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RESEARCH ARTICLE
Contents Vol 6(4)

A longitudinal analysis of sociodemographic and health correlates of sexual health among HIV-infected men in the USA

William L. Jeffries IV A C , Barbara A. Zsembik A , Chuck W. Peek A and Constance R. Uphold B
+ Author Affiliations
- Author Affiliations

A Department of Sociology and Criminology & Law, University of Florida, PO Box 117330, Gainesville, FL 32611-7330, USA.

B Rehabilitation Outcomes Research Center, Geriatric Research, Education and Clinical Center, North Florida/South Georgia Veterans Health System, 1601 SW Archer Road, 151B Gainesville, FL 32608-1197, USA.

C Corresponding author. Email: jeffries@ufl.edu

Sexual Health 6(4) 285-292 https://doi.org/10.1071/SH08070
Submitted: 18 September 2008  Accepted: 17 July 2009   Published: 13 November 2009

Abstract

Background: Sexual health among HIV-infected men primarily has been examined in cross-sectional designs. Few have used longitudinal data to measure sexual health change or factors associated with change. Moreover, studies of HIV-infected men disproportionately focus on sexual risk behaviours. The present paper examines temporal changes in sexual health based on measures of sexual activity, erectile function, sex drive, and sex life satisfaction. Methods: Data from a prospective cohort study of HIV-infected men (n = 197) in the USA were used. Sexual health measures were based on self-reported sexual activity, erectile function, sex drive, and sex life satisfaction at 12- and 24-month follow-ups. Transition matrices described 1-year sexual health changes. Logistic regression models determined sociodemographic and health-related factors associated with change. Results: Men reported considerable change in sexual health during the year-long observation interval. Among men who experienced change, younger age, cohabitation, and higher CD4 counts were associated with greater sexual activity over time. Men with more depression symptoms had lower erectile function over time, and higher education and higher income were protective against temporal declines in sex drive and satisfaction. Less disease comorbidity was associated with 1-year improvements in sex life satisfaction. Conclusions: Some men in our sample experienced sexual health change, but stability was common for most. Temporal changes in sexual health varied according to age, cohabitation, education, income, and physical and mental health covariates. The present paper highlights the benefits of longitudinal investigations and multidimensional definitions of sexual health.

Additional keywords: longitudinal data, sexuality.


Acknowledgements

This research was supported in part by Health Services Research and Development, USA Department of Veterans Affairs (NRI 98182, RCD 99011). The authors thank Kimberly Findley, RN (North Florida/South Georgia Veterans Affairs Health System) for assistance with data collection and Ronald H. Randles (Department of Statistics, University of Florida) for statistical assistance. We appreciate two anonymous referees for comments on an earlier draft. This project was conducted while the first author completed a McKnight Doctoral Fellowship provided by the Florida Education Fund.


References


[1] Schiltz MA,  Sandfort TGM. HIV-positive people, risk, and sexual behaviour. Soc Sci Med 2000; 50 1571–88.
| Crossref | GoogleScholarGoogle Scholar | PubMed | [verified May 2008].

[10] van Kesteren NM,  Hospers HJ,  Kok G,  Van Empelen P. Sexuality and sexual risk behaviors in HIV-positive men who have sex with men. Qual Health Res 2005; 15 145–68.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[11] Halkitis PN , Wilton L . The meanings of sex for HIV-positive gay and bisexual men: emotions, physicality, and affirmations of self. In: Halkitis PN, Gómez CA, Wolitski RJ, editors. HIV-positive sex: The psychological and interpersonal dynamics of HIV-seropositive gay and bisexual men’s relationships. Washington: American Psychological Association; 2005. pp. 21–37.

[12] Remien RH,  Carballo-Diéguez A,  Wagner G. Intimacy and sexual risk behavior in serodiscordant male couples. AIDS Care 1995; 7 429–38.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[13] Klitzman R,  Kirshenbaum S,  Kittel L,  Morin S,  Daya S,  Mastrogiacomo M, et al. Naming names: perceptions of name-based HIV reporting, partner notification, and criminalization of non-disclosure among persons living with HIV. Sex Res Soc Policy 2004; 1 38–57.
| Crossref | GoogleScholarGoogle Scholar |

[14] Benotsch EG,  Kalichman SC,  Kelly JA. Sexual compulsivity and substance use in HIV-seropositive men who have sex with men: prevalence and predictors of high-risk behaviors. Addict Behav 1999; 24 857–68.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[15] Hoff CC,  Stall R,  Paul J,  Acree M,  Daigle D,  Phillips K, et al. Differences in sexual behavior among HIV discordant and concordant gay men in primary relationships. J Acquir Immune Defic Syndr Hum Retrovirol 1997; 14 72–8.
| PubMed |

[16] Theodore PS,  Duran RE,  Antoni MH,  Fernandez MI. Intimacy and sexual behavior among HIV-positive men-who-have-sex-with-men in primary relationships. Arch Sex Behav 2004; 8 321–31.


[17] Rosser BRS,  Metz ME,  Bockting WO,  Buroker T. Sexual difficulties, concerns, and satisfaction in homosexual men: an empirical study with implications for HIV prevention. J Sex Marital Ther 1997; 23 61–73.
| PubMed |

[18] Sandfort TGM,  de Graaf R,  Bijl RV. Same-sex sexuality and quality of life: findings from the Netherlands Mental Health Survey and Incidence Study. Arch Sex Behav 2003; 32 15–22.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[19] Laumann EO , Paik A , Rosen RC . Sexual dysfunction in the United States: Prevalence and predictors. In: Laumann EO, Michael RT, editors. Sex, love, and health in America: Private choices and public policies. Chicago: University of Chicago Press; 2001. pp. 352–76.

[20] Aytaç IA,  Araujo AB,  Johannes CB,  Kleinman KP,  McKinley JB. Socioeconomic factors and incidence of erectile dysfunction: findings of the longitudinal Massachusetts Male Aging Study. Soc Sci Med 2000; 51 771–8.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[21] Asboe D,  Catalan J,  Mandalia S,  Dedes N,  Florence E,  Schrooten W, et al. Sexual dysfunction in HIV-positive men is multi-factorial: a study of prevalence and associated factors. AIDS Care 2007; 19 955–65.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[22] Collazos J,  Martínez E,  Mayo J,  Ibarra S. Sexual dysfunction in HIV-infected patients treated with highly active antiretroviral therapy. J Acquir Immune Defic Syndr 2002; 31 322–6.
| PubMed |

[23] Crum-Cianflone NF,  Bavaro M,  Hale B,  Amling C,  Truett A,  Brandt C, et al. Erectile dysfunction and hypogonadism among men with HIV. AIDS Patient Care STDS 2007; 21 9–19.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[24] Richardson D,  Lambda H,  Goldmeier D,  Nalabanda A,  Harris JRW. Factors associated with sexual dysfunction in men with HIV infection. Int J STD AIDS 2006; 17 764–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[25] Sandfort TGM,  Clement U,  Knobel J,  Keet R,  de Vroome EMM. Sexualization in the coping process of HIV-infected gay men. Clin Psychol Psychother 1995; 2 220–6.
| Crossref | GoogleScholarGoogle Scholar |

[26] Ross MW , Ryan L . The little deaths: Perceptions of HIV, sexuality and quality of life in gay men. In: Ross MW, editor. HIV/AIDS and Sexuality. New York: Harrington Park Press; 1995. pp. 1–20.

[27] Jia H,  Uphold CR,  Wu S,  Reid K,  Findley K,  Duncan PW. Health-related quality of life among men with HIV infection: effects of social support, coping, and depression. AIDS Patient Care STDS 2004; 18 594–603.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[28] Rosen RC,  Cappelleri J,  Smith M,  Lipsky J,  Peña B. Development and evaluation of an abridged, 5-item version of the international index of erectile dysfunction (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999; 11 319–26.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[29] Charlson ME,  Pompei P,  Ales KL,  MacKenzie CR. A new method for classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 1987; 40 373–83.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[30] Katz JN,  Chang LC,  Sangha O,  Fossel A,  Bates DW. Can comorbidity be measured by questionnaire rather than medical record review? Med Care 1996; 34 73–84.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[31] Chêne G,  Binquet C,  Moreau J,  Neau D,  Pellegrin I,  Malvy D, et al. Changes in CD4+ cell count and the risk of opportunistic infection or death after highly active antiretroviral treatment. AIDS 1998; 12 2313–20.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[32] Radloff L. The CESD-scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1 385–401.
| Crossref | GoogleScholarGoogle Scholar |

[33] SAS Institute Inc. SAS/STAT® 9.1 user’s guide. Cary, NC, USA: SAS Institute Inc.; 2004.

[34] Fergus KD,  Gray RE,  Fitch MI. Sexual dysfunction and the preservation of manhood: experiences of men with prostate cancer. J Health Psychol 2002; 7 303–16.
| Crossref | GoogleScholarGoogle Scholar |

[35] Haas SM. Social support as relationship maintenance in gay male couples with HIV or AIDS. J Soc Pers Relat 2002; 19 87–111.
| Crossref | GoogleScholarGoogle Scholar |

[36] Jenkins R,  Schover L,  Fouladi RT,  Warneke C,  Neese L,  Klein EC, et al. Sexuality and health-related quality of life after prostate cancer in African–American and white men treated for localized disease. J Sex Marital Ther 2004; 30 79–93.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[37] Lynch J , Kaplan G . Socioeconomic position. In: Berkman LF, Kawachi I, editors. Social Epidemiology. New York: Oxford University Press. pp. 13–35.

[38] Lee LM,  Lehman JS,  Bindman AB,  Fleming PL. Validation of race/ethnicity and transmission mode in the US HIV/AIDS reporting system. Am J Public Health 2003; 93 914–7.
| Crossref | GoogleScholarGoogle Scholar | PubMed |

[39] Meyer-Bahlburg HFL,  Exner TM,  Lorenz G,  Gruen RS,  Gorman JM,  Ehrhardt AA. Sexual risk behavior, sexual functioning, and HIV-disease progression in gay men. J Sex Res 1991; 28 3–27.