{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T20:47:04Z","timestamp":1767041224598,"version":"3.48.0"},"reference-count":48,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,9,4]],"date-time":"2025-09-04T00:00:00Z","timestamp":1756944000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000269","name":"Economic and Social Research Council","doi-asserted-by":"publisher","award":["ES\/T014547\/1"],"award-info":[{"award-number":["ES\/T014547\/1"]}],"id":[{"id":"10.13039\/501100000269","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["72061137001"],"award-info":[{"award-number":["72061137001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Perspect Sexual Reproductive"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sexual health is crucial for well\u2010being, yet research often overlooks middle\u2010aged and older adults, as well as those with disabilities. This study explores the sexual health of disabled middle\u2010aged and older adults in Britain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aim to explain sexual behaviors and outcomes among disabled adults aged 45\u201374 in Britain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a secondary quantitative analysis using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal\u20103), a British population\u2010representative survey. The study did not focus on a specific type of disability but rather included people who consider themselves to have a long\u2010standing illness that limits their activity. The analysis incorporated variables on sexual behaviors and outcomes: bivariate analyses and multiple logistic regressions stratified by sex compared behaviors and outcomes by disability status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 7082 participants included, 1906 were classified as being with limiting disability status. Adjusting for sociodemographic differences, compared to nondisabled individuals, those with limiting disability status adults were less likely to engage in sex in the last 4\u2009weeks (aOR: 0.60, CI: 0.51\u20130.71) or be in a steady relationship (aOR: 0.69, CI: 0.59\u20130.80) and were more likely to report poorer sexual health outcomes, including having experienced coerced sex attempts (aOR:1.83, CI:1.48\u20132.27), had coerced sex (aOR: 1.64, CI:1.33\u20132.01), had their sex life affected by health in the last year (aOR: 5.08, CI:4.27\u20136.05), and sought help for their sex lives (aOR:1.73, CI:1.38\u20132.17).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Middle\u2010aged and older disabled adults in Britain are less likely to be sexually active, yet more likely to experience negative sexual health outcomes. The increased health\u2010seeking behaviors and their vulnerability highlight the necessity for tailored sexual health services, extending into middle age and older adulthood.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/psrh.70034","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T04:00:57Z","timestamp":1757044857000},"page":"453-469","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Sexual Health Behaviors and Outcomes Among Middle\u2010Aged and Older Disabled Adults in Britain"],"prefix":"10.1111","volume":"57","author":[{"given":"Yoshiko","family":"Sakuma","sequence":"first","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropic Diseases London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernice","family":"Lin","sequence":"additional","affiliation":[{"name":"MSc Epidemiology London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eneyi","family":"Kpokiri","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropic Diseases London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junead","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropic Diseases London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huachun","family":"Zou","sequence":"additional","affiliation":[{"name":"School of Public Health (Shenzhen) Sun Yat\u2010Sen University Shenzhen Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph D.","family":"Tucker","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropic Diseases London School of Hygiene and Tropical Medicine London UK"},{"name":"Institute for Infectious Diseases and Global Health University of North Carolina at Chapel Hill Chapel Hill North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tom","family":"Shakespeare","sequence":"additional","affiliation":[{"name":"Department of Population Health, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Kuper","sequence":"additional","affiliation":[{"name":"Department of Population Health, Faculty of Epidemiology and Population Health London School of Hygiene and Tropical Medicine London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dan","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Research, Faculty of Infectious and Tropic Diseases London School of Hygiene and Tropical Medicine London UK"},{"name":"Department of Social Medicine and Health Education School of Public Health of Nanjing Medical University Nanjing China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,9,4]]},"reference":[{"key":"e_1_2_8_2_1","unstructured":"World Health Organization \u201cSexual Health \u201daccessed April 11 2024 https:\/\/www.who.int\/health\u2010topics\/sexual\u2010health#tab=tab_1."},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(18)30293\u20109"},{"key":"e_1_2_8_4_1","first-page":"3","volume-title":"Convention on the Rights of Persons With Disabilities. 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