Research ArticleOriginal Research

Sexual Dysfunction and Preferences for Discussing Sexual Health Concerns Among Veteran Primary Care Patients

Robyn L. Shepardson, Luke D. Mitzel, Nicole Trabold, Cory A. Crane, Dev Crasta and Jennifer S. Funderburk
The Journal of the American Board of Family Medicine March 2021, 34 (2) 357-367; DOI: https://doi.org/10.3122/jabfm.2021.02.200326

References

  1. 1.↵
    1. Laumann EO,
    2. Paik A,
    3. Rosen RC
    . Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999;281:537–44.
    OpenUrlCrossRefPubMedWeb of Science
  2. 2.↵
    1. Ford JV,
    2. Ivankovich MB,
    3. Douglas JM,
    4. et al
    . The need to promote sexual health in America: a new vision for public health action. Sex Transm Dis 2017;44:579–85.
    OpenUrl
  3. 3.↵
    1. Satcher D,
    2. Hook EW III.,
    3. Coleman E
    . Sexual health in America: improving patient care and public health. JAMA 2015;314:765–6.
    OpenUrlCrossRefPubMed
  4. 4.↵
    American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. 2013. Arlington (VA): American Psychiatric Association.
  5. 5.↵
    1. Berry MD,
    2. Berry PD
    . Contemporary treatment of sexual dysfunction: reexamining the biopsychosocial model. J Sex Med 2013;10:2627–43.
    OpenUrlPubMed
  6. 6.↵
    1. McCabe M,
    2. Althof SE,
    3. Assalian P,
    4. et al
    . Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med 2010;7:327–36.
    OpenUrlCrossRefPubMed
  7. 7.↵
    1. Brotto L,
    2. Atallah S,
    3. Johnson-Agbakwu C,
    4. et al
    . Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med 2016;13:538–71.
    OpenUrl
  8. 8.↵
    1. Laumann EO,
    2. Das A,
    3. Waite LJ
    . Sexual dysfunction among older adults: prevalence and risk factors from a nationally representative U.S. probability sample of men and women 57–85 years of age. J Sex Med 2008;5:2300–11.
    OpenUrlCrossRefPubMed
  9. 9.↵
    1. Kauth MR
    . Introduction to special issue on veterans' sexual health and functioning. Int J Sex Health 2012;24:1–5.
    OpenUrl
  10. 10.↵
    1. Rosebrock L,
    2. Carroll R
    . Sexual function in female veterans: a review. J Sex Marital Ther 2017;43:228–45.
    OpenUrl
  11. 11.↵
    1. Beaulieu GR,
    2. Latini DM,
    3. Helmer DA,
    4. Powers-James C,
    5. Houlette C,
    6. Kauth MR
    . An exploration of returning veterans' sexual health issues using a brief self-report measure. Sex Med 2015;3:287–94.
    OpenUrl
  12. 12.↵
    1. Helmer DA,
    2. Beaulieu GR,
    3. Houlette C,
    4. et al
    . Assessment and documentation of sexual health issues of recent combat veterans seeking VHA care. J Sex Med 2013;10:1065–73.
    OpenUrl
  13. 13.↵
    1. Nunnink SE,
    2. Fink DS,
    3. Baker DG
    . The impact of sexual functioning problems on mental well-being in U.S. veterans from the Operation Enduring Freedom and Operation Iraqi Freedom (OEF/OIF) conflicts. Int J Sex Health 2012;24:14–25.
    OpenUrl
  14. 14.↵
    1. Katon JG,
    2. Hoggatt KJ,
    3. Balasubramanian V,
    4. et al
    . Reproductive health diagnoses of women veterans using Department of Veterans Affairs health care. Med Care 2015;53:S63–S67.
    OpenUrl
  15. 15.↵
    1. Cohen BE,
    2. Maguen S,
    3. Bertenthal D,
    4. Shi Y,
    5. Jacoby V,
    6. Seal KH
    . Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: association with mental health diagnoses. Womens Health Issues 2012;22:e461–e471.
    OpenUrlPubMed
  16. 16.↵
    1. Turchik JA,
    2. Pavao J,
    3. Nazarian D,
    4. Iqbal S,
    5. McLean C,
    6. Kimerling R
    . Sexually transmitted infections and sexual dysfunctions among newly returned veterans with and without military sexual trauma. Int J Sex Health 2012;24:45–59.
    OpenUrl
  17. 17.↵
    1. Breyer BN,
    2. Fang SC,
    3. Seal KH,
    4. et al
    . Sexual health in male and female Iraq and Afghanistan U.S. war veterans with and without PTSD: findings from the VALOR cohort. J Traumatic Stress 2016;29:229–36.
    OpenUrl
  18. 18.↵
    1. Sadler AG,
    2. Mengeling MA,
    3. Fraley SS,
    4. Torner JC,
    5. Booth BM
    . Correlates of sexual functioning in women veterans: mental health, gynecologic health, health status, and sexual assault history. Int J Sex Health 2012;24:60–77.
    OpenUrlCrossRef
  19. 19.↵
    1. Peugh J,
    2. Belenko S
    . Alcohol, drugs and sexual function: a review. J Psychoactive Drugs 2001;33:223–32.
    OpenUrlCrossRefPubMedWeb of Science
  20. 20.↵
    1. Cheng JYW,
    2. Ng EML,
    3. Chen RYL,
    4. Ko JSN
    . Alcohol consumption and erectile dysfunction: meta-analysis of population-based studies. Int J Impot Res 2007;19:343–52.
    OpenUrlCrossRefPubMedWeb of Science
  21. 21.↵
    1. Hosain GMM,
    2. Latini DM,
    3. Kauth M,
    4. Goltz HH,
    5. Helmer DA
    . Sexual dysfunction among male veterans returning from Iraq and Afghanistan: prevalence and correlates. J Sex Med 2013;10:516–23.
    OpenUrl
  22. 22.↵
    1. Pulverman CS,
    2. Creech SK
    . The impact of sexual trauma on the sexual health of women veterans: a comprehensive review. Trauma Violence Abuse 2019;1–16.
  23. 23.↵
    1. Gott M,
    2. Hinchliff S,
    3. Galena E
    . General practitioner attitudes to discussing sexual health issues with older people. Soc Sci Med 2004;58:2093–103.
    OpenUrlCrossRefPubMedWeb of Science
  24. 24.↵
    1. Gott M,
    2. Galena E,
    3. Hinchliff S,
    4. Elford H
    . “Opening a can of worms”: GP and practice nurse barriers to talking about sexual health in primary care. Fam Pract 2004;21:528–36.
    OpenUrlCrossRefPubMedWeb of Science
  25. 25.↵
    1. Basson R,
    2. Schultz WW
    . Sexual sequelae of general medical disorders. Lancet 2007;369:409–24.
    OpenUrlCrossRefPubMedWeb of Science
  26. 26.↵
    1. Clark RD,
    2. Williams AA
    . Patient preferences in discussing sexual dysfunctions in primary care. Fam Med 2014;46:124–8.
    OpenUrlPubMed
  27. 27.↵
    1. Gott M,
    2. Hinchliff S
    . Barriers to seeking treatment for sexual problems in primary care: a qualitative study with older people. Fam Pract 2003;20:690–5.
    OpenUrlCrossRefPubMedWeb of Science
  28. 28.↵
    1. Laumann EO,
    2. Glasser DB,
    3. Neves RCS,
    4. Moreira ED Jr..
    , GSSAB Investigators' Group. A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America. Int J Impot Res 2009;21:171–8.
    OpenUrlCrossRefPubMed
  29. 29.↵
    1. Flynn KE,
    2. Whicker D,
    3. Lin L,
    4. Cusatis R,
    5. Nyitray A,
    6. Weinfurt KP
    . Sexual orientation and patient-provider communication about sexual problems or concerns among US adults. J Gen Intern Med 2019;34:2505–11.
    OpenUrl
  30. 30.↵
    1. Dyer K,
    2. das Nair R
    . Why don't healthcare professionals talk about sex?A systematic review of recent qualitative studies conducted in the United Kingdom. J Sex Med 2013;10:2658–70.
    OpenUrlCrossRefPubMed
  31. 31.↵
    1. Ladden MD,
    2. Bodenheimer T,
    3. Fishman NW,
    4. et al
    . The emerging primary care workforce: preliminary observations from the Primary Care Team: Learning from Effective Ambulatory Practices project. Acad Med 2013;88:1830–4.
    OpenUrlCrossRefPubMed
  32. 32.↵
    1. Vogel ME,
    2. Kanzler KE,
    3. Aikens JE,
    4. Goodie JL
    . Integration of behavioral health and primary care: current knowledge and future directions. J Behav Med 2017;40:69–84.
    OpenUrl
  33. 33.↵
    1. Kearney LK,
    2. Post EP,
    3. Zeiss A,
    4. Goldstein MG,
    5. Dundon M
    . The role of mental and behavioral health in the application of the patient-centered medical home in the Department of Veterans Affairs. Transl Behav Med 2011;1:624–8.
    OpenUrlCrossRefPubMed
  34. 34.↵
    1. Kaslow NJ,
    2. Kapoor S,
    3. Dunn SE,
    4. Graves CC
    . Psychologists' contributions to patient-centered medical homes. J Clin Psychol Med Settings 2015;22:199–212.
    OpenUrl
  35. 35.↵
    1. Kimerling R,
    2. Iverson KM,
    3. Dichter ME,
    4. Rodriguez AL,
    5. Wong A,
    6. Pavao J
    . Prevalence of intimate partner violence among women veterans who utilize Veterans Health Administration primary care. J Gen Intern Med 2016;31:888–94.
    OpenUrl
  36. 36.↵
    1. McGahuey CA,
    2. Gelenberg AJ,
    3. Laukes CA,
    4. et al
    . The Arizona Sexual Experience Scale (ASEX): reliability and validity. J Sex Marital Ther 2000;26:25–40.
    OpenUrlCrossRefPubMedWeb of Science
  37. 37.↵
    1. Kroenke K,
    2. Spitzer RL,
    3. Williams JBW
    . The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606–13.
    OpenUrlCrossRefPubMedWeb of Science
  38. 38.↵
    1. Kroenke K,
    2. Spitzer RL,
    3. Williams JBW,
    4. Löwe B
    . The Patient Health Questionnaire Somatic, Anxiety, and Depressive Symptom Scales: a systematic review. Gen Hosp Psychiatry 2010;32:345–59.
    OpenUrlCrossRefPubMedWeb of Science
  39. 39.↵
    1. Blevins CA,
    2. Weathers FW,
    3. Davis MT,
    4. Witte TK,
    5. Domino JL
    . The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J Traumatic Stress 2015;28:489–98.
    OpenUrlCrossRefPubMed
  40. 40.↵
    1. Bovin MJ,
    2. Marx BP,
    3. Weathers FW,
    4. et al
    . Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans. Psychol Assess 2016;28:1379–91.
    OpenUrlCrossRefPubMed
  41. 41.↵
    1. Babor TF,
    2. Higgins-Biddle JC,
    3. Saunders J,
    4. Monteiro MG
    . The Alcohol Use Disorders Identification Test: guidelines for use in primary care. 2nd ed. Geneva, Switzerland: World Health Organization; 2001. Available from: https://apps.who.int/iris/bitstream/handle/10665/67205/WHO_MSD_MSB_01.6a.pdf;jsessionid=E243EB9432BB72CBA54EF4AFF2F80ED5?sequence=1. Accessed March 1, 2019.
  42. 42.↵
    1. Reinert DF,
    2. Allen JP
    . The Alcohol Use Disorders Identification Test: an update of research findings. Alcohol Clin Exp Res 2007;31:185–99.
    OpenUrlCrossRefPubMedWeb of Science
  43. 43.↵
    1. Funk JL,
    2. Rogge RD
    . Testing the ruler with item response theory: increasing precision of measurement for relationship satisfaction with the Couples Satisfaction Index. J Fam Psychol 2007;21:572–83.
    OpenUrlCrossRefPubMedWeb of Science
  44. 44.↵
    1. Wilson LC
    . The prevalence of military sexual trauma: a meta-analysis. Trauma Violence Abuse 2018;19:584–97.
    OpenUrl
  45. 45.↵
    1. Pulverman CS,
    2. Christy AY,
    3. Kelly UA
    . Military sexual trauma and sexual health in women veterans: a systematic review. Sex Med Rev 2019;7:393–407.
    OpenUrl
  46. 46.↵
    1. Marwick C
    . Survey says patients expect little physician help on sex. JAMA 1999;281:2173–4.
    OpenUrlCrossRefPubMedWeb of Science
  47. 47.↵
    1. Moreira ED Jr..,
    2. Brock G,
    3. Glasser DB
    , GSSAB Investigators' Group, et al. Help-seeking behaviour for sexual problems: the Global Study of Sexual Attitudes and Behaviors. Int J Clin Pract 2005;59:6–16.
    OpenUrlCrossRefPubMedWeb of Science
  48. 48.↵
    1. McCabe MP
    . Evaluation of a cognitive behavioral therapy program for people with sexual dysfunction. J Sex Marital Ther 2001;27:259–71.
    OpenUrlCrossRefPubMed
  49. 49.↵
    1. Rosen RC,
    2. Leiblum SR,
    3. Spector IP
    . Psychologically based treatment for male erectile disorder: a cognitive-interpersonal model. J Sex Marital Ther 1994;20:67–85.
    OpenUrlPubMed
  50. 50.↵
    1. Hartmann U,
    2. Burkart M
    . Erectile dysfunctions in patient-physician communication: optimized strategies for addressing sexual issues and the benefit of using a patient questionnaire. J Sex Med 2007;4:38–46.
    OpenUrlPubMed
  51. 51.↵
    1. Tiefer L
    . Medicalizations and demedicalizations of sexuality therapies. J Sex Res 2012;49:311–8.
    OpenUrlCrossRefPubMedWeb of Science
  52. 52.↵
    1. Misra-Hebert AD,
    2. Santurri L,
    3. DeChant R,
    4. et al
    . A health assessment survey of veteran students: utilizing a community college–Veterans Affairs medical center partnership. Mil Med 2015;180:1059–64.
    OpenUrl
  53. 53.↵
    1. Gaeddert LA,
    2. Schneider AL,
    3. Miller CN,
    4. et al
    . Recruitment of women veterans into suicide prevention research: improving response rates with enhanced recruitment materials and multiple survey modalities. Res Nurs Health 2020;43:538–47.
    OpenUrl
  54. 54.↵
    1. Coughlin SS,
    2. Aliaga P,
    3. Barth S,
    4. et al
    . The effectiveness of a monetary incentive on response rates in a survey of recent U.S. veterans. Surv Pract 2011;4:1–8.
    OpenUrl
  55. 55.↵
    1. DeRogatis LR
    . Assessment of sexual function/dysfunction via patient reported outcomes. Int J Impot Res 2008;20:35–44.
    OpenUrlCrossRefPubMed
  56. 56.↵
    1. Rosen RC,
    2. Cappelleri JC,
    3. Smith MD,
    4. Lipsky J,
    5. Peña BM
    . Development and evaluation of an abridged, 5-item version of the International Index of Erectile Function (IIEF-5) as a diagnostic tool for erectile dysfunction. Int J Impot Res 1999;11:319–26.
    OpenUrlCrossRefPubMedWeb of Science
  57. 57.↵
    1. Flynn KE,
    2. Tessler Lindau S,
    3. Lin L,
    4. et al
    . Development and validation of a single-item screener for self-reporting sexual problems in U.S. adults. J Gen Intern Med 2015;30:1468–75.
    OpenUrl
  58. 58.↵
    1. Savoy M,
    2. O'Gurek D,
    3. Brown-James A
    . Sexual health history: techniques and tips. Am Fam Physician 2020;101:286–93.
    OpenUrl
  59. 59.↵
    1. Althof SE,
    2. Rosen RC,
    3. Perelman MA,
    4. Rubio-Aurioles E
    . Standard operating procedures for taking a sexual history. J Sex Med 2013;10:26–35.
    OpenUrl
  60. 60.↵
    1. Barratt BB,
    2. Rand MA
    . “Sexual health assessment” for mental health and medical practitioners: teaching notes. Am J Sex Educ 2009;4:16–27.
    OpenUrl
  61. 61.↵
    Atlarum Institute. Sexual health and your patients: A provider's guide. 2016. Available from: https://www.nationalcoalitionforsexualhealth.org/tools/for-healthcare-providers/document/Provider-Guide_9.27.19.pdf. Accessed August 20, 2020.
  62. 62.↵
    1. Annon J
    . The PLISSIT model: a proposed conceptual scheme for the behavioural treatment of sexual problems. J Sex Educ Ther 1976;2:1–15.
    OpenUrl
  63. 63.↵
    1. Taylor B,
    2. Davis S
    . The Extended PLISSIT model for addressing the sexual wellbeing of individuals with an acquired disability or chronic illness. Sex Disabil 2007;25:135–9.
    OpenUrlCrossRef
  64. 64.↵
    Centers for Disease Control and Prevention. A guide to taking a sexual history. 2011. Updated March 14, 2014. Available from: https://www.cdc.gov/std/treatment/sexualhistory.pdf. Accessed August 20, 2020.
  65. 65.↵
    1. Maurice WL,
    2. Bowman MA
    . Sexual medicine in primary care. St. Louis (MO): Mosby, 1999. Available from: https://kinseyinstitute.org/collections/archival/sexual-medicine-in-primary-care.php. Accessed August 26, 2020.
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