorbach: Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, United States.
Ken Ho: Department of Infectious Diseases and Microbiology, University of Pittsburgh, Pittsburgh, PA, United States.
Michael Plankey: Department of Medicine, Georgetown University Medical Center, Washington, DC, United States.
Introduction: Erectile dysfunction (ED) has been established as a comorbidity among men living with HIV, but comparisons by HIV serostatus of ED incidence in a longitudinal follow-up cohort of men are lacking. We sought to evaluate the incidence of ED spanning a period of 12 years in a longitudinal cohort of sexual minority men (SMM) living with and without HIV. Methods: We analyzed ED incidence data for 625 participants in the longitudinal Multicenter AIDS Cohort Study from visits spanning October 2006 to April 2019. Results: SMM living with HIV were more likely to have incident ED compared with those living without HIV (rate ratio: 1.41; 95% CI: 1.14-1.75). Older age, current diabetes, cumulative cigarette use, and cumulative antidepressant use were associated with increased incidence of ED in the entire sample. Self-identifying as Hispanic, current diabetes, and cumulative antidepressant use were positively associated with ED incidence among SMM living with HIV. Cumulative cigarette use was positively associated with greater ED incidence only among SMM living without HIV. Discussion: In summary, age (full sample/ with HIV), current diabetes (full sample/with HIV), cumulative cigarette use (full sample/without HIV), and cumulative antidepressant use (full sample/with HIV) were associated with increased ED incidence. Skillful management of diabetes and careful titration of antidepressants, along with smoking cessation practices, are recommended to mitigate ED in this population.
