How gay, bisexual and other men who have sex with men living with HIV experience sexual dysfunction: a thematic analysis of interviews in Montreal, Canada
Bibliographic record
Abstract
BACKGROUND: Sexual dysfunction (SD) is prevalent, yet underaddressed, among gay, bisexual and other men who have sex with men (GBM) living with HIV. We aimed at exploring the perceived causes and effects of SD from the perspective of Montreal-based GBM with HIV. METHODS: During 2024, semi-structured interviews were conducted with 31 Montreal-based GBM with HIV who experienced SD (reduced libido, erectile dysfunction, premature/delayed ejaculation or pain during sex) in the past 5 years, asking about perceived causes and impacts. Data were analyzed using reflexive thematic analysis. RESULTS: Participants' median age was 46 years (range 27-74 years). The most common SDs were reduced libido (n = 26; 84%) and erectile dysfunction (n = 25; 81%). Participants reported a median of three concurrent SDs. Themes regarding the perceived causes of SD were: (1) biopsychosocial challenges across the lifespan, including aging, physical health (e.g. hormonal/cardiovascular problems), adverse life events and mental health problems; (2) living with HIV (in terms of HIV diagnosis and stigma) and concerns about antiretroviral therapy side-effects; and (3) gay sexual culture, which encompassed challenges in navigating expectations, relational/sexual ambivalence, and combining sex and drugs. Themes related to the impacts of SD included: (1) negative emotions (e.g. frustration, low self-esteem); (2) relational strain; and (3) adaptation (e.g. prioritizing intimacy over sex alone). CONCLUSIONS: Findings highlight the multifaceted experience of SD among GBM with HIV. Participants perceived that biopsychosocial challenges across the lifespan, living with HIV and gay sexual culture contributed to SD. Although SD led to emotional and relational distress, participants indicated strategies to manage it.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".