DEEP Model (Differences, Emotional Sensitivities, External Stressors, Communication Patterns) Versus Sexual Health Empowerment on Sexual Function and Attitude Toward Condom Use Among Women Affected with Human Papilloma Virus (HPV): A Randomized Clinical Trial.

Abstract

Sexual dysfunction is a frequent consequence of Human Papillomavirus (HPV), besides the possibility of anogenital and oropharyngeal cancers, emphasizing the need for interventions involving couples' relationship management that address both individual and relational determinants of sexual well-being. This randomized clinical trial compared the DEEP model, grounded in differences, emotional sensitivities, external stressors, and communication patterns, with the Sexual Health Empowerment approach in improving sexual function and condom-use attitudes and behavior among women with HPV. Sixty-eight women were randomly assigned to the DEEP (n = 34) or empowerment (n = 34) group and attended eight online group counseling sessions. Sexual function scores increased from 16.09 ± 4.15 to 32.35 ± 3.50 at week 12 in the DEEP group and from 16.09 ± 4.74 to 25.30 ± 2.66 in the empowerment group. Time had a significant effect on sexual function, condom-use attitudes, and behavior in both groups (P < 0.001). Between-group differences were significant at post-intervention and follow-up for all outcomes (P < 0.001). The DEEP model produced greater and more sustained improvements, likely due to its focus on relational dynamics and partner engagement. These findings highlight the added value of couple-centered, relationship-based interventions in enhancing sexual function and protective behaviors among women with HPV.