Patient experiences of sexual dysfunction after transition to dolutegravir‑based HIV treatment in mid‑Western Uganda: a qualitative study
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
BMC Infectious Diseases
Abstract
The literature on dolutegravir (DTG)-based HIV treatment has focused on assessing therapeutic efficacy
particularly with regard to viral load suppression. However, little empirical attention has been devoted to understanding
the effects of DTG on quality of life, in particular sexual health and functioning in PLHIV. This study focused on
understanding patient experiences of sexual dysfunction, after transition to DTG-based regimens in Rwenzori region
in Mid-Western Uganda.
Methods: We adopted a qualitative exploratory research design. Between August and September 2021, we conducted
sixteen in-depth interviews and six focus group discussions (48 participants) with patients reporting ‘new’
sexual dysfunction after transition to DTG-based regimens at seven health facilities in mid-Western Uganda. Data were
analyzed by thematic approach.
Results: Decreased libido was reported in both sexes of patients within weeks of transition to DTG-based regimens.
Diminished interest in sex was more frequently reported among women while men complained of a marked reduction
in the frequency of sex. Women reported loss of psycho-social attraction to their long-term male partners.
Erectile dysfunction was common among men in this sample of patients. Patients described their experiences of
sexual dysfunction as an affront to their socially-constructed gender identities. Patients described tolerating sexual
adverse drug reactions (ADRs) as a necessary tradeoff for the extension in life granted through antiretroviral therapy. A
number of women reported that they had separated from their spouses as a result of perceived drug-induced sexual
dysfunction. Marital strife and conflict arising from frustration with sexual-partner dysfunction was frequently reported
by participants in both sexes. Several participants indicated experiencing insecurity in their heterosexual relationships
due to difficulties in sexual functioning.
Conclusion: Sexual dysfunction following transition to DTG-based regimens is common in both sexes of PLHIV, who
indicated that they had no prior experience of difficulties in sexual health. Our findings demonstrate that sexual ADRs
negatively impact self-esteem, overall quality of life and impair gender relations. DTG-related sexual health problems merit increased attention from HIV clinicians. Further research is warranted to assess the prevalence of DTG-associated
sexual dysfunction in patients in Uganda.
Description
Keywords
Pharmacovigilance, Dolutegravir, Antiretroviral therapy, Patient safety, HIV
Citation
Zakumumpa, H., Kiguba, R., Ndagije, H. B., Ategeka, G., Ssanyu, J. N., & Kitutu, F. E. (2022). Patient experiences of sexual dysfunction after transition to dolutegravir-based HIV treatment in mid-Western Uganda: a qualitative study. BMC Infectious Diseases, 22(1), 1-11. https://doi.org/10.1186/s12879-022-07673-z