About AIDS

A recent Italian study demonstrates that among poz people taking anti-HIV treatment, those relying on a "non-nuke" as part of their combo were more satisfied with their sex lives than those taking a protease inhibitor.

Study participants rated their general sexual satisfaction on a one-to-100 scale. Patients whose "drug cocktail" included a non-nuke (an NNRTI, such as Viramune or Sustiva) reported greater satisfaction than patients taking a protease inhibitor (a PI, such as Crixivan, Viracept, or Kaletra).

This shouldn't surprise anyone. The eight PIs are a very effective drug class – they were critical in the miraculous mid-1990s treatment revolution – but they are well-known for causing side effects, including sexual dysfunction and the cholesterol problems (lipodystrophy) that make heart disease a growing threat to HIVers.

Leave it to the Italians to ask the sexual satisfaction question, though! This is important information, but few American researchers would dare be so straightforward. Various side effects are a major reason why patients stop taking their meds or, even worse, take them sporadically. Knowing the likelihood of drug A or B causing problem X or Y, a doctor can discuss that with the patient before deciding on a particular combo. If the patient has reservations about an issue, that can be factored into the decision.

Having a satisfying sex life may sound trivial to some HIV- negative folks. However, remember that HIV treatment is going to continue every day, year after year, for the rest of the infected person's life. Every piece of information that a physician and patient have available helps toward a decision that promotes a successful outcome.

(For details, see the Journal of Acquired Immune Deficiency Syndromes, Dec. 15, 2003.)

Sandy Bartlett

Community Education Coordinator, AIDS Services of Austin