Sexual Abstinence and Associated Factors Among Young and Middle-Aged Men: A Systematic Review

Introduction: Sexual activity is an essential human need and an important predictor of other aspects of human life. A literature review was conducted to investigate whether sexual abstinence in young and middle-aged men is generally considered a deliberate, healthy behavior and whether it has other causes and consequences. Aim: To review the prevalence and factors associated with sexual abstinence in young (10-24 years) and middle-aged (25-59 years) men. Methods: Studies were retrieved from Science Direct, PubMed, and EBSCOhost published from 2008 to 2019. The selection criteria were original population- or community-based articles, published in the English language, on sexual abstinence, and in young and middle-aged men. Main Outcome Measure: This article reviewed the literature on the proportions of and factors associated with sexual abstinence in young and middle-aged men. Results: A total of 13,154 studies were retrieved, from which data were extracted for 37 population- or community-based studies. The prevalence of sexual abstinence varied from 0% to 83.6% in men younger than 60 years. The prevalence of primary sexual abstinence was 3.4%-83.3% for young men and 12.5%-15.5% for middle-aged men. The prevalence of secondary abstinence for youngmen ranged from 1.3% to 83.6%, while for middle-agedmen, it was from 1.2% to 67.7%. The prevalence of sexual abstinence decreased with increasing age in young men but increased with increasing age inmiddle-aged men. The significant factors reported were age, single status, poor relationships, low socioeconomic status, sex education, religious practices, caring and monitoring parents, and not using alcohol, cigarettes, or drugs. Although the variations in findings fromdifferent studies can be explained by different regions and cultures, the information cannot be generalized worldwide because of a lack of studies in Asian and Australian populations. Clinical Implications: The studies on sexual abstinence in the future should use a consistent and standard definition, cover all sexual behaviors, and investigate all related factors. Strength & Limitations: The restricted timeframe (2008-2019), English language, availability of full text, and variability in definition and time duration may be the sources of bias. Conclusion: Young men had higher proportions of sexual abstinence than middle-aged men, and age, unavailability of a partner, lower educational levels, low socioeconomic status, conservative and religious conditions, and no or less knowledge about sexually transmitted infections were common predictors of sexual abstinence in most of the men. Although determinants of sexual abstinence were identified, further investigation of biological factors in men younger than 60 years is needed. Copyright (C) 2019, The Authors. Published by Elsevier Inc. on behalf of the International Society for Sexual Medicine.