602. Factors Associated With Erectile Dysfunction Diagnosis in HIV-Infected Individuals: A Case–Control Study

Abstract

BackgroundHIV-infected men have increased incidence of erectile dysfunction (ED) compared with men without HIV infection. Risk factors for ED among HIV-positive individuals have not been widely described.MethodsA 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.ResultsAt HIV diagnosis, the median CD4 count was similar for cases (523 cells/μL, IQR 396–675) and controls (508 cells/μL, 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 with 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 apnea2.621.69–4.05<0.001Time from HIV diagnosis to ART start > mean2.071.58–2.71<0.001African-American race1.760.90–3.420.096Diabetes/cardiovascular disease1.611.01–2.580.048Tobacco use1.420.99–2.040.057Hypertension1.361.02–1.820.034Hyperlipidemia1.260.96–1.640.092Depression1.240.94–1.630.130CD4 count <200 cells/μL at HIV diagnosis0.630.32–1.250.184Prior protease inhibitor use0.430.31–0.60<0.001ConclusionDelay 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.Disclosures All authors: No reported disclosures.