Effects of testosterone replacement therapy on sexual interest, function, and behavior in HIV+ men

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Abstract
This report documents findings from the first 80 patients to enter our ongoing clinical trial of testosterone replacement therapy, designed for HIV+ men with low CD4 cell counts and low levels of serum testosterone, who complain of diminished sexual interest and/or sexual dysfunction. Patients were treated with testosterone for 8 weeks with biweekly intramuscular injections, starting at 200 mg. and increasing at Week 2 to 400 mg. biweekly. Week 8 responders were treated with testosterone for at least four more weeks and were then randomized to testosterone or placebo for six weeks or until relapse. Seventy‐three men completed the initial eight‐week phase of treatment; of the seven dropouts (9%), two men discontinued treatment because of side effects (irritability and hair loss). Of the 73 completers, 67 (92%) were rated as clearcut responders by the study doctor. Self‐ratings of sexual interest, erectile functioning, and satisfaction with one's sex life revealed significant improvement in all areas. Although much of the sample was sexually abstinent both before and after treatment, sexual activity (both with partners and solitary masturbation) increased after treatment. Progressive HIV illness entails many kinds of losses; restoration of one's sexuality associated with testosterone replacement can greatly enhance quality of life and sense of vitality.