Self-Reported Sexual Difficulties and Their Association With Depression and Other Factors Among Gay Men Attending High HIV-Caseload General Practices in Australia

In the current study, the researchers investigated gay men's self-reports of several sexual problems. While it is known that sexual expression affects physical, mental, and social well-being, there is a lack of understanding of sexual dysfunction in homosexually active men.

The survey subjects were 542 men in Australia recruited from six general practices with high HIV caseloads. All the men self-identified as gay, and 40 percent were HIV-positive. Having multiple sexual problems was defined as reporting three or more sexual problems over a period of at least one month in the preceding 12 months. The team explored several factors -- including HIV status, depression, alcohol and other drug use, and sexual risk-taking with casual male partners -- in association with multiple sexual problems.

Numerous sexual problems were self-reported at high rates. Erectile dysfunction and lack of desire were the most common. The high rates were consistent with the limited data available from previous Australian studies.

The men who had multiple sexual problems were likely to suffer from major depression (P<0.001). More HIV-positive men (48.4 percent) reported multiple sexual problems than HIV-negative men (35.1 percent, P=0.002). Among the HIV-negative men, poorer general health and interpersonal isolation were found to be independently associated with multiple sexual problems. Among the HIV-positive men, the adoption of avoidant strategies to cope with daily stress, sexual risk-taking in casual encounters, and use of antidepressants were found to be independently associated with multiple sexual problems.

"Our findings underscore the complex interactions between depression, sexual dysfunction, sexual risk taking, HIV infection, and general well-being among homosexually active men," the authors concluded.

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