AFTER Study: Armed Forces genital Trauma and psychosexual Experiences Research

The numbers of military personnel who have sustained conflict-related genital injury, scarring, and/or loss of sexual function, has increased in recent years. Previous interviews with men who have experienced conflict-related genital injury indicate that this type of injury can be difficult psychologically and can impact sexual function and intimate relationships. However, there is not much information about the experiences of those with these injuries or what support they need to manage and alleviate these difficulties. This lack of information makes it hard to develop appropriate support services for those who may need them.

This study will take a participatory approach with veterans and their intimate partners, to further understand the impacts of these types of injuries and develop and feasibility and acceptaibility test possible interventions/support materials. 

This study aims to:

1. Understand the long-term psychosocial and sexual impact of conflict-related genital injury, intimate scarring, and loss of function.
2. Develop evidence-based psychological interventions to address the long-term psychosocial and sexual impact of conflict-related genital injury, intimate scarring, and sexual dysfunction.
3. Assess the acceptability and feasibility of any developed interventions.

The project will take a participatory research approach, drawing on the principles of community-engaged research, patient centred outcomes research, and user centred design research.

To address the project aims, a mixed methods design will be taken including six studies/work packages:

1. A literature review of existing international evidence about the experiences of those affected by conflict-related genital injury, intimate scarring, and/or loss of function.
2. A quantitative survey (n=100) with male ex-Service personnel with conflict-related genital injuries, intimate scarring, and/or loss of function to understand their psychological, relationship, and sexual wellbeing  using validated measures.
3. A qualitative interview study with ex-Service personnel (n=20) who have sustained conflict-related genital injuries, intimate scarring, and/or loss of function, to gather deep experiential insights into their psychological, relationship, and sexual wellbeing experiences, and to explore support needs and preferences.
4. A qualitative interview study with the partners of ex-Service personnel (n=15) who sustained conflict-related genital injuries, intimate scarring, and/or loss of function, to gather deep experiential insights into their psychosocial, relationship, and sexual wellbeing experiences, and explore support needs and preferences.
5. Co-create possible evidence-based interventions/support materials. 
6. Acceptability and feasibility test of any developed interventions/support materials.  

Using the method described this reseach will address two research questions: 

1. How have conflict-related genital injuries, intimate scarring, and/or loss of function, affected ex-Service personnel and their partners’ psychosocial (including relationships) and sexual wellbeing in the long-term?
2. What are the psychosocial support needs of ex-Service personnel and their partners affected by conflict-related genital injuries, intimate scarring, and/or loss of function, and how can they be addressed?

We will seek a total of 100-120 UK ex-Service personnel with conflict-related genital injuries, intimate scarring, and/or loss of function and 15 intimate partners of ex-Service personnel with these kinds of injuries. 

We will also be working with additional ex-Service personnel and their partners throughout the study as part of the participatory approach and will be engaging with several relevant stakeholders.