Quality of Life, Sexual Health, and Associated Factors Among the Sexually Active Adults in a Metro City of India: An Inquiry During the COVID-19 Pandemic-Related Lockdown

Development and content validation of a survey assessing domains of sexual and reproductive health in adults with spina bifida

PurposeIndividuals with spina bifida (SB) often face substantial gaps in sexual and reproductive health (SRH) knowledge leading to low use of contraception, poor utilization of preventative sexual health care, unintended pregnancies, missed opportunities to pursue their SRH goals, and increased risk of abuse and coercion. Validated questionnaires are needed to reliably test and track the SRH and self-efficacy of adults with SB. This study aimed to develop a survey with content validity to assess five SRH domains in adults with SB.MethodsAn initial survey was informed by a targeted literature review as well as stakeholder and expert opinions. Social cognitive theory's self-efficacy concept, known for its predictive power in behavior change among those with physical disabilities, guided its development. The survey items were iteratively reviewed online by national sexual health experts using a modified Delphi method, assessing item clarity, relevance, and comprehensiveness. Then, cognitive interviews of the refined instrument were conducted with five adults with SB to analyze acceptance and understanding.ResultsOf the 26 potential panel members invited to participate, 22 (85%) responded and agreed to participate. There were seven urologists (two adult, five pediatric), six developmental pediatricians, six registered nurses from SB clinics, two physiatrists, and one medicine-pediatrics trained internist. Consensus was achieved after three rounds for 100 survey items. Following each round, items were refined through researcher consensus until the content validity index was met (agreement = 0.8-1.0) for each question, ensuring all domains were adequately represented. These domains included sexual knowledge/education, sexual practice, sexual safety/risk profile, history of abuse, and perceived self-efficacy.ConclusionContent validity, clarity, and functionality of a novel survey that probes five domains of SRH in adults with SB was established. The survey can be utilized in both research and clinical settings to assess baseline SRH knowledge, identify risky behaviors, and screen for sexual abuse.

Associations between sexual health and well-being: a systematic review

Objective

To investigate the associations between sexual health dimensions, and overall health and well-being.

Methods

In February 2024, we systematically searched Scopus, PsyArticles, PsycINFO®, PubMed®, Web of Science and LILACS for articles reporting on associations between sexual health, health and well-being indicators. We applied no language restrictions and followed the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. To assess the risk of bias in the included studies, we used the Risk Of Bias In Non-randomized Studies - of Exposures tool.

Findings

Of 23 930 unique titles identified, 63 studies met the inclusion criteria. We grouped the results into two categories: (i) sexual and physical health; and (ii) sexual and psychological health. The results consistently showed strong correlations between sexual health, overall health and well-being. Almost all studies found significant associations between positive sexual health indicators and lower depression and anxiety, higher quality of life, and greater life satisfaction among men and women, including older adults, pregnant women, and same-sex and mixed-sex couples.

Conclusion

Findings indicate that emphasizing a positive perspective on sexual health and highlighting its benefits should be regarded as an important component of the effort to improve overall health and well-being for everyone.

Evaluating male sexual function and reproductive health during Omicron outbreak in China

There are currently no studies exploring omicron infection and male sexual function and semen quality. Our aim was to estimate changes in sexual function and semen quality in men recovering from infection since the COVID-19 Omicron pandemic started in China in late 2022. We collected 1540 questionnaires and assessed male function before infection and acute phase after infection by using International Index of Erectile Function-5, Premature Ejaculation Diagnostic Tool, and Arizona Sexual Experience Scale. We also collected the before and after semen analysis results of 247 male patients. During the acute phase after infection, the proportion of erectile dysfunction was significantly higher than before infection, but ejaculatory function was not significantly altered; In addition, semen analysis showed significant difference in semen concentration, semen activity and PR a+b sperm forward movement after infection compared to pre-infection.: COVID-19 Omicron can affect erectile function as well as sexual experience in male patients in the acute phase. Decreased sexual function due to COVID-19 Omicron may be related to body temperature and anxiety during infection.

Sexual Function, Religion, Existential Well-being and Mental Health among Iranian Married Women of Reproductive Age

The present study investigates the relationship between sexuality and spirituality with mental health among Iranian married women of reproductive age. It was a cross-sectional, correlational study with a sample size of 120 Iranian married women in 2022. Goldberg general health, Female Sexual Function Index, and Paloutzian and Ellison spiritual health questionnaires were used to collect data. The level of spiritual health scale (SWBS) in more than half of the married women was high (50.8%) and 49.2% at the average level. Sexual dysfunction was reported at 43.3%. Sexual function, religious and existential well-being was predictors of mental health and its dimensions. The risk of sexual dysfunction was 3.33-fold higher in people who had an unfavorable level of SWBS (β = 3.33, CI: 1.558-7.099, P = 0.002) compared to those who had a favorable level of SWBS. Therefore, adhering to sexual health and relying on spirituality are emphasized in preventing mental health problems.

Subjective effects and perceived mechanisms of change of cognitive behavioral and mindfulness-based online interventions for low sexual desire in women

Cognitive-behavioral (CBT) and mindfulness-based therapy (MBT) are effective treatments for Hypoactive Sexual Desire Dysfunction (HSDD) in women. To date, evidence regarding the mechanisms of these treatments for improving low sexual desire is still lacking. To gain comprehensive information on the subjective effects and perceived mechanisms of change of CBT and MBT for HSDD, semi-structured qualitative interviews were conducted with 51 cis-women who participated in a trial investigating internet-based CBT and MBT for HSDD. Data were analyzed with deductive and inductive content analysis. Subjective treatment effects included increased desire, improved communication, and greater self-acceptance. Different mechanisms of change for CBT and MBT were endorsed by participants. This study provides tangible evidence of the different pathways through which CBT and MBT can improve women's sexual desire.

Exploring the adult sexual wellbeing and behavior during the COVID-19 pandemic. A systematic review and meta-analysis

Implemented social distancing measures may have forestalled the spread of COVID-19, yet they suppressed the natural human need for contact. The aim of this systematic review was to explore the impact of the COVID-19 pandemic on adult sexual wellbeing and sexual behavior. An extensive search in Pubmed, Scopus, and PsycInfo databases based on PRISMA guidelines was conducted. After applying specific eligibility criteria, screening resulted in 38 studies. Results were drawn from 31,911 subjects and outlined the negative effect of the pandemic in sexual frequency, function, satisfaction, and the behavioral changes regarding masturbation and internet-based practices. Meta-analyses of the drawn data on 1,343 female, and 1,372 male subjects quantified the degree of sexual function change during the COVID-19 pandemic vs. prior the pandemic. A random effects model revealed the significant negative impact of the pandemic on female sexual function (SMD: 0.76, 95% CI:0.74 to 1.59), while no significant change was found for the males (SMD: 0.25, 95% Cl: -0.03 to 0.52). Significant heterogeneity was identified across included studies (p < 0.00001, I² = 97%, I² = 90% for females and males, respectively). As part of the global health, sexual wellbeing should be on the focus of clinicians and researchers.