(618) Under the Surface: Sexual Dysfunction and Barriers to Care in Czech Adults Based on ICD-11 Guidelines

Introduction Sexual dysfunctions are a common but frequently underreported aspect of sexual health, affecting both men and women and often contributing to lower quality of life and psychological well-being. The recent transition to ICD-11 introduced revised diagnostic guidelines that highlight clinical distress and duration criteria. However, population-level data reflecting these updated standards remain limited, especially in Central and Eastern Europe. Objective This study aims to estimate the prevalence of sexual dysfunctions among Czech adults based on ICD-11 diagnostic guidelines, with a focus on patterns of help-seeking behavior and barriers to accessing care. Methods Data were drawn from the CZECHSEX study, a nationally representative survey conducted among 6,669 Czech-speaking adults aged 18 to 75 years. Quota sampling ensured representativeness by age, gender, education, region, and settlement size, based on the 2021 national census. A dual-mode data collection design was employed, consisting of Computer-Assisted Personal Interviewing (CAPI) and Self-Interviewing (CASI) for 2,009 participants (response rate: 47.0%), and Computer-Assisted Web Interviewing (CAWI) for 4,660 participants (response rate: 28.4%). Sensitive items were self-administered to enhance privacy and reduce social desirability bias. Interviewers in the CAPI/CASI mode received structured training based on the SHAPE framework to ensure that ethical and respondent-centered practices were employed. The final dataset was post-stratified and weighted. A screening instrument for sexual dysfunction based on ICD-11 diagnostic guidelines, adapted from the German GESID study, was used to assess lifetime and 12-month prevalence of specific dysfunctions, associated distress, duration, and contextual factors. Help-seeking behavior and barriers to care within the past five years were also assessed. The findings presented here represent a preliminary analysis. Results Overall, 55.0% of men and 61.2% of women reported experiencing at least one type of sexual problem in their lifetime. When using ICD-11 diagnostic thresholds that include clinically significant distress, 16.1% of men and 24.4% of women met the criteria for sexual dysfunction. Among men, the most common conditions were erectile dysfunction (7.8%) and early ejaculation (5.6%). Among women, hypoactive sexual desire (11.0%) and orgasmic difficulties (10.8%) were the most frequently reported issues. Despite the prevalence of dysfunctions, only 4.6% of men and 5.0% of women reported seeking professional help in the past five years. Conclusions Preliminary findings from the CZECHSEX study indicate that sexual dysfunctions defined by ICD-11 criteria are highly common among Czech adults. The low rate of help-seeking behavior points to significant unmet needs and possible gaps in sexual health education and access to care. These findings emphasize the importance of aligning clinical and public health responses with ICD-11 standards and better understanding the barriers that prevent individuals from seeking help for sexual health issues. Disclosure No