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Stress and Depression Are Associated with Sexual Function and Satisfaction in Young Men Who Have Sex with Men


Prior research suggests that better mental health and higher relationship quality are associated with better sexual function and satisfaction. Such insights can inform intervention development for mental, relationship, and sexual health concerns. This study examined the interactions among these variables in a racially and ethnically diverse group of young men who have sex with men (YMSM) in serious relationships (N = 348). Data were drawn from wave 5 of a longitudinal cohort study. We examined cross-sectional associations between depression and stress (predictors) and sexual function, sexual satisfaction, and anal discomfort (outcomes) and to what extent these associations were moderated by relationship quality. Higher endorsement of depression and stress was associated with worse sexual functioning, lower sexual satisfaction, and more anal discomfort. We also found that fewer negative interactions, stronger commitment, and higher relationship satisfaction were associated with better sexual functioning and higher sexual satisfaction. Higher relationship satisfaction and commitment were found to attenuate the association between stress and sexual satisfaction. Contrary to expectations, higher relationship satisfaction also showed a trend toward exacerbating the association between depression and sexual functioning. These results suggest that, for YMSM, high relationship satisfaction and commitment may protect sexual satisfaction from being negatively impacted by high stress. However, YMSM in highly satisfying relationships may experience poor sexual functioning associated with depression as particularly distressing. This study addressed a major gap in the literature by focusing on mental, relationship, and sexual health in a diverse sample. Future research should examine a wider range of sexual functioning outcomes and include minority stress in study design.

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This work was supported by the National Institute on Drug Abuse at the National Institutes of Health (U01DA036939; PI: Mustanski). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. The sponsor had no involvement in the conduct of the research or the preparation of the article.

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LL-C, MN, DTR, and BM contributed to the study conception and design. Material preparation, data collection, and analysis were performed by LL-C and DTR. The first draft of the manuscript was written by CC and LL-C, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Leiszle Lapping-Carr.

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The authors have no conflicts of interest to declare.

Ethical Approval

All study activities were conducted with oversight from the Northwestern University Institutional Review Board.

Informed Consent

Participants provided written consent, and parental/guardian consent was waived for those < 18 years old.

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Lapping-Carr, L., Mustanski, B., Ryan, D.T. et al. Stress and Depression Are Associated with Sexual Function and Satisfaction in Young Men Who Have Sex with Men. Arch Sex Behav 52, 2083–2096 (2023).

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