Sexual difficulties faced by men in the Solomon Islands: a mixed-methods study

Background: To date there has been little research into men's sexual and reproductive health in Pacific Island countries. The aim of this study was to describe men's sexual difficulties and barriers to their seeking reproductive health care in the Solomon Islands. Methods: The study included qualitative inquiry (17 individual interviews and three focus group discussions with a total of 21 men) and a quantitative quasi-randomised quota sample household survey (n = 400). The prevalence of sexual difficulties and potential risk factors, such as chronic diseases, health risk behaviours, depression and psychological distress were measured using standardised questions translated into pidgin. Results: The most commonly self-reported sexual difficulties were premature ejaculation (39.5%), low sexual desire (29.0%), orgasm difficulty (27.3%) and erectile difficulty (4.3%). More than half (56%) of the men experienced at least one sexual difficulty. Relatively few men (7.3%) had ever sought professional health care for reproductive health problems, and 15.4% of men preferred to use kastom (traditional) medicine for sexual problems. Multivariate analysis revealed that comorbid non-communicable diseases (NCDs), low health-related quality of life and dissatisfaction with sexual relationships were independently correlated with sexual difficulties. Contrary to expectations, self-reported psychological distress was inversely associated with these difficulties. In general, the insights gained from in-depth interviews validated the survey findings. Conclusion: This study adds the first data on symptoms of sexual dysfunction among men in the Solomon Islands and is one of few studies from the Pacific region. The findings strongly suggest the need for comprehensive health services that are gender-specific and sensitive to the sexual difficulties of Islander men.