Hello Doctor: Since I began taking a cocktail of kaletra,amprenivir,epivir,and viread about two years ago, I have noticed an overt inability to get an erection. My libido is seemingly stimulated enough for me to be "mentally sexual," but I cannot perform physically. My penis remains flaccid and gets only mildly erect. What's compounding this issue is the fact that I had been using Androgel for over a year and now have switched to Testim....but I have not experienced an abilty to produce a healthy erection. I have read a myriad of success stories from other hiv positive men who are using either of the two aforementioned prescriptions. Yes, I have used viagra, but the side effects (headache,sinus problems)make love-making anything but fun. Are the hiv meds I'm taking too potent to work productively with the testim? This has been going on now for two years, so should I see a specialist: urologist? endocrinologist?

There are some patients who experience impotence on HIV meds like yours and who don't get much help from normalizing testosterone levels and have side effects from Viagra. There are some new Viagra like drugs on the market that might be worth trying. I usually refer to an endocrinologist and urologist for the cases that I don't make much progress with such as yours. Caverject has been recommended for some of those patients. KH