Adverse Occupational Outcomes Among US Service Members With Sexual Health Difficulties: Findings From the Millennium Cohort Study

OBJECTIVE: To prospectively examine the independent associations between sexual health difficulties (SHD) and occupational outcomes, after accounting for posttraumatic stress disorder and/or depression, among service members. METHODS: Data were from service members who completed a Millennium Cohort survey in 2014-2016 (T1) and 2019-2021 (T2). SHD (T1) were defined as "bothered a lot" by (1) little sexual desire/pleasure or (2) pain/problems during sex. Adverse occupational outcomes (T2) included lost workdays, physical or emotional work limitations, and other financial problems. Logistic regression models adjusted for demographic, military, and psychosocial factors. RESULTS: Among 24,761 service members, 7.2% reported SHD. After adjustment, those with SHD were more likely to experience all 6 occupational outcomes than those without SHD. CONCLUSIONS: Findings suggest independent associations between SHD and occupational outcomes and warrant the expansion of SHD-related healthcare services and treatment among service members.