Patients Taking HIV Medications May Be at Increased Risk of Priapism

Patients Taking HIV Medications May Be at Increased Risk of Priapism

Priapism is a long-lasting, unwanted, and often painful erection. Individuals who have an erection for more than four hours should seek emergency medical care to mitigate any potential damage to the penis. Even when priapism is addressed quickly and properly, it can lead to sexual dysfunction such as erectile dysfunction (ED), Peyronie’s disease (PD), or recurrent priapism.

There are a few known factors that may increase a person’s risk of priapism such as hemolytic anemia (a blood disorder that occurs when the body has fewer red blood cells than normal), the use of antipsychotics, and the use of vasodilators (medications that open the blood vessels).

It is useful to know which medical conditions and/or treatments may be associated with priapism so that individuals can be better informed about their health and their risk of developing priapism. Therefore, data-mining techniques were used in a recent study to identify other medical conditions and medications that could be associated with priapism.

For this study, researchers used a large insurance claims database to identify all men aged 20 years or older with a diagnosis of priapism between 2003 and 2020. A total of 10,459 men in the database fit this description.

Then, the investigators matched these men on a 1:1 basis with men with other conditions that affect the male genitals: ED, PD, and premature ejaculation. The men in the priapism group were matched with the men in the control groups by age, race, education, and year of enrollment.

Using the random forest data-mining technique, the researchers were able to determine diagnoses/medications that were significantly associated with priapism. This technique confirmed the previously known medical associations with priapism including hemolytic anemia, antipsychotics, and vasodilating medications.

However, it also revealed that patients taking antiretroviral medications for HIV may be at increased risk of developing priapism. That is to say, the men in the priapism group had higher associations of HIV medication use than the men in the three control groups.   

Confirmation of the known associations with priapism suggests the validity of these results, and they indicate that HIV and HIV medications may be risk factors for priapism. Therefore, patients with HIV who are taking antiretroviral medications should be aware of the signs of priapism and seek emergency care for a prolonged erection that is not related to sexual activity.


  • Mulloy, E., Li, S., Belladelli, F., Del Giudice, F., Glover, F., & Eisenberg, M.L. (2023). Association between priapism and HIV disease and treatment. The Journal of Sexual Medicine20(4), 536-541.

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