1
|
Wang B, Peng X, Fu L, Lu Z, Li X, Tian T, Xiao X, Zhang W, Guo Z, Ouyang L, Wang Y, Yu M, Wu G, Wu D, Tang W, Tucker JD, Cai Y, Zou H. Sexual function and correlates among adults aged 50+ years in China: Findings from the sexual well-being (SWELL) study. J Am Geriatr Soc 2024; 72:1122-1135. [PMID: 38319006 DOI: 10.1111/jgs.18789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/02/2024] [Accepted: 01/07/2024] [Indexed: 02/07/2024]
Abstract
BACKGROUND Sexual function is an important yet understudied aspect of overall health and well-being in older adults. We aimed to examine sexual function and its correlates among people 50 years and older in China. METHODS We enrolled people aged 50 years and older recruited from four regions in China between September 2021 and July 2022 in a multicenter cross-sectional study. Data were collected through an investigator-administered questionnaire about demographic characteristics, health characteristics, and sexual function status. Logistic regression was used to assess correlates of lower sexual function (the highest quintile of the sex-specific population distribution of Natsal-SF scores [i.e., lower functioning compared with the remaining]). RESULTS A total of 465 women and 832 men who were sexually active in the past year were included in the analysis (mean age: 60.4 ± 7.2) [Correction added after first online publication on 12 Feb 2024. The word "years" has been changed to "year" in this sentence.]. Over a quarter of all participants were dissatisfied with their sex life. Notably, 92 women and 167 men were categorized as having a lower sexual function. Age (in men only), living in urban areas, general health status, being underweight or overweight (in men only), and having depressive symptoms were associated with lower sexual function. Among all participants, 43.1% of men and 54.0% of women experienced sexual response problems lasting 3 months or more. Less than one-third of all participants had sought help or advice for sex life in the past year. CONCLUSIONS Sexual dysfunction and sexual dissatisfaction are prevalent among older adults in China and are associated with self-assessed poor health. More efforts are needed to better understand sexual health needs and tailor service provision.
Collapse
Affiliation(s)
- Bingyi Wang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xin Peng
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Leiwen Fu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhen Lu
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xinyi Li
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Tian Tian
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Xin Xiao
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
- Department of Scientific Research, The People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Weijie Zhang
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Zhihui Guo
- School of Public Health (Shenzhen), Sun Yat-Sen University, Shenzhen, China
| | - Lin Ouyang
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Ying Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Maohe Yu
- Department of AIDS/STD Control and Prevention, Tianjin Center for Disease Control and Prevention, Tianjin, China
| | - Guohui Wu
- Department of AIDS/STD Control and Prevention, Chongqing Center for Disease Control and Prevention, Chongqing, China
| | - Dan Wu
- Department of Social Medicine and Health Education, School of Public Health, Nanjing Medical University, Nanjing, China
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China
- Dermatology Hospital, Southern Medical University, Guangzhou, China
| | - Joseph D Tucker
- Clinical Research Department, London School of Hygiene & Tropical Medicine, London, UK
- University of North Carolina Project-China, Guangzhou, China
| | - Yong Cai
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huachun Zou
- School of Public Health, Fudan University, Shanghai, China
- School of Public Health, Southwest Medical University, Luzhou, China
- Kirby Institute, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
2
|
Dugal C, Brassard A, Kusion PY, Lefebvre AA, Péloquin K, Godbout N. Romantic Attachment, Sex Motives and Sexual Difficulties in Emerging Adults: The Role of Childhood Interpersonal Victimization. JOURNAL OF SEX RESEARCH 2024; 61:359-373. [PMID: 36378882 DOI: 10.1080/00224499.2022.2141676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
A growing body of research has revealed that many emerging adults (i.e., aged 18 to 25) experience sexual difficulties. Past studies have emphasized the need to examine sexual difficulties by accounting for sex motives (i.e., reasons for engaging in sex) and by using a trauma-focused or attachment-based framework. This study examined the role of sex motives in the associations among attachment insecurities (anxiety, avoidance) and sexual difficulties in emerging adults, and assessed whether these links varied on the basis of low or high exposure to childhood interpersonal victimization (CIV) (i.e., 0-3 different types of CIV or 4 or more types of CIV). A sample of 437 French-Canadian emerging adults completed validated questionnaires online. Path analyses revealed that participants with higher attachment anxiety were more likely to endorse the partner approval sex motive, which was related to more sexual difficulties. Participants with higher attachment avoidance were less likely to endorse the pleasure sex motive, which was associated with more sexual difficulties. Results indicated a significant effect of CIV showing that some indirect effects were significant only in participants who reported high CIV exposure. Results suggest that addressing sex motives using an attachment- and trauma-focused framework might help understand, prevent and treat sexual difficulties among emerging adults.
Collapse
Affiliation(s)
- Caroline Dugal
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Audrey Brassard
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Pierre-Yves Kusion
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Audrey-Ann Lefebvre
- Département de Psychologie, Université de Sherbrooke, Sherbrooke, Québec, Canada
| | - Katherine Péloquin
- Département de Psychologie, Université de Montréal, Montréal, Québec, Canada
| | - Natacha Godbout
- Département de Sexologie, Université du Québec à Montréal, Montréal, Québec, Canada
| |
Collapse
|
3
|
Dion J, Hébert M, Sadikaj G, Girouard A, Godbout N, Martin-Storey A, Blais M, Bergeron S. Dating Violence Trajectories in Adolescence: How Do They Relate to Sexual Outcomes in Canada? ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2749-2765. [PMID: 37341862 DOI: 10.1007/s10508-023-02625-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/31/2023] [Accepted: 05/15/2023] [Indexed: 06/22/2023]
Abstract
Dating violence during adolescence is a major public health issue: it is highly prevalent and extensive research has documented its physical and psychological consequences, yet very little has focused on its sexual consequences. The present study investigated the longitudinal associations between dating violence victimization (psychological, sexual or physical) and sexual well-being (sexual satisfaction and sexual distress) among 1442 sexually active adolescents aged between 14 and 17 years who completed at least one of three data waves (51.1% girls; 45.7% boys; 0.3% non-binary; 3.0% varying gender identity). The study also examined whether these associations differed by gender identity and sexual minority status. Adolescents completed online questionnaires on electronic tablets during class. The results indicated that psychological, physical (except for boys), and sexual dating violence victimization were all associated with lower sexual satisfaction and greater sexual distress over time. Moreover, the between-level associations between dating violence and poorer sexual outcomes were stronger among girls and gender varying adolescents than among boys. The within-level association between physical dating violence and sexual satisfaction was significant among adolescents with a nonvarying sexual minority status, but not among those with a nonvarying heterosexual status or that varied in sexual minority status. Findings offer cues for dating violence prevention and intervention programs by suggesting the need to examine sexual well-being over time.
Collapse
Affiliation(s)
- Jacinthe Dion
- Département des Sciences de la Santé, Université du Québec à Chicoutimi, Chicoutimi, 555, Boul. de l'Université, Saguenay, QC, G7H 2B1, Canada.
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada.
| | - Martine Hébert
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Gentiana Sadikaj
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Alice Girouard
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| | - Natacha Godbout
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Alexa Martin-Storey
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychoeducation, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Martin Blais
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Sexology, Université du Québec à Montréal, Montréal, QC, Canada
| | - Sophie Bergeron
- Interdisciplinary Research Center on Intimate Relationship Problems and Sexual Abuse, Montreal, QC, Canada
- Department of Psychology, Université de Montréal, Montréal, QC, Canada
| |
Collapse
|
4
|
Hamzehgardeshi Z, Sabetghadam S, Pourasghar M, Khani S, Moosazadeh M, Malary M. Prevalence and predictors of sexual distress in married reproductive-age women: A cross-sectional study from Iran. Health Sci Rep 2023; 6:e1513. [PMID: 37655267 PMCID: PMC10468024 DOI: 10.1002/hsr2.1513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 04/12/2023] [Accepted: 08/09/2023] [Indexed: 09/02/2023] Open
Abstract
Background and Aim Although various surveys have been conducted for sexual problems, there is a lack of population-based studies on sexual distress in Iran. Thus, we sought to determine the prevalence and predictive factors of sexual distress in this population. Methods Overall, 1000 married women aged 16-49 years were enrolled in this study using the two-stage cluster sampling method. To identify sexual distress, the female sexual distress scale-revised (FSDS-R) was completed. The predictive factors were assessed using a checklist. Results A total of 318 women (31.8%) suffered from sexual distress. Among socio-demographic factors, satisfaction with marriage (p = 0.001), among personal factors history of infertility and fear of contracting sexually transmitted infections (p < 0.01), and among sexual and interpersonal factors satisfaction with the level of sexual desire (p = 0.01), pain during sexual intercourse (p < 0.01), premature ejaculation disorders in the partner (p < 0.05), and sexual satisfaction (p < 0.001) were significantly associated with sexual distress. Conclusion Clinicians should evaluate sexual distress comprehensively and consider all the related dimensions. The high overall prevalence of sexual distress, with or without an identifiable dysfunction, signals the importance of health professionals being adequately prepared to discuss sexual health concerns.
Collapse
Affiliation(s)
- Zeinab Hamzehgardeshi
- Sexual and Reproductive Health Research CenterMazandaran University of Medical SciencesSariIran
- Department of Reproductive Health and MidwiferyMazandaran University of Medical SciencesSariIran
| | - Shadi Sabetghadam
- School of Nursing and MidwiferyGuilan University of Medical SciencesRashtIran
- Reproductive Health Research CenterGuilan University of Medical SciencesRashtIran
| | - Mehdi Pourasghar
- Department of Psychiatry, Psychiatry and Behavioral Sciences Research Center, Addiction InstituteMazandaran University of Medical SciencesSariIran
| | - Soghra Khani
- Sexual and Reproductive Health Research CenterMazandaran University of Medical SciencesSariIran
- Department of Reproductive Health and MidwiferyMazandaran University of Medical SciencesSariIran
- Research Center of DiabetesMazandaran University of Medical SciencesSariIran
| | - Mahmood Moosazadeh
- Gastrointestinal Cancer Research Center, Non‐communicable Diseases InstituteMazandaran University of Medical SciencesSariIran
- Health Sciences Research CenterMazandaran University of Medical SciencesSariIran
| | - Mina Malary
- School of Nursing and MidwiferyShahroud University of Medical SciencesShahroudIran
| |
Collapse
|
5
|
Negri M, de Souza E, Torloni MR, Ribeiro MC, Araujo E, Guazzelli CAF. Sexual function in Brazilian female adolescents and young adults: a cross-sectional study. Rev Assoc Med Bras (1992) 2022; 68:1210-1215. [PMID: 36228252 PMCID: PMC9575009 DOI: 10.1590/1806-9282.20220232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/23/2022] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE The aim of this study was to investigate and compare the sexual function of Brazilian adolescents and young women who were using popular contraceptive methods. METHODS This cross-sectional study took place in 2012-2014 in a free family planning clinic of a tertiary teaching hospital in Brazil. Participants were female adolescents (10-19 years) and young adults (20-24 years) who were using barrier (condom) or hormonal contraceptive methods. The Female Sexual Function Index questionnaire was used to assess the sexual function in the last 4 weeks. RESULTS A total of 199 women (128 adolescents and 71 young adults) were included. There were no significant differences in the mean total Female Sexual Function Index scores of adolescents and young adults (26.6±5.7 versus 27.6±6.2, respectively, p=0.264). Compared to young adults, adolescents had significantly lower mean scores for orgasm (3.9±1.5 versus 4.4±1.4, p=0.020) and dyspareunia (4.4±1.6 versus 5.2±1.5, p=0.001; lower scores indicate more dyspareunia). There were no significant differences in the proportion of adolescents versus adults classified as being at risk for sexual dysfunction (38.3 versus 42.3%, p=0.651) or at risk of low desire (18.0 versus 21.1%, p=0.579). CONCLUSION Nearly 40% of Brazilian female adolescents and young adults are at risk for sexual dysfunctional symptoms and 19% have low desire, without significant differences between the two age groups.
Collapse
Affiliation(s)
- Mariana Negri
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | - Eduardo de Souza
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | - Maria Regina Torloni
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Internal Medicine – São Paulo (SP), Brazil
| | - Meireluci Costa Ribeiro
- Centro Universitário Salesiano de São Paulo, Postgraduate Program in Sex Therapy – São Paulo (SP), Brazil
| | - Edward Araujo
- Universidade Federal de São Paulo, Paulista School of Medicine, Department of Obstetrics – São Paulo (SP), Brazil
| | | |
Collapse
|
6
|
O'Sullivan LF, Byers ES, Dawson SJ. Individual and Relationship Predictors of Trajectories of Sexual Function across Adolescent and Young Adult Relationships. JOURNAL OF SEX RESEARCH 2022; 59:53-68. [PMID: 34275394 DOI: 10.1080/00224499.2021.1948497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Many young adults report poor sexual function, but research typically fails to consider relationship context and how problems might evolve over time. Research is needed to provide insights into how sexual problems are experienced across relationships, as well as the types of sexual function problems associated with various trajectories. We investigated retrospective trajectories of sexual problems across the multiple relationships of 688 young adults (18-24 years) as well as the individual and relationship factors associated with these trajectories. Both persistent suboptimal and optimal trajectories emerged for men and women. However, persistent and variable problematic function trajectories also emerged for women (and not men). Across all individual and relationship factors analyzed, multivariate multinomial regression analysis indicated that higher sexual esteem and more traditional gender beliefs best predicted membership in trajectories capturing better sexual function. Implications are discussed in terms of the need to provide substantive information regarding sexual function to young people as they transition to adulthood.
Collapse
|
7
|
Estrada LL. Clinical Considerations of the Evangelical Purity Movement's Impact on Female Sexuality. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:121-132. [PMID: 34556007 DOI: 10.1080/0092623x.2021.1977445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Evangelical Protestant Christianity is the most prevalent religion in America, with women being the dominant practitioners. The Evangelical Purity Movement that gained prominence in the 1990s sought to provide moral and religious based sexual education through private and public policies to both Christian and non-religious youth. This movement directly stressed the concept of abstinence-only until marriage education, while covertly spreading sexual scripts promoting sexual double standards, the mind-body split, female objectification, and sexual shame. The needs and concerns of women raised in this subculture are identified and explored for clinicians unfamiliar with their context. Although the intent of this movement claims to provide moral structure, research related to the main objectives reveal that they also created a negative effect on females that result in physical, emotional, and sexual dysfunction and dissatisfaction. This article provides context and articulates these concerns while calling for a significant increase in research to provide more resources for counselors and clients alike.
Collapse
|
8
|
Bullying Victimization and Sexual Wellbeing in Sexually Active Heterosexual, Cisgender and Sexual/Gender Minority Adolescents: The Mediating Role of Emotion Regulation. J Youth Adolesc 2021; 50:2136-2150. [PMID: 34228262 DOI: 10.1007/s10964-021-01471-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/22/2021] [Indexed: 12/28/2022]
Abstract
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 (Mage = 14.6 years, SDage = 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.
Collapse
|
9
|
Irfan M, Hussain NHN, Noor NM, Mohamed M, Sidi H, Ismail SB. Epidemiology of Male Sexual Dysfunction in Asian and European Regions: A Systematic Review. Am J Mens Health 2021; 14:1557988320937200. [PMID: 32623948 PMCID: PMC7338652 DOI: 10.1177/1557988320937200] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Male sexual dysfunctions (MSDs) often remain undiagnosed and untreated in Asia
compared to Europe due to conservative cultural and religious beliefs,
socioeconomic conditions, and lack of awareness. There is a tendency for the use
of traditional medicines and noncompliance with and reduced access to modern
healthcare. The present systematic review compared the incidence and factors of
MSD in European and Asian populations. English language
population/community-based original articles on MSDs published in MEDLINE from
2008 to 2018 were retrieved. A total of 5392 studies were retrieved, of which 50
(25 Asian and 25 European) were finally included in this review. The prevalence
of erectile dysfunction (ED) (0%–95.0% vs. 0.9%–88.8%), low satisfaction
(3.2%–37.6% vs. 4.1%–28.3%), and hypoactive sexual desire disorder (HSDD)
(0.7%–81.4 vs. 0%–65.5%) was higher in Asian than in European men, whereas the
prevalence of anorgasmia (0.4% vs. 3%–65%) was lower in Asian than in European
men. Age was an independent positive factor of MSD. In European men over 60
years old, the prevalence of premature ejaculation (PE) decreased. The
prevalence of MSD was higher in questionnaires than in interviews. The
significant factors were age, single status, low socioeconomic status, poor
general health, less physical activity, cardiovascular diseases, diabetes,
obesity, lower urinary tract symptoms, prostatitis, anxiety, depression and
alcohol, tobacco, and drug use. The prevalence of MSD differed slightly in Asian
and European men. There is a need to conduct large studies on the various Asian
populations for the effective management of MSD.
Collapse
Affiliation(s)
- Muhammad Irfan
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia.,Department of Zoology, Pir Mehr Ali Shah Arid Agriculture University, Rawalpindi, Pakistan
| | - Nik Hazlina Nik Hussain
- Women's Health Development Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Norhayati Mohd Noor
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Mahaneem Mohamed
- Department of Physiology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Hatta Sidi
- Department of Psychiatry, Faculty of Medicine, The National University of Malaysia, Kuala Lumpur, Malaysia
| | - Shaiful Bahari Ismail
- Department of Family Medicine, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| |
Collapse
|
10
|
Flesia L, Cavalieri F, Angelini S, Bottesi G, Ghisi M, Tonon E, Roldan AP, Di Nisio A, Garolla A, Ferlin A, Foresta C. Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study. Sex Med 2020; 8:361-369. [PMID: 32389594 PMCID: PMC7471067 DOI: 10.1016/j.esxm.2020.03.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 03/05/2020] [Accepted: 03/24/2020] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Young adult males are more likely to demonstrate health-risk behaviors than other individuals. The use of specific data about health-risk behaviors within this population might be important to promote effective preventive psychosocial and educational programs and interventions. AIM To provide a detailed description of health-related lifestyles, substance-related behaviors, and sexual habits that can negatively affect fertility, sexual sphere, and health in a large sample of Italian young adult males. METHODS A sample comprising 2,170 males aged 18-21 years, attending the last year of high school, was administered an online questionnaire made up of 39 multiple-choice questions. The questionnaire explored health-related lifestyles, substance-related behaviors, and sexuality and sexual habits. Descriptive analyses were conducted. MAIN OUTCOME MEASURE The outcome measures included data about health-related lifestyles, substance-related behaviors, and sexuality and sexual habits reported by Italian young adult males. RESULTS Health-related lifestyles: 92.9% of the sample reported practicing some physical activity during the week. 90.3% declared a Mediterranean diet and 8.1% a hyperproteic diet. Substance-related behaviors: 33.8% of the sample reported having smoked tobacco at least once in their lives; among them, 71% reported current daily smoking. 40.2% declared drinking alcohol from 5 to 7 days in a week. 32.9% of the sample reported currently using a substance. Sexuality and sexual habits: 97.1% of the sample self-defined themselves as heterosexual. 73.3% of participants rated their knowledge about sexuality as "excellent/good," 58.7% about sexually transmitted infections. Only 4.8% reported having had a seminal liquid examination. Half of the sample (52.2%) declared having had sexual intercourses, in the largest proportion protected sex. 14.7% of the sample reported having at least one sexual dysfunction. 88.6% of participants reported having used pornography, 18.7% every day. CONCLUSION The present study highlighted the need to empower the number and efficacy of preventive interventions to promote health-related behaviors among Italian young male population. Flesia L, Cavalieri F, Angelini S, et al. Health-Related Lifestyles, Substance-Related Behaviors, and Sexual Habits Among Italian Young Adult Males: An Epidemiologic Study. Sex Med 2020;8:361-369.
Collapse
Affiliation(s)
- Luca Flesia
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy.
| | - Francesca Cavalieri
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Stefano Angelini
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Gioia Bottesi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Marta Ghisi
- Department of General Psychology, University of Padova, Padova, Italy
| | - Enrico Tonon
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Agustina Perez Roldan
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | | | - Andrea Garolla
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| | - Alberto Ferlin
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Carlo Foresta
- Unit of Andrology and Reproductive Medicine, Department of Medicine, University of Padova, Padova, Italy
| |
Collapse
|
11
|
Shearn K, Piercy H, Allmark P, Hirst J. Clarity, conviction and coherence supports buy-in to positive youth sexual health services: focused results from a realist evaluation. BMC Health Serv Res 2019; 19:503. [PMID: 31324158 PMCID: PMC6642563 DOI: 10.1186/s12913-019-4298-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/24/2019] [Indexed: 11/10/2022] Open
Abstract
Background There is a call for sexual health services to support young people achieve sexual wellbeing in addition to treating or preventing sexual ill-health. Progress towards realising this ambition is limited. This study aimed to contribute theory and evidence explaining key processes to support local delivery of positive youth sexual health services. Methods A realist evaluation was conducted, comprising four research cycles, with a total of 161 data sources, primarily from the UK. Theory was refined iteratively using existing substantive theories, secondary and primary research data (including interviews, documentary analysis, feedback workshops and a literature search of secondary case studies). A novel explanatory framework for articulating the theories was utilised. Results The results focused on local level buy-in to positive services. Positive services were initiated when influential teams had clarity that positive services should acknowledge youth sexuality, support young people’s holistic sexual wellbeing and involve users in design and delivery of services, and conviction that this was the best or right way to proceed. How positive services were operationalised differed according to whether the emphasis was placed on meeting service objectives or supporting young people to flourish. Teams were able to effect change in local services by improving coherence between a positive approach and existing processes and practices. For example, that a) users were involved in decision making, b) multi-disciplinary professional working was genuinely integrated, and c) evidence of positive services’ impact was gathered from a breadth of sources. New services were fragile. Progress was frequently stymied due to a lack of shared understanding and limited compatibility between characteristics of a positive approach and the wider cultural and structural systems including medical hegemony and narrow accountability frameworks. These challenges were exacerbated by funding cuts. Conclusions This study offers clarity on how positive youth sexual health services may be defined. It also articulates theory explaining how dissonance, at various levels, between positive models of sexual health service delivery and established cultural and structural systems may restrict their successful inception. Future policy and practice initiatives should be theoretically informed and address barriers at societal, organisational and interpersonal levels to stimulate change. Electronic supplementary material The online version of this article (10.1186/s12913-019-4298-4) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Katie Shearn
- Department of Nursing and Midwifery, Faculty of Health and Wellbeing, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield, S10 2BA, England.
| | - Hilary Piercy
- Department of Nursing and Midwifery, Faculty of Health and Wellbeing, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield, S10 2BA, England
| | - Peter Allmark
- Department of Nursing and Midwifery, Faculty of Health and Wellbeing, Sheffield Hallam University, 32 Collegiate Crescent, Sheffield, S10 2BA, England
| | - Julia Hirst
- Department of Psychology, Sociology & Politics, Sheffield Hallam University, HC 2.03a, Heart of the Campus Building, Collegiate Crescent Campus, Sheffield, S10 2BQ, England
| |
Collapse
|
12
|
Byers ES, O’Sullivan LF, Hughes K. Sexual functioning of late adolescents and young adults in relationships: association with individual characteristics and relationship factors. SEXUAL AND RELATIONSHIP THERAPY 2019. [DOI: 10.1080/14681994.2019.1626982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- E. Sandra Byers
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Lucia F. O’Sullivan
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Kathleen Hughes
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| |
Collapse
|
13
|
O'Sullivan LF, Majerovich JA, Wuest J. From Promoting Healthy Sexual Functioning to Managing Biomedical Sexual Dysfunction: Health Professional Views of Youth Sexual Health. SAGE Open Nurs 2019; 5:2377960819832676. [PMID: 33415225 PMCID: PMC7774441 DOI: 10.1177/2377960819832676] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 01/15/2019] [Accepted: 01/25/2019] [Indexed: 01/23/2023] Open
Abstract
A body of work emerging in the last few years has expanded the focus of youth
sexual health to include problems in sexual functioning. Recent surveys show
that rates of youth sexual functioning problems are similar to those of adults.
Physicians' lack of awareness about problems of sexual functioning has been
identified as a major obstacle in treatment. Yet little is known about
health-care provider (HCP) perspectives on youth sexual functioning. We
conducted a descriptive qualitative study with HCPs to learn about their
perceptions of adolescent sexual problems and HCP roles in managing these issues
including sexual functioning. Nineteen HCPs: Family physicians, nurse
practitioners, and public health nurses working primarily with youth in
universities, schools, or sexual health clinics were recruited to draw on their
expert knowledge and experience. All completed in-depth individual interviews.
Data were analyzed using directed qualitative content analysis. Our findings
illuminate inconsistent views. Some HCPs, particularly those in youth-focused
services, adopt a holistic role in promoting healthy sexual functioning, and
others, commonly those in general practice, attend only to biomedical issues
related to sexual dysfunction. All HCPs in our study were challenged by a
paucity of sexual health preparation in their formal education. HCP interest in
youth sexual health affected their efforts to acquire new information and
training and, along with the structure of their practice setting, influenced
whether they framed their role in youth sexual health holistically within a
context of social determination or constrained their role to a medical model.
These findings draw attention to the need for new approaches for strengthening
knowledge, training, and resources to foster HCP promotion of healthy sexual
functioning and prevention of lifelong sexual health problems.
Collapse
Affiliation(s)
- Lucia F O'Sullivan
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Judith Wuest
- Faculty of Nursing, University of New Brunswick, Fredericton, New Brunswick, Canada
| |
Collapse
|
14
|
Naeij E, Khani S, Firouzi A, Moosazadeh M, Mohammadzadeh F. The effect of a midwife-based counseling education program on sexual function in postmenopausal women: a randomized controlled clinical trial. Menopause 2019; 26:520-530. [PMID: 30531440 DOI: 10.1097/gme.0000000000001270] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The present study was conducted to investigate the effect of a midwife-based counseling education program on sexual function in postmenopausal women. METHODS A randomized clinical trial was conducted on 52 eligible postmenopausal women. Participants' sexual function was assessed using the Female Sexual Function Index (FSFI). The women were randomly allocated into two groups: (1) the intervention group, in which the participants received a midwife-based counseling education program in 4 sessions held at 10-day intervals, with each session lasting for 70 minutes; (2) the control group, in which the participants only received routine care. Data were collected 1 week before the start of the sessions, 2 weeks after the end of the sessions, and 2 months after the last follow-up. RESULTS No statistically significant differences were reported between the groups in terms of personal and sociodemographic characteristics and sexual function before the intervention; the total FSFI score was 17.05 (±4.54) in the intervention group and 16.66 (±3.62) in the control group. After the program, in the first and second follow-ups, the scores reached 27.18 (±4.61) and 28.20 (±4.43) in the intervention group and 16.06 (±3.94) and 16.32 (±2.98) in the control group. Significant improvements were observed in the total score of sexual function and all the FSFI domains in the intervention group, but not in the control group (P < 0.001). CONCLUSION Midwife-based counseling education can be an appropriate approach to improving sexual function in postmenopausal women.
Collapse
Affiliation(s)
- Ehtram Naeij
- Student Research Committee, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Science, Sari, Iran
| | - Soghra Khani
- Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Diabetes Research Center, Nasibeh Nursing and Midwifery Faculty, Mazandaran University of Medical Sciences, Sari, Iran
| | - Armin Firouzi
- Member of Sexual and Reproductive Health Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Farnaz Mohammadzadeh
- Department of Reproductive Health, Student Research Committee, School of Nursing & Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
15
|
O'Sullivan LF, Wuest J, Byers ES. Figuring It Out: How Late Adolescent and Young Adult Men and Women Perceive and Address Problems in Sexual Functioning. JOURNAL OF SEX RESEARCH 2019; 56:327-336. [PMID: 29333876 DOI: 10.1080/00224499.2017.1416451] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Although there are high rates of sexual problems and sexual dysfunction in adulthood (Mitchell et al., 2013), little is known about the circumstances under which problems are first experienced. A growing body of research addresses prevalence of problems in sexual functioning among adolescents and young adults, yet little is known about the meanings that young people give to these experiences or how they deal with them. We used content analysis of qualitative interviews with 53 heterosexual, sexually active Canadian adolescents (ages 18 to 21) to explore their perceptions of the sexual problems in functioning they had experienced and the strategies (if any) they used to address them over time. Problems among most young people originated early in their partnered sexual life. Figuring it out emerged as an intentional process directed toward improving sexual experiences, although certainly not all young people were successful. Strategies for figuring it out included informational or material help seeking, experimentation to inform future actions, mutual sharing and problem solving, and building emotional connection to improve sexual functioning. Implications for understanding the development of sexual dysfunctions in adulthood are discussed.
Collapse
Affiliation(s)
| | - Judith Wuest
- b Faculty of Nursing, University of New Brunswick
| | | |
Collapse
|
16
|
Lo SST, Kok WM. Prevalence and Risk Factors for Sexual Problems and Distress in Chinese Unmarried Young Women: An Observational Study. J Sex Med 2018; 15:1620-1628. [PMID: 30415814 DOI: 10.1016/j.jsxm.2018.09.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 09/12/2018] [Accepted: 09/14/2018] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Research conducted in the West has shown that sexual function and distress was common in white women from younger to older adulthood; however, little research attention to date has been given to Chinese young women. AIM Our primary aim is to assess the prevalence and factors associated with sexual problems and distress in Chinese unmarried young women. METHODS Between November 2015 and June 2017, 431 young women who visited 3 sexual health clinics completed an anonymous questionnaire detailing their demographics, sexual behavior, current sexual relationship, sexual function, and sexual distress. Descriptive bivariate analysis and logistic regression analyses were performed. MAIN OUTCOME MEASURES Sexual function and distress were assessed by the Female Sexual Function Index (FSFI) and Female Sexual Distress Scale-Revised (FSDS-R), respectively. RESULTS Overall, 76 young women (17.6%) obtained total FSFI score ≤23.45 (Chinese cut-off), 47 of whom scored 11 or above for FSDS-R. Individual domain and total FSFI scores were significantly correlated with FSDS-R score (P < .001). Based on domain scores, 35.5%, 18.8%, 12.8%, and 10.7% of them were at risk for orgasmic, pain, arousal, and desire problems, respectively. Arousal and lubrication problems were strongly associated with distress. Sexual problems were associated with not initiating sex (odds ratio [OR] 2.50, P = .001), often had sexual fantasy (OR 0.55, P = .036), and willingness for vaginal sex (OR 0.49, P < .001). Sexual distress was associated with having life stressors (OR 1.88, P = .012) and willingness for vaginal sex (OR 0.61, P = .003). Self-perception of body being unattractive to boyfriend (OR 3.33, P = .015), not initiating sex (OR 3.21, P = .001), willingness for vaginal sex (OR 0.39, P < .001), and no life stressors (OR 0.46, P = .036) were associated with both sexual problem and distress. CLINICAL IMPLICATIONS Physicians should be alerted to sexual problems in young women and encourage those with distress to seek help. STRENGTHS & LIMITATIONS Using validated psychometric tools to assess sexual problems and distress provides reference for future comparison. Admission and recall biases are unavoidable in observational questionnaire study. Depression was not evaluated and might bias the estimation of distress. CONCLUSION About 11% of Chinese young women had sexual problems and were distressed (ie, sexual dysfunction). They were characterized by having a self-perception that their body was unattractive to their boyfriend, not initiating sex, unwilling for vaginal sex, and having life stressors. Lo SS-T, Kok W-m. Prevalence and Risk Factors for Sexual Problems and Distress in Chinese Unmarried Young Women: An Observational Study. J Sex Med 2018;15:1620-1628.
Collapse
Affiliation(s)
| | - Wai-Ming Kok
- Family Planning Association of Hong Kong, Hong Kong SAR, China
| |
Collapse
|
17
|
Vik A, Brekke M. Do patients consult their GP for sexual concerns? A cross sectional explorative study. Scand J Prim Health Care 2017; 35:373-378. [PMID: 29105541 PMCID: PMC5730036 DOI: 10.1080/02813432.2017.1398934] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 10/23/2017] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To explore how often general practitioners (GPs) deal with patients' sexual concerns, what kind of concerns are brought up and how the GPs deal with them. DESIGN Cross sectional observational study. SETTING/SUBJECTS 22 GPs in Southern Norway. MAIN OUTCOME MEASURES The percentage of consultations dealing with sexual concerns during three consecutive working days, as registered by the GPs on a questionnaire. RESULTS Out of 1 117 consultations, 47 (4.2%) dealt with sexual concerns, varying from 1.6 to 10.9% of consultations. The concerns brought up varied widely, with erectile dysfunction and pain related to sexual activity in females as the largest groups. Concerns regarding sexual orientation, preferences or behavior were also dealt with, as were problems due to sexual assaults or rape. In 36 (76.6%) of the consultations, discussion of the problem and/or advice was the only action. Medication was prescribed in one third of the consultations. Patients' mean age was 46.7 years, with a span from 17 up to 75 years and 60% were female. We found no associations between GP characteristics and how frequently they dealt with sexual concerns. CONCLUSIONS In around 4% of consultations, the GPs dealt with a wide variety of sexual concerns.
Collapse
Affiliation(s)
- Audun Vik
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Mette Brekke
- Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| |
Collapse
|