PurposeThe primary objectives were to describe the longitudinal course of sexual health in people undergoing curative (chemo)radiotherapy ([C]RT) for human papillomavirus-associated oropharyngeal squamous cell carcinoma (HPVOPSCC) and identify factors associated with higher sexual satisfaction 12 months after [C]RT. MethodsEligible participants from three sites were recruited to a prospective observational study between October 2020 and November 2021. Measures of sexual health (QLQ-SHQ22), treatment outcome priorities (Chicago priorities scale), quality of life (QLQ-C30), symptom burden (MDASI-HN), emotional distress (PROMIS), and facial appearance and appearance distress (FACE-Q) were administered before, at the end and three and 12 months after [C]/RT. ResultsOf 128 eligible participants, 100 were recruited; sexual health measure data was available for 89 of 98 patients alive at 12 months. Mean sexual satisfaction scores were 51.8 (SD=26.6) before [C]RT. Mixed model results indicated a clinically significant reduction in sexual satisfaction by the end of (-25.4, 95% CI -30.7 to -20.2) and three months after [C]RT (-12.2, -17.3 to -7.0), but not 12 months after [C]RT (-3.8, 95% CI -9.0 to 1.4). Of 13 treatment outcome priorities, ‘keeping sexual function’ had a median rank of 10 and 9 before and 12 months after [C]RT, respectively; 24% and 26% identified it as a top priority at these times. Cohabiting, having a sexual partner, being sexually active, higher global health status, lower sexual health issues, lower depression, and considering sexual function a top priority were associated with higher sexual satisfaction scores 12 months after [C]RT. ConclusionsWhile affected acutely by [C]RT, average sexual satisfaction returns to near pre-treatment levels after 12 months. Sexual function is considered a ‘top’ survivorship priority by approximately one-quarter of HPVOPSCC patients.