Risky sex: interactions among ethnicity, sexual sensation seeking, sexual inhibition, and sexual excitation

Impulsivity, sex-related alcohol expectancies, alcohol use, and sexual risk-taking among bisexual women

BACKGROUND AND OBJECTIVES

According to the acquired preparedness model, personality traits, such as impulsivity, may influence the learning process, contributing to heightened expectations surrounding risky behaviors (i.e., alcohol use, sexual risk-taking). As bisexual women demonstrate heightened risk for hazardous alcohol- and sex-related behaviors, the present study examined a sequential pathway, whereby the relation between impulsivity and sexual risk-taking is mediated through sex-related alcohol expectancies and alcohol use.

METHODS

Data were collected from 225 self-identified cisgender, bisexual women between the ages of 18 and 30 years (M = 22.77, SD = 3.45), who participated in an online survey. Participants reported on impulsivity, sex-related alcohol expectancies, alcohol use, and experiences of sexual risk-taking.

RESULTS

Results revealed that sex-related alcohol expectancies and alcohol use sequentially mediated the relation between impulsivity and sexual risk-taking. Thus, greater impulsivity was related to greater sexual risk-taking through heightened sex-related alcohol expectancies and elevated alcohol use.

DISCUSSION AND CONCLUSIONS

Findings from this study highlight mechanisms associated with risky drinking and sexual behaviors among this at-risk population. Such information could aid the development of more efficacious prevention and intervention programs aimed at reducing consequences associated with alcohol use and sexual risk-taking among bisexual women.

SCIENTIFIC SIGNIFICANCE

Bisexual women are at heightened risk for alcohol-related problems, including sexual risk-taking. Findings from the current study identify impulsivity and sex-related alcohol expectancies as independent and integrative predictors of such risky behaviors. Incorporation of these constructs may aid in the development of more efficacious clinical methods aimed at bettering health outcomes among bisexual women.

Major Depressive Disorder as a Driver of Dual Systems Model Development During Adolescence and Emerging Adulthood Among Justice-Involved Youth: Is Salience Age-Graded?

The dual systems model is a psychological framework centered on differential development of sensation-seeking and impulse control during adolescence and emerging adulthood with implications for understanding antisocial behavior. However, there is a dearth of research which has examined mental illness as a driver of differential development of these constructs. This study examined major depressive disorder as a risk factor for elevated sensation-seeking and diminished impulse control and tested to determine whether the salience differed by age. The Pathways to Desistance data were analyzed. Mixed effects models examined the direct effect of major depressive disorder on dual systems outcomes and test for moderation by age. Findings indicated that major depressive disorder at baseline was associated with increased sensation-seeking and diminished impulse control. Relationships did not differ in salience based on age. Results suggest that treatment effective for addressing depression may have relevance for mitigating the impact of the disorder on cognition.

The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022

The Dual Control Model proposes that sexual arousal and related processes are dependent on the balance between sexual excitation and sexual inhibition, and that individuals vary in their propensity for these processes. This scoping review provides an overview and discussion of the questionnaires used to measure the propensities for sexual excitation and inhibition, their translation and validation in other languages, and their application in empirical research on topics ranging from sexual desire and arousal, sexual (dys)function, sexual risk taking, asexuality, hypersexuality, and sexual aggression. A total of 152 papers, published between 2009 and 2022 and identified using online databases, were included in this review. The findings, consistent with those reviewed by Bancroft et al. (2009), suggest that sexual excitation is particularly relevant to sexual desire and responsivity and predictive of asexuality and hypersexuality. Sexual inhibition plays a role in sexual dysfunction. sexual risk taking, and sexual aggression, although often in interaction with sexual excitation. Suggestions for the further development of the model and for future studies are discussed.

Higher sexual excitation is associated with an increase in sex-linked substance use in women with a history of unwanted sexual contact

Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex histories primarily engage in SLSU to increase sexual excitation or decrease inhibitions. We conducted exploratory analyses of an online survey in a convenience sample of 516 undergraduate women including data on their history of unwanted sex, SLSU, and sexual excitation/inhibition. Sexual excitation mediated the association between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sexual histories reported higher levels of sexual excitation, which in turn was associated with a higher likelihood of using substances to increase pleasure during sexual activity. Specifically, arousability, partner characteristics, and power dynamics subfactors were significant mediators. Sexual inhibition did not mediate the relationship between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sex histories may have been less likely to use substances to reduce sexual inhibitions. If replicated, these findings suggest that sexual excitation may be a useful target of intervention surrounding SLSU, particularly in women with histories of unwanted sexual contact. Specifically, treatments targeting cognitive and affective tendencies associated with sexual excitation may help women who engage in SLSU to have safe, pleasurable sexual activity, without increasing the risk of intoxication-related harms.

Risk Prediction Score for Screening Asymptomatic Sexually Transmitted Infections in HIV-positive French Men Who Have Sex with Men (ANRS 9520 DRIVER)

OBJECTIVES

Asymptomatic sexually transmitted infections (STI) are frequent among men who have sex with men (MSM). Identifying asymptomatic STIs is a crucial issue, not only for secondary but also for primary prevention, as early treatment can reduce transmission risk. We aimed to develop a self-reported predictive score for early identification of asymptomatic STIs.

METHODS

Participants provided clinical data and completed a self-administered questionnaire including sociodemographic variables and behaviors during the 6 previous months. We used multivariable logistic regression to identify factors associated with asymptomatic STIs. We calculated the accuracy of the model by the non-parametric area (AUC) under the receiver-operating-characteristic (ROC) curve to find the optimal discriminant threshold for screening.

RESULTS

A total of 781 HIV-positive MSM were included with a mean age of 46.8 years. Asymptomatic STI prevalence was 13.2%. Detectable plasma HIV RNA (adjusted odds ratio (aOR [95% CI): 2.54 [1.23;5.25]), inconsistent condom use during anal sex (2.20 [1.36;3.56]), group sex (2.00 [1.15;3.45]), during or-genital practices (1.83 [1.12;3.01]), not being in stable relationship (1.70 [1.01;2.66] and an item from a sensation-seeking behavioral scale "I don't like watching porn videos" (1.61 [1.01;2.59] were associated with asymptomatic STI. AUC was 0.7 and with optimal threshold of 0.1082 for this model; sensitivity was 80.4%. Self-reported asymptomatic STI predictive score was built with this threshold according to the 6 factors in the final model.

CONCLUSIONS

As this predictive score is not designed to be diagnostic, but to provide indications for diagnostic tests, its ease of administration and sensitivity remain the most important features. Its use in clinical practice for early detection of asymptomatic STIs potentially can reinforce STI primary and secondary prevention.

Online Partner Seeking and Sexual Behaviors Among Men Who Have Sex With Men From Small and Midsized Towns: Cross-sectional Study

BACKGROUND

Men who have sex with men (MSM) residing outside of large urban areas are underrepresented in research on online partner seeking and sexual behaviors related to transmission of HIV.

OBJECTIVE

We aimed to determine associations between the use of the internet or social networking apps (online tools) to meet partners for sex, dating, or for both purposes (online partner seeking) and sexual behaviors among MSM residing in small and midsized towns in Kentucky, United States.

METHODS

Using peer-referral sampling and online self-administered questionnaires, data were collected from 252 men, aged 18 to 34 years, who had recently (past 6 months) engaged in anal sex with another man and resided in Central Kentucky. Using multivariable logistic regression models, we assessed associations of online partner seeking and HIV-related sexual behaviors.

RESULTS

Most (181/252, 71.8%) of the participants reported using online tools for partner seeking. Of these 181 respondents, 166 (91.7%) had used online tools to meet partners for sex (n=45, 27.1% for sex only; and n=121, 72.9% for sex and dating) and 136 (75.1%) had used online tools to meet partners for dating (n=15, 11% for dating only; and n=121, 89% for sex and dating). Adjusted analyses revealed that MSM who had engaged in condomless insertive and receptive anal intercourse were less likely to report online partner seeking (adjusted odds ratio [aOR] 0.22, 95% CI 0.07-0.68; P=.009 and aOR 0.25, 95% CI 0.10-0.66; P=.005, respectively). Increased number of insertive and receptive anal sex partners and substance use before or during sex were associated with higher odds of online partner seeking (aOR 1.31, 95% CI 1.11-1.55; P=.001; aOR 1.20, 95% CI 1.05-1.39; P=.008; and aOR 2.50, 95% CI 1.41-4.44; P=.002, respectively).

CONCLUSIONS

Among MSM who reside outside of large urban areas and practice online partner seeking, HIV risk-reduction interventions should address safer sex practices, including the risks for HIV transmission associated with alcohol or drug use before or during sex. MSM who do not practice online partner seeking are in need of continued outreach to reduce condomless anal sex.

Sexual sensation seeking, hookups, and alcohol consumption among first-year college students

OBJECTIVE

To explore sexual sensation seeking (SSS) among an ethnically-diverse sample of first-year college students and their hookup behaviors.

PARTICIPANTS

1,480 first-year college students who hooked up in the last 30 days were recruited from four universities in 2016.

METHODS

Students completed an online survey before completing an online STI and alcohol prevention intervention.

RESULTS

Male and sexual minority students had significantly higher SSS scores compared to female and heterosexual students respectively. Students with higher SSS scores were less likely to report condom use at last vaginal and anal hookup, more likely to hookup under the influence of alcohol and participate in a wide range of sexual behaviors. There were no significant mean differences in SSS scores by level of intoxication during their last hookup.

CONCLUSION

These findings highlight the role of SSS in predicting sexual risk behaviors of first-year college students and the overall low SSS scores among this sample.

Sexual Inhibition and Sexual Excitation Scales in Men: Psychometric Properties of a Polish Adaptation

The present study aimed to develop a Polish version of the Sexual Inhibition/Sexual Excitation Scale (SIS/SES-PL) and explore its psychometric validity in a sample of 498 men aged between 18 and 55 years. We used exploratory and confirmatory factor analyses to obtain the best model fit. Out of the 45 items in the original scale, 32 items with eight subscales and three higher-order factors: (sexual excitation [SES], sexual inhibition due to performance failure [SIS1], and sexual inhibition due to performance consequences [SIS2]) were included in the SIS/SES-PL. The SIS/SES-PL was found to have a good and satisfactory fit (comparative fit index = .87; Tucker-Lewis Index = .85; root mean square error of approximation = .054; χ² = 1108.7; p < .001; test-retest reliability Cronbach's alpha = .93). A small correlation between age and the SIS1 and SIS2 scores was detected. However, forward multiple regression analysis revealed a significant correlation only between age and SIS1 [β = .23, p < .001, R² for model = .05; F(1, 494) = 27.52, p < .001]. Furthermore, a moderate correlation between SIS1 and SES2, as well as SIS1 and general inhibition properties (measured using the Behavioral Inhibition Scale), was noted. In the case of SIS2, only small effects were observed, with the highest values for engaging in risky sexual behavior. Out of the total number of 42 variables, a moderate correlation between SES and the following was described: importance of sex, hypersexual behaviors, frequency of masturbation, frequency of sexual activities per month, sexual risk-taking, high promiscuity (measured using the Sociosexual Orientation Inventory Revised-Drive), general activation properties (measured using the Behavioral Activation Scale), neuroticism, and erotophilic tendencies (measured using the Sexual Opinion Survey-Short Form). The results of the study allowed us to conclude that the SIS/SES-PL might be a useful tool for tailoring therapy for men with sexual problems, as well as in the field of clinical research on sexual inhibition and excitation. Furthermore, it is a reliable and useful tool for measuring propensities for sexual excitement and inhibition.

Theoretical Antecedents of Male Adolescents' Problematic Pornography Use: A Longitudinal Assessment

Although considerable research has examined the antecedents of adolescents' pornography use (PU), little data exist on the underlying mechanisms of problematic pornography use (PPU) in adolescence. To bridge this gap, the current longitudinal study examined the long-term associations between adolescent boys' PU frequency, PPU, and theory-based predictors of PPU. Testing three conceptual models (the moral incongruence, out of control, and mood management models), we examined the relative contributions of impulsivity, depression/anxiety symptoms, and religiosity to PPU, controlling for PU over time. The analysis was conducted using a panel sample of 337 Croatian men (M_age = 15.9 years, SD = 0.52). Latent growth curve modeling showed that baseline levels of, and subsequent growth in PU predicted later higher levels of PPU, irrespective of participants' religiosity, negative emotions, and impulsivity. Baseline higher levels of negative emotions and impulsivity predicted higher levels of PPU three years later, even after controlling for the growth in PU over time. Religiosity moderated the association between changes in PU and PPU. Growth in PU resulted in higher PPU among more religious adolescents, compared to their less religious peers. This study's findings support all three conceptual models explaining PPU in adults and may guide clinical work with adolescents seeking help for PPU.

The relationship between sexual sensation seeking and problematic Internet pornography use: A moderated mediation model examining roles of online sexual activities and the third-person effect

BACKGROUND AND AIMS

Internet pornography consumption is prevalent among college students and problematic for some, yet little is known regarding the psychological constructs underlying problematic Internet pornography use (PIPU). Drawing on the Interaction of Person-Affect-Cognition-Execution model, this study tested a model that sexual sensation seeking (SSS) would impact PIPU through online sexual activities (OSAs) and that this relationship would be influenced by the third-person effect (TPE; a social cognitive bias relating to perceived impacts on others as compared to oneself) in a gender-sensitive manner.

METHODS

A total of 808 Chinese college students (age range: 17-22 years, 57.7% male) were recruited and surveyed.

RESULTS

Men scored higher than women on OSAs and PIPU and on each scale's component factors. The relationship between SSS and PIPU was mediated by OSAs, and the TPE moderated this relationship: the predictive path (SSS to PIPU) was significant only in participants with high TPE. The moderated mediation model was not invariant across gender groups, with data suggesting that it accounted for a greater proportion of the variance in men as compared with women.

DISCUSSION AND CONCLUSIONS

The findings suggest that SSS may operate through participation in OSAs to lead to PIPU, and this relationship is particularly relevant for college-aged males scoring high on the TPE. These findings have implications for individuals who might be particularly vulnerable to developing PIPU and for guiding educational efforts and targeting interventions in college-aged students. The extent to which these findings extend to other age groups and cultures warrants further examination.

Psychometric Properties of the Spanish Version of the Sexual Inhibition/Sexual Excitation Scales for Men

The dual control model (DCM) postulates the involvement of relatively independent inhibitory and excitatory systems, which together provide a "double control" over sexual response and associated behavior (Janssen & Bancroft, 2007). Based on this model, the Sexual Inhibition and Sexual Excitation Scales assess the propensity for sexual excitation and sexual inhibition. This research focused on analyzing some psychometric properties of this questionnaire and developing a Spanish version in men. The sample consisted of 823 heterosexual men of ages ranging from 18 to 74 years. Confirmatory factor analysis generated a version of the scale that consisted of 34 items (11 items with the worst factor loadings were eliminated) distributed in four factors (one sexual excitation factor and three sexual inhibition factors). This is consistent with the DCM of sexual response. The four factors demonstrated good reliability coefficients except for sexual inhibition due to the threat of performance consequences, which was found to have a low internal consistency. Consequently, this is something that will be addressed in future studies. The four factors were found to have good test-retest reliability. The measures of the Sexual Inhibition and Sexual Excitation Scales had good validity properties and a coherent relationship with sexual sensation seeking and erotophilia.

Psychometric properties of the Sexual Excitation/Sexual Inhibition Inventory for Women and Men (SESII-W/M) and the Sexual Excitation Scales/Sexual Inhibition Scales short form (SIS/SES-SF) in a population-based sample in Germany

The Sexual Excitation Sexual/Inhibition Inventory for Women and Men (SESII-W/M) and the Sexual Excitation Scales/Sexual Inhibition Scales short form (SIS/SES-SF) are two self-report questionnaires for assessing sexual excitation (SE) and sexual inhibition (SI). According to the dual control model of sexual response, SE and SI differ between individuals and influence the occurrence of sexual arousal in given situations. Extreme levels of SE and SI are postulated to be associated with sexual difficulties or risky sexual behaviors. The present study was designed to assess the psychometric properties of the German versions of both questionnaires utilizing a large population-based sample of 2,708 participants (Mage = 51.19, SD = 14.03). Overall, psychometric evaluation of the two instruments yielded good convergent and discriminant validity and mediocre to good internal consistency. The original 30-item version of the SESII-W/M did not show a sufficient model fit. For a 24-item version of the SESII-W/M partial strong measurement invariance across gender, and strong measurement invariance across relationship status, age, and educational levels were established. The original structure (14 items, 3 factors) of the SIS/SES-SF was not replicated. However, a 4-factor model including 13 items showed a good model fit and strong measurement invariance across the before-mentioned participant groups. For both questionnaires, partial strong measurement invariance with the original American versions of the scales was found. As some factors showed unsatisfactory internal consistency and the factor structure of the original scales could not be replicated, scores on several SE- and SI-factors should be interpreted with caution. However, most analyses indicated sufficient psychometric quality of the German SESII-W/M and SIS/SES-SF and their use can be recommended in German-speaking samples. More research with diverse samples (i.e., different sexual orientations, individuals with sexual difficulties) is needed to ensure the replicability of the factor solutions presented in this study.

Addressing adolescents' risk and protective factors related to risky behaviours: Findings from a school-based peer-education evaluation in the Western Cape

BACKGROUND

Peer-education programmes aim to bring about attitudinal and behavioural changes in their target audience. In the South African educational context, peer education is a favoured approach in dealing with issues such as HIV and AIDS, sexual decision-making and substance misuse. Given the reliance on peer-education programmes in the educational system, it is important to establish how well they are working. This study aims to assess the effect of an extensive, structured, time-limited, curriculum-based, peer-led educational programme on first-year high school learners in public schools in the Western Cape Province of South Africa.

METHOD

The curriculum called 'Listen Up' addresses issues such as supporting peers, sexual decision-making, healthy relationships, HIV risk, alcohol misuse and unwanted pregnancy in seven structured sessions. The programme targeted adolescents in Grade 8 growing up in what are considered to be risky environments in public schools in the Western Cape during 2012 and 2013. The intervention was evaluated based on 10 scales sourced from published literature related to the outcome indicators of future orientation, sensation-seeking, self-efficacy in sexual relations, HIV transmission knowledge, HIV prevention knowledge, HIV attitudes, sexual attitudes, decision-making, healthy relationships and social support. Descriptive statistics were used to analyse demographic and community characteristics and analyses of variance were used to detect differences between groups. The surveys were administered to a total of 7709 learners across three waves of the study in 27 peer intervention schools and eight control schools.

RESULTS

Immediately post intervention, statistically significant differences were noted for the intervention schools when compared to their baseline levels on measures of future orientation, self-efficacy in sexual relations, knowledge regarding HIV transmission, knowledge regarding HIV prevention and knowledge in terms of healthy relationships. Comparing baseline values with results collected between five and seven months post intervention, statistically significant results were noted for self-efficacy in sexual relations and knowledge regarding HIV transmission.

CONCLUSION

The findings of this study suggest that peer-education can improve adolescents' self-efficacy in sexual relations as well as knowledge regarding the transmission of HIV and therefore can contribute to the prevention of HIV transmission among adolescents.

Devaluation of Safe Sex by Delay or Uncertainty: A Within-Subjects Study of Mechanisms Underlying Sexual Risk Behavior

The value of safe sex may be discounted based on contextual factors associated with an opportunity for sex. College students in a within-subjects study selected hypothetical sexual partners from a set of pictures and classified them based on attractiveness and estimated chance of having an sexually transmitted infection (STI). In the Sexual Delay Discounting (SDD) task, participants rated their likelihood (0-100 %) of waiting for some period of time (e.g., 3 h) to have protected sex with their selected partners, when they could have immediate sex without protection. In the Sexual Probability Discounting (SPD) task, participants rated their likelihood of having protected sex if the opportunity was uncertain (e.g., 50 %), when they could have unprotected sex for sure (100 %). All participants included in the final analyses were aware of and had a positive attitude towards protection against STIs as they were likely to have immediate (or certain) protected sex. Results from 432 delay data in the SDD task and 488 probability data in the SPD task showed that participants' preference for safe sex systematically decreased as the delay to and odds against having safe sex increased. However, this preference was altered by the participants' perception of their partner's attractiveness and STI risk.

Spanish version of the Sexual Excitation/Sexual Inhibition Inventory for Women: Factorial structure, reliability and validity evidences

Background/Objective: The Dual Control Model suggests that sexual excitation and associated behaviors are the result of the balance between relatively independent excitatory and inhibitory mechanisms. Based on this theoretical model, the Sexual Excitation/Sexual Inhibition Inventory for Women (SESII-W) was developed to evaluate excitation and inhibition dimensions in women. The aim was to adapt and validate the SESII-W in the Spanish population. Method: A sample of 1,380 heterosexual women (aged 18 to 52) completed the Spanish SESII-W, together with other related instruments. After the translation and adaptation of the SESII-W, a Confirmatory Factor Analysis (CFA) was performed. Results: CFA resulted in a version consisting of 33 items divided into eight sub-factors, which were grouped into two higher-order factors (Sexual Excitation and Sexual Inhibition). The sub-factors demonstrated adequate internal consistency values except for Sexual Power Dynamics and Concerns about Sexual Function. Test-retest reliabilities were good. Their scores correlated with erotophilia, sexual sensation seeking, age at first intercourse, and number of sexual partners in the expected direction. Conclusions: The Spanish version of SESII-W has adequate psychometric guarantees for use in clinical practice and research, although it would be necessary to further revise factors that showed a lower level of reliability.

Investigating Female Sexual Concordance: Do Sexual Excitation and Sexual Inhibition Moderate the Agreement of Genital and Subjective Sexual Arousal in Women?

The agreement of subjective and genital sexual response, also referred to as sexual concordance, shows substantial variability between women. Identifying predictors of sexual arousal and sexual concordance is important to improve our understanding of female sexual response and its relationship to sexual function or dysfunction. The aim of this study was to assess the relevance of sexual excitation and sexual inhibition as predictors of subjective sexual arousal, genital arousal, and sexual concordance. In a laboratory setting, sexual arousal was induced by erotic video stimuli. Subjective sexual arousal was assessed continuously during stimulus presentation and genital arousal was measured with vaginal photoplethysmography. Data of 58 women (M age = 24.95, SD = 4.65) were analyzed using multilevel analyses (HLM). This data analytic technique estimates the within-subject associations of subjective and genital arousal, by controlling for between-subject differences. An interaction term of sexual excitation and sexual inhibition significantly predicted genital sexual arousal. In exploratory analyses, two lower order factors of sexual inhibition (Concerns about Sexual Function and Arousal Contingency) were predictive of sexual concordance. Further examination of these associations might increase our knowledge of female sexual function and deepen our understanding of how sexual excitation and sexual inhibition affect sexual arousal and consequently, impact sexual behaviors, in women.

Sexuality-related issues in borderline personality disorder: A comprehensive review

OBJECTIVE

Sexuality is somewhat neglected in clinical research on borderline personality disorder (BPD).

METHOD

We performed a systematic review from 1980 to November 2014 through PubMed and PsycINFO.

RESULTS

Empirical evidence underscores that childhood sexual trauma may be considered a non-specific risk factor for BPD. Furthermore, individuals with BPD also display higher sexual identity disturbances and homosexual relationships than non-BPD individuals. Moreover, patients with BPD also exhibit higher sexual impulsivity than non-BPD. In addition, sexual risk behaviours among individuals with BPD are related to increased rates of sexually transmitted diseases, unwanted pregnancies, rape and commercial sexual relationships, especially among drug abusers. Although psychotherapy is widely recommended for BPD, there has been little systematic research on the effect of these treatments with respect to co-morbid post-traumatic symptoms related to childhood sexual trauma.

CONCLUSIONS

Sexuality-related issues represent a major clinical topic within this population. Findings are discussed concerning their methodological limitations and clinical implications. Copyright © 2016 John Wiley & Sons, Ltd.

Relationships between risky sexual behaviour, dysexecutive problems, and mental health in the years following interdisciplinary TBI rehabilitation

Little is known about the long-term consequences of traumatic brain injury (TBI) regarding risky sexual behaviour. The objectives of the study were (1) to compare risky sexual behaviour in a sample of individuals with TBI having received interdisciplinary rehabilitation with that of healthy controls, and (2) to explore the relationships between risky sexual behaviour, executive functions, and mental health in individuals with TBI. The study group consisted of 42 individuals with TBI with a mean age of 37.9 years (SD = 9.7), 12.8 years of education (SD = 3.3), and 3.3 years post-injury (SD = 4.3). Healthy controls consisted of 47 participants, with a mean age of 37.6 years (SD = 10.7), and 13 years of education (SD = 3). Risky sexual behaviour was measured with the Sexual Risk Survey and executive function with the Dysexecutive Questionnaire. Mental health measures included the Generalised Anxiety Disorder Scale, and the Patient Health Questionnaire for depression. Compared to healthy controls, individuals with TBI reported more dysexecutive and mental health problems, without differences in risky sexual behaviour. In individuals with TBI, risky sexual behaviour was associated with behavioural, cognitive and emotional dysexecutive problems, but not with anxiety or depression. It was concluded that special attention should be given to individuals with TBI showing difficulties in executive functions given their association with risky sexual behaviour.

Unprotected Intercourse and One-Night Stands: Impact of Sexual Excitation, Sexual Inhibition, and Atypical Sexual Arousal Patterns on Risky Sexual Behaviors in Women

INTRODUCTION

Associations among sexual excitation, sexual inhibition, atypical sexual arousal patterns, and risky sexual behaviors have been reported in studies involving men and women. To date, longitudinal studies have not evaluated the predictive value of these propensities for future sexual behaviors in women.

AIM

To investigate associations among sexual excitation, sexual inhibition, atypical sexual arousal patterns, and potentially risky sexual behaviors in women.

METHODS

Overall, 2,214 women (mean age = 30.65 years, standard deviation = 9.91 years) participated in a baseline Web-based survey. The 1- and 2-year follow-up surveys included 396 and 382 participants, respectively. Correlational analyses and multiple linear regression analyses were conducted to analyze the relations between predictor and outcome variables.

MAIN OUTCOME MEASURES

Number of partners, number of one-time sexual encounters, and number of partners with whom no condoms were used during the 12-month periods before each of the three data assessment points.

RESULTS

All five lower-order factors of sexual excitation showed positive correlations and all three lower-order factors of sexual inhibition showed negative correlations with outcomes at baseline and follow-up. Atypical sexual arousal patterns, the tendency to become aroused in unusual sexual situations, and the importance of relationship factors, such as trust, for sexual arousal were the strongest predictors for sexual behaviors at baseline. These variables also predicted the number of sexual partners and the number of one-night stands at follow-up.

CONCLUSION

The findings suggest that increased sexual arousal when experiencing negative mood might be a risk factor for potentially health-threatening sexual decisions and support the assumptions of the dual control model that sexual excitation is positively and sexual inhibition is negatively predictive of risky sexual behavior in women.

The Relationship Between Hypersexual Behavior, Sexual Excitation, Sexual Inhibition, and Personality Traits

The term hypersexuality was introduced to describe excessive sexual behavior associated with a person's inability to control his or her sexual behavior. The main aim of the present study was to investigate the impact of different personality traits on the degree of hypersexual behavior as measured by the Hypersexual Behavior Inventory (HBI). A further aim was to evaluate the association between sexual inhibition and excitation [as described in the Dual Control Model (DCM)] and hypersexual behavior. A sample of 1,749 participants completed an internet-based survey comprised the HBI, the short form of the Sexual Inhibition/Sexual Excitation Scales (SIS/SES-SF) as well as more general personality measures: the Behavioral Inhibition System/Behavioral Activation System-scales (BIS/BAS-scales) and a short version of the Big Five Inventory (BFI-10). Using the recommended HBI cut-off, 6.0 % (n = 105) of the present sample could be categorized as hypersexual, which is comparable to the results of previous studies about the prevalence of hypersexual behavior in the general population. The results provided strong support for the components of the DCM-sexual excitation and inhibition-to explain hypersexual behavior, irrespective of gender and sexual orientation. Some of the general personality traits also showed significant relationships with hypersexual behavior. Taken together, the results of the present study provide further support for the relevance of research about the relationships between sexual problems and disorders, the DCM, and personality variables.

Racial-ethnic differences in sexual risk behaviors: The role of substance use

This research investigates the impact adolescent substance use has on adult sexual risk behaviors within racial-ethnic groups. Previous research has found support for this relationship, but often relies on concurrent measures of substance use and sexual risk behavior meaning that the causal direction of this relationship may be unclear. The data for this study come from the National Longitudinal Survey of Adolescent to Adult Health (Add Health), a nationally representative survey that followed respondents from adolescence in 1994 to adulthood in 2008. Results show that substance use correlates with sexual risk behavior, but the impact varies by race-ethnicity.

Use of the Internet and mobile-based "apps" for sex-seeking among men who have sex with men in New York City

The Internet continues to be a popular venue for men who have sex with men (MSM) to seek sexual partners. Increased sexual risk behavior has been linked to MSM who use the Internet to seek partners. However, there has been little research on how new mobile-based social networking applications ("apps") may affect sex-seeking and sexual risk behaviors of MSM. One hundred twenty-six MSM in New York City were recruited to complete an online survey on the use of the Internet and other technology for sex-seeking. The authors collected data on variables of interest including sexual sensation seeking, gay identity affirmation, internalized homophobia, Internet/app use, and sexual behavior with men met via the Internet and mobile apps. Results indicated that men who use both the Internet and mobile apps to seek partners were younger and reported higher incomes (p<.05) than men who used the Internet only. There were no significant differences between the groups with regard to race, sexual sensation seeking, gay identity affirmation, or internalized homophobia, indicating that the use of mobile-based apps for sex-seeking may be simply an example of evolving technologies. These findings may provide insight for the feasibility and planning of effective mobile app-based HIV/STI programs for MSM.

Sexual sensation seeking and Internet sex-seeking of Middle Eastern men who have sex with men

Despite recent evidence of stabilization in many developed nations, new human immunodeficiency virus (HIV) infections remain a public health concern globally. Efforts remain fragile in a number of world regions due to incomplete or inconsistent social policies concerning HIV, criminalization of same-sex encounters, social stigma, and religious doctrine. Middle Eastern men who have sex with men (MSM) remain one of the most hidden and stigmatized of all HIV risk groups. High-risk sexual bridging networks from these men to low prevalence populations (e.g., to spouse to offspring) are emerging HIV transmission pathways throughout the region. This cross-sectional, exploratory study investigated Sexual Sensation Seeking Scale (SSSS) scores to predict numbers of recent MSM sexual activities and to predict any recent unprotected receptive anal intercourse (URAI) activities in 86 Middle Eastern MSM who resided in the Middle East and who used the Internet to sex-seek. In a multivariate hierarchical regression, higher SSSS scores predicted higher numbers of recent MSM sexual activities (p = .028) and URAI (p = .022). In a logistic regression, higher SSSS scores increased the likelihood of engaging in URAI activities threefold (OR 3.0, 95 % CI 1.15-7.85, p = .025). Age and drug/alcohol use during sexual activities served as covariates in the regression models and were not significant in any analyses. Despite numerous hurdles, adopting Internet-based, non-restricted HIV education and prevention public health programs in the Middle East could instrumentally enhance efforts toward reducing the likelihood of new HIV transmissions in MSM and their sexual partners, ultimately contributing to an improved quality of life.

Heterosexual anal intercourse among men in Long Beach, California

Anal intercourse poses a greater risk for human immunodeficiency virus (HIV) transmission than vaginal intercourse, and in recent years there has been a growing understanding that heterosexual anal intercourse (HAI) is not uncommon. However, the majority of the anal intercourse literature has focused on men who have sex with men. The little research on HAI has mostly looked at women, with limited work among men. This analysis examined the association between HAI and high-risk behaviors (N = 1,622) and sexual sensation seeking (N = 239) in a sample of men recruited from 2001 to 2012 in Long Beach, California. Almost half of the sample was non-Hispanic Black. The median age was 42 years, 42% were homeless, and 20% reported recent HAI. Men who reported HAI were likely to be Hispanic, were likely to be homeless, had a male partner, engaged in sex exchange, and used cocaine or amphetamines during sex. Men who reported HAI scored higher on the Sexual Sensation Seeking scale. This research supports other work showing the relationship between HAI and high-risk behaviors. More important, it contributes new knowledge by demonstrating the association between HAI and sexual sensation seeking. This research highlights the importance of personality traits when trying to understand sexual behavior and when developing HIV prevention interventions.

Sensation seeking in major depressive patients: relationship to sub-threshold bipolarity and cyclothymic temperament

BACKGROUND

High levels of sensation seeking (SS) have been traditionally reported for lifetime bipolar disorder (BD) and/or substance use disorder (SUD) rather than major depressive disorder (MDD). Nonetheless, a renewed clinical attention toward the burden of sub-threshold bipolarity in MDD, solicits for a better assessment of "unipolar" major depressive episodes (MDEs) via characterization of putative differential psychopathological patterns, including SS and predominant affective temperament.

METHODS

Two hundred and eighty currently depressed cases of MDD and 87 healthy controls were screened using the Zuckerman's sensation seeking scale-Form-V, the Hypomania Check List-32-item (HCL-32), the Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire-110-item, the Barratt Impulsivity Scale-11-item, the State-Trait Anxiety Inventory modules and the Structured Clinical Interview for DSM-IV axis-I disorders. Cases were divided into HCL-32(+)(sub-threshold bipolar)/HCL-32(-)("true" unipolar depressed) depending on the HCL-32 total score.

RESULTS

Upon correlation and multivariate regression analyses, the HCL-32(+) patients showed the highest levels of SS, higher prevalence of cyclothymic temperament, and higher rates of multiple lifetime axis-I co-morbidities, including SUD.

LIMITS

Recall bias on some diagnoses, including BD, grossly matched healthy control group, lack of ad-hoc validated measures for ADHD, SUD, or axis-II disorders.

CONCLUSIONS

In our sample, the occurrence of higher levels of SS in "sub-threshold" bipolar cases outlined a differential psychopathological profile compared to DSM-defined "true unipolar" cases of MDE. If confirmed by replication studies, these findings may aid clinicians in delivering a more accurate diagnosis and a safer use of antidepressants in some MDD cases.

Prevalence of HIV, syphilis, HCV and their high risk behaviors among migrant workers in eastern China

Objective

The goal of this study was to understand the knowledge about AIDS, identify the correlates and determine the prevalence of HIV infection, syphilis, HCV among migrant workers in Zhejiang, China.

Methods

A cross-sectional study using face-to-face anonymous questionnaire interviews was conducted and blood samples were collected for HIV, syphilis and Hepatitis C infection screening.

Results

17,377 (92.8%) of 18,730 migrant workers approached were interviewed. Among 17,377 participants, the HIV/AIDS knowledge rate was 66.2%. A total of 12,694 (73%) of the participants reported having ever had sexual intercourse, with 30.1% of single participants reporting having had sexual intercourse. Among those respondents with sexual experiences, 7.5% admitted they had two or more sexual partners and 4.9% reported having had sex with casual (unpaid) partners in the previous 12 months, whilst 3.7% had paid for sex. More than half of those who had paid for sex (59.4%) had not used a condom every time in their sexual acts with the sex workers. Multiple logistic regression analysis indicated that high risk sexual behavior (defined as sex with a casual or commercial sex partner without using a condom consistently) was associated with being divorced or widowed (P<0.05 for single); male gender; shorter duration of stay in Zhejiang; working in factory, market or domestic service (P<0.05 for odd job); having a province of origin inside Zhejiang; and drug use. The prevalence of HIV and HCV infections were 0.02% (95% CI: 0.01%–0.06%) and 0.40% (95%CI: 0.31%–0.51%), respectively. The prevalence of syphilis among those who were sexually active was 0.55% (95% CI: 0.43%–0.70%). Risk factors for syphilis included shorter duration of stay in Zhejiang, ethnic minority status, being divorced or widowed and having had multiple sex partners.

Conclusions

Much greater efforts are needed to promote safer sex, and programs for the control of syphilis need to be tailored for migrant workers in China.