Limitations A limitation of this study is that the questionnaires were self-administered and the data is thus prone to self-report and recall bias. Furthermore, symptoms that were being treated so that they were not bothersome during the study visit (e.g., selleck chemicals llc pain controlled with analgesics) may not have been reported. Also, it is difficult to compare the results of this study to other research, since different methods of assessing symptoms yield large differences in the reported prevalence. For example, the percentage of patients reporting symptoms on a checklist is higher compared to physicians’ questioning [32], and the longer the symptom checklist, the more symptoms that are potentially reported.

In addition, study design issues may limit the generalizability of our findings, since we did not include a control group, so that there is no internal comparison to people with HIV who are not taking ART or to the general population. In addition we did not control for other potential confounders such as race/ethnicity, socioeconomic status, sexual orientations, and substance use. Finally, women and men were not matched for length of exposure to ART, with women having on average 18 months less ART-exposure than men, which may account for some variance in symptoms and laboratory abnormalities. Conclusions Men and women with HIV suffer from a wide range of symptoms but attribute these symptoms more to side effects of the treatment than to effects of the disease. This is more true for women than for men, since the likelihood of symptom attribution to HIV is greater among men, which may motivate men to take ART despite side effects.

Women, on the other hand, view their symptoms more like lyasside effects of ART and are more prepared to switch or interrupt treatment in order to avoid toxicity. Furthermore, patients’ causal attributions of sexual or menstrual dysfunction are relevant for clinical practice. Finally, tackling potentially ART-related laboratory abnormalities even in their early stages and adjusting treatment accordingly might help reducing toxic effects of ART. In summary, as patients’ causal attributions of symptoms to HIV or ART have an influence on treatment decisions, their perspectives are of clinical importance. Clinicians need to be aware of gender differences in causal attributions of symptoms and communicate about the patients’ perceptions of the causes of their symptoms, as well as potentially ART-related laboratory abnormalities.

Note Source of support: German Federal Ministry of Education and Research. Acknowledgements The authors thank the Federal Ministry of Education and Research for funding this study Cilengitide within the frame of the German Competence Network HIV/AIDS and all participants for volunteering to complete the questionnaires.