Sexual Health Problems among Service Men: The Influence of Posttraumatic Stress Disorder.

Military operational stressors, such as combat exposure, may increase the risk of sexual health problems. This study examined factors associated with sexual health problems, and tested the mediating effect of probable posttraumatic stress disorder (PTSD) on the association between stressors (i.e., combat deployment and sexual assault) and sexual health problems among U.S. service men. Using multivariable logistic regression (n = 16,603) and Cox proportional hazards models (n = 15,330), we estimated the risk of self-reported sexual health difficulties and sexual dysfunction medical encounters, respectively. Mediation analyses examined the effect of probable PTSD as an intermediate factor between high combat deployment and sexual assault on sexual health problems. Approximately 9% endorsed sexual health difficulties and 8% had a sexual dysfunction. Risk factors for these sexual health problems included older age, lower education level, enlisted rank, disabling injury, certain medical conditions, and higher body mass index. Probable PTSD significantly mediated the associations between high combat with sexual health problems and sexual assault with sexual dysfunction. Additionally, high combat was directly associated with sexual health difficulties. These findings indicate a relationship between these stressors and sexual health problems which suggests that treatment options should be expanded, especially to include psychogenic sexual dysfunctions.