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Quality of life in HIV clinical trials: why sexual health must not be ignored.

Koole O, Noestlinger C, Colebunders R - PLoS Clin Trials (2007)

View Article: PubMed Central - PubMed

Affiliation: Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium.

AUTOMATICALLY GENERATED EXCERPT
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Using them in combination therapy, we are able to treat HIV-infected patients with highly potent regimens and suppress the virus below detectable levels... Given the choice of several different potent antiretroviral regimens, doctors and patients will tend to prefer those regimens that are easy to take and that have limited short-term and long-term side effects... One potential side effect of antiretroviral treatment that has received very little scientific attention so far is sexual dysfunction... While it may include a variety of diverse issues, comprehensive definitions such as the World Health Organization's (WHO) working definition define sexual health as a state of physical, emotional, mental, and social well-being, and not merely the absence of disease, dysfunction, or infirmity... Sexual health encompasses the possibility of having pleasurable and safe sexual experiences... Ideally, we should assess sexual health, including sexual functioning, during randomised clinical trials (RCTs) comparing different antiretroviral regimens, early versus late initiation of antiretroviral therapy, and treatment interruption studies... We believe that sexual dysfunction needs more attention from researchers developing clinical trials, since it seems to be quite important from the patients' perspective... Focus group discussions among PLHA performed in Europe have shown that sexual well-being in general was felt to be a crucial part of overall HRQOL, and that sexual dysfunction was perceived to decrease it significantly... PLHA are confronted with many factors that may interfere with their sexual well-being: the psychological impact of the HIV infection itself, the stigma associated with the infection, hormonal abnormalities, fear of transmitting the infection to others, depression, illnesses, and the side effects of drugs such as antiretrovirals... With respect to the latter, PLHA often attribute sexual problems specifically to prescribed drugs which they are taking, and this may ultimately compromise both adherence and secondary prevention... In one study in Italy, sexual dysfunction was associated with poorer adherence to protease inhibitor–containing antiretroviral treatment regimens... Sexual health is an important contributing factor to overall quality of life; therefore we propose that specific questions regarding sexual health, including sexual functioning, should be included in quality of life questionnaires in HIV clinical trials... Obviously, besides the importance of posing sexual health questions in HRQOL questionnaires, asking patients about their sexual health during consultations remains essential... While discussing such topics in the context of safer sex practices may increase the quality of life for individual patients, from a public health point of view it can be viewed as contributing to primary HIV prevention.  

No MeSH data available.


Related in: MedlinePlus

Medications for Sexual Dysfunction Available in One Private Pharmacy in Antwerp, Belgium (Photo: O. Koole)
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pctr-0020008-g001: Medications for Sexual Dysfunction Available in One Private Pharmacy in Antwerp, Belgium (Photo: O. Koole)

Mentions: The importance of sex in most people's lives is illustrated by the fact that there is a growing market for drugs that increase sexual pleasure. The pharmaceutical industry has recently discovered this market, which has resulted in the development of popular erectile dysfunction medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) (Figure 1). Evidence from studies in the United Kingdom and United States [24–26] show that these drugs are also commonly used among HIV-infected people, particularly by men who have sex with men (MSM).


Quality of life in HIV clinical trials: why sexual health must not be ignored.

Koole O, Noestlinger C, Colebunders R - PLoS Clin Trials (2007)

Medications for Sexual Dysfunction Available in One Private Pharmacy in Antwerp, Belgium (Photo: O. Koole)
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC1808068&req=5

pctr-0020008-g001: Medications for Sexual Dysfunction Available in One Private Pharmacy in Antwerp, Belgium (Photo: O. Koole)
Mentions: The importance of sex in most people's lives is illustrated by the fact that there is a growing market for drugs that increase sexual pleasure. The pharmaceutical industry has recently discovered this market, which has resulted in the development of popular erectile dysfunction medications such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra) (Figure 1). Evidence from studies in the United Kingdom and United States [24–26] show that these drugs are also commonly used among HIV-infected people, particularly by men who have sex with men (MSM).

View Article: PubMed Central - PubMed

Affiliation: Prince Leopold Institute of Tropical Medicine, Antwerp, Belgium.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Using them in combination therapy, we are able to treat HIV-infected patients with highly potent regimens and suppress the virus below detectable levels... Given the choice of several different potent antiretroviral regimens, doctors and patients will tend to prefer those regimens that are easy to take and that have limited short-term and long-term side effects... One potential side effect of antiretroviral treatment that has received very little scientific attention so far is sexual dysfunction... While it may include a variety of diverse issues, comprehensive definitions such as the World Health Organization's (WHO) working definition define sexual health as a state of physical, emotional, mental, and social well-being, and not merely the absence of disease, dysfunction, or infirmity... Sexual health encompasses the possibility of having pleasurable and safe sexual experiences... Ideally, we should assess sexual health, including sexual functioning, during randomised clinical trials (RCTs) comparing different antiretroviral regimens, early versus late initiation of antiretroviral therapy, and treatment interruption studies... We believe that sexual dysfunction needs more attention from researchers developing clinical trials, since it seems to be quite important from the patients' perspective... Focus group discussions among PLHA performed in Europe have shown that sexual well-being in general was felt to be a crucial part of overall HRQOL, and that sexual dysfunction was perceived to decrease it significantly... PLHA are confronted with many factors that may interfere with their sexual well-being: the psychological impact of the HIV infection itself, the stigma associated with the infection, hormonal abnormalities, fear of transmitting the infection to others, depression, illnesses, and the side effects of drugs such as antiretrovirals... With respect to the latter, PLHA often attribute sexual problems specifically to prescribed drugs which they are taking, and this may ultimately compromise both adherence and secondary prevention... In one study in Italy, sexual dysfunction was associated with poorer adherence to protease inhibitor–containing antiretroviral treatment regimens... Sexual health is an important contributing factor to overall quality of life; therefore we propose that specific questions regarding sexual health, including sexual functioning, should be included in quality of life questionnaires in HIV clinical trials... Obviously, besides the importance of posing sexual health questions in HRQOL questionnaires, asking patients about their sexual health during consultations remains essential... While discussing such topics in the context of safer sex practices may increase the quality of life for individual patients, from a public health point of view it can be viewed as contributing to primary HIV prevention.  

No MeSH data available.


Related in: MedlinePlus