背景:中国女性性健康服务的目标人群尚不清楚。识别对性健康寻求行为有心理障碍的高危个体和性欲减退(HSDD)的高危个体,我们调查了中国女性不愿意表达性健康的相关性,与性健康相关的疾病的耻辱,性困扰,和HSDD。
方法:于2020年4月至7月进行了一项在线调查。
结果:我们在线收到3443份有效回复(有效率82.6%)。参与者主要是中国城市育龄妇女(中位数26岁,Q1-Q323-30)。对性健康知识知之甚少(aOR0.42,95CI0.28-0.63)和对性健康相关疾病感到羞耻(aOR0.32-0.57)的女性不太愿意交流性健康。年龄(aOR4.29,95CI2.26-8.17),低收入(AOR1.52-2.11),家庭负担(AOR1.34-1.43),与配偶(aOR0.66,95CI0.51-0.86)或子女(aOR0.77,95CI0.62-0.96)生活与女性对性健康相关疾病的羞耻感独立相关。年龄(aOR0.98,95CI0.96-0.99)和研究生学位(aOR0.45,95CI0.28-0.71)与生儿育女时低性欲的性困扰较少(aOR1.38-2.10),紧张的工作压力(aOR1.32,95CI1.10-1.60)和沉重的家庭负担(aOR1.43,95CI1.07-1.92)增加了女性痛苦的几率。具有研究生学位的女性(aOR0.42,95CI0.19-0.90),更多关于性健康的知识(AOR0.53-0.67),怀孕引起的性欲下降,最近分娩,或更年期症状(aOR0.60,95CI0.41-0.85)不太可能患有HSDD,而当他们的性欲下降是由于其他性问题(aOR2.56,95CI1.84-3.57)和伴侣性问题(aOR1.72,95CI1.23-2.39)时,他们更有可能患有HSDD。
结论:性健康教育和相关服务需要关注老年女性的心理障碍,性健康知识不足,工作压力大,和恶劣的经济条件。医护人员需要关注工作或生活压力大、有妇科疾病史的女性的性健康。性欲低下不等于性欲问题,这在将来应该引起注意。
The target population for women\'s sexual health services in
China was unclear. To identify high-risk individuals with psychological barriers to sexual health-seeking behaviors and those at high risk of hypoactive sexual desire disorder (HSDD), we investigated correlates of Chinese women\'s unwillingness to communicate sexual health, the shame of sexual health-related disorders, sexual distress, and HSDD.
An online survey was conducted from April to July 2020.
We received 3443 valid responses online (effective rate 82.6%). Participants were mainly Chinese urban women of childbearing age (median 26 years old, Q1-Q3 23-30). Women who knew little about sexual health knowledge (aOR 0.42, 95%CI 0.28-0.63) and were ashamed (aOR 0.32-0.57) of sexual health-related disorders were less willing to communicate sexual health. Age (aOR 4.29, 95%CI 2.26-8.17), low income (aOR 1.52-2.11), family burden (aOR 1.34-1.43), and living with friends (aOR 1.39, 95%CI 1.02-1.91) were independent correlates of women\'s shame about sexual health-related disorders while living with a spouse (aOR 0.66, 95%CI 0.51-0.86) or children (aOR 0.77, 95%CI 0.62-0.96) were correlated with less shame. Age (aOR 0.98, 95%CI 0.96-0.99) and a postgraduate degree (aOR 0.45, 95%CI 0.28-0.71) were linked with less sexual distress of low sexual desire while having children (aOR 1.38-2.10), intense work pressure (aOR 1.32, 95%CI 1.10-1.60) and heavy family burden (aOR 1.43, 95%CI 1.07-1.92) increased women\'s odds of having distress. Women with a postgraduate degree (aOR 0.42, 95%CI 0.19-0.90), more knowledge about sexual health (aOR 0.53-0.67), and decreased sexual desire caused by pregnancy, recent childbirth, or menopausal symptoms (aOR 0.60, 95%CI 0.41-0.85) were less likely to have HSDD, while they were more likely to have HSDD when their decreased sexual desire was due to other sexual issues (aOR 2.56, 95%CI 1.84-3.57) and partners\' sexual problems (aOR 1.72, 95%CI 1.23-2.39).
Sexual health education and related services need to focus on psychological barriers of women with older age, insufficient knowledge of sexual health, intense work pressure, and poor economic conditions. The medical staff need to pay attention to the sexual health of women with intense work or life pressure and a history of gynecological disease. Low sexual desire is not equal to the sexual desire problem, which should be noticed in the future.