Sexual dissatisfaction and associated factors in a sample of patients on antiretroviral treatment in KwaZulu-Natal, South Africa

Abstract

Background: Sexual expression affects physical, mental and social well-being. There is a lack of understanding on sexual problems among patients on antiretroviral treatment in Africa.

Methods: Using systematic sampling, HIV-positive patients were selected prior to commencing on ART from outpatient departments from three hospitals and followed-up for 20 months (n=495) and interviewed with a questionnaire.

Results: Rates of self-reported sexual problems were high (34.3%, among men: 30.3% and women 36.0%) but significantly reduced from prior to ART (57.7%) to 20 months on ART (34.3%) (P=0.006). In multivariate analysis not being formally employed (odds ratio: 0.4, 0.2-0.9), having had sexual intercourse in the past 3 months (OR: 5.8, 1.7-19.8), taking medications for HIV-related opportunistic infections (OR: 2.5, 1.1-5.7), internalized stigma (OR: 1.4, 1.2-1.6), lack of social support (OR: 0.4, 0.3-0.6), and low depressive symptoms (OR: 0.9, 0.8-1.0) were found to be associated with sexual problems.

Conclusions: This prospective study with a large sample of persons on ART showed evidence of reduction of sexual problems over time and a number of factors influencing sexual problems which should be addressed in health care provider interventions.