Sexual dysfunction care needs of gay, bisexual, and other men who have sex with men living with HIV in Montreal, Canada

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Abstract
Objectives: Sexual dysfunction (SD) is common among gay, bisexual and other men who have sex with men (GBM) with HIV, yet little is known about their views on SD care. We explored these views to inform patient‐centred SD care to improve care delivery and sexual health outcomes. Methods: Semi‐structured interviews were conducted in 2024 with 31 Montreal‐based GBM with HIV who experienced SD in the last 5 years (reduced libido, erectile dysfunction, premature/delayed ejaculation and/or pain during sex), covering SD care experiences and preferences. Thematic analysis was applied to interview transcripts. Results: Participants mostly reported reduced libido (83.9%) and erectile dysfunction (ED(80.6%), with over half (58.0%) experiencing multiple SDs concurrently. Themes regarding SD care experiences were (1) costs and benefits of ED medication, (2) limited benefits of testosterone replacement therapy, (3) mixed views on talk therapy (and a preference for group therapy), and (4) not seeking care due to questions of SD definition and normalcy. SD care preferences concerned both provider characteristics (identity, approach to patients and expertise) and care delivery (information provision, involvement and respect and access to diverse resources). Conclusions: Irrespective of the approach to SD care sought (medication or talk therapy), participants experienced limited success. For some, doubts about the severity of their SD impeded help‐seeking. SD care preferences for the provider (e.g., expertise) and care provided (e.g., information, patient involvement) offer paths to more patient‐centred care.
Funding Information
  • Canadian Foundation for AIDS Research (32‐142)

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