Limites des données autorapportées sur les comportements sexuels des adolescents

Survey of adolescents' needs and parents' views on sexual health in juvenile idiopathic arthritis

BACKGROUND

Although the advent of new therapeutics for juvenile idiopathic arthritis (JIA) patients has considerably lessened the impact of the disease and reduced its sequelae, the outcomes of JIA remain important in their lives. Disease repercussions and side effects of treatments may affect sexual health and cause psychological distress. This aim of the study was to determine the expectations of adolescent JIA patients and the perceptions of their parents regarding knowledge and communication with healthcare providers (HCPs) in the field of sexual health (SH).

METHODS

In France, from September 2021 to April 2022, a survey was conducted, using anonymous self-administered questionnaires, among JIA patients (adults (aged 18-45 years) to provide insights from their recollection of their adolescence) and their parents in nine rheumatology centers and three patient associations.

RESULTS

The responses to the 76 patient questionnaires and 43 parent questionnaires that were collected were analyzed. Half of the patients thought JIA impacted their romantic relationships, but the results were less clear-cut for their sexual activity; and 58.7% of the patients said they would be comfortable discussing the subject with HCPs, but only 26.3% had done so, mainly regarding biomedical issues. The patients and their parents thought that ideally, the topic should be addressed in an individual patient education session at the hospital (51.3% and 34.9%, respectively), in a regular consultation (47.4% and 53.5%), or in a dedicated consultation requested by the adolescent without the adolescent's parents being informed (38.2% and 20.9%). Most of the respondents thought HCPs should be proactive in SH (77.6% of the patients and 69.8% of their parents). More patients than parents said the following digital information tools must be used: videos (29.0% vs. 9.3%, p = 0.0127) and smartphone applications (25.0% vs. 9.3%, p = 0.0372).

CONCLUSION

HCPs should consider addressing the unmet need for SH discussions during their patient encounters. To meet this need, we propose concrete actions in line with the wishes of patients and parents.

CLINICAL TRIAL REGISTRATION NUMBER

NCT04791189.

Insecure Attachment and Sexual Satisfaction: A Path Analysis Model Integrating Sexual Mindfulness, Sexual Anxiety, and Sexual Self-Esteem

This study examines the intermediary role of three variables (sexual mindfulness, sexual anxiety, and sexual self-esteem) in a path analysis model to explain the association between insecure attachment and sexual satisfaction. A community sample of 543 adults completed an online survey. Results supported our hypothesized integrative model, which explained 44.1% of the variance in sexual satisfaction and presented satisfactory fit indices. This study suggests that the association between attachment insecurities and lower sexual satisfaction could be partially explained by a proximal association with lower sexual mindfulness, which emphasizes the relevance of examining sexual mindfulness during the screening and treatment of people presenting low sexual satisfaction.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.2011808 .

Adolescents' Perception of Their Sexual Self, Relational Capacities, Attitudes Towards Sexual Pleasure and Sexual Practices: a Descriptive Analysis

Positive psychosexual development in adolescence is crucial to sexual health. Evidence suggests that adolescent's psychosexual development is influenced by the sexual self-concept, relational skills, attitudes toward sexual pleasure, and sexual practices. To date, however, understanding of normative dispositions and experiences that positively shape adolescents' psychosexual development remains limited. The goal of the study was to provide a descriptive analysis of adolescents' perceptions of their sexual self, relational skills, and attitudes towards sexual pleasure as well as their sexual practices while considering age and gender differences. A Canadian sample of 1584 adolescents (49.7% girls, 49.4% boys and 0.9% gender diverse) aged 14 to 18 years old (M = 15.53, SD = 0.93) completed a self-reported questionnaire evaluating various aspects of sexuality and sexual practices. Results indicated that most youth are sexually active through autoerotic or partnered sexual practices, and that positive perceptions towards the sexual self, relational capacities and pleasure increase with age. Moreover, compared to girls, boys presented a more positive sexual self-concept, less positive perceptions of their relational skills and they were more likely to report autoerotic sexual practices. Cluster analysis supported classifying adolescents into the following profiles: positive, mildly positive, mildly negative and negative perception of the sexual self and sexuality. These profiles varied according to sexual practices, gender and age. This study provides further insight into general patterns and heterogeneity of adolescents' sexuality that are relevant for adapting sexuality education and sexual health intervention.

Why Do Socially Withdrawn Children Tend to Become Heterosexually Active Later than Their Peers? A Mediation Model

Socially withdrawn children are more likely to be heterosexually inactive in early adulthood. This study aimed to test a three-mediator model. We hypothesized that social withdrawal during childhood would hinder a sense of social competence in early adolescence, limiting other-gender friendships in mid-adolescence, in turn limiting involvement in romantic relationships in late adolescence, and thus favoring a later transition into sexual activity. This mediation model was tested on a sample of 332 participants assessed annually between the ages of 12 and 22. Structural equation modeling revealed a significant indirect effect of social withdrawal on late transition into heterosexual activity through the three tested mediators. The direct effect of social withdrawal on late transition into heterosexual activity was also significant, suggesting a partial mediation.

Early Sexual Onset and Alcohol Use and Misuse From Adolescence Into Young Adulthood

PURPOSE

Little is known about the longitudinal association between early first heterosexual intercourse (e.g., intercourse before the age of 15 years) and alcohol use during adolescence and young adulthood. This study sought to determine whether early first heterosexual intercourse is associated with (1) frequency of alcohol use at age 16 years, (2) changes in alcohol use from ages 16 to 22 years, and (3) alcohol misuse at age 22 years, while controlling for alcohol use, antisocial behavior, pubertal timing, and parental monitoring in early adolescence.

METHODS

A sample of 289 participants (63% female) was surveyed annually from ages 12 to 22 years.

RESULTS

Latent growth curve modeling indicated that youth who experienced an early first heterosexual intercourse report a higher frequency of alcohol use at age 16 years compared with those who have experienced their first heterosexual intercourse at an "on-time" age. However, timing of first heterosexual intercourse was not related to growth in frequency of alcohol use over time. Hierarchical multiple regression analysis showed that experiencing an early first heterosexual intercourse predicted problematic alcohol use at age 22 years (β = .153, p = .027). These results were found while controlling for confounding individual- and family factor-level variables.

CONCLUSIONS

The effect of early first heterosexual intercourse on adolescent alcohol use appears to be long lasting and is associated with a more problematic use of this substance in young adulthood. Further research should be conducted to uncover the developmental processes involved.

Trajectories of Annual Number of Sexual Partners from Adolescence to Emerging Adulthood: Individual and Family Predictors

Adolescent sexual development is not the same across the board, and can be seen as both normative as well as risky behavior, depending on factors such as age of onset and number of partners. This longitudinal study identified developmental trajectories of annual number of sexual partners from adolescence to emerging adulthood and their antecedents. From the ages of 16-22, 332 participants (60.8 % females) annually reported their number of sexual partners. Measures of adolescent and family characteristics taken at ages 13-15 were used as predictors. Group-based modeling identified four trajectory groups: the abstainers group (9.1 %), low-increasing group (30.6 %), medium-increasing group (53.0 %), and multiple-partners group (7.3 %). Multinomial logistical regressions indicated that better social competence increased chances of belonging to the multiple-partners group as compared to the abstainers and low-increasing groups, and more substance use predicted membership in the multiple-partners group as compared to the abstainers group. Moreover, females were overrepresented in the low-increasing and medium-increasing groups. These results imply a greater diversity in sexual development than proposed in the literature and highlight the importance of identifying the strengths and competencies associated with healthy sexual development along with the early risk factors.

Sexuality (and Lack Thereof) in Adolescence and Early Adulthood: A Review of the Literature

Youth sexuality has been primarily studied with a focus on its potential public health issues, such as sexually transmitted infections and unwanted pregnancies, and its comorbidity with other risky behaviors. More recently, it has been studied as a normative step in romantic partnerships, either pre- or post-marital, as well as outside the context of romantic involvement. In this paper, we review the extensive literature on sexuality in adolescence and early adulthood both within and outside romantic relationships (i.e., casual sexual relationships and experiences; CSREs). Furthermore, the recent recognition of youth sexuality as a developmental task has led to a renewed interest from scholars in youth who abstain from sexual encounters, whether deliberately or not. A brief overview of the literature on cultural differences in sexuality, and sexual-minority youth sexual development is also provided. This paper concludes by suggesting future directions to bring the field of youth sexuality and romantic relationships forward.