Background/Purpose: Few studies have comprehensively evaluated the information needs and priorities that men with rheumatic diseases have about their sexual and reproductive health (SRH). This qualitative study sought to explore their SRH needs within the rheumatology context.

Methods: Men aged 18-45 years who were diagnosed with at least one rheumatic disease and used at least one disease-modifying anti-rheumatic drug or immunosuppressive medication were recruited from academic outpatient rheumatology clinics in western Pennsylvania. Research coordinators engaged participants in phone-based semi-structured qualitative interviews about their reproductive histories, parenting experience, perceptions of how their diseases and medications affected their SRH, and experiences of SRH-related clinical care. Interviews were audio-recorded and transcribed verbatim. Thematic saturation was reached after the twelfth interview, and additional interviews were conducted to verify that no new information emerged. Research coordinators developed a preliminary codebook based on the interview content. Using an inductive approach, two coders applied the codebook to the transcripts and adjudicated coding differences to full agreement. The finalized codebook was used to conduct a thematic analysis.

Results: The 18 participants ranged in age from 22 to 44 years old, and identified as Black (n=2), White (n=14), and Asian (n=2). The most common disease diagnoses were spondyloarthritis, systemic lupus erythematosus, and rheumatoid arthritis. Most men were married or in a heterosexual relationship; no men were in a same-sex relationship. Twelve men had at least one child, and six men had no children. Six participants were vasectomized— five of whom had the procedure prior to their disease diagnosis.

Four major themes were elicited from the interviews: 1) Men had family planning concerns, particularly related to the heritability of their diseases, their fertility, and potential effects of their medications on their offspring’s health; 2) Men felt that fatigue, disability, and/or pain from their diseases either impaired or would impair their abilities to parent; 3) Men rarely discussed SRH with their rheumatologists, who they assumed would initiate the discussion if relevant to their health; 4) Men rarely discussed sexual dysfunction with their rheumatologists, even when they believed that it arose from their diseases or anti-rheumatic drugs.

Conclusion: In this study, men expressed a number of concerns related to their diseases, particularly the health and well-being of their children and physical challenges with parenting. Men rarely articulated these concerns to their rheumatologists, who, in turn, rarely initiated family planning conversations with them. Men who experienced sexual dysfunction generally implicated their diseases or medications as the cause but did not discuss this health issue with their rheumatologists. Our study found that some men’s information needs are incompletely addressed in the current rheumatology clinical setting and suggests that rheumatologists may need to include SRH in their routine counseling and care of male patients.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/exploring-the-sexual-and-reproductive-health-srh-needs-of-men-with-rheumatic-diseases/