In this thesis, I explore sexual health outcomes within a sample of
HIV-infected men. The extant research on sexual health within
this population has primarily focused on sexual risk and disease
transmission. While these topics are of critical importance, they
provide limited insight into the meanings of sexuality and contexts in
which sexual interactions occur for HIV-infected men. In this
thesis, I address sexuality as being normative to HIV-infected men’s
existences and critical to their perceptions of themselves along lines
of age, race/ethnicity, gender, and sexual orientation. I
specifically examine the role of sociodemographic, health-related, and
substance use correlates in the distribution of sexual health outcomes
for this sample. I analyze baseline, 12-month, and 24-month data
collected within a prospective cohort study, “Predictors of Outcomes in
HIV-Infected Men.” I use four self-reported indicators of sexual
health: sexual activity, erectile function, sexual drive, and sex
life satisfaction. Bivariate analyses are conducted to measure
aggregate change for both cross-sectional and longitudinal
phases. For longitudinal analyses, however, I utilize transition
matrices in order to depict individual-level change. Analyses
indicate that indicators of sexual health are consistently related to
one another. At the individual-level, sexual health change is not
likely for the majority of men. When change occurs, however, it
tends to be for the worse. This pattern is consistent across
sexual health indicators, despite men with worse sexual health outcomes
being lost to attrition. Men who experience better sexual health
are those who are younger, cohabiting, heterosexual, physically and
mentally healthier, and moderately using chemical substances.
These patterns are also consistent over time. I conclude by
articulating the role of sexual health correlates in the distribution
of sexual health outcomes. I also discuss implications of this
study for clinical and public health practitioners who work with
populations of HIV-infected men.