Sexual Functioning in Men With and Without Disabilities: Findings From a Representative Sample of Australian Men

Introduction: Studies on sexual function in men with disabilities have mainly relied on clinical samples; population-based evidence on this topic is limited. Aim: The aim of this study was to compare aspects of sexual function between disabled and nondisabled men using a representative sample. Methods: We used data from Ten to Men, a national cohort study of Australian men aged 18-55 years. We first compared the prevalence of 15 sexual function-related difficulties in disabled vs non-disabled men. Next, we used Poisson regression to examine associations between disability and sexual function. The main analytic sample had 8,496 men. Weights and adjustments appropriate to the samplingmethodology were applied. Models adjusted for potential confounders. Resultswere reported as prevalence ratios (PRs). P values of <.05 were considered statistically significant. Main Outcome Measure: Outcomes were 15 individual items from the National Survey of Sexual Attitudes and Lifestyles-Sexual Function, a validated measure of sexual function with items in 3 domains: physiopsychological aspect; relational aspect; and global self-rating (the 16th item on help-seeking was excluded). These were coded as binary variables denoting past-year sexual problems. Results: Disabled men had higher prevalence of all outcomes than nondisabled men. 25.6% of men with disabilities and 15.1% of nondisabled men experienced at least 2 of 15 difficulties. The most prevalent problems were "orgasmed too early" (43.8% of disabled men, 37.1% of nondisabled men), imbalance of sexual desire between partners (47.6% of disabled men, 39.2% of nondisabled men), and overall sexual dissatisfaction (39.4% of disabled men, 26.7% of nondisabled men). All adjusted PRs were > 1.00 for disability; associations were statistically significant except "partner experienced sexual difficulties" (PR = 1.23; 95% CI = 0.99-1.53; P =.058) and "orgasmed too early" (PR = 1.16; 95% CI = 1.00-1.35; P =.050). "Presence of discomfort/pain" had the largest adjusted PR for disability (PR = 2.77; 95% CI = 1.89-4.06; P <.001). Clinical Implication: This population-based analysis on the relationship between disability and sexual function contextualizes evidence from clinical studies. Findings suggest that disparities between men with and without disability exist but are not uniform across different aspects of sexual function. Strengths & Limitations: Two major strengths of this study are that the sample included a nondisabled reference group and results are generalizable to Australian men. A key limitation is that disability and sexual function measures are self-reported. Conclusion: This study provides a broad foundation of population-based evidence about sexual function in men with disabilities, relative to men without, showing positive associations between disability and 13 of 15 sexual difficulties. Copyright (C) 2019, International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.