title: Ankylosing spondylitis and its impact on sexual relationships.
abstract: OBJECTIVE
  To explore the impact of AS on the sexual relationships of a large cohort of patients, across the UK.
  
  
  METHODS
  A total of 1000 patients with a confirmed diagnosis of AS under the clinical care of 10 specialist rheumatology centres across the UK were invited to participate in a study evaluating a new quality of life measure. Patients completed a questionnaire, which also included questions relating to the impact of AS on their sexual relationships, sociodemographic and clinical characteristics.
  
  
  RESULTS
  Six hundred and twelve (64%) patients took part in the study. The majority were male (71.6%), mean age 50.8 +/- 12.2 years, mean diagnosed disease duration 17.3 +/- 11.7 years and mean symptom duration 23 +/- 18.6 years. Of those who responded to the question on sexual relationships (n = 552), 210 (38.0%) reported that their sexual relationships were affected 'moderately', 'quite a bit' or 'extremely' by their AS. Males reported greater sexual problems with increasing age. Poor function [odds ratio (OR) 3.64; 95% CI 1.92, 6.87], depression (OR 2.03; 95% CI 1.21, 3.41), greater disease activity (OR 2.10; 95% CI 1.01, 4.40), unemployment (OR 1.99; 95% CI 1.16, 3.40) and poor self-efficacy (OR 1.25; 95% CI 1.09, 1.43) were independently associated with a greater impact on patients' sexual relationships.
  
  
  CONCLUSIONS
  AS has a substantial impact on patients' sexual relationships. Management of AS and its impact on sexual relationships should be directed not only towards physical outcomes such as disease activity and physical function, but also take into consideration the psychological state of the patient.
authors.affiliation: Arthritis Research Campaign National Primary Care Centre, Primary Care Sciences, Keele University, Staffordshire ST5 5BG UK. e.healey@cphc.keele.ac.uk
authors.forename: Emma L
authors.initials: EL
authors.lastname: Healey
authors.forename: Kirstie L
authors.initials: KL
authors.lastname: Haywood
authors.forename: Kelvin P
authors.initials: KP
authors.lastname: Jordan
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Garratt
authors.forename: Sarah
authors.initials: S
authors.lastname: Ryan
authors.forename: Jon C
authors.initials: JC
authors.lastname: Packham
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012737:Sex Factors; D012725:Sexual Behavior; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology / Q000209:etiology; D013167:Spondylitis, Ankylosing / Q000150:complications / Q000453:epidemiology / Q000523:psychology / Q000534:rehabilitation*; D006113:United Kingdom / Q000453:epidemiology; D055815:Young Adult