Sexual difficulties faced by men in the Solomon Islands: a mixed-methods study
Paraniala Silas C. Lui A C , Michael P. Dunne A , Philip Baker A and Verzilyn Isom B
+ Author Affiliations
- Author Affiliations
A School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Vitoria Park Road, Kelvin Grove, Brisbane, Qld 4059, Australia.
B School of Nursing and Applied Health Sciences, Solomon Islands National University, Kukum Campus, R113, Honiara, Solomon Islands.
C Corresponding author. Email: paraniala@gmail.com
Sexual Health 14(4) 338-344 https://doi.org/10.1071/SH16170
Submitted: 14 September 2016 Accepted: 2 March 2017 Published: 18 May 2017
Abstract
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.
References
[1] Al Naimi A, Majzoub AA, Talib RA, Canguven O, Al Ansari A. Erectile dysfunction in Qatar: prevalence and risk factors in 1,052 participants – a pilot study. Sex Med 2014; 2 91–5.| Erectile dysfunction in Qatar: prevalence and risk factors in 1,052 participants – a pilot study.Crossref | GoogleScholarGoogle Scholar |
[2] Campbell MM, Stein DJ. Sexual dysfunction: a systematic review of South African research. S Afr Med J 2014; 104 440–4.
| Sexual dysfunction: a systematic review of South African research.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC287lslemtA%3D%3D&md5=cdf606343450c58df866761f134e6f7bCAS |
[3] Quinta Gomes AL, Nobre PJ. Prevalence of sexual problems in Portugal: results of a population-based study using a stratified sample of men aged 18 to 70 years. J Sex Res 2014; 51 13–21.
| Prevalence of sexual problems in Portugal: results of a population-based study using a stratified sample of men aged 18 to 70 years.Crossref | GoogleScholarGoogle Scholar |
[4] McCabe MP, Sharlip ID, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Lewis R, Segraves RT. Definitions of sexual dysfunctions in women and men: a consensus statement from the Fourth International Consultation on Sexual Medicine 2015. J Sex Med 2016; 13 135–43.
| Definitions of sexual dysfunctions in women and men: a consensus statement from the Fourth International Consultation on Sexual Medicine 2015.Crossref | GoogleScholarGoogle Scholar |
[5] Moreira ED, Glasser DB, King R, Duarte FG, Gingell C, GSSAB Investigators’ Group. Sexual difficulties and help-seeking among mature adults in Australia: results from the Global Study of Sexual Attitudes and Behaviours. Sex Health 2008; 5 227–34.
| Sexual difficulties and help-seeking among mature adults in Australia: results from the Global Study of Sexual Attitudes and Behaviours.Crossref | GoogleScholarGoogle Scholar |
[6] Ramezani MA, Ahmadi K, Ghaemmaghami A, Marzabadi EA, Pardakhti F. Epidemiology of sexual dysfunction in Iran: a systematic review and meta-analysis. Int J Prev Med 2015; 6 43
| Epidemiology of sexual dysfunction in Iran: a systematic review and meta-analysis.Crossref | GoogleScholarGoogle Scholar |
[7] The Joint United Nations Programme on HIV and AIDS (UNAIDS) Pacific region. Turning the tide: an open strategy for a response to AIDS in the Pacific. Suva: UNAIDS Pacific Region; 2009.
[8] Laumann EO, Nicolosi A, Glasser DB, Paik A, Gingell C, Moreira E, Wang T. Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors. Int J Impot Res 2004; 17 39–57.
| Sexual problems among women and men aged 40–80 y: prevalence and correlates identified in the Global Study of Sexual Attitudes and Behaviors.Crossref | GoogleScholarGoogle Scholar |
[9] Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr,. Lewis RW, Fugl-Meyer KS, Corona G, Hayes RD, Laumann EO, Moreira ED Jr,. Definitions/epidemiology/risk factors for sexual dysfunction. J Sex Med 2010; 7 1598–607.
| Definitions/epidemiology/risk factors for sexual dysfunction.Crossref | GoogleScholarGoogle Scholar |
[10] McCabe MP, Sharlip ID, Lewis R, Atalla E, Balon R, Fisher AD, Laumann E, Lee SW, Segraves RT. Incidence and prevalence of sexual dysfunction in women and men: A consensus statement from the fourth international consultation on sexual medicine 2015. J Sex Med 2016; 13 144–52.
| Incidence and prevalence of sexual dysfunction in women and men: A consensus statement from the fourth international consultation on sexual medicine 2015.Crossref | GoogleScholarGoogle Scholar |
[11] Rosen RC, Heiman JR, Long JS, Fisher WA, Sand MS. Men with sexual problems and their partners: findings from the International Survey of Relationships. Arch Sex Behav 2016; 45 159–73.
| Men with sexual problems and their partners: findings from the International Survey of Relationships.Crossref | GoogleScholarGoogle Scholar |
[12] Lee DM, Nazroo J, O’Connor DB, Blake M, Pendleton N. Sexual health and well-being among older men and women in England: findings from the English Longitudinal Study of Ageing. Arch Sex Behav 2016; 45 133–44.
| Sexual health and well-being among older men and women in England: findings from the English Longitudinal Study of Ageing.Crossref | GoogleScholarGoogle Scholar |
[13] Sengupta P, Dutta S, Krajewska-Kulak E. The disappearing sperms: analysis of reports published between 1980 and 2015. Am J Men Health 2017;
| The disappearing sperms: analysis of reports published between 1980 and 2015.Crossref | GoogleScholarGoogle Scholar |
[14] Hinchliff S, Tetley J, Lee D, Nazroo J. Older adults’ experiences of sexual difficulties: qualitative findings from the English Longitudinal Study on Ageing (ELSA). J Sex Res 2017;
| Older adults’ experiences of sexual difficulties: qualitative findings from the English Longitudinal Study on Ageing (ELSA).Crossref | GoogleScholarGoogle Scholar |
[15] Laumann EO, Kang JH, Glasser DB, Rosen RC, Carson CC. Lower urinary tract symptoms are associated with depressive symptoms in white, black and Hispanic men in the United States. J Urol 2008; 180 233–40.
| Lower urinary tract symptoms are associated with depressive symptoms in white, black and Hispanic men in the United States.Crossref | GoogleScholarGoogle Scholar |
[16] Ho CC, Singam P, Hong GE, Zainuddin ZM. Male sexual dysfunction in Asia. Asian J Androl 2011; 13 537–42.
| Male sexual dysfunction in Asia.Crossref | GoogleScholarGoogle Scholar |
[17] Narokobi B. The Melanesian way: Institute of Papua New Guinea Studies. 1983. Available online at: http://www.alastairmcintosh.com/general/resources.htm [verified 30 January 2014].
[18] Solomon Islands National AIDS Committee. UNGASS Country progress report 2011, Solomon Islands . Honiara: UNAIDS Pacific; 2010.
[19] Solomon National Statistics Office. Solomon Islands National Population and housing Census. In Treasury Ministry of Finance, ed. Honiara: Solomon Islands Government; 2015.
[20] The Ministry of Health and Medical service M. National health strategic plan: 2016–2020. Honiara: Solomon Islands Government; 2016.
[21] Rosen RC, Riley A, Wagner G, Osterloh IH, Kirkpatrick J, Mishra A. The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction. Urology 1997; 49 822–30.
| The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2szjtFemsQ%3D%3D&md5=1d004ebcd828fadbf44c320432888dfcCAS |
[22] Kessler RC, Andrews G, Colpe LJ, Hiripi E, Mroczek D, Normand S, Zaslavsky AM. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med 2002; 32 959–76.
| Short screening scales to monitor population prevalences and trends in non-specific psychological distress.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38vls1Wltg%3D%3D&md5=04a70fe006054d8b1cbdb40e30f27597CAS |
[23] Dreger S, Buck C, Bolte G. Material, psychosocial and sociodemographic determinants are associated with positive mental health in Europe: a cross-sectional study. BMJ Open 2014; 4 e005095
| Material, psychosocial and sociodemographic determinants are associated with positive mental health in Europe: a cross-sectional study.Crossref | GoogleScholarGoogle Scholar |
[24] World Health Organization. Process of translation and adoption of instruments. 2014. Available online at: http://www.who.int/substance_abuse/research_tools/translation/en/ [verified 26 November 2014].
[25] Hsieh HF, Shannon SE. Three approaches to qualitative content analysis. Qual Health Res 2005; 15 1277–88.
| Three approaches to qualitative content analysis.Crossref | GoogleScholarGoogle Scholar |
[26] Traeen B, Stigum H. Sexual problems in 18–67-year-old Norwegians. Scand J Public Health 2010; 38 445–56.
| Sexual problems in 18–67-year-old Norwegians.Crossref | GoogleScholarGoogle Scholar |
[27] Christensen BS, Gronbaek M, Osler M, Pedersen BV, Graugaard C, Frisch M. Sexual dysfunctions and difficulties in Denmark: prevalence and associated sociodemographic factors. Arch Sex Behav 2011; 40 121–32.
| Sexual dysfunctions and difficulties in Denmark: prevalence and associated sociodemographic factors.Crossref | GoogleScholarGoogle Scholar |
[28] Kirby M. Premature ejaculation: definition, epidemiology and treatment. Trends Urol Men’s Health 2014; 5 23–8.
| Premature ejaculation: definition, epidemiology and treatment.Crossref | GoogleScholarGoogle Scholar |
[29] McMahon CG, Lee G, Park JK, Adaikan PG. Premature ejaculation and erectile dysfunction prevalence and attitudes in the Asia-Pacific region. J Sex Med 2012; 9 454–65.
| Premature ejaculation and erectile dysfunction prevalence and attitudes in the Asia-Pacific region.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC383ovFWgtg%3D%3D&md5=df4341560ba7431523695b291e6ecea0CAS |
[30] McCabe MP, Connaughton C. Psychosocial factors associated with male sexual difficulties. J Sex Res 2014; 51 31–42.
| Psychosocial factors associated with male sexual difficulties.Crossref | GoogleScholarGoogle Scholar |
[31] El-Sakka AI. Association of risk factors and medical comorbidities with male sexual dysfunctions. J Sex Med 2007; 4 1691–700.
| Association of risk factors and medical comorbidities with male sexual dysfunctions.Crossref | GoogleScholarGoogle Scholar |
[32] Laumann EO, Glasser DB, Neves RC, Moreira ED, GSSAB Investigators’ Group. A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America. Int J Impot Res 2009; 21 171–8.
| A population-based survey of sexual activity, sexual problems and associated help-seeking behavior patterns in mature adults in the United States of America.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1MzjsFCqtw%3D%3D&md5=87a730a8abfcf747c36297a822a8ad4aCAS |
[33] Laumann EO, Paik A, Rosen RC. Sexual dysfunction in the United States: prevalence and predictors. JAMA 1999; 281 537–44.
| Sexual dysfunction in the United States: prevalence and predictors.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M7ksVOjug%3D%3D&md5=78d762be2bbf55156b34602d11dcb37dCAS |
[34] Laumann EO, Waite LJ. Sexual dysfunction among older adults: prevalence and risk factors from a nationally representative US probability sample of men and women 57–85 years of age. J Sex Med 2008; 5 2300–11.
| Sexual dysfunction among older adults: prevalence and risk factors from a nationally representative US probability sample of men and women 57–85 years of age.Crossref | GoogleScholarGoogle Scholar |
[35] Hendrickx L, Gijs L, Enzlin P. Distress, sexual dysfunctions, and DSM: dialogue at cross purposes? J Sex Med 2013; 10 630–41.
| Distress, sexual dysfunctions, and DSM: dialogue at cross purposes?Crossref | GoogleScholarGoogle Scholar |
[36] Sanchez-Cruz JJ, Cabrera-Leon A, Martin-Morales A, Fernandez A, Burgos R, Rejas J. Male erectile dysfunction and health-related quality of life. Eur Urol 2003; 44 245–53.
| Male erectile dysfunction and health-related quality of life.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3szntlGktA%3D%3D&md5=f42ca090d662e85f859a24f310b928e1CAS |
[37] Shabsigh R, Perelman M. Men with both premature ejaculation (PE) and erectile dysfunction (ED) experience lower quality of life than men with either PE or ED alone. J Sex Res 2006; 43 27
| Men with both premature ejaculation (PE) and erectile dysfunction (ED) experience lower quality of life than men with either PE or ED alone.Crossref | GoogleScholarGoogle Scholar |
[38] Moreira ED, Brock G, Glasser DB, Nicolosi A, Laumann EO, Paik A, Wang T, Gingell C, GSSAB Investigators’ Group. Help-seeking behaviour for sexual problems: the global study of sexual attitudes and behaviors. Int J Clin Pract 2005; 59 6–16.
| Help-seeking behaviour for sexual problems: the global study of sexual attitudes and behaviors.Crossref | GoogleScholarGoogle Scholar |
[39] Adams MJ, Collins VR, Dunne MP, de Kretser DM, Holden CA. Male reproductive health disorders among Aboriginal and Torres Strait Islander men: a hidden problem? Med J Aust 2013; 198 33–8.
| Male reproductive health disorders among Aboriginal and Torres Strait Islander men: a hidden problem?Crossref | GoogleScholarGoogle Scholar |
[40] MacLaren D, Asugeni J, Asugeni R, Kekeubata E. Incorporating sociocultural beliefs in mental health services in Kwaio, Solomon Islands. Australas Psychiatry 2009; 17 S125–7.
| Incorporating sociocultural beliefs in mental health services in Kwaio, Solomon Islands.Crossref | GoogleScholarGoogle Scholar |
[41] Straume A. Medicine of the past in the present: A study of medicine knowledge and practice in a Solomon Islands village. Bergen: Department of Social Anthropology, University of Bergen; 2009.
[42] Maclaren D. Culturally appropriate health care in Kwaio, Solomon Islands: an action research approach. Brisbane: School of Public Health, Griffith University; 2006.
