Sexual Quality of Life and Help-seeking Preferences in Adults With Diabetes in Primary Care: A Cross-sectional Study

Diabetes mellitus (DM) can negatively affect sexual health through vascular, neurologic, hormonal, and psychosocial pathways. Despite the high burden of diabetes-related sexual problems, patients' needs are often overlooked in primary care due to stigma and communication barriers. Understanding determinants of sexual quality of life and patient perspectives may support better integration of sexual health care into diabetes management. Thus, our aim in this study was to assess the sexual quality of life (SQoL) among adults with DM and examine its associations with sociodemographic and clinical factors, as well as attitudes, and expectations regarding sexual health discussions in primary care.

This analytical cross-sectional study included 326 sexually active adults with DM recruited from primary care clinics in Izmir, Türkiye. Data were collected through interviewer-administered questionnaires that captured demographic/clinical characteristics, SQoL (SQoL-F/SQoL-M), and patients' attitudes and expectations regarding sexual health communication. Statistical analyses included group comparisons, correlations, and multiple linear regression.

Older age and longer diabetes duration were independently associated with lower SQoL scores. More favourable attitudes toward discussing sexual health were linked to being male, younger, and more educated. Preference for clinician-initiated communication was greater among women, more educated individuals, and those with longer disease duration. SQoL correlated moderately with attitude scores but not expectation scores.

Sexual well-being in diabetes is shaped by age, disease course, and communication-related beliefs. Routine, proactive inquiry by family physicians, supported by culturally sensitive communication, may reduce barriers and improve sexual health outcomes in diabetes care.