Special considerations in the management of erectile dysfunction in the HIV-positive patient

Restoration of sexual function to HIV-positive men with erectile dysfunction (ED) is a challenging problem with many faces. Interactions between the novel phosphodiesterase inhibitors for treatment of ED and the highly active antiretroviral therapy (HAART) that currently forms the foundation of medical therapy for HIV infection require appropriate dose adjustment and familiarity with common medical conditions affecting the HIV-positive man. Urologists and general practitioners caring for this group of patients will also have to consider legal precedents governing delivery of care to HIV-positive patients in a new scenario in which the traditional physicianpatient encounter is affected by a third party—the patient’s current and future partner(s) and his or her respective rights.