Background People with disabilities often face a range of social and economic adversities. Evidence suggests that these disadvantages result in poorer mental health. Some research also indicates that people with disabilities are more likely experience thoughts about suicide than people without disability, although most of this research is based on small cross-sectional samples. Methods We explored the relationship between self-reported disability (measured at baseline) and likelihood of reporting thoughts of suicide (measured at follow up) using a large longitudinal cohort of Australian males. A logistic regression model was conducted with thoughts of suicide within the past 12 months (yes or no) as the outcome and disability as the exposure. The models adjusted for relevant confounders, including mental health using the SF-12 MCS, and excluded males who reported thoughts of suicide at baseline. Results After adjustment, there was a 1.48 (95% CI: 0.98–2.23, P = 0.063) increase in the odds of thoughts of suicide among men who also reported a disability. The size of association was similar to that of being unemployed. Conclusions Males reporting disability may also suffer from thoughts of suicide. We speculate that discrimination may be one explanation for the observed association. More research on this topic is needed.
Introduction. Studies on sexual function in men with disabilities have mainly relied on clinical samples; population-based evidence on this topic is limited. Aim. We aimed to compare aspects of sexual function between disabled and non-disabled men using a representative sample. Methods. We used data from Ten to Men, a national cohort study of Australian men aged 18 to 55 years. We first compared the prevalence of 15 sexual function-related difficulties in disabled versus non-disabled men. Next, we used Poisson regression to examine associations between disability and sexual function. The main analytic sample had 8,496 men. Weights and adjustments appropriate to the sampling methodology were applied. Models adjusted for potential confounders. Results were reported as prevalence ratios (PRs). P-values of <0.05 were considered statistically significant. Outcomes. Outcomes were 15 individual items from the Natsal-SF, a validated measure of sexual function with items in 3 domains: physio-psychological aspect; relational aspect; and global selfrating (the 16 th item on help-seeking was excluded). These were coded as binary variables denoting past-year sexual problems. Results. Disabled men had higher prevalence of all outcomes than non-disabled men. 25.6% of men with disabilities and 15.1% of non-disabled men experienced at least 2 out of 15 difficulties. The most prevalent problems were 'orgasmed too early' (43.8% of disabled men, 37.1% of non-disabled men), imbalance of sexual desire between partners (47.6% of disabled men, 39.2% of non-disabled men), and overall sexual dissatisfaction (39.4% of disabled men, 26.7% of non-disabled men). All adjusted PRs were greater than 1.00 for disability; associations were statistically significant except 'partner experienced sexual difficulties' (PR 1.23; 95% CI 0.99, 1.53; p=0.058) and 'orgasmed too early' (PR 1.16; 95% CI 1.00, 1.35; p=0.050). 'Presence of discomfort/pain' had the largest adjusted PR for disability (PR 2.77, 95% CI 1.89, 4.06; p<0.001). Clinical Translation. This population-based comparative analysis helps contextualize evidence from clinical studies on the relationship between disability and sexual function, and may lead clinicians to new insights about sexual function in male patients with disabilities. Strengths & Limitations. Two major strengths of this study are that the sample included a nondisabled reference group and results are generalizable to Australian men. A key limitation is that disability and sexual function measures are self-reported. Conclusion. This study provides a broad foundation of population-based evidence about sexual function in men with disabilities, relative to men without, showing positive associations between disability and 13 of 15 sexual difficulties.
Some research suggests that disabled people are more likely to be sexual minorities than nondisabled people, but this evidence comes mainly from younger or older populations. We used data from a large survey of Australian men aged 18-55 to examine the relationship between disability and minority sexual orientations. Results from our statistical analyses suggest that a larger proportion of disabled than non-disabled men are sexual minorities. Our estimates showed that disabled men were at least twice as likely as non-disabled men to be attracted to females and males, not experience sexual attraction, identify as bisexual, identify as homosexual, and have female and male sexual partners-relative to the likelihood of female-only attraction, heterosexual identity, and female-only sexual partners. Findings provide new information about sexual diversity in disabled versus non-disabled Australian men, which can help inform inclusive service provision and identify avenues for future research about sexual minority disabled people.
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