Abstract
Sexual health and well-being is important for middle-aged and older adults, but knowledge is limited on prevalence and determinants in countries in Sub-Saharan Africa. We analyzed cross-sectional data collected in 2021 from married or cohabitating adults age ≥ 40 in Nouna, Burkina Faso. Sexual health and well-being were measured using the Sexual Relationships and Activities Questionnaire. Descriptive statistics and multivariable logistic models were used to describe the dimensions of sexual health and well-being-including levels of sexual activity, sexual function, and sexual health concerns-and their associations with age, sex, and education. Among 2336 individuals (56.8% men; mean age 53.2 years) almost all reported having a sexual partner (96.0% men, 93.2% women) in the last year. Men reported more frequent sexual thoughts (71.8% versus 51.2%) and sexual activity (69.4% versus 46.4%, both p < 0.001) than women. Being a woman was associated with lower sexual activity (aOR = 0.57) and intercourse frequency (aOR = 0.37, both p < 0.001). Older age was associated with reduced sexual thoughts and intercourse (both aOR = 0.93, p < 0.001), greater erectile difficulties in men (aOR = 1.06, p < 0.001), and arousal difficulties in women (aOR = 1.07, p < .001). Higher education was associated with more frequent sexual thoughts (aOR = 1.50, p < 0.001), and intercourse (aOR = 1.41, p = 0.012). Married and co-habitating middle-aged and older respondents in Nouna reported high rates of sexual activity, with variability in other areas of sexual health and well-being, identifying areas where more research and interventions are needed.