Objective:

To evaluate the phenotypic signature and duration-dependent prevalence of dolutegravir-associated sexual dysfunction among males living with HIV in Uganda.

Approach:

• Study Design: Cross-sectional study conducted among 546 males living with HIV at Kisenyi Health Centre IV outpatient HIV care clinic in Uganda.
• Data Collection: Sociodemographic, clinical, and medication data were collected electronically using the KoboCollect app, with clinical data abstracted from Electronic Medical Records.
• Instruments Used: Utilized the Changes in Sexual Functioning Questionnaire—Male (CSFQ-M) and the 5-item International Index of Erectile Function (IIEF-5) for assessment.

Key Findings:

• The prevalence of erectile dysfunction among males on dolutegravir-based cART is 59%, compared to 26% in cART-naive males.
• Erectile dysfunction prevalence plateaus after 6 months of dolutegravir therapy.
• Reduced sexual desire is time-limited, observed only within the first 6 months of therapy.

Interpretation:

Dolutegravir is associated with both peripheral erectile dysfunction and central neuro-behavioral suppression of sexual desire, with the latter being transient.

Limitations:

• The study may not account for all potential confounding factors influencing sexual dysfunction.
• Reliance on self-reported data for some variables may introduce bias.

Conclusion:

The study highlights the need for awareness of sexual dysfunction in males on dolutegravir-based therapy, particularly within the first 6 months.