Prospective Association of Psychological Distress and Sexual Quality of Life Among Hematopoietic Stem Cell Transplant Survivors

J Clin Psychol Med Settings. 2025 Mar;32(1):137-144. doi: 10.1007/s10880-024-10013-9. Epub 2024 Apr 14.

Abstract

Sexual health concerns are one of the most common late effects facing hematopoietic stem cell transplant (HSCT) survivors. The current study tested whether self-reported depression and anxiety symptoms before transplant were associated with embedded items assessing two specific areas of sexual health-sexual interest and sexual satisfaction-one year post-HSCT. Of the 158 study participants, 41% were diagnosed with a plasma cell disorder (n = 60) and most received autologous transplantation (n = 128; 81%). At post-HSCT, 21% of participants reported they were not at all satisfied with their sex life, and 22% were not at all interested in sex. Greater pre-HSCT depressive symptomology was significantly predictive of lower sexual interest (β = -.27, p < .001) and satisfaction (β = -.39, p < .001) at post-HSCT. Similarly, greater pre-HSCT trait anxiety was significantly predictive of lower sexual interest (β = -.19, p = .02) whereas higher levels of state and trait anxiety were both predictive of lower satisfaction (β = -.22, p = .02 and β = -.29, p = .001, respectively). Participant sex significantly moderated the relationship between state anxiety and sexual satisfaction (b = -.05, t = -2.03, p = .04). Additional research examining the factors that contribute to sexual health post-HCST is needed to inform and implement clinical interventions to address these commonly overlooked survivorship concerns.

Keywords: Cancer distress; Hematopoietic stem cell transplant; Oncology; Sexual health; Sexual quality of life.

MeSH terms

  • Adult
  • Anxiety* / psychology
  • Depression* / psychology
  • Female
  • Hematopoietic Stem Cell Transplantation* / psychology
  • Humans
  • Male
  • Middle Aged
  • Personal Satisfaction*
  • Prospective Studies
  • Psychological Distress*
  • Quality of Life* / psychology
  • Sexual Behavior* / psychology
  • Survivors* / psychology
  • Survivors* / statistics & numerical data