title: Psoriasis and sexual behavior in U.S. women: an epidemiologic analysis using the National Health and Nutrition Examination Survey (NHANES).
abstract: BACKGROUND
  Although sexual behavior is an integral part of most adults' overall well-being, this aspect of psoriasis patients' quality of life is rarely explored.
  
  
  OBJECTIVE
  The aim of this study is to assess the relationship between psoriasis and sexual behavior in U.S. women.
  
  
  METHODS
  We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006. Our study focuses on responses to the dermatology and sexual behavior questionnaires of the NHANES.
  
  
  METHODS
  This study examines the association between psoriasis and sexual behavior in U.S. women with regard to sexual orientation, age of first sexual encounter, number of sexual partners, and frequency of unprotected sex.
  
  
  RESULTS
  A total of 3,462 women provided responses to their psoriasis status: 2,753 (80%) women were heterosexual and 709 (20%) were nonheterosexual. Among them, 2.7% reported a physician-given diagnosis of psoriasis. On multivariate analyses, psoriasis was not associated with differences in sexual orientation (odds ratio [OR] 0.90, 95% confidence interval [CI] 0.62-2.01). Among nonheterosexual women, multivariate analysis revealed a lower number of lifetime female sexual partners in women with psoriasis (rate ratio [RR] 0.11, 95% CI 0.04-0.33, P = 0.001). Among heterosexual women, no significant differences existed between those with and without psoriasis in age of first sexual encounter (weighted difference -0.54 years, 95% CI -1.27 to 0.19), number of lifetime male sexual partners (RR 1.19, 95% CI 0.69-2.06), or number of lifetime male oral sex partners (RR 0.72, 95% CI 0.40-1.29). Heterosexual women with psoriasis had 1.13 times more unprotected sex (RR 1.13, 95% CI 1.02-1.24, P = 0.03) compared with those without psoriasis.
  
  
  CONCLUSIONS
  Psoriasis is associated with a significantly reduced number of sexual partners in nonheterosexual women. Psoriasis may differentially impact sexual behavior based on sexual orientation in women.
authors.affiliation: Department of Dermatology, University of California Davis, Sacramento, CA 95816, USA. aprilarmstrong@post.harvard.edu
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Follansbee
authors.forename: Caitlin T
authors.initials: CT
authors.lastname: Harskamp
authors.forename: Clayton W
authors.initials: CW
authors.lastname: Schupp
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003075:Coitus / Q000523:psychology; D005260:Female; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D011565:Psoriasis / Q000453:epidemiology* / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D012747:Sexual Partners / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D047568:Unsafe Sex / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult