4 research outputs found
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Lipoatrophy of the footpad in HIV-treated patients is associated with increased PAI-1
Purpose: To describe lipoatrophy of the plantar pedis fat pads in HIV patients with or without long-term antiretroviral therapy (ART); to compare the characteristics of ART patients with and without plantar pedis lipoatrophy; and to examine the effects of HIV and metabolic/cardiovascular risk parameters and treatment history on plantar pedis lipoatrophy.
Design: One hundred and thirty four patients who started PI-ART in 1996 and 49 treatment naĂŻve patients, recruited 2004, were examined and graded for lipoatrophy of five body compartments including the plantar fat pads eight years after start of ART. Baseline HIV- and ART-related factors were documented together with follow up metabolic/cardiovascular risk parameters.
Results: Plantar pedis lipoatrophy occurred more often among ART patients (60%) than among treatment naĂŻve patients (12%; p <0.001). ART patients with plantar lipoatrophy were older, had higher PAI-1 values, a higher prevalence of lipoatrophy in other body compartments, and longer stavudine and didanosine treatment history as compared to patients without plantar lipoatrophy. In multiple logistic regression, the best predictive model for plantar lipoatrophy was increased PAI-1 when HIV and metabolic/cardiovascular risk parameters were studied and treatment with didanosine when treatment history was studied. Increased PAI-1 was not associated to lioatrophy in any other location.
Conclusions: Plantar lipoatrophy is common among patients on long-term ART and, although often overlooked, may cause significant discomfort. The association to PAI-1, a well known marker of increased cardiovascular risk, is intriguing and further focuses on the need of an active approach to evaluating and lowering cardiovascular risk factors in long-term HIV treatment
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Sexual (Dis)satisfaction and Its Contributors Among People Living with HIV Infection in Sweden
Earlier research reports lower sexual satisfaction among people living with HIV (PLHIV) compared to HIV-negative persons. A number of psychosocial factors directly associated with sexual dissatisfaction have been identified. Little is known about sexual satisfaction and their contributors among PLHIV in Sweden. The aim of this study was to examine direct and indirect effects of variables within sociodemographic, clinical HIV-related, psychological, and sexual domains on sexual(dis)satisfaction among PLHIV in Sweden. Data for this study was derived from a national representative, anonymous survey among PLHIV conducted in 2014 (n=1096). Statistical analysis included four steps: descriptive analyses, identification of variables associated with sexual (dis)satisfaction, identification of variables associated with those contributors of sexual (dis)satisfaction, and a path model integrating all these analyses. A total of 49% of participants reported being sexually dissatisfied and no significant differences were observed when non-heterosexual men, heterosexual men and women were compared. Among women, a negative change in sex life after HIV diagnosis and distress with orgasmic difficulties were directly associated with sexual dissatisfaction. For men, hopelessness, high HIV stigma, sexual inactivity in the last 6 months, and a negative change in sex life after HIV diagnosis were directly associated with sexual dissatisfaction. Path analyses showed in both men and women significant indirect association between not being involved in an intimate relationship, lower self-reported CD4 cell counts, and perceiving obligation to disclose HIV status to sexual partners as a barrier to look for a long-term partner and sexual dissatisfaction. Our results show that despite good treatment outcomes, the HIV diagnosis has a negative bearing on sexual satisfaction. The need for gender-tailored interventions and clinical implications of these findings are discussed