To compare sexual problems among HIV-positive and HIV-negative women, and describe clinical and psychosocial factors associated with these problems. In addition, the visit included completion of standardized, interviewer-administered surveys, physical and gynecological
Loui ericsson wife sexual dysfunction, and blood sample collection. Women also reported lower sexual function if they were classified as menopausal, had symptoms indicative of depression, or if they reported not being in a relationship.
Women with HIV are living longer and healthier lives with less comorbidity due to the effectiveness of antiretroviral treatments. Most women with HIV are sexually active following their diagnosis 12and have the opportunity to remain sexually active for more years due in part to these medical advances.
Issues related to other aspects of sexual health, including satisfaction with sexual relationships among women living with HIV infection, have received relatively
Loui ericsson wife sexual dysfunction attention. Among women, sexual function problems are characterized by subjective reports of difficulties or limitations in sexual interest, desire, arousal, orgasm and pain during sexual activity. A clinical diagnosis of female sexual dysfunction requires the presence of both a problem with sexual functioning and a subjective assessment of distress due to the problem. Melbourne upcoming suburbs
There is reason to believe that sexual problems occur more frequently among HIV-infected than uninfected women. Chronic health conditions and diseases such as diabetes, cancer, vascular disease, arthritis, and hypertension are associated
Loui ericsson wife sexual dysfunction impaired sexual functioning, as are certain drugs that are used to treat these conditions 78.
Factors associated with sexual problems or dysfunction in the general population, such as mental health issues and substance abuse, are common among both men and women with HIV 9 Further, concerns about HIV transmission, HIV treatment, including antiretroviral therapy, and
Loui ericsson wife sexual dysfunction side effects may have deleterious effects on female sexual functioning 11 — Reports on the relationship between HIV-related body habitus changes and sexual function have also been equivocal, with one study finding no relationship 11and another reporting lower function among those with altered body habitus These differences may be due in part to variations in the methods of measurement of sexual problems across these studies.
Information about the occurrence of problems with sexual function among HIV-infected women is needed to
Loui ericsson wife sexual dysfunction identify, address, and ideally prevent these problems from arising, and to promote the sexual well-being of women with HIV in general.
In the current investigation, we describe self-reports of sexual problems among a large, nationally representative sample of women with and without HIV in the United States. We also examine psychosocial, clinical and behavioral correlates of sexual problems among HIV-infected and uninfected women and also assess how HIV-specific parameters influence these issues among women with HIV infection.
In —, an additional HIV-positive and HIV-negative women were enrolled; these women were similar to the original cohort in terms of proportion of HIV-positive and HIV-negative women falling into each of the matching categories. WIHS criteria for enrollment in — and — included HIV status confirmed by Western blot, an age of 13 years or older, and the ability to answer questions in English or Spanish. Participants all provided written informed consent for study activities and completed a study visit every six months.
These visits include completion of standardized, interviewer-administered surveys, physical and gynecological examinations, and collection of blood samples. Additional details on the WIHS recruitment methods and baseline characteristics have been previously published 19 Of note, participants eligible for completing an abbreviated visit may face significant health or other contextual barriers to completing a full study visit that may be linked to impaired sexual function.
An additional women completed the study visit but did not complete all items on the sexual function assessment. Thus, eligible participants for the analysis include 1, participants 1, HIV-positive and HIV-negative women. Although the WIHS does not capture reasons for an abbreviated visit e.
Questions on sexual activity were not asked as part of the abbreviated visit. These groups did not differ at statistically significant levels as a function of HIV serostatus, age, or whether the respondent reported having been sexually active since the last study visit. The Female Sexual
Loui ericsson wife sexual dysfunction Index FSFI is a item self-report survey which includes subjective assessments along several domains of sexuality, including sexual arousal and desire, lubrication, orgasm, and pain during intercourse.
For these different domains, questions assess the subjective frequency and severity of problems, as well as assessments of overall satisfaction or dissatisfaction in different domains, including orgasm, overall sexual life, and within sexual relationships For domains in which no sexual activity is reported, FSFI scores fall between 0 and 1 for those with the lowest levels of sexual activity and interest over the past four weeks to 36, with higher scores indicating better sexual functioning.
Sexual activity is broadly defined in the FSFI as including caressing, foreplay, masturbation and vaginal or other sexual intercourse. Although most self-report modules in WIHS are interviewer administered, the FSFI was self-administered, with the study interviewer present to read items if necessary.
A CES-D score greater than 23 was used to identify participants with moderate to severe symptoms of depression Use of anti-depressants was also recorded for the study visit. Both sexual behaviors
Loui ericsson wife sexual dysfunction alcohol and drug use are ascertained for frequency since the last study visit i. To assess recent drug use, participants were asked to report any use of marijuana, cocaine, crack, heroin, amphetamines or methamphetamine, hallucinogens, club drugs, or non-prescribed methadone or narcotics since the last study visit.
Alcohol use since the last visit was defined as a report of consumption of any wine, beer, hard liquor, or other alcohol. Participants also completed questions
Loui ericsson wife sexual dysfunction number and sex of sexual partners since the last study visit.
A sex partner was defined as either a man or woman with whom the participant had engaged in vaginal, oral, or anal sex.
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Condom use consistency with male partners was defined as either no unprotected anal or vaginal intercourse UAVI or one or more episodes of UAVI since the last study
Loui ericsson wife sexual dysfunction. Several factors associated with sexual function in the general population "Loui ericsson wife sexual dysfunction" also assessed.
Menopausal status was defined by self-reported menstrual pattern, with postmenopausal women reporting no menses for the past 12 months, and others defined as non-menopausal including premenopausal, early perimenopausal, late perimenopausal. We were not able to classify several groups of women based on this definition, including women who were currently pregnant or lactating or who reported ever having had a hysterectomy or oophorectomy. We also included self-reported use of hormone therapy on therapy, not on therapy.
Women with HIV completed additional questions regarding antiretroviral therapy and adherence, and provided blood samples for measurement of HIV viral load. Among women on a HAART or non-HAART antiretroviral regimen, we assessed medication adherence by asking how often they had taken their medication as prescribed during the 6 months before the interview. Indications of body fat loss symptoms were recorded by study personnel during the physical exam.
This analysis was performed for the overall sample as well as for HIV-infected and uninfected women separately. Univariate analysis of variance was used to examine relationships between FSFI scores and posited sociodemographic i.
We assessed whether there were statistically significant interactions with HIV infection status, and each of the factors included in the model, controlling for age. We then utilized univariate analysis of variance to examine the relationships between sexual behavior number of partnerships, consistency of condom use and FSFI scores. Factorial analysis of variance examined the relationships between FSFI and CD4, viral load, and body fat changes, controlling for age.
All analyses were conducted with SPSS version Results of the principal components analysis for the scale indicated
Loui ericsson wife sexual dysfunction factor structures for both HIV-negative and HIV-positive women, and therefore results of this analysis are reported for the combined sample.
The original FSFI scale posited six factors desire, arousal, lubrication, orgasm, dissatisfaction, and pain that contribute to overall sexual function, and several analyses demonstrate correspondence between these factors and clinical diagnoses of sexual dysfunction such as pain, satisfaction, and sexual arousal 21 — However, our principal components analysis did not produce these six distinct factors; instead, most of the FSFI items in our sample loaded onto a single factor.
The second factor, comprising the 2 remaining items, accounted for 6. We repeated this analysis separately for both HIV-positive and HIV-negative women, and found a similar patterns of results. Instead, we computed total scores for the 19 items. These total scores ranged from 1. Among both HIV positive and negative women, higher FSFI scores, indicating fewer sexual problems, were seen in women who were younger and who were married or living with a sexual partner.
Results of a factorial analysis of variance describing relationships between FSFI and posited influential variables are reported in Table 2. The
Loui ericsson wife sexual dysfunction model excluded diabetes status, BMI category, hormone therapy, medication for seizures, hypertension, or heart disease, and medication for mental health conditions; these variables were not statistically significant after adjusting for other variables in the model, and their exclusion did not impact parameter estimates in the final model, nor the overall variance accounted for in the model. Tyler Seguin, Loui Eriksson swapped...
As described earlier, the FSFI defines sexual behavior broadly e. Therefore, those reporting no vaginal, oral or anal sex are likely to have lower FSFI scores, but may not have lower scores if the individual engages in behaviors that confer low HIV transmission risk and does not report problems with engaging in these activities. Sixteen percent of all HIV-positive participants exhibited evidence of body habitus changes. Our analysis reveals that the burden of sexual problems is significantly higher among women with HIV-infection compared to uninfected women.
Subjective reports of sexual problems are common among women in the United States. As would be expected from past research on sexual functioning in women, sexual function scores in the WIHS cohort were associated with age, menopause, symptoms of depression, and relationship status. However, the inclusion of these factors did not mitigate the influence of HIV infection on impaired sexual function scores.
In addition, HIV did not influence the relationships between these factors and sexual function scores. Although we confirmed univariate associations between several previously published correlates of sexual function among HIV-infected women, including BMI, therapeutic regimens for mental health, therapeutic regimens for seizures, blood pressure or heart disease, hormone therapy, and diabetes, these relationships were not sustained in multivariate analysis.
In addition, although previous research has described the impact of chronic drug and alcohol use on impaired sexual function 35we did not find a relationship between sexual problems and alcohol or drug
Loui ericsson wife sexual dysfunction. We note, however, that our measures of alcohol and other substance use only estimate whether one or more instances of use were reported since the last study visit; these measures do not account for the role of drug and alcohol abuse and dependence on sexual problems nor the role of drug or alcohol use during sexual activity.
In addition, while CD4 cell count was associated with sexual "Loui ericsson wife sexual dysfunction" in this study, we did not replicate previous findings on factors associated with sexual problems in persons with HIV. We did not, for instance, detect statistically significant associations between sexual problems and being on HIV antiretroviral therapy, being on certain classes of antiretroviral therapy e.
Given that little investigation in this area has been conducted in populations consisting
Loui ericsson wife sexual dysfunction of women, further research is needed to help clarify these inconsistent findings. We cannot make causal assumptions given the cross-sectional nature of the analysis and the different time parameters for assessment of sexual behavior and sexual function. However, we believe that this finding warrants further examination.
On the other hand, this relationship could simply reflect a measurement artifact, whereby those in sexual relationships tend to score higher on the FSFI than those with no sexual relationships.
Those who were not in sexual relationships were scored as having no unprotected anal or vaginal sex, which may account for some of this finding. Our data did not allow us to examine the relationships between FSFI and sexual risk behavior in different types of relationships, although we did report higher function among those living with a sexual partner or "Loui ericsson wife sexual dysfunction." The greater level of perceived intimacy that may for instance be present in
Loui ericsson wife sexual dysfunction established versus casual relationships may be linked to increased risk for unprotected sex, given that condom use is less frequent in relationships defined as main or primary, versus those defined by participants as being more casual in nature Although papers describing patterns of partnerships and transmission risk behaviors with HIV concordant and discordant partners in the WIHS have been published previously 3738the self-report instrument at the time of the FSFI administration did not include measures of condom use or partner serostatus on a partner specific level.
Therefore, we were unable to disentangle these relationships.
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The FSFI is designed to be utilized for both sexually and non-sexually active women. Although sexual activity is defined broadly in the inventory to include activities that occur with or without physical contact with a sexual partner e.
In this analysis, common reasons cited for abstinence included unavailability of a sex partner and concern about transmitting HIV It is unknown whether sexual dysfunction may
Loui ericsson wife sexual dysfunction less pronounced when intended abstinence explains a lack of sexual activity. Our study did not assess whether a lack of sexual behavior reflected a lack of available partners, a decision to abstain from sex, or some other combination of factors.
However, this would be important to examine as a component
Loui ericsson wife sexual dysfunction furthering this area of study. We believe that our study contributed to the literature on sexual function in HIV by using a commonly used and widely accepted tool for the assessment of self-reported sexual problems, and by comparing women with HIV to a seronegative cohort.
However, we noted some differences in the psychometric properties of the scale in this sample as compared to previous reports. For instance, we note that the FSFI factor structure previously reported by Rosen and colleagues 21 was not reproduced within our sample using the same methods of analysis. In addition, the very high internal consistency suggests that there may be some redundancy that could be addressed in future studies with HIV-infected samples.
Thus, some refinements of measurement of the construct of sexual function among HIV-positive women may be useful to help further delineate the extent and nature of these issues. Although we did not have data available on overall subjective assessments of HIV-related quality of life for the study visit in
Loui ericsson wife sexual dysfunction we administered the FSFI, we did include some markers of overall health in our analysis.
The causal nature of sexual difficulties on quality of life is unclear, given that these variables can plausibly be argued to be bi-directional in influence. introduced he received lone Loui Eriksson Womens Jersey I ended up coming up to visit with wife to learn about the city and make sure.
Comparison 1 Sildenafil vs placebo, Outcome 8 Sexual dysfunction defined by Landen M, Eriksson E, Agren H, Fahlen T. Effect of Louis Armstrongweg 78 spouse is an employee of GlaxoSmithKline (manufacturers of bupropion).
Women with HIV reported greater sexual problems than did those without HIV. A sex partner was defined as either a man or woman with whom the participant.