Sexual Dysfunctions of HIV-Positive Men: Associated Factors, Pathophysiology Issues, and Clinical Management

Table 2

Clinical management studies.

Study	Population	Method	Results
Wasserman et al., 2008 [66]	3 HIV+ male with ED, decreased morning erections, and libido, wasting syndrome, and hypogonadism	Case report.; All presented low testosterone and SHBG serum levels while using oxandrolone and testosterone	After discontinuing oxandrolone one showed improved libido and ED and all showed improved testosterone and SHBG
Richardson et al., 2007 [70]	13 MSM HIV+ on HAART with LSD and estradiol levels >120 pmol/L	Subjects were randomly allocated to receive testosterone (𝑁=6) or letrozole (𝑁=7) for 6 weeks.; Spector Sexual Desire Inventory (SSDI), Depression/Anxiety Stress Scale (DASS) were used	Desire and mean sexual acts improved in both treatment arms.; Luteinizing hormone and testosterone increased in all men on letrozole
Schrader et al., 2005 [42]	48 HIV+ males with decreased testosterone levels, libido, and sexual functioning	Multicenter randomized controlled trial. Testim gel was used by 24 men after 2 weeks using AndroGel. Brief male sexual function inventory (BMSFI) was used	Experimental group improved in 4 of 5 domains (sexual drive, erectile function, problem assessment, and sexual satisfaction) of BMSFI (𝑃<0.05)
Catalan and Meadows, 2000 [27]	34 gay and bisexual men HIV+	Cross-sectional study.; Nonstandardized instrument was used	Cognitive behavioral therapy, alprostadil, and sildenafil.76% resolved the problem and 14% improved, particularly with physical therapy
Rabkin et al., 2000 [69]	74 HIV+ male outpatients	Double-blind, placebo-controlled 6-week trial with biweekly testosterone injections, followed by 12 weeks.; Clinical Global Impressions Scale (CGIS) was used	Testosterone group improved more on libido and energy than placebo group (𝑃<0.05). Parameters were kept by 18 weeks
Wagner and Rabkin, 1998 [45]	23 AIDS eugonadal men with hypogonadism symptoms	Intervention study of 12 weeks of biweekly intramuscular injections of testosterone cypionate CGIS was used	Majority of the 19 subjects who completed the trial showed improvement of SD and other hypogonadism symptoms

Note: AndroGel is a registered trademark of Solvay Pharmaceuticals, Inc., Marietta, Georgia, USA, and Testim is a registered trademark of Auxilium Pharmaceuticals, Inc., Norristown, Pennsylvania, USA. MSM: Men who have sex with men. SD: sexual dysfunctions.