title: Psoriasis and Sexual Behavior in Men: examination of the National Health and Nutrition Examination Survey (NHANES) in the United States.
abstract: BACKGROUND
  Epidemiologic data on sexual behavior in psoriasis patients are lacking.
  
  
  OBJECTIVE
  We aim to examine and compare the sexual behaviors between men with and without psoriasis in the United States.
  
  
  METHODS
  We analyzed data from the National Health and Nutrition Examination Survey (NHANES) from 2003 to 2006 and 2009 to 2010. Responses from male participants to the dermatology and sexual behavior questionnaires of the NHANES were collated and analyzed.
  
  
  METHODS
  Outcome measures included sexual orientation, age of first sexual encounter, number of oral and non-oral sexual partners, and frequency of unprotected sex.
  
  
  RESULTS
  Among 6,444 U.S. men that responded to the psoriasis question, 170 (2.6%) reported a physician-given diagnosis of psoriasis. Heterosexual men accounted for 95.5% and nonheterosexual men 4.5% of the overall study population. On multivariate analysis, psoriasis was not associated with differences in sexual orientation (odds ratio 1.78, 95% confidence interval [CI] 0.75-4.15). Heterosexual men with psoriasis experienced first sexual encounter at an earlier age than those without psoriasis (weighted difference -0.9 years, P = 0.002). Heterosexual men with psoriasis had significantly fewer female oral sexual partners compared with heterosexual men without psoriasis on multivariate analysis (lifetime partner number: rate ratio [RR] 0.65, 95% CI 0.45-0.95; past-year partner number: RR 0.64, 95% CI 0.42-0.97). No significant differences existed between heterosexual men with and without psoriasis regarding frequency of unprotected sex (RR 0.96, 95% CI 0.85-1.09). Among nonheterosexual men with and without psoriasis, no significant differences existed in age first had sex, number of sexual partners, or frequency of unprotected sex.
  
  
  CONCLUSIONS
  Heterosexual men with psoriasis have significantly fewer lifetime female oral sexual partners compared with those without psoriasis. Dermatologists and other healthcare providers need to examine the genital region routinely and initiate appropriate therapy to improve patients' sexual health.
authors.affiliation: Department of Dermatology, University of California Davis, Sacramento, CA, USA.
authors.forename: April W
authors.initials: AW
authors.lastname: Armstrong
authors.forename: Caitlin T
authors.initials: CT
authors.lastname: Harskamp
authors.forename: Clayton W
authors.initials: CW
authors.lastname: Schupp
mesh_terms: D000328:Adult; D003075:Coitus; D005260:Female; D020010:Heterosexuality / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D011565:Psoriasis / Q000453:epidemiology* / Q000523:psychology*; D012725:Sexual Behavior / Q000523:psychology* / Q000706:statistics & numerical data*; D012747:Sexual Partners; D011795:Surveys and Questionnaires; D014481:United States; D047568:Unsafe Sex / Q000706:statistics & numerical data
keywords: Comorbidity; Dermatology; Psoriasis; Sex; Sexual Behavior