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A mixed study systematic review and meta-analysis of sexuality and sexual rehabilitation in LGBTQI+ adults living with chronic disease

Published:August 13, 2022DOI:https://doi.org/10.1016/j.apmr.2022.07.018

      Abstract

      Objective

      : To systematically review how sexuality is experienced by LGBTQI+ persons living with chronic disease.

      Data Sources

      PsycINFO, Embase, MEDLINE, Scopus, CINAHL and Web of Science were searched from date of inception to November 2021 for English language publications. Reference lists of relevant publications were also searched.

      Study Selection

      Eligible studies reported on sexuality among LGBTQI+ persons living with chronic disease. The search yielded 12626 records; 665 full texts were assessed for eligibility and 63 documents included (59 unique studies). Study quality was rated using the Mixed Methods Appraisal Tool.

      Data Extraction

      Characteristics of included studies were recorded independently by two authors. Differences were resolved through discussion or with a third author.

      Data Synthesis

      A sequential, exploratory mixed-studies approach was used for synthesis. Pooled analysis indicated that among gay and bisexual men living with prostate cancer 68.3% experienced erectile dysfunction and 62.9% had insufficient quality of erection to engage in anal sex. Among gay and bisexual men living with HIV /AIDS, 29.3% experienced loss of libido and 25.3 % experienced erectile dysfunction. Although sexual dysfunction was common, LGBTQI+ persons had difficulty accessing appropriate sexual counselling and identified negative attitudes and heteronormative assumptions by healthcare providers as significant barriers to sexual health. Interventions to address sexuality focused entirely on reduction of risky sexual behavior among men living with HIV/AIDS. Women, transgender and intersex persons were largely excluded from the research studies.

      Conclusion

      : Current understandings of the impact of chronic disease on LGBTQI+ sexuality are limited and mostly focus on the male sexual response. LGBTQI+ persons who experience difficulty with sexuality struggle to identify appropriate services and there is an absence of evidence-based interventions to promote sexual health and well-being in this population.

      Keywords

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