Sexual difficulties, distress and dysfunction among women with refugee background in Australia

Objective: This study aimed to document the prevalence of sexual difficulties, sexually-related personal distress, sexual dysfunction and associated factors among refugee women in Australia. Method: The cross-sectional study included refugee women aged 18–63 years. Sexual difficulties were defined as selecting ‘always’ or ‘very often’ on the Profile of Female Sexual Function, while distress was a score of at least 11 on the Female Sexual Distress Scale–Revised. Female sexual dysfunction (FSD) combined these scores. Participants also completed the Woman Abuse Screening Tool and the Bristol Female Lower Urinary Tract Symptoms questionnaire. Results: Among 299 participants (median age 41 years), sexual difficulties, sexually-related personal distress and FSD were present in 39.3%, 33.2% and 7.0%, respectively. Perimenopausal/postmenopausal status (adjusted odds ratio [aOR] = 2.8, 95% confidence interval [CI]: 1.4–5.6, p = 0.003) and sexual activity (aOR = 0.2, 95% CI: 0.1–0.4, p < 0.001) predicted sexual difficulties. Intimate partner abuse (aOR = 5.9, 95% CI: 2.4–14.5, p < 0.001) and urinary incontinence (aOR = 4.5, 95% CI: 1.5–13.0, p = 0.006) were associated with sexually-related personal distress. Conclusion: Perimenopausal/postmenopausal status and sexual inactivity were associated with sexual difficulties, while intimate partner abuse and urinary incontinence were associated with sexually-related distress, highlighting the importance of proactive screening for psychosocial and physical health issues in sexual health assessments among refugee women.