Erectile dysfunction (ED) is a multidimensional condition commonly affecting men living with HIV. The structured interview of erectile dysfunction (SIEDY) is the only validated tool assessing organic, relational, and psychological factors contributing to ED, while dynamic penile color Doppler ultrasound (dPCDU) is a reliable method for evaluating vascular causes of ED.
This monocentric cross-sectional study aims to assess the reliability of the SIEDY questionnaire in determining the underlying causes of ED in young men living with HIV.
Young men (<50 years) living with HIV, on antiretroviral therapy for at least the last 12 months, and reporting symptoms of ED were enrolled. The degree of sexual dysfunction was assessed with the International Index of Erectile Function-5 (IIEF-5), while SIEDY was used to explore the pathogenetic components of ED. dPCDU was performed to assess vascular damage in the penile district. Univariate binomial logistic regression models were used to evaluate the association between ultrasound parameters and SIEDY results.
A total of 50 young men living with HIV were enrolled, of whom 40 (80%) had at least one altered SIEDY scale, most frequently Scale 3 (70%). Forty-five (90%) participants presented with at least one abnormal ultrasound parameter, with intima-media thickness being the most common (76%). No correlation was found between ultrasound parameters and the SIEDY Scale 1, while logistic regression identified IMT as the only variable significantly associated with SIEDY Scales 2 (relational) and 3 (psychological).
SIEDY may have limited reliability in detecting vascular causes of ED in this population, particularly underestimating organic causes. The lack of correlation with objective vascular findings highlights the importance of including tools like dPCDU for vascular assessment in routine clinical evaluations of the ED.
Andrology. 2026 Mar 09 [Epub ahead of print]
Giorgio Tiecco, Federico Cesanelli, Cosimo Colangelo, Marco Di Gregorio, Andrea Delbarba, Paolo Facondo, Matteo Riva, Carlo Cappelli, Emanuele Focà, Francesco Castelli, Eugenia Quiros-Roldan
Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy., Department of Clinical and Experimental Sciences, Unit of Endocrinology and Metabolism, University of Brescia and ASST Spedali Civili di Brescia, Brescia, Italy., Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, ASST Spedali Civili of Brescia, Piazzale Spedali Civili, Brescia, Italy.