General Erectile Inoshanda pakati peVechidiki, varume vanoita zveHeterosexual Avo Vanoita uye Havasati Vaudza Matambudziko Ekubatwa Kwemakumbo (CAEP) (2015)

COMMENTS: Ona izvi kuongorora kwekudzidza

Stephanie A. Sanders PhD1,2,3, Brandon J. Hill PhD1,4, Erick Janssen PhD1,5, Cynthia A. Graham PhD1,2,6, *, Richard A. Crosby PhD1,2,7, Robin R. Milhausen PhD1,2,8 uye William L. Yarber HSD1,2,3,9

Nyaya yekutanga yakabudiswa paIndaneti: 17 AUG 2015

DOI: 10.1111 / jsm.12964

Kutsvakurudza kwakaitwa mubhuku rino kwakatsigirwa neEunice Kennedy Shriver National Institute of Child Health uye Human Development (NICHD) yeNational Institutes of Health pasi peAward Number R21 HD 060447, E. Janssen uye SA Sanders (PIs). Zvinyorwa ndezvomutoro wevanyori uye hazvirevi hazvo kuti zvinomiririra maonero ehurumende yeNational Institutes of Health.

ngovepo

ziviso

Kondomu-inobatanidza erection matambudziko (CAEP) isinganzwisisiki chimwe chinhu chakaenderana nekusawirirana kana kusakwana kushandiswa kwekondomu yevanhu. Nzira dzinotungamira dzeCCA dzinonzwisiswa, uye kana varume vanotaura matambudziko aya vanogonawo kuwana zvinetso zvehutachiona mumamiriro ezvinhu apo makondomu haashandisi haana kudzidza.

vavarira

Chinangwa chekudzidza ndechekutsvaga, mumuenzaniso wekondomu-kushandisa vechidiki, varume vanoita zvepabonde (vane makore anopfuura 18-24), kana varume vanoparidza CAEP vanogona kunge (i) vane matambudziko ekugadzirisa kana vasingashandisi makondomu uye (ii ) kugadzirisa zvirongwa zve erectile dysfunction.

nzira

Zvose zvevarume ve479 vakanyorerwa paIndaneti vakapedza International Index ye Erectile Function (IIEF-5) uye vakapindura mibvunzo pamusoro pematambudziko ekugadzirisa akawanikwa pavanoshandisa uye vasingashandisi makondomu mumazuva ekupedzisira e90. Kuwanda kwevanhu, ruzivo rwepabonde, uye mararamiro emamiriro ezvinhu ehutano zvakatsvakurudzwa sechirrelates.

Mhedzisiro mikuru Mitezo

Kuzvidzivirira kwehuwandu hwekurasikirwa kwekodzero panguva yekushandiswa kwekondomu kana panguva yepenile-vaginal zvepabonde (PVI) munguva yakapfuura 90 mazuva uye IIEF-5 scores.

Results

Pakati pevarume, 38.4% yakarongerwa mune rimwe boka reC CAEP, 13.8% seC CAEP panguva yekushandisa kondomu, 15.7% seine CAEP munguva yePVI, uye 32.2% seine CAEP panguva yekushandisa kondomu uye PVI. Varume vanoparidza chero maitiro eCCA vainyanya kukosha kudarika varume vanoratidzira kwete CAEP kuti vaudzewo matambudziko ekugadzirisa panguva dzepabonde kana vasingashandisi makondomu. Varume vakashuma CAEP munguva yePVI chete kana panguva iyo yose yekushanda uye PVI yakawana zvakanyanya pasi pa IIEF-5 kupfuura varume vasina CAEP.

mhedziso

Izvo zvinowanikwa zvinoratidza kuti varume vanotaura nezveCCA vanogonawo kuve nekuwana huwandu hwekuita erection matambudziko. Vanachiremba vanofanira kuongorora kana varume vanoshandisa kondomu vachiwana CAEP uye kana pane zvakakodzera, vachitaura nezvechirwere chepabonde kana kupa ruzivo rwehutano hwekondomu.

ziviso

Kufananidzirwa kwehuwandu hwekusavhiringidza kwe erectile (ED) kunowirirana pane zvidzidzo, zvichienderana nechikamu pane tsanangudzo nemitemo inoshandiswa [1-3]. Chimwe chezvinyorwa zvinonyanya kushandiswa zvezvinetso zve erectile ndezera. Kunyange zvazvo kupararira kweED kuchikwirira zvikuru pakati pevakuru [4], matambudziko erectile anorondedzerwa nevarume vaduku pamwe chete. Imwe epidemiologic inofungidzira kuti inenge 2% yevarume vaduku vaduku kudarika makore 40-50 yakanyunyuta pamusoro pezvinetso zvekugadzirisa kazhinji (EPs) [2]. Imwe tsvakurudzo yemazuva ano kune dzimwe nyika nhatu dzeEurope yakashuma kuti 5% yevarume vane makore pakati peC18 nemakore 29 vane makore makumi maviri nemana akapfuura. [5]. Chiyero chevarume vechidiki vanoona matambudziko erectile pane dzimwe nguva, zvisinei, zvakakwirira kwazvo, kubva ku16% mune imwe shanduro yevarume veUnited States pasi pemakore 40 [6] kusvika ku30% muSwitzerland shanduro yevarume vane makore 18-25 [7].

Izvo zvinowanzoitika kune dzimwe nguva zvinetso zve erectile zvinoratidza kuti zviitiko zvepakati zvinogona kutamba basa rinokosha etiologic. Kushandisa kondomu dzevarume kunogona kuva muenzaniso mumwe wemamiriro ezvinhu anoita kuti vamwe varume vawane dambudziko rekugadzirisa. Mune chidzidzo chevadzidzi vezvokurapa veBrazil (makore anorevei: makore 21.2), 13.3% vakaonekwa kuti vane ED, vachishandisa iri nyore iri International Index of Erectile Function (IIEF-5) [8]. Vakomana vaduku vari muchidzidzo ichi avo vakashandisa makondomu kaviri vanogona kutaurira matambudziko erectile. Muchienzaniso chechidiki chechirwere chepabonde chinopararira pabonde (STI) kliniki inopinda [9], 37.1% yevarume vakataura nezvekondomu-inosangana nehutano hwekugadzirisa (CAEP) pane imwe nguva. Zvidzidzo zvakasiyana-siyana, zvinosanganisira vose vanoita zvepabonde uye vanhu vanoita zvepabonde, iko zvino zvakanyora kuti CAEP inogona kunge yakakurumbira [10]. Kunyange zvazvo nzira dziri pasi peCEP dzisati dzisinganzwisiswi, mune imwe nguva yemazuva inonzi psychophysiologic yekuongorora zvekuita zvepabonde, varume vane CAEP vaida nguva yakawanda uye / kana kukurudzira zvakanyanya kukurudzira kupfuura varume vasina CAEP [11]. Zvakakosha, zvisinei, kuti mhinduro dze erectile dzaive dzakaderera muboka reC CAEP chete muminiti yekutanga yekutsvaga kurudziro rwepabonde, pasina misiyano yakakura pashure.

Kondomu-inobatanidza erectile zvinetso zvingangodaro isinganzwisisiki yakabatana nekushandiswa kusina kukwana, pakuti varume vanoparidzira CAEP vanowanzopa ruzivo rwezvimwe zvikanganiso zvekushandisa kondomu nematambudziko, kusanganisira kusvitsa kondomu [12], kushandiswa kwekondomu kusingaperi (kushandiswa kwekupedzisira uye kubviswa kwekutanga) [9,13], uye kushandiswa kwekondomu kusinganzwisisiki [14,15]. Mune imwe nguva ichangobva kuitika inotaridzirwa inobatanidza varume ve1,875, pfungwa dzekugadzirisa "hutano" (kusanganisira kuverenga kwekusagadzikana, urefu hwepenile, uye kukanganisa, pamwe nekuoma kwekuchengetedza zvigadziriswa) zvakabatanidzwa nehuwandu hwakawanda hwokushandiswa kwekondomu kusakwana [13]. Varume vanogona kunge vane ruzivo rwekuwana CAEP kana vasina chivimbo chokushandisa makondomu zvakanaka, kana vane zvinetso nenzira iyo makondomu akakodzera kana kunzwa, uye kana vakaita zvepabonde nevakawanda [9].

Chinangwa

Mumwe mubvunzo une, kunyange zvakadaro, usina kuongororwa ndeyekuti varume vanozivisa CAEP vane mikana yekuwana matambudziko erectile mune zvepabonde apo makondomu haashandisi. Saizvozvowo, chinangwa chechidzidzo ichi chaiva chekuongorora, mumuenzaniso wekondomu-uchishandisa vechidiki, varume vanoita zvepabonde (vakwegura vane 18-24), ingave avo vanoparidza CAEP (zvimwe panguva yekushandisa kondomu, panguva yepenile-vaginal sex [PVI], kana mumamiriro ose ezvinhu) zvinowanzoita kuti: (i) ave neEEP kana asingashandisi makondomu; uye (ii) kuenzanisa zvakasiyana neEEE. Chinangwa chedu chakanga chisingafungidzire kupararira kwematambudziko erectile asi kuziva hukama hweC CAEP mune zvidzidzo zvisingabatsiri zvevechidiki, varume vanoshandisa kondomu.

nzira

Vakwikwidzi

Vatori vechidiki vakanga vari vaduku, varume vanoita zvepabonde vakanyoreswa kuburikidza nemayunivhesiti (eg, mapoka evadzidzi veyunivhesiti uye mapepa ekunyora) uye mapurisa emagetsi akaparidzirwa pa Facebook. Chibvumirano chakawanikwa kubva kune vatungamiri vekuchengetedza uye Facebook kushambadzira mirayiridzo yakateverwa. Takapfurikidza varume neC CAEP nemapurisa akavakirwa akakumbira kuti: "Ko kondomu inopindira nemabasa ako here?" Uye "Ko makondomu anopindira nekumutsa kwako here?" Zvigadziriswa zvinokodzera zvinosanganisira kuva neIndaneti, iri pakati pe18 nemakore 24, kuzviratidza sehutachiona, akashandisa kondomu kuPVI mumazuva anopfuura 90, uye kukwanisa kuverenga Chirungu. Uyezve, varume vakanga vasina kubhadhara kana vainge vari mune hukama hwepabonde (hukama hwemumwechete) hwemwedzi we1 kana kuti hwakareba, sezvo kushandiswa kwekondomu kwakawanikwa kuregerera mukati memwedzi wokutanga wehukama [16]. Varume vanodudza CAEP vakanyanyiswa. Takabvunza vaverengi mubvunzo chaiwo pamagumo ekuongororwa pamusoro pekuti vanga vatora mubvunzo uyu zvakanyanyisa uye kana ruzivo rwavo ruchishandiswa; chete 1.2% vakapindura kuti havana kutora sarudzo yacho zvakanyanyisa uye isu takabvisa deta yavo.

Muenzaniso wekupedzisira waive nevarume vechidiki ve479. Mvumo yakanyorwa yakaziviswa yakawanikwa kubva kune vese vatori vechikamu uye yunivhesiti yeInstitutional Ongororo Bhodhi yakabvumidza maitiro ese ekudzidza

Nzira

Mitezo yePamusoro Mitezo

EPs Kana Usingashandisi Makondomu

Mibvunzo miviri yakaongorora EPs apo varume vaisashandisa makondomu. Vatori vechikamu vakabvunzwa kuti "Funga nezvenguva apo pawakanga uine pabonde - kusangana nekutsi kwemukadzi pabonde muZVAKAITWA 90 MAZUVA uye iwe USINA kushandisa kondomu." Izvi zvakateverwa nemibvunzo miviri, "Wakarasikirwa kangani kana kutanga kurasikirwa nekumiswa usati wapinda (usati waisa nhengo yako mukati memukadzi)?" uye "Wakarasikirwa kangani kana kutanga kurasikirwa nekumira pawaive uchiita zvepabonde (usati waita)?" Dzimwe nzira dzekupindura dzaive: "never," "apo neapo," "isingasviki hafu yenguva," "kazhinji yenguva," "nguva dzose," uye "Handigone kupindura nekuti ini ndaigara ndichishandisa kondomu." Aya maviri akasiyana anotaurwa seEPs usati wapinda (EP-Pamberi) uye EPs panguva yePVI (EP-PVI), zvichiteerana. Pamusiyano wega wega, varume vaisarudzwa se "Hongu" kana vakapindura pano neapo kana kazhinji uye "Kwete" kana vakapindura vasina.

IIEF-5 [17]

IEEE-5 ichinyorwa chechidimbu che 15-chinhu IIEF, chinoshandiswa sechidimbu chekuongorora chirongwa chekuongorora ED. Chikamu chakakosha chakagadzirwa chimwe nechimwe chezvinhu zvishanu uye chakashandiswa kuongorora. Kubva pane zvidzidzo izvi, varume vakadaro vakaiswa sevasina ED (22-25), mild ED (17-21), zvishoma kusvika pakuenzanisa ED (12-16), kuenzanisa ED (8-11), kana ED yakanyanya (5 -7), achitevera nzira inoratidzirwa naRosen nevamwe vashandi [17].

Vadzidzi Vakakosha Kubatana

CAEPs

Mhando mbiri dzeC CAE dzaiongororwa imwe neimwe nezvinhu zvakafanana. Kutanga, varume vakabvunzwa, "Kakawanda sei mumazuva 90 apfuura wakarasikirwa kana kutanga kurasikirwa nekodzero yako paunenge uchiisa kondomu pamberi pepabonde?" Zvimwe zvinopindura ndezvekuti: "nguva dzose," "dzimwe nguva," "pasi pehafu "nguva zhinji," uye "nguva dzose," uye "nguva dzose." Zvadaro, varume vakabvunzwa kuti, "Kazhinji sei mumazuva 90 akapfuura wakarasikirwa kana kutanga kurasikirwa kwako apo uchipfeka kondomu munguva yepabonde?" : "Nguva dzose," "nguva inopfuura hafu yenguva," "nguva zhinji," uye "nguva dzose." Zvimwe zvinhu zviviri zvinonzi CAEP-Application (CAEP panguva yekushandisa kondomu) uye CAEP-PVI ( CAEP pakushandisa kondomu kuPVI), maererano. Pamusana pekusiyana kwevanhu, varume vakaiswa se "Hongu" kana vakapindura nguva nenguva kana kupfuura uye "Kwete" kana vakapindura kwete. Mapoka mana akaumbwa achishandura zvinhu izvi zviviri: No-CAEP, CAEP-Kushanda chete, CAEP-PVI chete, uye CAEP-Vose.

Sample Descriptors uye Potential Correlates

Mukuwedzera kune kukodzera uye kuregererwa kutsanangurwa kunotsanangurwa kare, shanduro inotevera inotsanangurwa yezvinyorwa uye zvinogona kuwirirana zvemigumisiro zvakaongororwa: marudzi, maSpain / Latino rudzi, dzidzo, dzidziso dzezvitendero, mari, ruzivo rwemusha, kugadziriswa, nhoroondo yeupenyu hweHIV, mutori wenharaunda akambomira mumwe munhu asingazivi, uye angave akambodzidziswa kushandisa kondomu yevarume. Mazuva ano zvinetso zvehutano (chirwere cheshuga, epilepsy, kushushikana / kushushikana, multiple sclerosis, muscular dystrophy, kukanda ropa, mwoyo, zvimwe) uye kushandiswa kwemishonga (kutarisira kukanganisa kusagadzikana kwehutano / kucherechedza chirwere chinokonzera [ADHD / ADD], chirwere cheshuga, mwoyo , kuora mwoyo, kuzvidya mwoyo, hormonal, nezvimwe) zvakaongororwa uyewo kana muiti wacho ainge aporerwa nechinetso chepabonde mumwedzi yakapfuura ye12. Kushandisa 90-zuva yekuyeuka nguva, zviyamu zvinotevera zvakaenzaniswa: kana muiti wacho aive ari purogiramu yekushandura kushandiswa kwekondomu kana kuti kuchinja maitiro ehupombwe, kushandiswa kwemimwe nzira yekudzivirira, kana anga achiedza kuisa mumwe wake mukana ( s), uye kakawanda sei akashandisa phosphodiesterase aina 5 inhibitors (PDE-5i) munguva yepabonde paakanga ari uye asina kushandisa kondomu.

Data Analysis

Chi-squared miedzo yakashandiswa kugadzirisa masangano pakati peboka reC CAEP (No-CAEP, CAEP-Kushanda chete, CAEP-PVI chete, uye CAEP-Yose) pamwe nemhinduro dzemibvunzo miviri pamusoro pekugadzirisa kana kusashandisa kondomu, IIEF-5 makanga (kwete ED kune zvakanyanya ED), nezvimwe zvikamu zvakasiyana. Zvichipa kuti zviduku kusvika zero zvakachengetedza mafungiro mune mamwe masero akatyora kufunga kwechi-squared kuongorora, takaita 4 × 2 (tisambopikisana nezvimwe zviitiko zvePPE munguva yekuzivisa). Kutevera izvi, kufananidzwa kwemashure-hoc kwakaitwa uchishandisa 2 × 2 chi-squared miedzo.

Kuongorora kwekusiyana kwakashandiswa kuenzanisa IIEF-5 uye zvimwe zvinoramba zvichiitika mumapoka ane bvunzo dzaScheffé dzinoshandiswa pakuenzanisa kwepashure-hoc. Kukosha kwakagadzwa pa P <0.05. Ongororo dzakaitwa pachishandiswa SPSS Shanduro 21 (IBM SPSS manhamba eWindows, vhezheni 21.0; IBM Corp., Armonk, NY, USA).

Results

Nguva yekare yaive ye20.43 makore (kumira kwakakwana = 1.63). Vazhinji vakaonekwa sechena (80.1%), 6.8% seAsia, 4.7% seAfrica America / yakasviba, uye vakasara sevamwe madzinza. Nhamba yePaspanish / Latino yakataurwa ne4.2% yevarume. Vazhinji (66.5%) vakaratidza huwandu hwavo hwepamusoro hwezvidzidzo segoroji / tekorosi yechikoro, 3.8% yepamusoro digiri, 29.4% chikoro chesekondari, uye 0.4% havana kupedza chikoro chesekondari. Vanopfuura hafu yehafu (54.7%) vakaratidza kuti purogiramu yavo yega yega yaive yepakati-yepakati pekirasi kana kuti zvishoma uye 53.0% yakakura mumasikati kusvika kumaguta makuru. Vazhinji vakanga vadzingiswa (87.3%), vakanga vasina kumboonekwa kuti vane STI (97.3%), uye vakanga vadzidziswa kushandisa kondomu yevarume (63.0%). Kusarudzwa kwekusazvipira kwakarondedzerwa ne9.2%.

Pakati pevarume ve479, 184 (38.4%) yakarongerwa seNo-CAEP, 66 (13.8%) seC CAEP-Application chete, 75 (15.7%) seC CAEP-PVI chete, uye 154 (32.2%) seC CAEP-Yose. Hapana misiyano yakasiyana yakawanikwa nekuda kwezera, rudzi, masangano eEngland / Latino, dzidzo, dzidziso dzezvitendero, mari, ruzivo rwemusha wekuno, kudzingiswa, nhoroondo yeupenyu hweHIV, zvisati zvamboitwa munhu asingazviiti, uye kana akazodzidziswa kushandisa kondomu yevarume.

Zvichipa huwandu hwematambudziko ehutano huripo uye kushandiswa kwemishonga, data kubva kuvanhu vose vanoratidzira chero ipi neipi yeC CAEP yakabatanidzwa (chero boka reC CAEP) uye rinoenzaniswa nevaya vanobva kune varume vasingatauri CAEP. Rutsigiro rweboka roga rakawanikwa rwaiva rwekuora mwoyo / kushushikana, ne12.9% yevarume muboka reC CA reporting izvi zvichienzaniswa ne4.9% yevarume muboka reNo-CAEP (χ2 = 8.14, madhigirii erusununguko [df] 1, P  = 0.004). Pakanga paine, zvisinei, hapana musiyano weboka mukushandiswa kwemushonga kwekushandisa kushushikana (3.2%) kana kushushikana (2.9%). Musiyano weboka chete pakushandisa mishonga waive wemishonga yeADHD / ADD, iine 3.3% yeboka reNo-CAEP uye 8.9% yeboka ripi neripi reCAEP rinotaura nezvekushandisa kwemishonga iyi (χ2 = 5.62, df 1, P = 0.018). Pasi pe1% yakashumwa chirwere cheshuga (0.8%), pfari (0.8%), multiple sclerosis (0.2%), muscular dystrophy (0.2%), moyo mamiriro (0.9%); yakangofanana yakaderera chikamu chakashandiswa chirwere cheshuga (0.8%), moyo mishonga (0.4%), uye mahormone mishonga (0.9%). Vashoma vatori vechikamu vakaratidza kuwedzera kweropa (2.1%), mamwe matambudziko ekurapa (1.7%), uye kurapwa kwezvinetso zvebonde mumwedzi gumi nemiviri yapfuura (12%).

Mumazuva anopfuura 90, vashomanana vatori vechikamu vakanga vari mumapurogiramu ekuchinja kushandiswa kwekondomu (1.7%) kana kuita zvepabonde (1.3%) uye vashomanana vakashandisa PDE-5i kuita zvepabonde ne (1.9%) kana vasina kondomu (1.9%) . Hapana chakanga chiri kuedza kuwana mumwe mukadzi pamuviri. Vanopfuura hafu yevarume vakaratidza kuti vaivimba nemakondomu evanhu nekuda kwekuberekwa (54.9%) uye / kana kuti vakashandisa makondomu evanhu nemamwe marudzi ekudzivirira kuberekwa (59.1%) pane imwe nguva mumazuva 90 apfuura. Hapana misiyano yeboka yakawanikwa yeimwe yezvimwe zvinoshandiswa. Zvinoshamisa kuti varume vakawanda mune imwe boka reC CAEP (17.3%) kupfuura yeboka raNo-CAEP (9.8%) rakashuma kuti vakanga vatarisira maitiro ekudzivirira kuberekwa kunze kwekondomu pane dzimwe nguva mumazuva 90 apfuura (χ2 = 5.18, df 1, P = 0.023).

Nhamba inoreva nguva dzinoshandiswa nevarume mumakondomu mumazuva ekurangarira kwezuva 90 yaiva 10.8 (kuregerera kwakasiyana = 14.3) uye izvi hazvina kusiyana zvakanyanya mumapoka mana. Kushandiswa kwekondomu kushandiswa, zvisinei, zvakanyanya kuderera kuti CAEP-Zvose zviviri (73.4%) zvienzane neboka reNo-CAEP (82.4%) (F (3,471) = 3.44, P = 0.017), pamwe nemamwe mapoka ari pakati uye asiri akasiyana zvakanyanya kubva kune mumwe (CAEP-Kunyorera chete 82.1%; CAEP-PVI Chete 77.7%).

EPs Kana Usingashandisi Makondomu

Inenge kota imwe yemuenzaniso (23.0%) yakaratidza kuti havaikwanisa kupindura mibvunzo iyi nekuti vaigara vachishandisa makondomu. Tafura 1 inopa kuongorora kwevarume vakasara. Nokuti varume vashomanana vairatidza kuitika kwema EPs apo makondomu akanga asina kushandiswa, chi-squared analysis yakaenzanisa mapoka mana eCEP pamapepanhe akanzi "Hongu" kana "Kwete" yeP-P uye EP-PVI. Iko mapoka eCEP akasiyana zvakanyanya pane EP-Before kushanduka (χ2 = 40.14, df 3, P  <.001). Iyo muzana yevarume vanotaura kanenge dzimwe nguva EP vasati vapinda muNo-CAEP, CAEP-Kunyorera chete, CAEP-PVI chete, uye CAEP-Mapoka ese ari maviri, aive 9.9, 35.7, 23.6, uye 43.0, zvichiteerana. Mukuongorora kwepashure-hoc, iro boka reNo-CAEP raive nevarume vashoma vanotaura ma EP vasati vapinda mukati kana vasingashandisi kondomu zvichienzaniswa nemamwe mapoka. Tafura 1 zvipo zvinokonzerwa nekuenzanisira kose kwemashure.

Tafura 1. Kakawanda kwematambudziko eErection kana usinga shandisa makondomu uchienzaniswa nemapoka eC CAEP

Dambudziko rekugadzirisa kana usingashandisi kondomu

Groups

Kwete-CAEP (n = 142)

CAEP-Kushanda chete (n = 42)

CAEP-PVI chete (n = 55)

CAEP-Zvose (n = 128)

  1. *P <0.001
  2. Zvinyorwa zvinoratidza migumisiro yekufananidza kwemashure-hoc uchishandisa P  <0.05 maitiro. Mapoka anogovera tsamba haasi akasiyana zvakanyanya. Avo vasiri kugovera tsamba vakasiyana zvakanyanya.
  3. CAEP = dambudziko rinosangana nedambudziko rekusimudza; PVI = penile-vaginal zvepabonde.
Usati wapinda    
Hazvina (%)90.1a64.3b, c75.4b57.0 c
Dzimwe nguva (%)4.928.616.430.5
Pasina hafu yenguva (%)3.57.15.58.6
Kazhinji yenguva (%)1.401.83.9
Nguva dzose (%)0000
Panguva yePVI    
Hazvina (%)95.1a85.7b43.6 c54.6 c
Dzimwe nguva (%)3.511.940.033.1
Pasina hafu yenguva (%)1.42.412.77.7
Kazhinji yenguva (%)001.84.6
Nguva dzose (%)001.80

Makira eCEPE akasiyanawo zvikuru neE-PVI (χ2 = 8 3.00, df 3, P  <.001). Iyo muzana yevatori vechikamu vanoratidzira angangoita dzimwe nguva EP panguva yePVI vaive 4.9, 14.3, 56.4, uye 45.4 yeNo-CAEP, CAEP-Kunyorera chete, CAEP-PVI chete, uye CAEP-Mapoka ese ari maviri, zvichiteerana. Mukuongorora-post-hoc, varume vashoma kwazvo muboka reNo-CAEP vakashuma kuva nemaEPs panguva yePVI pavanenge vasingashandise kondomu zvichienzaniswa nemamwe mapoka ese. Iyo CAEP-PVI Chete uye CAEP-Mapoka ese ari maviri aive neepamusoro muzana uye anga asiri akasiyana zvakanyanya kubva kune mumwe. Iyo muzana yevarume muCAEP-Chikumbiro Chete boka rine angangoita dzimwe nguva EP panguva yePVI yaive yepakati uye zvakasiyana zvakanyanya kubva kune mamwe ese mapoka.

IIEF-5

Cronbach's alpha ye IIEF-5 yemuenzaniso uyu yaive 0.76. Sezvinoratidzwa mu Tafura 2, IIEF-5 zvikamu zvakasiyana zvakanyanya pamapoka eCEPE (F(3,475) = 15.40, P <.001). Izvo zvinorehwa zvikwata zvemapoka ese zvaive pamusoro makumi maviri neshanu (mune nonclinical renji) [17]. Bhuku reNo-CAEP rakange rakakosha zvikuru (23.92) (rinoratidza zviri nani erectile kushanda), zvakasiyana zvikuru neC CAEP-PVI chete (22.93) neC CAEP-Mapoka maviri (22.12), asi kwete kubva ku CAEP-Application chete (23.20) . Izvo zvinorehwa neC CAEP-Zvose izvi hazvisi zvakasiyana zvakasiyana neyeCEPEP-PVI chete boka, asi rakange rakasiyana zvikuru nedzimwe mapoka maviri. Izvo zvinoreva zvakawanda zveC CAEP-Kushanda chete uye CAEP-PVI-mapoka chete akanga asinawo zvakasiyana zvakasiyana.

Tafura 2. IIEF-5 zvikoro uye ED kusarudzwa nemapoka eC CAEP

 

Kwete-CAEP (n = 184)

CAEP-Kushanda chete (n = 66)

CAEP-PVI chete (n = 75)

CAEP-Zvose (n = 154)

  1. *P <0.001
  2. Zvinyorwa zvinoratidza migumisiro yekufananidza kwemashure-hoc uchishandisa P  <0.05 maitiro. Mapoka anogovera tsamba haasi akasiyana zvakanyanya. Avo vasiri kugovera tsamba vakasiyana zvakanyanya.
  3. CAEP = dambudziko rinosangana nedambudziko rekusimudza; ED = erectile kusagadzikana; IIEF-5, International Index of Erectile Function; PVI = penile-vaginal zvepabonde; SD = kupotsa kwakasiyana.
Zvichireva (SD) IIEF-5 chikamu*23.92 (2.24)a23.20 (2.51)a, b22.93 (2.56)b, c22.12 (2.54)c
Kuenzanisa kweE IIEF-5 Score*    
Kwete ED (%)91.3a81.8b77.3b, c68.2 c
Firi ED (%)7.115.220.028.6
Zvinyoro kuenzanisa ED (%)0.53.01.33.2
Moderate ED (%)1.101.30
Zvikuru (%)0000

Kushandisa IIEF-5 zvikoro, varume vakabva vagovererwa kubva kuEED kusvika kuneEED zvakashandiswa nenzira yakataurwa naRosen et al. [17] (ona Tafura 2). Nemhaka yekuti varume vashomanana vashoma vakaiswa sevanyoro kuti vaenzanise ED kana kuti pamusoro, takabatanidza varume neDD mune rimwe boka. Kuenzanisa machina emapoka eCEP pamapepanisi anotsanangurwa seari ED vs. vese ED, pane sangano rinokosha (χ2 = 28.98, df 3, P <.001). Iyo muzana yevatori vechikamu yakarongedzwa seyese ED aive 8.7, 18.2, 22.7, uye 31.8 yeNo-CAEP, CAEP-Kunyorera chete, CAEP-PVI chete, uye CAEP-Mapoka ese ari maviri, zvichiteerana. Tafura 2 Zvinyorwa zvinyorwa zvinoratidza migumisiro yekutsvaga kwemashure-hoc kuratidza kuti boka reNo-CAEP raisanganisira vanhu vashomanana vaine ED pane mamwe mapoka.

hurukuro

Muchienzaniso ichi chevechidiki, kusangana pabonde, kondomu-vachishandisa varume, CAEPs dzakabatanidzwa nevakawanda, asi kunyanya zvishoma (zvishoma) mazinga erectile zvinetso. Varume vanoparidza chero maitiro eCCA (panguva yekushanda uye / kana panguva yePVI) vainyanya kukosha kupfuura boka reNoa-CAEP kuti ripotire nekugadzirisa matambudziko asati apinda uye panguva yepabonde kana kusashandisa kondomu. Varume vakashuma CAEP munguva yePVI chete kana panguva iyo yose yekushanda uye PVI yakawana zvakanyanya pasi pa IIEF-5 kupfuura varume vanotaura kwete CAEP. Vose mapoka anozivisa CAEP ainyanya kukoshesa kurongerwa seve kuva nekunyorera kusvika kuEED pane boka raNo-CAEP. Kunyange zvakadaro, kunyange muCCAEP-Zvose izvi, izvo zvakave nezvikamu zvakakwirira zve IIEF-5-yakazivikanwa ED, vazhinji (68.2%) yevarume havana kugona chirongwa chekliniki yekuva ED.

Pane uwandu hwezvinogona kuwanikwa zvezviwanikwa izvi. Kutanga, hazvingashamisi kana varume vane ED zvakare vane EPS pavanoshandisa kondomu. Chechipiri, kana zvichifungidzira, zvinokwanisika kuti varume vanotanga kurasikirwa nekurasikirwa pavanoshandisa kondomu vangazvidya mwoyo pamusoro pekuwana erections kakawanda uye saka vangave vakaomerwa nekuwana yakawanda ED [18]. Izvi zvingave zvichienderana nezvimwe kutsvakurudza zvinoratidza kukosha kwekufungisisa uye mafungiro ezvinhu zvakadai sekuzvidya mwoyo nekuvhiringidzika mu etiology nekugadzirisa ED [19].

Varume avo vakataura kushandiswa kwemishonga yeDHD vakanga vari kunyanya kuudza CAEP. Ongororo dzakapfuura dzakashambadza mitero yakawanda yehutano hwepabonde kune vechidiki vane ADHD [20] uye varume vachishandisa mishonga yeDHD dzimwe nguva vanorondedzera zvinetso zve erectile sechikamu chemagetsi emishonga [21].

Nokuremara

Generalizability yezviwanikwa zvedu zvingave zvishoma. Muenzaniso wacho wakagadziriswa nekugadzirirwa kune munhu mukuru wechidiki, hutano hwepabonde, kondomu-achishandisa varume iye zvino kwete muhukama hwepanguva refu hwepabonde, uyo aitaura Chirungu, uye aive neInternet access. Nokudaro, zvitsva zvinogona kunge zvisingakwanisi kuwanikwa kune varume vasiri izvozvi zvinotenderwa. Chikonzero chedu chekusabvisa varume vakanga vari muukama hwepabonde kwemwedzi mumwe chete kana kupfuura ndeyekutsvakurudza kwakaratidza kuti varume vari muzera rezera rezera reChNUMX-18 gore remakore vanorondedzera kushandiswa kwemakondomu zvakaderera nevakashamwaridzana nevasikana kupfuura vanowanzobatana navo [22]. Varume vari muzana remakore re 18-24 vari panjodzi yakakura yekutapurirwa kweHIV neHIV [23], pasinei nekukwirira kwemakondomu anoshandiswa [24].

Tichifunga kuti kushandisa kondomu yaive nzira yekutenderwa, varume vakamboshandisa makondomu asi vakarega kushandisa, pamwe nekuda kweCAEP kana mamwe matambudziko, havana kumiririrwa mune yedu sampuli. Chimwe chirevo ndechekuti nepo isu tikashandisa chishandiso chakasarudzika kuongorora kusimba kwematambudziko e erectile, hatina kuongorora kushushikana kwemunhu padambudziko. Maitiro ekuongororwa kwechirume erectile kusagadzikana kunoda kuvepo kwekukiriniki kwakanyanya kunetseka pamusoro pezviratidzo [25]. Chinangwa chedu muchidzidzo ichi chakanga chisiri, kunyanya kuudza huwandu hwehuwandu hwehutano hwe erectile, asi kusimbisa kana varume vanotaura nezveCAPEP vanotaurawo nezvekuona ma EPs apo vasingashandisi makondomu uye kana zvikamu zveEEF zvakasiyana nevarume vasina kupa CAEP.

Zvatinowana zvinoratidza kuti kune varume vanozivisa CAEP mune samuenzaniso yedu, inenge 18-32% yakasangana nezvirevo zveEEE zvinyoro zvishoma kusvika pakuenzanisa ED (zvichienderana nekuti vaiudza CAEP panguva yekushandiswa kwekondomu chete, panguva yePVI, kana panguva iyo yose yekushandiswa uye PVI). Kunyange zvazvo vazhinji vevatori vechikamu vacho vakagoverwa mu "runyoro" ED urongwa, pane zvisinei zvakajeka zvekliniki zvinorehwa nezviwanikwa izvi. EPs dzave dzakabatanidzwa kusingapindirani uye kusakwana kushandiswa kwekondomu, [9] izvo zvinowirirana zvine njodzi yekuwana njovhera / hutachiwana hweHIV; saka, kugadzirisa zviitiko zvevarume zvekushandisa kondomu kwakakosha. Iri boka revarume rinogona kubatsirwa kubva kune imwe mhando yekupfupika maitiro ekupindira kudzikisa yavo yakaoma erectile. Kunyange zvazvo kurapwa kwemishonga yeEED kazhinji iri "yekutanga-mutsara" nzira yevarume vane erectile matambudziko, zvidzidzo zvekare zvakaratidza kuti PDE-5i hazvireve kukunda CAEP [26]. Uyezve, PDE-5i inoshandiswa inogona kuva chiitiko chekuisa kondomu yekuparara kwekondomu [27].

Mukuona kwezvakawanikwa izvo varume vane CAEP vangada nguva yakawanda kuti vamuke kunze kwevarume vasingatauri CAEP, Janssen uye vashandi pamwe navo [11] yakakurudzira kuti varume vane CAEP vanofanirwa kukurudzirwa kutora nguva yakakwana yekumutswa uye kuona kuti vanowana kukurudzira kwakaringana, kunyanya kana vachishandisa makondomu. Zvidzidzo zvenguva pfupi zvemutyairi zvekuzvitungamira pamba-kusimudzira kusimudzira mashandisirwo emakondomu pakati pevarume vechidiki (zvinongoda kiriniki zvishoma) zvakaratidza kuvimba kwakanyanya mukugona kwevarume kushandisa makondomu, kuzvigonesa pakushandisa kondomu, nekunyaradza kondomu pamwe ne kuderedzwa kwekuputsa uye EPs yekupindira [28,29]. Panewo chido chekudzidzisa zvakanakisisa mukushandiswa kwakakwana kwekondomu. Zvinopfuura chikamu chetatu (37%) chemuenzaniso wazvino wekondomu-kushandisa varume vakanga vasina kumbodzidziswa nzira yekushandisa kondomu zvakanaka. Vanachiremba vanofanira kuongorora kana varume vanoshandisa kondomu vachiwana CAEP uye kana pane zvakakodzera, kutumira mazita ekurapwa kwepabonde kana kupa ruzivo rwehutano hwekondomu [28,29].

mhedziso

Izvo zvinowanikwa zvinoratidza kuti varume vanotaura nezveCCA vanogonawo kuve nekuwana huwandu hwekuita erection matambudziko. Kunyange zvazvo EPs isingasviki nekliniki yehutano hweEED, vanachiremba vanofanira kuongorora kana varume vanoshandisa kondomu vanoona CAEP uye kana zvakakodzera, vachitaura nezvehutano hwepabonde kana kupa ruzivo rwehutano hwekondomu.

Kupesana kwezvaunofarira: Munyori (s) anorondedzera kusina kukakavara kwekufarira.

Statement of Authorship

Category 1

  • (A) Kubata uye KubwinyaStephanie Sanders; Erick Janssen; Brandon Hill
  • (B) Acquisition of DataStephanie Sanders; Erick Janssen; Brandon Hill
  • (C) Kuongorora nekujekeswa kweDhetaStephanie Sanders; Erick Janssen

Category 2

  • (A) Kugadzira chirevoStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen
  • (B) Kuchidzokorora Icho nokuda kweIntellectual ContentStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen; Erick Janssen; Brandon Hill

Category 3

  • (A) Kugamuchirwa Kwekupedzisira kweNyaya YakapedzwaStephanie Sanders; Cynthia Graham; Bill Yarber; Rick Crosby; Robin Milhausen; Erick Janssen; Brandon Hill

References

1 Mitchell KR, Mercer CH, Ploubidis GB, Jones KG, D, J J, Field J, Copas AJ, Tanton C, Erens B, Sonnenberg P, Clifton S, Macdowall W, Phelps A, Johnson AM, Wellings K. Basa rezvepabonde muBritain : Tsvaga kubva kuNational Survey Surveillance and Lifestyles (Natsal-3). Lancet 2013; 382: 1817-1829.