Perceived influence of health status on sexual activity in RA patients: associations with demographic and disease‐related variables

Abstract

Objective: To examine the prevalence of self‐reported problems with sexual activity in patients with rheumatoid arthritis (RA), and associations with demographic and disease‐related variables.

Methods: Perceived levels of problems with sexual activity were addressed through question 15 of the Health‐Related Quality of Life (HRQoL) instrument 15D. Disease‐related variables were determined with the Visual Analogue Scale (VAS), the Arthritis Impact Measurement Scale (AIMS2), the Health Assessment Questionnaire (HAQ), and the Arthritis Specific Self‐Efficacy (ASES) questionnaire.

Results: Data were available from 830 patients with RA 74% female, mean (SD) age 58.5 (14.2) years, disease duration 13.4 (10.3) years, HAQ score 0.98 (0.72). No impact on sexual activity was reported by 31%, little by 38%, considerable by 21%, 3% reported sexual activity as almost impossible, and 7% reported sexual activity as impossible. When dichotomized, the ‘large impact’ group had worse health status across all dimensions compared to the group with ‘no/little impact’ (p<0.001). In the multiple logistic regression analyses, perceived impact on sexual activity was associated with male vs. female gender [odds ratio (OR) 3.18, 95% confidence interval (CI) 2.05–4.94], age (youngest vs. oldest group) (OR 3.56, 95% CI 1.78–7.09), increased levels of fatigue (OR 1.01, 95% CI 1.0–1.02) and mental distress (OR 1.21, 95% CI 1.06–1.38), HAQ score (OR 2.46, 95% CI 1.78–3.39), and low self‐efficacy regarding symptoms (OR 0.97, 95% CI 0.96–0.98).

Conclusion: One‐third of the RA patients reported that their health status considerably influenced their sexual activity. Higher levels of fatigue, mental distress, functional limitations, lower levels of self‐efficacy, and male gender were independently associated with perceived problems with sexual activity.