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Background HIV-infected men have increased incidence of erectile dysfunction (ED) compared with men without HIV infection. Risk factors for ED among HIV-positive individuals have not been widely described. Methods A retrospective cohort study was completed evaluating participants in the US Military HIV Natural History Study, a cohort of HIV-infected active duty members and beneficiaries. Men with a diagnosis of ED after HIV diagnosis were included (n = 488). Cohort controls (n = 976) without ED diagnosis were matched 2:1 by age at HIV diagnosis. Multivariate logistic regression model was used to identify risk factors for ED. Results At HIV diagnosis, the median CD4 count was similar for cases (523 cells/μL, IQR 396–675) and controls (508 cells/μL, IQR 366–673; P = 0.310) and the overall median age was 32 years. At ED diagnosis, cases had a median age of 43 years (IQR 37.0–49.0) and 445 (92.3%) were on antiretroviral therapy (ART). The median time from HIV diagnosis to ART start was longer for cases (5.0 years, IQR 2.0–9.0) compared with controls (3.0 years, IQR 1.0–6.0; P < 0.001). Cases had a higher proportion of the following diagnoses compared with controls (P < 0.001 for all): depression (33.4% vs. 21.7%), hypertension (37.9% vs. 20.4%), hyperlipidemia (54.3% vs. 32.4%), tobacco use (31.1% vs. 23.1%), sleep apnea (14.8% vs. 4.2%) and diabetes/cardiovascular disease (CVD)(10.5% vs. 4.7%). Multivariate logistic regression model is reported below (table). Logistic Regression Model to Predict ED Characteristic Odds Ratio 95% CI P-value Sleep apnea 2.62 1.69–4.05 <0.001 Time from HIV diagnosis to ART start > mean 2.07 1.58–2.71 <0.001 African-American race 1.76 0.90–3.42 0.096 Diabetes/cardiovascular disease 1.61 1.01–2.58 0.048 Tobacco use 1.42 0.99–2.04 0.057 Hypertension 1.36 1.02–1.82 0.034 Hyperlipidemia 1.26 0.96–1.64 0.092 Depression 1.24 0.94–1.63 0.130 CD4 count <200 cells/μL at HIV diagnosis 0.63 0.32–1.25 0.184 Prior protease inhibitor use 0.43 0.31–0.60 <0.001 Conclusion Delay in ART initiation as well as risk factors for and presence of CVD were associated with ED in HIV-infected persons. Mitigating risk factors and optimizing comorbidities is important to improve sexual health and reduce ED in HIV-infected persons. Disclosures All authors: No reported disclosures.

602. Factors Associated With Erectile Dysfunction Diagnosis in HIV-Infected Individuals: A Case–Control Study