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

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.