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British investigators (Cove & Petrak, 2004) surveyed 78 gay men receiving HIV-related medical services and found that about two-thirds reported one or more sexual dysfunctions (SDs). More specifically, 41% reported loss of sexual desire, 24% reported delayed ejaculation, and 38% reported erectile dysfunction (ED). ED increased to 51% when condom use was attempted and was associated with inconsistent condom use by the insertive partner during anal sex, being the receptive partner during anal sex, and risk cognitions (e.g., "condoms interfere with pleasure"; "I want to lose myself in sex"). Cove and Petrak also found that
[g]ay men attribute [their SDs to] a variety of causes according to the type of problem and in particular report high levels of perceived psychological causation [of ED associated with condom use]. These factors, together with patients' physical and general mental health status, indicate the multi-factorial aetiology of sexual difficulties and thus the need for thorough psychological as well as physiological assessment and intervention. Untreated sexual difficulties may contribute to risk taking in sex as some seropositive gay men attempt to bolster impaired sexual arousal by avoiding use of condoms or taking the receptive role in anal sex. ... [B]oth [sexual problems and risk taking in sex] need to be addressed in order to improve sexual fulfilment of patients whilst reducing the onward transmission of HIV. (p. 736)
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Winter 2005 Newsletter / Volume 6, Issue 2
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