Puberty and adolescent sexuality

Bullying Victimization and Sexual Wellbeing in Sexually Active Heterosexual, Cisgender and Sexual/Gender Minority Adolescents: The Mediating Role of Emotion Regulation

Bullying victimization is prevalent in adolescence and associated with adverse consequences on physical and psychological wellbeing, paricularly in sexual and gender minority youth. However, little is known about its associations with sexual wellbeing and the underlying mechanisms that could explain this association. The present study assessed the associations between bullying victimization and sexual wellbeing (sexual satisfaction, sexual desire/arousal and orgasmic function difficulties, sexual distress) via the mediating role of emotion regulation difficulties, considering potential sexual/gender minority status-based differences. Self-report online surveys were completed by 1036 sexually active (49.7% were girls) high school students (M_age = 14.6 years, SD_age = 0.6). Bullying victimization was directly and negatively associated with sexual desire/arousal difficulties and positively with sexual distress. Higher emotion regulation difficulties mediated the associations between higher bullying victimization and higher orgasmic function difficulties, as well as higher bullying victimization and higher sexual distress. No significant association was observed between bullying victimization and sexual satisfaction. No significant differences were observed between heterosexual, cisgender and sexual and gender minority youth in any of the associations. The findings suggest that bullying victimization is associated with adolescents' sexual wellbeing. The cross-sectional design and small effect sizes support the need for further prospective cohort studies.

Condom application skills and self-efficacy in youth: A systematic review and meta-analysis

Globally, and in the United States (U.S.) specifically, rates of reported sexually transmitted infections (STIs) have been steadily increasing and are especially high among youth aged 13-25 years. Using condoms correctly and consistently is an effective STI prevention measure for sexually active youth, yet public health endeavors tend to focus only on condom use consistency. Directly measuring condom application is challenging and expensive. Alternative tools evaluate this behaviour, but little evidence exists on the appropriateness of these instruments in measuring application skills. This systematic review and meta-analysis examined the association between condom application skills and self-efficacy. We conducted a search of several databases as well as unpublished works. Studies were included if they were in English, examined youth aged 13-25 years, and were available between 1992 and 2019. The authors screened 630 titles and abstracts for initial inclusion criteria. A full-text review of 30 studies was conducted. The authors included 19 studies in the systematic review and 5 studies were included in the meta-analysis. Both a fixed- and random-effects model (Q = .2321, I2 = 0%) yielded a medium-sized statistically non-significant association (r = 0.217) between skills and self-efficacy. Despite the small sample size, findings suggest that skills and self-efficacy may not be as interchangeable as previously assumed when assessing condom application. Implications for future research are discussed.

Social isolation at adolescence: a systematic review on behaviour related to cocaine, amphetamine and nicotine use in rats and mice

Adolescence is known for its high level of risk-taking, and neurobiological alterations during this period may predispose to psychoactive drug initiation and progression into more severe use patterns. Stress is a risk factor for drug consumption, and post-weaning social isolation increases drug self-administration in rodents. This review aimed to provide an overview of the effects of adolescent social isolation on cocaine, amphetamine and nicotine use-related behaviours, highlighting the specific period when animals were submitted to stress and these drugs. We wondered if there was a specific period during adolescence that isolation stress would increase drug use vulnerability. A total of 323 publications from the Scopus, Web of Science and PubMed (Medline) electronic databases were identified using the words "social isolation" and "adolescence" and "drug" or "cocaine" or "amphetamine" or "nicotine", resulting in 24 articles after analyses criteria following the PRISMA statement. The main points raised were social isolation during adolescence increased cocaine self-administration, amphetamine and nicotine locomotor activity. We did not observe a pattern of a specific moment during the adolescent period that could lead to an increased vulnerability to drug use. The precise conditions under which adolescent social stress alters drug use parameters are complex and likely depend on several factors.

Adolescents and young adults with early acquired HIV infection in the united states: unique challenges in treatment and secondary prevention

INTRODUCTION

Worldwide, children who acquired human immunodeficiency virus (HIV) at an early age, either perinatally or through blood transfusion, are reaching adolescence and adulthood due to successful antiretroviral treatment (ART). While many are thriving, a significant proportion face unprecedented multilevel challenges that can affect their long-term outcomes. Specifically, longstanding and poorly controlled HIV resulting from inadequate early regimens and nonadherence, along with the toxicities of some ART agents, can predispose them to sequelae including HIV-associated complications and other comorbidities.

AREAS COVERED

This paper reviews and summarizes the unique issues facing adolescents and young adults with early acquired HIV (AYA-EAHIV), including ART challenges, emerging comorbidities, and complications, including mental health comorbidities, secondary prevention, and transition from pediatric/adolescent to adult care.

EXPERT OPINION

AYA-EAHIV are a special population that have lived their entire lives with the physical and psychological toll of HIV mandating targeted and purposeful approaches to optimize their management and outcomes. Multifaceted inclusive and context-specific approaches focusing on heightened research, risk reduction interventions, and 'outside the box' thinking will be required to optimize treatment and reduce morbidity and mortality.

Testing the Confluence Model of the Association Between Pornography Use and Male Sexual Aggression: A Longitudinal Assessment in Two Independent Adolescent Samples from Croatia

According to confluence model theorizing, pornography use contributes to sexual violence, but only among men who are predisposed to sexual aggression. Support for this assertion is limited to cross-sectional research, which cannot speak to the temporal ordering of assumed causes and consequences. To address this issue, we employed generalized linear mixed modeling to determine whether hostile masculinity, impersonal sexuality, and pornography use, and their interactions, predicted change in the odds of subsequently reported sexual aggression in two independent panel samples of male Croatian adolescents (N₁ = 936 with 2808 observations; N₂ = 743 with 2972 observations). While we observed the link between hostile masculinity and self-reported sexual aggression in both panels, we found no evidence that impersonal sexuality and pornography use increased the odds of subsequently reporting sexual aggression-regardless of participants' predisposed risk. This study's findings are difficult to reconcile with the view that pornography use plays a causal role in male sexual violence.

A Social Affective Neuroscience Model of Risk and Resilience in Adolescent Depression: Preliminary Evidence and Application to Sexual and Gender Minority Adolescents

Depression is a disorder of dysregulated affective and social functioning, with attenuated response to reward, heightened response to threat (perhaps especially social threat), excessive focus on negative aspects of the self, ineffective engagement with other people, and difficulty modulating all of these responses. Known risk factors provide a starting point for a model of developmental pathways to resilience, and we propose that the interplay of social threat experiences and neural social-affective systems is critical to those pathways. We describe a model of risk and resilience, review supporting evidence, and apply the model to sexual and gender minority adolescents, a population with high disparities in depression and unique social risk factors. This approach illustrates the fundamental role of a socially and developmentally informed clinical neuroscience model for understanding a population disproportionately affected by risk factors and psychopathology outcomes. We consider it a public health imperative to apply conceptual models to high-need populations to elucidate targets for effective interventions to promote healthy development and enhance resilience.

Compulsive Internet Pornography Use and Mental Health: A Cross-Sectional Study in a Sample of University Students in the United States

Background

The sustained rise in negative mental health reports among university students is a source of continued global concern, and investigation continues into potential contributors to this rise. This includes the increased prevalence of risky sexual behaviors. Related is the increased prevalence of pornography use. Our study sought to explore the potential relationship between compulsive use of pornography and mental health in university students.

Methods

Our sample consisted of university students (N = 1031; 34% male, 66% female) from Franciscan University of Steubenville, Steubenville, Ohio. An anonymous survey was sent to all students at the university over the age of 18. The survey was comprised of the following: (1) demographic questions, (2) questions on pornography use and perception, (3) a modified version of the Compulsive Internet Use Scale (mCIUS) assessing various factors associated with compulsive internet pornography use, (4) questions assessing emotional and sexual states relative to pornography use (EmSS), and (5) the 21-question version of the Depression, Anxiety and Stress Scale (DASS-21).

Results

Our results indicate that 56.6% of those surveyed reported lifetime pornography use, with a significantly higher proportion of males than females reporting such use. The majority of students reported accessing pornography through internet-related technologies. Additionally, 17.0, 20.4, and 13.5% of students reported severe or extremely severe levels of depression, anxiety and stress, respectively, with compulsive pornography use significantly affecting all three mental health parameters in both sexes. Exploratory Factor Analysis identified three factors suggesting emotional coping, dependence and preoccupation for the mCIUS items and three factors reflecting interoceptive, impotent, and extrinsic characteristics for the EmSS items. Regression analysis indicated that various demographics, items pertaining to reduced control and social impairment, and other variables pertaining to pornography use predicted mental health outcomes. Faith, morals and personal motivation were the primary variables reported to help reduce pornography use.

Conclusion

Our analyses indicate a significant relationship between mental health and pornography use, including behaviors reflecting behavioral addictions, highlighting the necessity for a better understanding and consideration of the potential contribution of internet pornography to negative mental health among university students.

Does age influence self-perception of the soft-tissue profile in children?

INTRODUCTION

Appreciation of the soft-tissue profile is important in orthodontic diagnosis and treatment. However, are the patients themselves aware of their profile appearance? We aimed to evaluate if age influences self-perception of the soft-tissue profile in children.

METHODS

The study population for this prospective cross-sectional investigation consisted of 3 groups of 60 patients, classified according to age (<12 years; 12-15 years; >15 years). Each subject's right-sided facial profile was photographed to obtain a silhouette. Facial profile silhouette templates were created to represent the local population. Each subject's photograph was inserted into the corresponding template, and the subjects were asked to identify themselves. Facial profile self-recognition was recorded as a binary variable (yes or no). Other recorded variables included age, sex, and sexual maturity rating (using Tanner staging). Chi-square tests were used to analyze facial profile self-recognition between different subgroups, and stepwise multiple regression was used to predict the probabilities of facial profile self-recognition, with age, sexual maturity rating, and other recorded variables as independent variables.

RESULTS

Eighty percent of subjects aged >15 years recognized their own profile, compared with only 55% and 50% of subjects aged 12-15 years and <12 years, respectively. Subjects aged >15 years were significantly more likely to recognize their profile than younger subjects (P = 0.001). Similarly, subjects with the most advanced sexual maturity rating (stage V) were significantly more likely to recognize their profile (85% self-recognition) than those in groups I-IV (P <0.001). Girls were more likely to recognize their profiles than boys (P = 0.028). When using multiple regression analysis, sexual maturity rating appears to be the only significant predictor for facial profile self-recognition (R² = 0.25; P <0.001).

CONCLUSIONS

Facial profile self-recognition seems to improve with age and sexual maturity (sexual maturity rating stage V). Because orthodontic treatment planning takes possible soft-tissue changes into account, it is important to evaluate the degree of self-perception of the patients to adapt our goals and treatment discussions.

Puberty Initiates Cascading Relationships Between Neurodevelopmental, Social, and Internalizing Processes Across Adolescence

Adolescence is a period of dramatic developmental transitions-from puberty-related changes in hormones, bodies, and brains to an increasingly complex social world. The concurrent increase in the onset of many mental disorders has prompted the search for key developmental processes that drive changes in risk for psychopathology during this period of life. Hormonal surges and consequent physical maturation linked to pubertal development in adolescence are thought to affect multiple aspects of brain development, social cognition, and peer relations, each of which have also demonstrated associations with risk for mood and anxiety disorders. These puberty-related effects may combine with other nonpubertal influences on brain maturation to transform adolescents' social perception and experiences, which in turn continue to shape both mental health and brain development through transactional processes. In this review, we focus on pubertal, neural, and social changes across the duration of adolescence that are known or thought to be related to adolescent-emergent disorders, specifically depression, anxiety, and deliberate self-harm (nonsuicidal self-injury). We propose a theoretical model in which social processes (both social cognition and peer relations) are critical to understanding the way in which pubertal development drives neural and psychological changes that produce potential mental health vulnerabilities, particularly (but not exclusively) in adolescent girls.

Geosocial Networking Application Use, Characteristics of App-Met Sexual Partners, and Sexual Behavior Among Sexual and Gender Minority Adolescents Assigned Male at Birth

Although many sexual and gender minorities (SGM) assigned male at birth (AMAB) use sexual networking applications intended for adult sexual minority men, little is known about adolescents' use of these technologies and characteristics of their online-met partners. We conducted an online survey of 219 sexually experienced SGM AMAB adolescents in the USA aged 15-17 (39.3% racial/ethnic minority; 74.9% gay; 94.1% cisgender male). Questions assessed app use patterns, partner-seeking behaviors on sexual minority male-specific apps vs. social media/other dating apps, app-met partner characteristics, and sexual behavior with app-met partners. Most (70.3%) used apps for sexual minority men, 14.6% used social media/other apps to meet partners, and 15.1% used neither. Nearly 60% of adolescents who used any type of app reported having met people from the apps in person, and nearly 90% of these reported at least one online-met sexual partner. Most partners were reportedly older than participants, and participants were more likely to report condomless receptive anal sex with older (vs. younger) online-met partners. Although partnerships were primarily sexual in nature, a minority reported friendships or serious partnerships. Meeting same-sex/gender partners via applications for adults may be common among SGM AMAB adolescents, which has implications for their sexual health and well-being.

Pubertal timing predicts adult psychosexuality: Evidence from typically developing adults and adults with isolated GnRH deficiency

Evidence suggests that psychosexuality in humans is modulated by both organizational effects of prenatal and peripubertal sex steroid hormones, and by activational effects of circulating hormones in adulthood. Experimental work in male rodents indicates that sensitivity to androgen-driven organization of sexual motivation decreases across the pubertal window, such that earlier puberty leads to greater sex-typicality. We test this hypothesis in typically developing men (n = 231) and women (n = 648), and in men (n = 72) and women (n = 32) with isolated GnRH deficiency (IGD), in whom the precise timing of peripubertal hormone exposure can be ascertained via the age at which hormone replacement therapy (HRT) was initiated. Psychosexuality was measured with the Sexual Desire Inventory-2 (SDI-2) and Sociosexual Orientation Inventory-Revised (SOI-R). In both sexes, earlier recalled absolute pubertal timing predicted higher psychosexuality in adulthood, although the magnitude of these associations varied with psychosexuality type and group (i.e., typically developing and IGD). Results were robust when controlling for circulating steroid hormones in typically developing participants. Age of initiation of HRT in men with IGD negatively predicted SOI-R. We discuss the clinical implications of our findings for conditions in which pubertal timing is medically altered.

Psychosexual effects resulting from delayed, incomplete, or absent puberty

Puberty is a remarkable period of postnatal development culminating in reproductive capacity. Biological changes of puberty are accompanied by social and emotional changes including psychosexual development. Developmental changes of adolescence are influenced by numerous biological, psychological and social influences. Work to date has identified associations between disrupted puberty (i.e. delayed, incomplete or absent) and psychosexual development. This brief review summarizes our current understanding of the psychosexual effects of delayed puberty and congenital hypogonadotropic hypogonadism (Kallmann syndrome). The importance of psychosocial support and transitional care is highlighted and future directions are discussed.

Investigating sexuality in adolescents with cancer: patients talk of their experiences

Objective. The aim of the present study is to understand which areas of sexuality were regarded as most important and/or problematic among adolescents with cancer.Methods. A questionnaire was administered to adolescent and young adult patients who had been receiving treatments at the Pediatric Oncology Unit of our Institution, for at least 2 months, and those in follow-up who had completed their treatments no more than two years previously. The questionnaire was devised to investigate patients' experiences in various areas, i.e. personal relations, sexual relations; functional aspects, body image, and communication.Results. Questionnaires were given to 70 patients and completed by 66. As main results, the survey showed that disease and treatment might negatively affect patients' way of relating with others (53% of cases) and their body image (56%), though their sexual desire remains unchanged (69.7%). Most patients (67%) reported not having the chance to talk to someone about having sex while receiving their treatments; 79% of patients felt this topic deserved more attention.Conclusion. This study promotes the discussion of an important topic for young people with cancer, which is inadequately addressed today. When establishing an age-specific model of care, aspects related to sexuality should be considered and managed.

A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual, Cisgender Adolescents' Pornography Use Characteristics

BACKGROUND

The ease of access to pornography has made its use common among adolescents. Although sexual and gender minority (SGM) (eg, gay, transgender) adolescents may be more prone to use pornography owing to sexual orientation-related information seeking and/or scarcity of potential romantic or sexual partners, relatively little attention has been paid to their pornography use and to the quantitative examination of the similarities and differences between heterosexual, cisgender (HC) and SGM adolescents' pornography use characteristics.

AIM

The aim of the present study was to compare SGM and HC adolescents' pornography use considering potential sex differences.

METHODS

We used a sample of 2,846 adolescents (52.5% girls; M_age = 14.5 years, SD = 0.6), which was collected as part of an ongoing longitudinal study on adolescents' sexual health. Data were analyzed with 5 groups: HC boys; HC girls; SGM boys; SGM girls; and SGM non-binary individuals.

OUTCOMES

Adolescents completed a self-report questionnaire about sexual and gender minority status and pornography use (ie, lifetime use, age at first exposure, and frequency of use in the past 3 months.) RESULTS: Results indicated significant differences between all groups: 88.2% of HC boys, 78.2% of SGM boys, 54.2% of SGM girls, 39.4% of HC girls, and 29.4% of SGM non-binary individuals reported having ever viewed pornography by the age of 14 years. SGM girls indicated a significantly younger age at first pornography use than HC girls, but this difference was not significant among boys. SGM boys reported the highest (median: many times per week), whereas HC girls reported the lowest (median: less than once a month) frequency of pornography use.

CLINICAL TRANSLATION

Results suggest that SGM and HC boys' pornography use characteristics are rather similar, whereas SGM and HC girls' pornography use patterns may be considered different presumably because of the varying underlying motivations (eg, using pornography to confirm sexual orientation).

STRENGTHS & LIMITATIONS

Self-report measures and cross-sectional designs have potential biases that should be considered. However, the present study involved a large sample of adolescents including SGM adolescents, a population group that is understudied.

CONCLUSION

Approximately two-thirds of teenagers had gained their first experience with pornography in the present sample, and 52.2% reported using it once a week or more often in the past 3 months, indicating that pornography use may play an important role in both HC and SGM adolescents' sexual development. Gender-based differences concerning pornography use seem to be robust regardless of SGM status. Bőthe B, Vaillancourt-Morel, MP, Girouard A, et al. A Large-Scale Comparison of Canadian Sexual/Gender Minority and Heterosexual, Cisgender Adolescents' Pornography Use Characteristics. J Sex Med 2020;17:1156-1167.

A Community-Based Participatory Approach to the Development and Implementation of an HIV Health Behavior Intervention: Lessons Learned in Navigating Research and Practice Systems from Project HAPPY

African American young adults continue to be disproportionately affected by HIV/AIDS. The Southern United States has been particularly affected by HIV/AIDS, accounting for 52% of the new HIV diagnoses. Efforts to reduce the burden of HIV among young African Americans are still needed. Project HAPPY (HIV/AIDS Prevention Project for Youth) was developed and implemented using a community-based participatory research (CBPR) model. There were several challenges that arose during implementation of Project HAPPY that included recruitment, partner engagement, and retention. The realities of implementing an HIV prevention project with urban adolescents is discussed in detail and strategies to overcome these challenges, using a CBPR approach are described. The lessons learned from CBPR implementation of Project HAPPY include: (1) Create a feedback loop to receive community input and guidance throughout the life of the project; (2) Periodic community inventory to determine who is providing similar services to avoid saturation; (3) Prepare for Alternative Partner Engagement; (4) Consult (formally and informally) with the Institutional Review Board prior to submitting proposed changes to avoid unnecessary delays in implementation; (5) Select meaningful incentives for your priority population; and (6) Maintain multiple points of contact with community partners to mitigate the effects of staff turnover.

Precocious and Problematic? The Consequences of Youth Violent Victimization for Adolescent Sexual Behavior

PURPOSE

Violent victimization is concentrated in adolescence and is disruptive to both the timing and sequencing of key life course transitions that occur during this developmental stage. Drawing on recent work establishing the interpersonal consequences of youth victimization, we examined the effect of violent victimization on adolescents' timing of sexual debut and involvement in additional sexual risk behaviors (multiple sexual partnering and inconsistent contraceptive use).

METHODS

This study relied on secondary data analysis of 10,070 youth from four waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health). To predict sexual debut and subsequent sexual risk-taking, analyses were limited to youth not yet sexually active at their wave I interview.

RESULTS

Findings from Cox proportional hazards models, negative binomial regression, and repeated measures ordinal logistic regression showed that adolescent victims of violence initiated sex sooner than non-victims and accumulated more sexual partners, but patterns varied by age at victimization. Youth victimized in late adolescence displayed an accelerated trajectory of sexual activity while youth victimized in early adolescence were less likely to debut or engage in other sexual risk behaviors (although younger victims were more likely to engage in other deviant activities).

CONCLUSION

Sexual activity is a normative part of adolescent development, yet this study finds that violent victimization may disrupt the timing of this life course task, exacerbating deviant risk-taking and undermining youths' subsequent well-being. This study also highlights the importance of life course criminology's attention to timing in lives, given that the consequences of victimization varied by the age when it occurred.

Sexually Explicit Media Use Among 14-17-Year-Old Sexual Minority Males in the U.S

Adolescent sexual minority males (ASMM; < 18 years old) do not typically receive sexual education that addresses male-male relationships from traditional sources (i.e., school, parents). Therefore, many rely on sexually explicit online media (SEOM; i.e., pornography) to find sexual health information. The current study describes SEOM use by ASMM in the U.S. and examined the association between exposure to condomless anal sex (CAS) in SEOM and engagement in CAS. In 2017, ASMM (N = 206; M age = 16, range: 14-17; 51% racial/ethnic minorities) from across the U.S. completed an online sexual health survey, including questions about SEOM use and sexual behaviors. Most (86%) reported that they had viewed SEOM. Engagement with SEOM was frequent (86% reported viewing ≥ one time per week) and lengthy (70% reported viewing for ≥ 15 min per session). Youth perceived that SEOM influenced how they, and other ASMM, think and behave sexually. Further, exposure to risky sexual behavior in SEOM appeared to be associated with youths' dyadic sexual behavior. To support the healthy sexual development of ASMM, it is important to acknowledge the near-universal use of SEOM by ASMM, to identify ways to maximize its potential value, and to minimize potential harms.

Sexuality and cancer in adolescents and young adults - a comparison between reproductive cancer patients and patients with non-reproductive cancer

BACKGROUND

Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients' sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently.

METHODS

Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses.

RESULTS

About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = - 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R2 = .002, p = .243), changes in sexuality (R2 = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R2 = .004, p = .131).

CONCLUSIONS

The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.

Protective sexual behaviours among young adults in Nigeria: influence of family support and living with both parents

Background

Many studies have focused on risky sexual behaviour among adolescents and young adults; however, literature on protective sexual practices among this age cohort is still evolving. Since young adults are disproportionately burdened by sexually transmissible infections, including HIV, understanding factors that influence protective sexual behaviour among the age group is crucial in developing age-appropriate interventions. Drawing from a cross-sectional survey conducted among adolescents and young adults in two Nigerian universities, we examined gender differences in protective sexual behaviours and the influence of family support and living with both parents on these behaviours.

Methods

A total of 800 male and female university students in two Nigerian universities were recruited using stratified random sampling between February and April 2018. Analysis was, however, based on 599 participants aged between 15 and 24 . Adjusted and unadjusted multinomial logistic regression models were used to examine the influence of family support, and living with both parents on protective sexual behaviours at a 95% confidence interval.

Results

Findings show that the largest proportion of our participants engaged in protective sexual behaviours. We found no gender differences in protective sexual behaviours, including sexual abstinence, consistent condom use, and sexual fidelity. Family support and living with both parents were positively associated with protective sexual behaviours among adolescents and young adults.

Conclusion

This study found that a majority of adolescents and young adults in Nigerian Universities engage in protective sexual behaviours. Adequate family support and living with both parents are positively associated with protective sexual behaviours. The study however revealed that about one-fifth of our participants engaged in high-risk sexual behaviour. This suggests a need for behavioural change interventions, provision of sexual health services and empowerment of students who receive inadequate family support.

Characteristics of Adolescent Sexting: Results from the 2015 National Survey of Sexual Health and Behavior

Using data from 78 sexting-experienced adolescents from the 2015 National Survey of Sexual Health and Behavior, we describe sexting frequency, sexting partners, sexual relationships with such partners, and characteristics associated with sexting. Most (59.2%) respondents sexted at most monthly, usually with romantic partners (62.0%). About 41% of sexting-experienced adolescents did not usually have sexual relationships with sexting partners, 36.6% usually sexted after starting a sexual relationship, and 16.8% reported that their sexting typically preceded sexual relationships. Younger adolescents sexted more frequently. Those without vaginal sex/anal sex experience, or prior romantic experience, were more likely to have sexted a non-romantic/sexual partner.

Parenting perspective on the psychosocial correlates of adolescent sexual and reproductive health behavior among high school adolescents in Ethiopia

BACKGROUND

While parents are a crucial part of the social environment in which adolescents live, learn and earn, they could play important roles in efforts to prevent adolescent sexual and reproductive health (SRH) risk behaviors and promote healthy development. Involving parents in prevention programs to risky SRH practices in adolescents requires understanding of the effect of different parenting practices and styles on these behaviors. The purpose of this study was to investigate the relationships between various aspects of perceived parenting and self-reported engagement in sexual risk behavior among adolescents.

METHODS

A cross-sectional study was employed among 406 randomly selected 14-19 years old high school adolescents in Legehida district, Northeast Ethiopia from 15 February to 15 March/ 2016. Structured and pre-tested self-administered questionnaire adapted from the Youth Risk Behavior Surveillance questionnaire was used for the data collection. Bivariate and multivariate logistic regression analysis with odds ratio along with the confidence interval of 95% were used. P-value < 0.05 were considered for statistical significance.

RESULTS

About two-third (64.5%) of the participants reported that they had ever had sex. Nearly half (48.6%) of the participants who were currently sexually active reported that they engaged in at least one type of risky sexual behavior. Specifically, 42.7% reported starting sexual life earlier, 32.2% having more sexual partners in the past 12 months and 23.8% never used condom during the most recent sexual intercourse. High quality parent─adolescent relationships (AOR = 0.53; 95% CI (0.45-0.63) and authoritative form of parenting (AOR = 0.74; 95% CI (0.61-0.92) were associated with lower odds of engaging in risky sexual behaviors in adolescents. The odds of risky sexual behaviors were about three-fold higher in adolescents who perceived parental knowledge as poor (AOR = 2.97; 95% CI (1.51-4.25) and to some extent (AOR = 3.00; 95% CI (1.43-5.55) toward SRH than those whose parents were very knowledgeable. Adolescents with poor behavioral beliefs on SRH issues had a 37% increased odds of engaging in risky sexual behaviors.

CONCLUSIONS

Therefore, to engage the parents within preventive interventions design to support healthy SRH behaviors among adolescents, the role of authoritative parenting style, and improved quality of parent-adolescent relationship, as well as improving adolescents' behavioral beliefs and parental knowledge towards SRH are essential.

[Changes in prevalence of knowledge, attitudes and practices of sexuality in teenage students, Bogotá, 2011-2015]

OBJECTIVE

To present the changes in the prevalence of knowledge, attitudes and practices in high school adolescents in sexuality after an intervention process.

METHODOLOGY

Observational descriptive study. It was administered a questionnaire to 319 adolescents, attending three public schools, for five consecutive years as they progressed in school years (seventh to eleventh). Health promotion workshops were held. Changes in the prevalence were measured (identification of the menstrual cycle, emergency contraception and, condom protection, as well as parents' acceptance of contraception methods, having sex, reasons for do it and, whether they used protection in the first and last relationship). The results were compared by gender.

RESULTS

The identification of emergency contraception was increased from 52% in seventh to 70% in eleven; also, the certainty of the condom protection (from 45% to 62%, respectively). The average of the prevalence of sexual intercourse was 24%, protection in the first relationship 52% and, in the last one was 81%; no statistical differences of these variables were found when comparing them by gender. Parents' perception of acceptance of planning increased from 45% to 79%.

CONCLUSION

The program results highlighted the need to strengthen the educational processes.

Social Support and Its Effects on Adolescent Sexual Risk Taking: A Look at Vulnerable Populations in Baltimore and Johannesburg

INTRODUCTION

We seek to understand whether and how much social support affects adolescent sexual risk-taking in disadvantaged urban environments.

METHODS

Secondary analyses were conducted on data from the global Wellbeing of Adolescents (15-19 years old) in Vulnerable Environments study. The outcomes of interest were sexual experience, age at sexual debut, number of lifetime sexual partners, and condom use at last sex. Social support scales measuring support at home, at school, and from peers were created, as well as a measure about who raised them. Logistic and linear regressions were used to examine associations between social support and sexual risk-taking after controlling for age, schooling, and family structure.

RESULTS

Higher social support was associated with adolescents taking less sexual risk but it was context- and gender-specific. Boys raised by males had lower odds of having sex (adjusted odds ratios (aORs) from .15 (CI = .05-.42) to .19 (.04-.88)). Baltimore girls raised by grandmothers had lower odds of having sex (aOR .34 (.16-.71)). Female support at home was positively associated with girls in Baltimore (aOR .08 (CI = .04-.17)) and Johannesburg (aOR .17 (CI = .03-.87)) having fewer partners. Baltimore girls raised by fathers (aOR 3.78 (CI = 2.33-6.12)) and Johannesburg boys raised by non-biological/step caregivers (aORs from 3.89 (CI = 1.12-13.44) to 8.85 (CI = 6.02-12.99)) were more likely to use condoms.

CONCLUSION

Young men without male support and young women lacking parental support are at particular risk of sexual risk-taking in disadvantaged communities. Parental support can be affected by other contextual factors. Violence in neighborhoods and at home should be considered.

Disgust Toward Sex-Relevant and Sex-Irrelevant Stimuli in Pre-, Early, and Middle Adolescence

For prepubertal youth, sexual stimuli elicit disgust and avoidance, yet in adolescence this avoidance shifts to sexual approach. One explanation could be that disgust declines in adolescence. This project examined whether disgust is indeed lower in adolescence compared to preadolescence, and whether this difference across age groups would be restricted to sex-relevant disgust elicitors. We also examined whether the strength of disgust would depend on familiarity between participant and source. To examine disgust responses in youths, two cross-sectional studies (N = 248, ages six to 17 years) were conducted using scenario-based measurements. Disgust was overall higher in early adolescence than in preadolescence and relatively weak when the source of disgust was a familiar person. Specifically, when parents were the source, sex-relevant disgust was higher in the groups of early and middle adolescents than in the group of preadolescents. Sex-relevant disgust elicited by a stranger or best friend, however, was lower in middle than in early adolescence. The latter is consistent with the view that repeated confrontation with disgusting stimuli might attenuate disgust, which could contribute to healthy sexual functioning. The heightened sex-relevant disgust in middle adolescents when parents were the source might reflect a functional avoidance mechanism of inappropriate sex mates.

A harmful traditional practice exposing young girls to experience virgin pregnancy (Shilshalo): a qualitative study in Argoba community, Amhara National Regional State, Ethiopia

Background

There are various harmful traditional practices and beliefs across the different parts of Ethiopia. Shilshalo, which is yet little known about, is one of these practices existing in Argoba, a community in Amhara National Regional State of Ethiopia. This study was conducted to explore the various features associated with the practice of Shilshalo.

Methods

To address the objective of the study, qualitative approach with case study design was employed. Purposive sampling technique was used to select the participants of the study. Data were collected through interview and focus group discussion and analyzed using thematic qualitative analysis technique.

Results

This study found that Shilshalo is practiced by unmarried young boys and girls as a substitute for sexual intercourse. The actors conduct all activities performed during sexual intercourse except inserting the boy’s genital organ (penis) into the girl’s (vagina). The activities include warming up the girls’ body by hand, kissing and brushing the girl’s thigh and the areas around the outer part of the vagina with the erected penis. Shilshalo is practiced in two ways, i.e. between a boy and a girl, and between boys and a girl. This study also indicated that most members of the Argoba community including the actors consider Shilshalo as a beneficial cultural practice, yet the most shocking story is that some teenage girls experienced unwanted pregnancy without losing their virginity. In addition to virgin pregnancy, Shilshalo exposed girls to STIs, psycho-social problems and physical injuries.

Conclusion

This study concluded that Shilshalo is a harmful traditional practice that severely affects the lives of girls. The overall health and social well beings of girls are affected by different saddles that came from it. It brings almost all kinds of consequences that the other harmful traditional practices such as female genital mutilation and early marriage bring. It is also worse than the other harmful traditional practices as it poses virgin pregnancy as an additional consequence. Therefore, it is suggested that international and national organizations working on issues related to harmful traditional practice should pay due attention to Shilshalo just like what they are doing with female genital mutilation and early marriage.

Electronic supplementary material

The online version of this article (10.1186/s12914-018-0179-x) contains supplementary material, which is available to authorized users.

The Effect of a Text Messaging Based HIV Prevention Program on Sexual Minority Male Youths: A National Evaluation of Information, Motivation and Behavioral Skills in a Randomized Controlled Trial of Guy2Guy

There is a paucity of literature documenting how the constructs of the Information-Motivation-Behavioral Skills (IMB) model are affected by exposure to technology-based HIV prevention programs. Guy2Guy, based on the IMB model, is the first comprehensive HIV prevention program delivered via text messaging and tested nationally among sexual minority adolescent males. Between June and November 2014, 302 14-18 year old gay, bisexual, and/or queer cisgender males were recruited across the US on Facebook and enrolled in a randomized controlled trial testing Guy2Guy versus an attention-matched control program. Among sexually inexperienced youth, those in the intervention were more than three times as likely to be in the "High motivation" group at follow-up as control youth (aOR = 3.13; P value = 0.04). The intervention effect was not significant when examined separately for those who were sexually active. HIV information did not significantly vary by experimental arm at 3 months post-intervention end, nor did behavioral skills for condom use or abstinence vary. The increase in motivation to engage in HIV preventive behavior for adolescent males with no prior sexual experience is promising, highlighting the need to tailor HIV prevention according to past sexual experience. The behavioral skills that were measured may not have reflected those most emphasized in the content (e.g., how to use lubrication to reduce risk and increase pleasure), which may explain the lack of detected intervention impact.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov ID# NCT02113956.

Vloga staršev in vzgoje za zdravje pri oblikovanju odgovornega spolnega vedenja

Uvod: Spolno vedenje je pogosto povezano z določenim zdravstvenim tveganjem, kar vključuje nizko spolno ozaveščenost, značilno za spolno vedenje mladih brez izkušenj. Namen raziskave je bil ugotoviti odnos učencev do spolnega vedenja ter vlogo staršev in spolne vzgoje pri zavedanju učencev o posledicah tveganega spolnega vedenja.Metode: Izvedena je bila kvantitativna neeksperimentalna metoda raziskovanja, s pomočjo strukturiranega vprašalnika na vzorcu 144 učencev ene izmed osnovnih šol na Gorenjskem, septembra 2013. Za analizo podatkov so bili uporabljeni opisna statistika, Mann Whitneyjev U-test, Kruskall – Wallisov test ter linearna večkratna regresijska analiza.Rezultati: Trditev »Kadar imam težave, mi družina nudi oporo« ima statistično značilen vpliv na pozitivno oblikovanje mnenj o spolnem vedenju (β = 0,259, p = 0,002). Ugotovili smo statistično pomemben vpliv zavedanja anketirancev o posledicah tveganega spolnega vedenja in proučevanih spremenljivk, kot sta »Spolna vzgoja pomaga pri razumevanju telesnih in čustvenih sprememb, ki jih prinaša puberteta (β = 0,089,p < 0,001)« in »Pri prvem spolnem odnosu moram paziti, da sem zaščiten/-a« (β = 0,066, p = 0,001).Diskusija in zaključek: Anketirani učenci so dovzetni za ustvarjanje boljšega spolnega vedenja takrat, ko jim podporo - pogosto kot prvi vir - nudi družina. Spolna vzgoja predstavlja preventivo pred tveganim spolnim vedenjem. Gre za proces, v katerem posameznik pridobi informacije in oblikuje stališče / prepričanja o spolnosti, spolni identiteti, odnosih in intimnosti. 

Comparing Postnatal Development of Gonadal Hormones and Associated Social Behaviors in Rats, Mice, and Humans

Postnatal development includes dramatic changes in gonadal hormones and the many social behaviors they help regulate, both in rodents and humans. Parental care-seeking is the most salient social interaction in neonates and infants, play and prosocial behaviors are commonly studied in juveniles, and the development of aggression and sexual behavior begins in peripubertal stages but continues through late adolescence into adulthood. Although parental behaviors are shown after reproductive success in adulthood, alloparenting behaviors are actually high in juveniles as well. These behaviors are sensitive to both early-life organizational effects of gonadal hormones and later-life activational regulation. However, changes in circulating gonadal hormones and the display of the previous behaviors over development differ between rats, mice, and humans. These endpoints are of interest to endocrinologist, toxicologists, and neuroscientists because of their relevance to mental health disorders and their vulnerability to effects of endocrine-disrupting chemical exposure. As such, the goal of this mini-review is to succinctly describe and relate the postnatal development of gonadal hormones and social behaviors to each other, over time, and across animal models. Ideally, this will help identify appropriate animal models and age ranges for continued study of both normative development and in contexts of environmental disruption.

Longitudinal impacts of pubertal timing and weight status on adolescent Internet use: Analysis from a cohort study of Taiwanese youths

Aim

To investigate the longitudinal impacts of pubertal timing and weight status on Internet use in adolescents.

Methods

Three waves of data on a longitudinal cohort of 7^th grade students (N = 2430) were retrieved from the Taiwan Youth Project. Univariate and multivariate regression models were applied using crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) to examine the concomitant impacts of pubertal timing and weight status on adolescent Internet use.

Results

The dataset identified 210 (8.7%) students using the Internet for more than 20 hours/week, and 81 (3.3%) were viewing pornographic material online. Early maturing and thin-weight adolescents were at 35% and 46% increased risks of spending long hours on Internet use, respectively. While early puberty was associated with online pornography viewing among males (adjusted OR 1.84, 95% CI 1.04–3.28), early puberty was contrarily a protective factor against online gaming in females (adjusted OR 0.59, 95% CI 0.36–0.96).

Conclusion

Early puberty was found to be positively related to adolescent Internet use. Appropriate health education and guidance regarding Internet use should be provided to those with different developing needs.

The Role of Religiosity in Adolescents' Compulsive Pornography Use: A Longitudinal Assessment

Despite increasing concerns that adolescent men are vulnerable to developing compulsive pornography use, little research has been done in this area. Given recent theorizing and research concerning moral incongruence, we hypothesized that symptoms of compulsive pornography use should generally be associated with higher levels of pornography use and increased growth in male adolescent pornography use over time, but that this pattern would be attenuated among very religious participants. These hypotheses were tested with mixed effects growth models using two independent panel samples of male Croatian adolescents. As expected, adolescent men who reported features of compulsive pornography use tended to exhibited higher levels of pornography use. However, contrary to expectations, increased growth in pornography use was limited to more religious compulsive users. Compared to nonreligious compulsive users, these adolescents started with lower initial levels of pornography use and their use increased over time at a greater rate of change. This study's results are the first to suggest that some adolescent men who report high levels of pornography use tend to exhibit symptoms of compulsive use, which highlights a need for counseling and therapeutic attention. Our findings also have implications for the emerging theory of moral incongruence.

Adolescent Sexual Risk Taking: The Distribution of Youth Behaviors and Perceived Peer Attitudes Across Neighborhood Contexts

PURPOSE

Sexual activity is a normative part of adolescent development, yet early sexual debut and sex with multiple partners undermine health and well-being. Both structural (e.g., poverty) and social (e.g., norms) characteristics of neighborhoods shape sexual risk taking, yet scholarship remains focused on urban areas. Thus, this study explores sexually permissive attitudes and sexual risk taking across a wider expanse of neighborhood types.

METHODS

Among 8,337 nonsexually active respondents in Wave I (1994-1995 [ages 11-18]) of the National Longitudinal Study of Adolescent to Adult Health (Add Health), a hierarchical linear model and a hierarchical generalized linear model were used to estimate the effect of neighborhood type and permissive sexual climate on youths' sexual debut, age at debut, and lifetime number of sexual partners by Wave III (2001-2002 [ages 18-26]), controlling for individual, familial, and peer factors.

RESULTS

Sexual climates varied in overall permissiveness and internal consistency both across and within neighborhood types and were linked to increased sexual risk taking. Compared with youth from upper middle class white suburbs, the odds of sexual debut and the number of partners were highest among youth from rural (black and white) neighborhoods; youth from almost all other neighborhood types initiated sex earlier.

CONCLUSIONS

Early sexual debut in adolescence is a public health issue with immediate and long-term implications. Adolescence unfolds in neighborhood environments, the characteristics of which may spur youth into such risk taking. Continued scholarship on sexual risks should consider further variations in the geographic distributions of such risks to investigate more fully their consequences.

Comparison of the Predictive Capacity of the Erotophobia–Erotophilia and the Attitudes Toward Sexual Behaviors in the Sexual Experience of Young Adults

The prediction of sexual behaviors in emerging adult population is important because the number of sexually active individuals is high, and many young adults engage in sexually risky behaviors. Attitudes are an effective way to predict behaviors. The attitude–behavior relation is stronger when both attitude and behavior are measured at equivalent levels of specificity. The aim of this study was to provide empirical support of the Attitudes toward Sexual Behaviors Scale (ASBS) predictive capacity for the sexual experience (number of different sexual behaviors performed) as well as to compare it with the Sexual Opinion Survey (SOS; erotophobia–erotophilia dimension) predictive capacity. Participants were 632 heterosexual young adults (57.8% were women) of Spanish nationality aged 18 to 30 years, selected by incidental and snowball sampling. Sociodemographic questions, the ASBS, the SOS, and a checklist about sexual experience were administered online. When the age and sex variables were controlled, the ASBS predictive capacity for the sexual experience was found to be greater than the SOS predictive capacity in both young men and women. These results might be explained by the higher correspondence in the sexual experience measure (specific sexual behaviors) with the ASBS than with the SOS.

Becoming a sexual being: The 'elephant in the room' of adolescent brain development

The onset of adolescence is a time of profound changes in motivation, cognition, behavior, and social relationships. Existing neurodevelopmental models have integrated our current understanding of adolescent brain development; however, there has been surprisingly little focus on the importance of adolescence as a sensitive period for romantic and sexual development. As young people enter adolescence, one of their primary tasks is to gain knowledge and experience that will allow them to take on the social roles of adults, including engaging in romantic and sexual relationships. By reviewing the relevant human and animal neurodevelopmental literature, this paper highlights how we should move beyond thinking of puberty as simply a set of somatic changes that are critical for physical reproductive maturation. Rather, puberty also involves a set of neurobiological changes that are critical for the social, emotional, and cognitive maturation necessary for reproductive success. The primary goal of this paper is to broaden the research base and dialogue about adolescent romantic and sexual development, in hopes of advancing understanding of sex and romance as important developmental dimensions of health and well-being in adolescence.

Puberty Experiences of Low-Income Girls in the United States: A Systematic Review of Qualitative Literature From 2000 to 2014

PURPOSE

Puberty is a critical period of development that lays the foundation for future sexual and reproductive health. It is essential to learn about the puberty experiences of low-income girls in the United States given their increased vulnerability to negative sexual and reproductive health outcomes. To understand the present-day puberty experiences of this population, we conducted a qualitative systematic review.

METHODS

We systematically searched the peer-reviewed literature published between 2000 and 2014 on the puberty experiences of low-income girls in the United States. Reviewers screened titles, abstracts, and the full texts of articles. Using standardized templates, reviewers assessed the methodologic quality and extracted data. Data were synthesized using thematic analysis. Confidence in each finding was assessed using Confidence in the Evidence from Reviews of Qualitative research.

RESULTS

Twenty qualitative articles were included. They described the experiences of mostly African-American, Caucasian, and Hispanic girls living primarily in urban areas of Northeastern United States. Five overarching themes emerged: content of girls' puberty experiences, quality of girls' puberty experiences, messages girls receive about puberty, other factors that shape girls' puberty experiences, and relationships that shape girls' experiences of puberty.

CONCLUSIONS

The limited existing evidence suggests that low-income girls in the United States are unprepared for puberty and have largely negative experiences of this transition.

A Sex-Positive Framework for Research on Adolescent Sexuality

In this article, I propose a sex-positive framework for research on adolescent sexuality in which I consider consensual sexual activities in adolescence as developmentally normative and potentially healthy. The sex-positive framework is contrasted with the predominant "risk" perspective that presumes that abstinence from sexual activity is the ideal behavioral outcome for teenagers. Evidence from longitudinal and behavioral genetic studies indicates that engaging in sexual intercourse in adolescence does not typically cause worse psychological functioning. The relationship context of sexual experience may be a critical moderator of its psychological impact. Moreover, cross-cultural data on adolescents' contraception usage, unintended pregnancy, and sexually transmitted infections suggest that, despite the unacceptably high rate of negative health consequences among U.S. teenagers, adolescents can have the developmental capacity to regulate the health risks inherent in sexual activity. Understanding adolescent sexuality can be fostered by considering sexual well-being, a multidimensional construct that incorporates an adolescent's sexual self-efficacy, sexual self-esteem, feelings of sexual pleasure and satisfaction, and freedom from pain and negative affect regarding sexuality. New research is necessary to understand the development of adolescent sexual well-being, including its normative age trends, its reciprocal links with sexual behavior, and its impact on psychological and physical health.

Adolescent boys with an autism spectrum disorder and their experience of sexuality: An interpretative phenomenological analysis

This qualitative study explored how adolescent boys with autism spectrum disorder experience their sexuality. Previous research has demonstrated that sexuality is a developmental task for boys with autism spectrum disorder, as it is for their peers. Case studies have suggested a relation between autism spectrum disorder and atypical sexual development; empirical studies on this subject, however, are scant and inconsistent. This study is based on interviews with eight boys, aged 16-20 years, with Asperger's disorder or autistic disorder. Interpretative phenomenological analysis of the data revealed three major themes relating to (a) how they experience sexual feelings, think about sexuality and think about themselves as sexual beings; (b) how they perceive messages relating to sexuality in their surroundings; and (c) how they experience finding and having a partner and partnered sex. We believe that attention to these themes is needed in assessment, education and further research.

Demographic and developmental differences in the content and sequence of adolescents' ideal romantic relationship behaviors

This study utilizes data from 18,392 respondents (aged 12-19) in Wave 1 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to provide a detailed descriptive analysis of U.S. adolescents' desired behaviors in their ideal romantic relationships. Age, gender, and ethnic group differences in the desire for--and preferred sequence of--a set of activities that could occur in a hypothetical romantic relationship were explored within subsets of heterosexual (n = 17,274) and sexual minority adolescents (n = 1118). Non-sexual behaviors were more commonly desired compared to sexual behaviors. The typical desired behavioral sequence was: holding hands, going out alone, telling others they were a couple, kissing, saying "I love you," sexual touching, and finally having sex. Overall, more similarities than differences emerged across groups, with some notable differences in the percentages who desired sexual behaviors. Results provide a nuanced picture of adolescent relationship scripts, with implications for education and prevention.

Sexuality in adolescent boys with autism spectrum disorder: self-reported behaviours and attitudes

Differences in sexual functioning of adolescents with and without autism spectrum disorder (ASD) are understudied. In the current study, self-reported sexual behaviours, interests and attitudes of 50 adolescent boys, aged 15-18, with at least average intelligence and diagnosed with ASD, were compared with a matched general population control group of 90 boys. Results demonstrated substantial similarity between the groups in terms of sexual behaviours. The only significant difference was that boys with ASD reacted more tolerant towards homosexuality compared to the control group. Results reveal that sexuality is a normative part of adolescent development in high-functioning boys with ASD. Hence, attention should be given to this topic in education and mental health care.