Males with cystic fibrosis report suboptimal STI prevention and counseling compared to males in the general population, highlighting an urgent need to encourage sexual health counseling and care in the CF model and partnerships with primary care providers and other specialists.
Key Findings
Results
Males with cystic fibrosis (MwCF) reported never using condoms at significantly higher rates than males in the general population when sexually active with multiple partners.
Among those sexually active with ≥2 partners in the prior year, 36% of 15-49-year-old MwCF reported never using condoms compared to 16% of NSFG males (p < 0.001).
Over 75% of MwCF overall reported never using a condom.
Comparison was made to the U.S. National Survey of Family Growth (NSFG; n = 5,206 15-49-year-old males).
Total CF survey sample was 532 MwCF with a mean age of 35.3 years.
Results
MwCF received very limited sexual health information from healthcare providers.
Only 8% of MwCF had ever received information from a healthcare provider about HIV/AIDS.
Only 14% had ever received information about other STIs.
Only 18% had ever received information about condom use.
These findings indicate a substantial gap in provider-delivered sexual health counseling within the CF care model.
Results
STI testing rates among MwCF were low.
Only 32% of MwCF reported having ever been tested for sexually transmitted infections (STIs).
This is notable given the lower condom use rates reported in this population.
The study used descriptive statistics and adjusted linear and logistic regression analyses for comparisons.
Results
MwCF reported pubertal onset timing that was largely similar to or earlier than peers, with minimal hypogonadism symptoms.
MwCF reported an average pubertal onset of 13.2 ± 1.7 years.
The majority reported undergoing puberty at the same time or earlier than their peers.
MwCF reported minimal hypogonadism symptoms.
Only 36% had ever had their testosterone measured.
10% had ever been diagnosed with hypogonadism.
Results
Most MwCF relied on their CF care team as their main health provider and nearly half lacked a primary care provider.
82% of MwCF considered their CF team their main health provider.
45% reported having no primary care provider.
This suggests that the CF care team may be the primary or sole point of contact for addressing sexual health needs.
The study highlights the need for partnerships with primary care providers and other specialists.
Methods
The study surveyed MwCF aged ≥15 years and compared their sexual health experiences to a large national sample.
532 MwCF participated with a mean age of 35.3 years.
Comparison group was the U.S. National Survey of Family Growth (NSFG) with n = 5,206 males aged 15-49 years.
The study used descriptive statistics and adjusted linear and logistic regression analyses.
Sexual health topics assessed included condom use, STI testing, provider counseling, pubertal timing, and hypogonadism.
What This Means
This research surveyed 532 males with cystic fibrosis (CF) about their sexual health experiences and compared them to a large nationally representative sample of males from the U.S. general population. The study found that males with CF were much less likely to use condoms during sexual activity with multiple partners — more than twice as many (36% vs. 16%) reported never using condoms in this situation. At the same time, very few had ever received sexual health counseling from a healthcare provider: only 8% had been counseled about HIV/AIDS, 14% about other STIs, and 18% about condom use. Just 32% had ever been tested for an STI.
The study also found that most males with CF (82%) consider their CF care team their primary healthcare provider, and nearly half (45%) have no primary care provider at all. This means CF clinics may be the main — or only — place where sexual health topics could be discussed. Despite this, males with CF reported receiving very little sexual health guidance from their CF providers. The study also found that pubertal development in males with CF was generally similar in timing to their peers, and that while 10% had been diagnosed with hypogonadism (low testosterone), testosterone testing was infrequent.
This research suggests that there is a significant unmet need for sexual health education and counseling among males with CF. Because this population tends to rely heavily on CF specialty care and often lacks a primary care provider, CF clinics may need to take a more active role in providing sexual health services or coordinating with other healthcare providers to ensure these needs are addressed.
Kazmerski T, Stransky O, Wright C, Jathal I, Prangley A, Tangpricha V, et al.. (2026). Sexual health experiences and care utilization of males with cystic fibrosis.. Journal of cystic fibrosis : official journal of the European Cystic Fibrosis Society. https://doi.org/10.1016/j.jcf.2025.09.010