Structural model of sexual factors relating to sexual and reproductive health behaviors among Iranian women

We aim to explore the sexual factors related to SRH behaviors among Iranian women using structural equation modeling (SEM). The sexual factors considered were sexual function, distress, and satisfaction, with a specific emphasis on sexual esteem and genital dissatisfaction. This online cross-sectional study recruited 722 married women of reproductive age in Amol, Iran through a two-stage sampling method at health centers from March to June 2022. To analyze the data, SEM was employed in Amos software version 24. The results indicated an acceptable fit of the model to the data. Sexual esteem was directly (β = 0.29, p = 0.009) and indirectly (β = 0.29, p = 0.009) associated with SRH behaviors. However, genital dissatisfaction was only indirectly associated with SRH behaviors (β = 0.29, p = 0.009). Furthermore, a direct effect of genital dissatisfaction on sexual esteem (β = 0.41, p = 0.007) and an indirect effect of genital dissatisfaction on SRH behaviors was found via only sexual esteem (β = 0.07, p = 0.003). By considering the roles of sexual factors especially genital dissatisfaction and sexual esteem on SRH behaviors, this study offers practical implications for designing interventions aimed at enhancing SRH behaviors and sexual well-being.