Association between human immunodeficiency virus diagnosis and risk of penoscrotal conditions in adult males: A propensity‐matched retrospective cohort study

Abstract Objectives This study aimed to examine the temporal association between human immunodeficiency virus (HIV) diagnosis and subsequent development of penoscrotal conditions including priapism, phimosis, epididymo‐orchitis, testicular torsion and paraphimosis. Patients and methods A propensity‐matched retrospective cohort study was conducted using the TriNetX database. Adult males with HIV (B20) were matched 1:1 to controls on age and race. Outcomes were assessed over a 10‐year follow‐up period using the Cox proportional hazards model. Results Following matching, cohort sizes ranged from 48 615 to 65 423 patients per group. HIV diagnosis was associated with significantly increased rates of priapism (HR 1.892, 95% CI 1.115–3.210, p = 0.0162), phimosis (HR 2.364, 95% CI 1.631–3.428, p < 0.0001) and epididymo‐orchitis (HR 2.346, 95% CI 2.116–2.602, p < 0.0001). No significant association was observed for testicular torsion (HR 1.579, 95% CI 0.756–3.295, p = 0.2200). Paraphimosis could not be evaluated in the corrected analysis due to insufficient data. Conclusion HIV diagnosis was associated with significantly elevated rates of priapism, phimosis and epididymo‐orchitis, while no significant association was observed for testicular torsion. These findings are hypothesis‐generating, and prospective studies with more granular clinical data are needed to confirm and characterize these associations.