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Istiko SN, Remata S, Ndayizeye A, Moreno MEV, Kirunda V, Hollingdrake O, Osborne R, Hou JZ, Abell B, Mullens AB, Gu Z, Debattista J, Vujcich D, Lobo R, Parma G, Howard C, Durham J. Developing critical HIV health literacy: insights from interviews with priority migrant communities in Queensland, Australia. CULTURE, HEALTH & SEXUALITY 2024; 26:936-951. [PMID: 37950430 DOI: 10.1080/13691058.2023.2265960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 09/28/2023] [Indexed: 11/12/2023]
Abstract
In Australia, surveillance data establish that there are higher rates of late HIV diagnoses among heterosexual migrants from Sub-Saharan Africa and new HIV diagnoses among gay and bisexual men (GBM) from Southeast and Northeast Asia and Latin America. Together, these groups are identified as priority migrant communities in current efforts to eliminate HIV transmissions. HIV health literacy is recognised as a key means of improving access to services and health outcomes. This qualitative paper explores critical HIV health literacy among priority migrant communities in Queensland, Australia. To foreground community voices, peer researchers from priority migrant communities participated in the project design, data collection and analysis, with 20 interviews completed. The findings demonstrate how participants' engagement with HIV health information and services is highly relational and situated within the framework of sexual health and wellbeing. Participants strategically selected where to seek information and who they trusted to help them appraise this information. They further demonstrated reflective capacities in identifying the contextual barriers that inhibit the development of their HIV health literacy. The findings highlight the need for HIV health promotion strategies that embrace a sex positive approach, promote cultural change, and involve collaboration with general practitioners (GPs).
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Affiliation(s)
- Satrio Nindyo Istiko
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Faculty of Medicine, School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Simeon Remata
- Queensland Positive People, Brisbane, Queensland, Australia
- ACON, Sydney, New South Wales, Australia
| | - Aimable Ndayizeye
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Miguel Eduardo Valencia Moreno
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Vanessa Kirunda
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Olivia Hollingdrake
- School of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Richard Osborne
- Department of Health and Medical Sciences, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Jenny Zhengye Hou
- Faculty of Creative Industries, Education, and Social Justice, School of Communication/Digital Media Research Centre, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bridget Abell
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
- Australian Centre for Health Services Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amy B Mullens
- Centre for Health Research, School of Psychology and Wellbeing, Institute for Resilient Regions, University of Southern Queensland, Ipswich, Queensland, Australia
| | - Zhihong Gu
- Ethnic Communities Council of Queensland, Brisbane, Queensland, Australia
| | - Joseph Debattista
- Metro North Public Health Unit, Metro North Hospital and Health Service, Herston, Queensland, Australia
| | - Daniel Vujcich
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Roanna Lobo
- Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Gianna Parma
- True Relationships & Reproductive Health, Brisbane, Queensland, Australia
| | - Chris Howard
- Queensland Positive People, Brisbane, Queensland, Australia
| | - Jo Durham
- Faculty of Health, School of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia
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Ashrafinia F, Nakhaee N, Chen H, Kelley EL, Heydari O. Validity, reliability and factor structure of the Female Sexual Well-Being Scale in married Iranian women. Sex Health 2024; 21:SH24043. [PMID: 38991105 DOI: 10.1071/sh24043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 06/21/2024] [Indexed: 07/13/2024]
Abstract
Background Promoting the quality of women's sex life is crucial for their overall well-being. The aim of this study was to translate and validate the Iranian adaptation of the Female Sexual Well-Being Scale (FSWB), and assess its cross-cultural comparability. Methods The Persian version of the FSWB was developed through forward and backward translations, followed by revision by a research team and pilot testing. A total of 400 women completed the FSWB questionnaire. Test-retest reliability was determined using the intraclass correlation coefficient, whereas Cronbach's alpha coefficient was used to assess internal consistency. Construct validity was assessed by exploratory factor analysis using principal axis factorisation with varimax rotation, followed by confirmatory factor analysis. Results Only one factor was found in the scale by factor analysis using the principal component method and varimax rotation. The Kaiser-Meyer-Olkin measure demonstrated high sampling adequacy (0.961), and Bartlett's test of sphericity confirmed the appropriateness of the correlation matrix for exploratory factor analysis (P Conclusions The Persian version of the FSWB (consisting of 17 questions) and its scoring system showed robust validity and reliability in assessing women's sexual well-being in the Iranian context.
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Affiliation(s)
- Farzaneh Ashrafinia
- Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Nouzar Nakhaee
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Hui Chen
- School of Life Sciences, Faculty of Science, University of Technology Sydney, Sydney, NSW, Australia
| | - Erika L Kelley
- Department of Reproductive Biology, Case Western Reserve University Hospitals, Cleveland, Cleveland, OH, USA
| | - Omolbanin Heydari
- Department of Nursing and Midwifery, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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Larsdotter Zweygberg A, Martin FZ, Brynedal B, Storck Lindholm E, Kosidou K, Ahlqvist VH, Magnusson C. Mode of delivery and subsequent self-perceived sexual life satisfaction: a population-based cohort study. Am J Obstet Gynecol 2024; 231:107.e1-107.e19. [PMID: 38367755 DOI: 10.1016/j.ajog.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/31/2024] [Accepted: 02/09/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND The potential association between mode of obstetrical delivery and subsequent sexual outcomes of the birthing parent remains uncertain and has not been well investigated from the perspective of positive sexual life satisfaction. OBJECTIVE This study aimed to investigate if there was any association between mode of delivery and subsequent sexual life satisfaction of the birthing parent. A secondary aim was to assess the extent to which this association changed when stratified by time elapsed since delivery. STUDY DESIGN The study matched participants in the Stockholm Public Health Cohort with deliveries recorded in the Swedish Medical Birth Register. Any deliveries recorded in the registry before the participation in the Stockholm Public Health Cohort were included (n=46,078). The length of time from delivery to outcome assessment varied from 1 month to 41 years (mean, 18 years [±10.8]). Mode of delivery was retrieved from the same registry, whereas self-perceived sexual life satisfaction was retrieved from the Stockholm Public Health Cohort Questionnaires where participants had assessed their sexual life satisfaction as 1 out of 5 mutually exclusive options. Multinomial logistic regression was used to test for any association between mode of delivery (cesarean, instrumental, and spontaneous vaginal delivery) and sexual life satisfaction, both overall and stratified by time elapsed since delivery. RESULTS After adjusting for covariates, no statistically significant (P < .05) difference in subsequent sexual life satisfaction of the birthing parent between modes of delivery was identified. Adjusted odds ratios for assessing sexual life satisfaction as the lowest level ("very unsatisfactory") were 1.11 (95% confidence interval, 0.98-1.25) for cesarean delivery and 1.16 (95% confidence interval, 0.99-1.35) for instrumental delivery, compared with spontaneous vaginal delivery. The difference in covariate-adjusted prevalence of the lowest level of sexual life satisfaction among the different groups categorized by time since delivery was small: 4.0% (95% confidence interval, 2.4%-5.6%) for cesarean delivery as opposed to 2.8% (95% confidence interval, 2.1%-3.6%) for spontaneous vaginal delivery within 2 years since delivery. CONCLUSION These findings do not support any impact of mode of delivery on the subsequent self-perceived sexual life satisfaction among birthing people, either overall or across different time periods since delivery.
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Affiliation(s)
| | - Florence Z Martin
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden; Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom
| | - Boel Brynedal
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | | | - Kyriaki Kosidou
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Viktor H Ahlqvist
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Magnusson
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Bergeron S, Vaillancourt-Morel MP, Péloquin K, Rosen NO. Intimacy Promotes Couples' Sexual Well-Being on a Daily Basis and Over One Year: The Role of Positive Sexual Cues. ARCHIVES OF SEXUAL BEHAVIOR 2024; 53:2737-2749. [PMID: 38872013 DOI: 10.1007/s10508-024-02912-7] [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: 12/06/2023] [Revised: 04/18/2024] [Accepted: 05/20/2024] [Indexed: 06/15/2024]
Abstract
There is growing interest in identifying factors that promote sexual well-being in romantic relationships. One such factor is intimacy-a process involving self-disclosure and empathic response that is positively associated with sexuality outcomes. However, most work among community couples examined cross-sectional associations in mixed-sex/gender couples using a single sexual outcome, which may not capture daily variations in intimacy and different dimensions of sexual well-being among a diversity of unions over time. Additionally, potential mediating mechanisms of the intimacy-sexual well-being association, such as attention to positive sexual cues (i.e., sexual thoughts and feelings), have been neglected. Adopting daily diary and longitudinal designs, the present study examined whether greater intimacy was associated with higher levels of positive sexual cues and, in turn, higher sexual well-being (sexual desire, satisfaction and distress). A convenience sample of 211 couples (Mage = 30.2 years; SD = 8.3; 75 sexually diverse couples) completed a survey on days of sexual activity with their partner, over a 35-day period and 12 months later. Daily results showed that intimacy was related to greater attention to positive sexual cues for both partners, which in turn was associated with their greater sexual desire and satisfaction and lower sexual distress. Longitudinal results showed that a person's greater daily intimacy was linked to their own greater sexual desire and satisfaction 12 months later via their own higher positive sexual cues, but not to their partner's cues or well-being. Findings extend interpersonal models of sexual well-being and support the role of intimacy and positive sexual cues therein.
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Affiliation(s)
- Sophie Bergeron
- Department of Psychology, Université de Montréal,, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada.
| | | | - Katherine Péloquin
- Department of Psychology, Université de Montréal,, C.P. 6128, Succursale Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - Natalie O Rosen
- Departments of Psychology & Neuroscience, Obstetrics & Gynecology, Dalhousie University, Halifax, NS, Canada
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Ashmore LA, Eastham R, Hadley O, Hanbury A, Singleton V. Supporting practitioners to talk about sexual wellness and pleasure during radiotherapy for gynaecological cancer. Radiography (Lond) 2024:S1078-8174(24)00160-3. [PMID: 38944580 DOI: 10.1016/j.radi.2024.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/30/2024] [Accepted: 06/13/2024] [Indexed: 07/01/2024]
Abstract
INTRODUCTION Radiotherapy treatment for gynaecological cancer has significant negative effects on sexual wellness and pleasure (1-3). Patients undergoing radiotherapy for gynaecological cancers have more sexual dysfunction and experience more sexual and depressive symptoms than those who undergo surgery alone (4). The World Health Organization defines sexual health as a crucial part of health and wellbeing and recognizes the importance of positive and respectful approaches to sexuality, alongside safe and pleasurable sexual experiences free from violence and coercion (5). METHODS Taking a sex critical approach to sexual wellness and pleasure, this project aimed to support practitioners to have improved and impactful conversations with people receiving radiotherapy treatment for gynaecological cancers. A series of three professional development workshops were held to explore language, unpack assumptions and develop key competencies for practitioners. A fourth workshop involved co-development of resources for use by other practitioners. RESULTS The group united, sharing insights, learning, and developing practices through reflection developing critical awareness about damaging silences around sexual wellness and pleasure. Co-created resources included conversation cards and a poster. CONCLUSION The project aimed to build and extend research findings to develop practitioner skills in supporting sexual wellness and pleasure for people receiving gynae-radiotherapy. The study shows the benefits of discussing norms and harms associated with biomedically focused conversations in gynae-radiotherapy to acknowledge diversity and validate concerns about sexual wellbeing and pleasure. IMPLICATIONS FOR PRACTICE A sex critical approach to sexual wellness and pleasure should be considered a core principle of care for patients during their treatment for gynaecological cancers. Conversations are a key (free) resource within the practitioner-patient relationship that can address and improve patients' psychosocial wellbeing.
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Affiliation(s)
- L A Ashmore
- Lancaster Medical School, Lancaster University, Bailrigg, Lancaster LA1 4SY, UK.
| | - R Eastham
- Division of Health Research, Lancaster University, Bailrigg, Lancaster LA1 4SY, UK
| | - O Hadley
- Lancaster Medical School, Lancaster University, Bailrigg, Lancaster LA1 4SY, UK
| | - A Hanbury
- School of Social Sciences, Manchester University, Oxford Road, Manchester M13 9PL, UK
| | - V Singleton
- Department of Sociology, Lancaster University, Bailrigg, Lancaster LA1 4SY, UK
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Donz R, Russia B, Barbaret C, Braybrook D, Perceau-Chambard E, Reverdy T, Economos G. What contributes to promote sexual health in cancer palliative care? A realist review. Sex Med Rev 2024; 12:334-345. [PMID: 38508856 DOI: 10.1093/sxmrev/qeae008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 01/23/2024] [Accepted: 01/28/2024] [Indexed: 03/22/2024]
Abstract
INTRODUCTION Sexuality is an important determinant of the overall health of a population and remains so at the end of life and in patients with advanced cancers. Despite the abundant literature on sexuality and intimacy, these topics have been rarely discussed in the context of cancer palliative care, and very few interventions to promote sexual health in patients undergoing cancer palliative care have been explored. OBJECTIVES In this study we sought to identify which factors and mechanisms contribute to promoting sexual health in cancer palliative care. METHODS A realist review was performed according to the guidelines of the realist and meta-narrative evidence synthesis method guidelines. Articles published between January 2010 and June 2021 were searched in 4 databases. Records were screened for their relevance regarding a predefined list of context-mechanism-outcome (CMO) configurations. Abstracts were independently screened by 2 authors before the data were extracted from the full-text articles selected for inclusion. With the use of abductive and retroductive reasoning techniques, each article was examined for evidence of its contribution to one of the CMO configurations, which could be refined when relevant. The data were summarized according to the final CMO configurations. RESULTS Of the 2056 articles identified, 38 articles were included in the review. The data reported in these articles contributed to 7 CMO hypotheses: (1) improving communication skills, (2) healthcare provider training, (3) reorganizing the patient environment in care settings or at home, (4) managing sexual symptoms and also general symptoms, (5 and 6) patient-centered counseling or couple counseling, and (7) lifting the taboo. CONCLUSIONS The findings reported here highlight various ways to improve sexual health for patients in cancer palliative care but are limited to genital cancers. Further research should consider all types of cancer rather than being restricted to genital cancers.
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Affiliation(s)
- Roxane Donz
- Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
- Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins
| | - Bruno Russia
- Hospitalisation à domicile, Centre Léon Bérard, Lyon 69008, France
| | - Cécile Barbaret
- Service de soins palliatifs, CHU de Grenoble, La Tronche 38700, France
| | - Debbie Braybrook
- Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London SE5 9PJ, United-Kingdom
| | - Elise Perceau-Chambard
- Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
| | - Thibaut Reverdy
- Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins
- Oncology Department, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
| | - Guillaume Economos
- Centre de soins palliatifs, Hospices Civils de Lyon, Hôpital Lyon Sud, Pierre-Benite 69495, France
- Centre pour l'Innovation en cancérologie de Lyon, Université Claude Bernard Lyon 1, Faculté de médecine Lyon Sud, EA 3738, 69921 Oullins
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Logie CH, Lys CL, Taylor SB, Lad A, Mackay KI, Hasham A, Gittings L, Malama K, Pooyak S, Monchalin R, Adamassu Z. Land-Based Retreats as a Method for Building Enabling Environments for HIV Prevention with Northern and Indigenous Adolescents in the Northwest Territories, Canada: Mixed-Methods Findings. AIDS Behav 2024:10.1007/s10461-024-04397-w. [PMID: 38900311 DOI: 10.1007/s10461-024-04397-w] [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] [Accepted: 05/28/2024] [Indexed: 06/21/2024]
Abstract
The Northwest Territories (NWT), Canada has high rates of sexually transmitted infections (STI) that elevate HIV acquisition risks. We conducted a mixed-methods study to explore the potential of land-based peer leader retreats (PLR) in building HIV prevention enabling environments among Northern and Indigenous youth in the NWT. PLRs are grounded in Indigenous principles and ways of knowing, acknowledging the land as a physical, spiritual, emotional, and intellectual being with the potential to facilitate (re)connection to culture, community, and self. We conducted one-week PLRs between 2016 and 2021 with adolescents aged 13-17 in the NWT. PLRs addressed HIV/STIs, safer sex, and gender equity. We conducted post-retreat focus groups (FGs) and pre/post-retreat surveys with youth participants (n = 353), and post-retreat FGs with PLR facilitators (n = 252). We applied thematic analysis to FGs and assessed pre/post-retreat changes in HIV/STI knowledge and safer sex efficacy (SSE) using paired sample t-tests. We assessed factors associated with post-test SSE and HIV/STI knowledge using multivariable linear regression. Youth participants (n = 353; mean age: 14.5, standard deviation [SD]: 1.3) were mostly Indigenous (71%) and women (66%). Participant narratives revealed PLRs enhanced technical communication (e.g., correct condom use). There were significant post-retreat HIV/STI knowledge increases; change score increases were lower for Indigenous participants. Qualitative narratives described how PLRs fostered transformative communication (e.g., sexual consent). There were significant post-retreat increases in SSE, and these were lower among men and sexually diverse (vs. heterosexual) participants. Land-based PLRs offer the potential to build technical and transformative communication to facilitate HIV prevention with youth in Canada's North.
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Affiliation(s)
- Carmen H Logie
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada.
- United Nations University Institute for Water, Environment, and Health, Hamilton, Canada.
- Centre for Gender and Sexual Health Equity, Vancouver, Canada.
- Women's College Research Institute, Women's College Hospital, Toronto, Canada.
| | - Candice L Lys
- Fostering Open eXpression Among Youth (FOXY), Yellowknife, NT, Canada
- Aurora Research Institute, Yellowknife, NT, Canada
| | - Shira B Taylor
- Faculty of Environmental and Urban Change, York University, Toronto, ON, Canada
- SExT: Sex Education by Theatre, Toronto, ON, Canada
| | - Anoushka Lad
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | | | - Aryssa Hasham
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Lesley Gittings
- Faculty of Health Sciences, School of Health Studies, Western University, London, ON, Canada
| | - Kalonde Malama
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
| | - Sherri Pooyak
- Communities, Alliances, and Networks (CAAN), Fort Qu'Appelle, SK, Canada
| | - Renée Monchalin
- School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
- Well Living House, Li Ka Shing Knowledge Institute of Unity Health Toronto, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Zerihun Adamassu
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street W, Room 504, Toronto, ON, M5S 1V4, Canada
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Bajada JEC, Grey W, Ciaffoni S, Hinton JDX. Exploring the Relationships Between Body Image, Sexual Well-Being, and Community Connectedness among Gay, Bisexual and Queer+ Men. JOURNAL OF SEX RESEARCH 2024:1-11. [PMID: 38836791 DOI: 10.1080/00224499.2024.2360599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
Sexual minority (SM) men are more likely than heterosexual men to experience body dissatisfaction due to prevailing body ideals (e.g. lean and muscular) within the SM community. Negative body image can have harmful effects on well-being, and, by extension, sexual well-being. The current study aimed to investigate whether SM men's minority identification and LGBTQ+ community connectedness moderates the relationship between drives for muscularity and sexual anxiety. To address this aim, 298 Australian-residing SM men completed an online survey that examined drive for muscularity, sexual anxiety, and connectedness or identification with the LGBTQ+ and SM-specific communities. As hypothesized, the results showed a positive relationship between drive for muscularity and sexual anxiety. Additionally, LGBTQ+ community connectedness, but importantly not SM identification, was found to moderate this relationship, showing a positive association only when connection was at low or average levels. These results highlight the beneficial effects that LGBTQ+ community connection can have for SM men, such as protecting them against the harmful impacts of poor body image on sexual well-being. These results also provide preliminary insights into the need to expand the understandings of bodily diversity, and diversity of sexual well-being experiences, among SM men less connected to the broader LGBTQ+ community.
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Affiliation(s)
| | - Wesley Grey
- Melbourne School of Psychological Sciences, University of Melbourne
| | - Stefano Ciaffoni
- Department of Psychology, Alma Mater Studiorum University of Bologna
| | - Jordan D X Hinton
- School of Behavioural and Health Sciences, Australian Catholic University
- Australian Research Centre in Sex, Health, and Society, La Trobe University
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Bigras N, Popova N, Pedneault L, Brassard A, Bergeron S. Sexual well-being among partnered adults and couples over 60: a scoping review. Sex Med Rev 2024:qeae037. [PMID: 38824393 DOI: 10.1093/sxmrev/qeae037] [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: 01/26/2024] [Revised: 04/25/2024] [Accepted: 05/08/2024] [Indexed: 06/03/2024]
Abstract
INTRODUCTION Although society still holds age-related stereotypes dismissing the sexuality of aging individuals, older adults remain sexually active and find sexuality to be an important part of their quality of life. Primarily oriented toward a biomedical and dysfunctional lens, prior research neglected the subjective well-being of elderly individuals, especially partnered adults and couples aged 60 years or more. Shedding a more positive light on this area of life could promote older individuals' and couples' sexual well-being. OBJECTIVES This scoping review aimed to synthetize the studies including community samples of partnered adults or couples over 60 who reported on various indicators of subjective sexual well-being including sexual satisfaction, distress, and function using validated measures. METHODS Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMAScR), the electronic literature search was conducted using PubMed, PsycINFO, Medline, and CINAHL for peer-reviewed journal articles published before July 2023. RESULTS Results showed how relational variables such as relationship satisfaction and intimacy emerge as important correlates of older adults' sexual well-being. CONCLUSION Avenues for future research arising from gaps in the studies identified thorough this scoping review, including the underrepresentation of sexual/gender diverse individuals and the use of single and/or non-validated items to assess sexual well-being, are discussed.
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Affiliation(s)
- Noémie Bigras
- Department of Psychoeducation and Psychology, Université du Québec en Outaouais, Québec, J8X 3X7, Canada
| | - Nevena Popova
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada
| | - Lydia Pedneault
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada
| | - Audrey Brassard
- Department of Psychology, Université de Sherbrooke, 2500, boul. Université, Sherbrooke, Quebec, J1K 2R1, Canada
| | - Sophie Bergeron
- Department of Psychology, Université de Montréal, C.P. 6128, Succursale Centre-Ville, Montréal, Québec, H3C 3J7, Canada
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Ma S, Knapp P, Galdas P. 'My sexual desires, everything, my normal life just stops'; a qualitative study of male sexual health in inflammatory bowel disease. J Clin Nurs 2024. [PMID: 38797921 DOI: 10.1111/jocn.17292] [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: 02/13/2024] [Revised: 04/23/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024]
Abstract
AIM To describe and interpret the sexual health experiences of men with IBD. DESIGN Interpretive qualitative study. METHODS In-depth, semi-structured interviews were conducted with 22 men with a diagnosis of Inflammatory Bowel Disease. Interviews were digitally audio-recorded and transcribed verbatim. Data were analysed using constant comparative, thematic analysis. RESULTS Three themes were identified from interview data: (1) the disease shapes intimate connections, (2) the disease thwarts sexual experiences and (3) the disease disrupts male gender norms. Men reported that active disease lowered libido and could change pre-, inter- and post-coital sexual practices. All participants noted that health professionals did not initiate the discussion of sexual health and well-being needs in the outpatient hospital setting. Men who engaged in receptive anal sex reported a lack of disease-specific guidance and understanding from professionals. CONCLUSION Inflammatory bowel disease can negatively impact the sexual well-being, gender identity and activities of men. Further research is required to identify the care preferences of men with IBD and clarify the barriers and facilitators to sexual health assessment so that nurses may better support the health needs of this population. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE This study highlights the need for sexual health and well-being support that is specific to disease and gender in IBD. There is a paucity of information and guidance for men with peri-anal disease and proctitis who engage in receptive anal sex, which requires urgent attention. REPORTING METHOD Reporting follows the COREQ checklist. PATIENT OR PUBLIC CONTRIBUTION A patient and public involvement group informed the development of the study design. The group reviewed public facing documents and interview guides. One member of the group provided comments on the identified themes.
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Affiliation(s)
- Sara Ma
- School of Science, Technology & Health, York St John University, York, UK
- York and Scarborough Teaching Hospital NHS Foundation Trust, York, UK
- Department of Health Sciences, The University of York, York, UK
| | - Peter Knapp
- Department of Health Sciences, The University of York, York, UK
- Hull York Medical School, York, UK
| | - Paul Galdas
- Department of Health Sciences, The University of York, York, UK
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Blondeel K, Mirandola M, Gios L, Folch C, Noestlinger C, Cordioli M, De Sutter P, Temmerman M, Toskin I. Sexual satisfaction, an indicator of sexual health and well-being? Insights from STI/HIV prevention research in European men who have sex with men. BMJ Glob Health 2024; 9:e013285. [PMID: 38789276 PMCID: PMC11129029 DOI: 10.1136/bmjgh-2023-013285] [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: 06/30/2023] [Accepted: 03/31/2024] [Indexed: 05/26/2024] Open
Abstract
INTRODUCTION Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general. METHODS The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013-2014 among men who have sex with men. Sexual satisfaction was explored using one single item: 'How satisfied are you with your sex life?' A multivariable multilevel logistic random-intercept model was estimated to identify factors associated with reporting positive sexual satisfaction versus negative sexual satisfaction. RESULTS Age, the number of partners and self-reported HIV status were not significantly associated with sexual satisfaction in the multivariate model. Participants reporting an insertive role or reported both an insertive and receptive role during the last anal intercourse were more likely to be sexually satisfied, compared with a receptive role. Participants reporting anal intercourse with a condom were more likely to be satisfied than those declaring no anal intercourse in the last 6 months, but no significant association was found compared with anal intercourse without condom. Knowledge of HIV-serostatus concordance with the last sexual partner was positively correlated with sexual satisfaction. Having had sexual intercourse with non-steady partners only in the last 6 months was negatively correlated. The more positive participants perceived their work/school, parents and friends/acquaintances' attitudes towards gay or bisexual persons, the higher the odds they were satisfied with their sexual life. CONCLUSION Using a single item on sexual satisfaction in a bio-behavioural study, our analysis has shown that it is associated with individual, interpersonal and social/structural factors and has proven its usefulness as a sexual health indicator among men who have sex with men.
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Affiliation(s)
- Karel Blondeel
- Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), World Health Organization, Geneva, Switzerland
- Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Massimo Mirandola
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Lorenzo Gios
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Cinta Folch
- Centre Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT) Departament de Salut, Generalitat de Catalunya, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | | | - Maddalena Cordioli
- Infectious Diseases Section, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Petra De Sutter
- Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
| | - Marleen Temmerman
- Ghent University Faculty of Medicine and Health Sciences, Gent, Belgium
- Centre of Excellence in Women, Adolescents and Child Health, The Aga Khan University, Nairobi, Kenya
| | - Igor Toskin
- Department of Sexual and Reproductive Health and Research (includes the UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction [HRP]), World Health Organization, Geneva, Switzerland
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12
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Prieto LR, Shires DA, Xiong Y. Social and Mental Health Factors Associated with Sexual Satisfaction Among Older Gay Men. JOURNAL OF HOMOSEXUALITY 2024:1-18. [PMID: 38776454 DOI: 10.1080/00918369.2024.2353054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
The internalization of ageist stereotypes or messages based on the framework of an aging gay man is known as internalized gay ageism. Internalized gay ageism may influence an older gay man's sexual satisfaction. The aim of this study was to examine the relationship between internalized gay ageism and sexual satisfaction and determine if body image was a potential mediator. A cross-sectional online survey collected data on sexual satisfaction and other variables related to sexual health and well-being among older gay men. Inclusion criteria included: aged 50 or older, identified as gay, identified as male, assigned male at birth, and resided in the Midwestern region of the United States. Descriptive, bivariate, and mediation analyses were conducted. A complete mediation effect was found between internalized gay ageism and sexual satisfaction when mediated by body image. Older gay men who were in open relationships were more sexually satisfied than single/widowed older gay men. Future research should continue to explore internalized gay ageism, relationship status, body image, and sexual satisfaction among older gay men.
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Affiliation(s)
- Lucas R Prieto
- Department of Social Work, George Mason University, Fairfax, Virginia, USA
| | - Deirdre A Shires
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
| | - Yuan Xiong
- School of Social Work, Michigan State University, East Lansing, Michigan, USA
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13
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Ask S, Schildmeijer K, Kaldo V, Hellström A. The effect of psychosocial interventions for sexual health in patients with pelvic cancer: a systematic review and meta-analysis. Acta Oncol 2024; 63:230-239. [PMID: 38682457 DOI: 10.2340/1651-226x.2024.24204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 03/15/2024] [Indexed: 05/01/2024]
Abstract
AIM The aim of this systematic review and meta-analysis was to explore and evaluate the effect of psychosocial interventions in improving sexual health outcomes among post-treatment patients with pelvic cancer. METHODS Inclusion and exclusion criteria were pelvic cancer survivors; psychosocial interventions; studies with a control group and measures of sexual health. Five databases were searched for literature along with an inspection of the included studies' reference lists to extend the search. Risk of bias was assessed with the RoB2 tool. Standardised mean difference (SMD) with a random effects model was used to determine the effect size of psychosocial interventions for sexual health in patients with pelvic cancers. RESULTS Thirteen studies were included, with a total number of 1,541 participants. There was a large heterogeneity regarding the type of psychosocial intervention used with the source found in a leave one out analysis. Six studies showed statistically significant improvements in sexual health, while three showed positive but non-significant effects. The summary effect size estimate was small SMD = 0.24 (95% confidence interval [CI]: 0.05 to 0.42, p = 0.01). DISCUSSION There is limited research on psychosocial interventions for sexual health in pelvic cancer patients. There are also limitations in the different pelvic cancer diagnoses examined. Commonly, the included articles examined physical function rather than the whole sexual health spectrum. The small effect sizes may in part be due to evaluation of psychosocial interventions by measuring physical dysfunction. Future research should broaden sexual health assessment tools and expand investigations to more cancer types.
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Affiliation(s)
- Samuel Ask
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden.
| | - Kristina Schildmeijer
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Viktor Kaldo
- Department of Psychology, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Region Stockholm, Sweden
| | - Amanda Hellström
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
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14
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Gerymski R, Latusek-Mierzwa M. Network Analysis of Sexual Well-Being in Women with Heart Failure: The Psychocardiological Perspective. Healthcare (Basel) 2024; 12:817. [PMID: 38667579 PMCID: PMC11050502 DOI: 10.3390/healthcare12080817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 03/25/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
Sexuality is an important sphere of every person's life. Sexual dysfunctions and sexual dissatisfaction may also be present in cardiac diseases. Individuals affected by heart failure (HF) deserve special attention since it can be the final stage of many cardiac diseases. Therefore, it is important to verify potential correlates of sexual well-being in individuals with HF. This study was conducted online between 2019 and 2023, and 262 Polish women aged between 18 and 59 years (M = 45.48; SD = 7.65) participated in it. The Short Sexual Well-Being Scale, Depression Anxiety and Stress Scale, Fatigue Assessment Scale, and authors' questionnaire were used. Relationships between tested variables were verified with the use of network analysis performed with the EBICglasso estimator. Centrality assessment showed that sexual well-being had the highest values of betweenness, closeness and degree, followed by fatigue and depression measures. Sexual well-being was negatively related to the number of declared sexual dysfunctions, fatigue, stress and depression levels. Participants' age and HF duration were not related to the sexual well-being of tested women. Multiple additional partial correlations were detected. The obtained results show that sexuality may be a central sphere of life in women with HF and that one's sexuality should not be negated when working with cardiac patients.
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Affiliation(s)
- Rafał Gerymski
- Department of Health Psychology and Quality of Life, Institute of Psychology, Opole University, 45-040 Opole, Poland
| | - Maria Latusek-Mierzwa
- St. Hedwig’s Provincial Specialist Hospital, 45-221 Opole, Poland;
- Doctoral School of the University of Opole, 45-040 Opole, Poland
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15
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Bosas J, Toffol E, Pohjoranta E, Mentula MJ, Hurskainen R, Suhonen S, Heikinheimo O. Factors affecting female sexual well-being: a 5-year follow-up of a randomised clinical trial on post-abortion contraception. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:92-98. [PMID: 37857463 DOI: 10.1136/bmjsrh-2023-201879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023]
Abstract
INTRODUCTION Sexual well-being is associated with general well-being. Several factors, such as overweight, infertility, anxiety and sex hormones, also play a role, but the effects of hormonal contraception remain a point of debate. We characterised the factors associated with sexual well-being in fertile-aged women following induced abortion. METHODS A 5-year follow-up of a nested, longitudinal, cohort study examining the effects of routine provision of intrauterine contraception as part of abortion care. Sexual well-being, anxiety and quality of life were assessed annually using validated questionnaires (McCoy Female Sexuality Questionnaire, State-Trait Anxiety Inventory and EuroQoL), along with data on general and reproductive health, and relationship status. Of the 742 women participating in the trial, 290 (39%) provided sufficient follow-up data and were included in this study. RESULTS Based on trajectories of McCoy scores across the 5-year follow-up, two groups were identified: those with stable and higher (n=223, 76.9%) and those with declining sexual well-being (n=67, 23.1%). Women in the group of declining sexual well-being had significantly higher levels of anxiety and lower quality of life at all time points. They also had chronic diseases more often and were less happy in their relationships. No differences were found in method of contraception when classified as hormonal versus non-hormonal, or long-acting versus short-acting reversible contraception. CONCLUSIONS Lower anxiety and higher quality of life are associated with stable and higher sexual well-being. Method of contraception or relationship status are not associated with sexual well-being during long-term follow-up in fertile-aged women.
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Affiliation(s)
- Janina Bosas
- University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Elena Toffol
- University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Elina Pohjoranta
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
| | - Maarit J Mentula
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Satu Suhonen
- University of Helsinki Faculty of Medicine, Helsinki, Finland
| | - Oskari Heikinheimo
- University of Helsinki Faculty of Medicine, Helsinki, Finland
- Obstetrics and Gynaecology, Helsinki University Central Hospital, Helsinki, Finland
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16
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Lin CY, Tsai MC, Koós M, Nagy L, Kraus SW, Demetrovics Z, Potenza MN, Ballester-Arnal R, Batthyány D, Bergeron S, Billieux J, Briken P, Cárdenas-López G, Carvalho J, Castro-Calvo J, Chen L, Ciocca G, Corazza O, Csako RI, Fernandez DP, Fernandez EF, Fujiwara H, Fuss J, Gabrhelík R, Gewirtz-Meydan A, Gjoneska B, Gola M, Grubbs JB, Hashim HT, Islam MS, Ismail M, Jiménez-Martínez M, Jurin T, Kalina O, Klein V, Költő A, Lee SK, Lewczuk K, Lochner C, López-Alvarado S, Lukavská K, Mayta-Tristán P, Milea I, Miller DJ, Orosová O, Orosz G, Ponce FP, Quintana GR, Garzola GCQ, Ramos-Diaz J, Rigaud K, Rousseau A, Scanavino MDT, Schulmeyer MK, Sharan P, Shibata M, Shoib S, Sigre-Leirós V, Sniewski L, Spasovski O, Steibliene V, Stein DJ, Strizek J, Štulhofer A, Ünsal BC, Vaillancourt-Morel MP, Van Hout MC, Bőthe B. The short version of the Sexual Distress Scale (SDS-3): Measurement invariance across countries, gender identities, and sexual orientations. Int J Clin Health Psychol 2024; 24:100461. [PMID: 38706570 PMCID: PMC11067538 DOI: 10.1016/j.ijchp.2024.100461] [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: 01/19/2024] [Accepted: 04/04/2024] [Indexed: 05/07/2024] Open
Abstract
Background The three-item Sexual Distress Scale (SDS-3) has been frequently used to assess distress related to sexuality in public health surveys and research on sexual wellbeing. However, its psychometric properties and measurement invariance across cultural, gender and sexual subgroups have not yet been examined. This multinational study aimed to validate the SDS-3 and test its psychometric properties, including measurement invariance across language, country, gender identity, and sexual orientation groups. Methods We used global survey data from 82,243 individuals (Mean age=32.39 years; 40.3 % men, 57.0 % women, 2.8 % non-binary, and 0.6 % other genders) participating in the International Sexual Survey (ISS; https://internationalsexsurvey.org/) across 42 countries and 26 languages. Participants completed the SDS-3, as well as questions regarding sociodemographic characteristics, including gender identity and sexual orientation. Results Confirmatory factor analysis (CFA) supported a unidimensional factor structure for the SDS-3, and multi-group CFA (MGCFA) suggested that this factor structure was invariant across countries, languages, gender identities, and sexual orientations. Cronbach's α for the unidimensional score was 0.83 (range between 0.76 and 0.89), and McDonald's ω was 0.84 (range between 0.76 and 0.90). Participants who did not experience sexual problems had significantly lower SDS-3 total scores (M = 2.99; SD=2.54) compared to those who reported sexual problems (M = 5.60; SD=3.00), with a large effect size (Cohen's d = 1.01 [95 % CI=-1.03, -0.98]; p < 0.001). Conclusion The SDS-3 has a unidimensional factor structure and appears to be valid and reliable for measuring sexual distress among individuals from different countries, gender identities, and sexual orientations.
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Affiliation(s)
- Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
- Biostatistics Consulting Center, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Meng-Che Tsai
- Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Mónika Koós
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Léna Nagy
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Shane W. Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Zsolt Demetrovics
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Centre of Excellence in Responsible Gaming, University of Gibraltar, Gibraltar, United Kingdom
- College of Education, Psychology and Social Work, Flinders University, Adelaide, Australia
| | - Marc N. Potenza
- Yale University School of Medicine, New Haven, CT, USA
- Connecticut Council on Problem Gambling, Wethersfield, CT, USA
| | - Rafael Ballester-Arnal
- Departamento de Psicología Básica, Clínica y Psicobiología, University Jaume I, Castelló, Spain
| | - Dominik Batthyány
- Institute for Behavioural Addictions, Sigmund Freud University, Vienna, Austria
| | - Sophie Bergeron
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Montréal, Canada
| | - Joël Billieux
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Center for Excessive Gambling, Addiction Medicine, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine & Forensic Psychiatry, University Medical Center Hamburg-Eppendorf (UKE), Hamburg, Germany
| | - Georgina Cárdenas-López
- Virtual Teaching and Cyberpsychology Laboratory, School of Psychology, National Autonomous University of Mexico, Mexico, Mexico
| | - Joana Carvalho
- William James Center for Research, Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
| | - Jesús Castro-Calvo
- Department of Personality, Assessment, and Psychological Treatments, University of Valencia, Valencia, Spain
| | - Lijun Chen
- Department of Psychology, College of Humanity and Social Science, Fuzhou University, Fuzhou, Fujian province, China
| | - Giacomo Ciocca
- Section of Sexual Psychopathology, Department of Dynamic and Clinical Psychology, and Health Studies, Sapienza University of Rome, Rome, Italy
| | - Ornella Corazza
- Department of Clinical, Pharmaceutical and Biological Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
- Department of Psychology and Cognitive Science, University of Trento, Trento, Italy
| | - Rita I. Csako
- Department of Psychology and Neuroscience, Auckland University of Technology, Auckland, New Zealand
| | - David P. Fernandez
- Department of Psychology, Nottingham Trent University, Nottingham, United Kingdom
| | | | - Hironobu Fujiwara
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Decentralized Big Data Team, RIKEN Center for Advanced Intelligence Project, Tokyo, Japan
| | - Johannes Fuss
- Institute of Forensic Psychiatry and Sex Research, Center for Translational Neuro- and Behavioral Sciences, University of Duisburg-Essen, Essen, Germany
| | - Roman Gabrhelík
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Addictology, General University Hospital in Prague, Prague, Czech Republic
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - Biljana Gjoneska
- Macedonian Academy of Sciences and Arts, Skopje, Republic of North Macedonia
| | - Mateusz Gola
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
- Institute for Neural Computations, University of California San Diego, CA, USA
| | - Joshua B. Grubbs
- Center on Alcohol, Substance use, and Addictions, University of New Mexico, Albuquerque, New Mexico, United States
| | | | - Md. Saiful Islam
- Department of Public Health and Informatics, Jahangirnagar University, Savar, Dhaka, Bangladesh
- Centre for Advanced Research Excellence in Public Health, Savar, Dhaka, Bangladesh
| | - Mustafa Ismail
- University of Baghdad, College of Medicine, Baghdad, Iraq
| | | | - Tanja Jurin
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Ondrej Kalina
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik University in Kosice, Kosice, Slovakia
| | - Verena Klein
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - András Költő
- Health Promotion Research Centre, University of Galway, Galway, Ireland
| | - Sang-Kyu Lee
- Department of Psychiatry, College of Medicine, Hallym University, Chuncheon, Republic of Korea
- Chuncheon Addiction Management Center, Republic of Korea
| | - Karol Lewczuk
- Institute of Psychology, Cardinal Stefan Wyszynski University, Warsaw, Poland
| | - Christine Lochner
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Cape Town, South Africa
| | | | - Kateřina Lukavská
- Department of Addictology, First Faculty of Medicine, Charles University, Prague, Czech Republic
- Department of Psychology, Faculty of Education, Charles University, Prague, Czech Republic
| | | | - Ion Milea
- International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Dan J. Miller
- College of Healthcare Sciences, James Cook University, Queensland, Australia
| | - Oľga Orosová
- Department of Educational Psychology and Psychology of Health, Pavol Jozef Safarik Universit y in Kosice, Kosice, Slovakia
| | | | | | - Fernando P. Ponce
- Facultad de Psicología, Universidad de Talca, Talca, Talca, Region del Maule, Chile
| | - Gonzalo R. Quintana
- Departamento de Psicología y Filosofía, Facultad de Ciencias Sociales, Universidad de Tarapacá, Arica, Arica y Parinacota, Chile
| | - Gabriel C. Quintero Garzola
- Florida State University, Panama, Republic of Panama
- Sistema Nacional de Investigación (SNI), SENACYT, Panama, Republic of Panama
| | - Jano Ramos-Diaz
- Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Perú
| | | | - Ann Rousseau
- Leuven School For Mass Communication, KU Leuven, Leuven, Belgium
| | - Marco De Tubino Scanavino
- Department of Psychiatry, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
- Experimental Pathophisiology Post Graduation Program, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | | | - Pratap Sharan
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mami Shibata
- Department of Neuropsychiatry, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Sheikh Shoib
- Department of Psychology, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Vera Sigre-Leirós
- Institute of Psychology, University of Lausanne, Lausanne, Switzerland
- Institute of Legal Psychiatry, Lausanne University Hospitals (CHUV), Lausanne, Switzerland
| | - Luke Sniewski
- Auckland University of Technology, Auckland, New Zealand
| | - Ognen Spasovski
- Faculty of Philosophy, University of Ss. Cyril and Methodius in Trnava, Trnava, Slovakia
| | - Vesta Steibliene
- Laboratory of Behavioral Medicine, Neuroscience Institute, Lithuanian University of Health sciences, Kaunas, Lithuania
| | - Dan J. Stein
- SAMRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | | | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Berk C. Ünsal
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Marie-Pier Vaillancourt-Morel
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Montréal, Canada
| | - Marie Claire Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool, Merseyside, United Kingdom
| | - Beáta Bőthe
- Département de Psychologie, Université de Montréal, Montréal, Canada
- Centre de recherche interdisciplinaire sur les problèmes conjugaux et les agressions sexuelles, Montréal, Canada
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17
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Mark KP, Arenella K, Girard A, Herbenick D, Fu J, Coleman E. Erectile dysfunction prevalence in the United States: report from the 2021 National Survey of Sexual Wellbeing. J Sex Med 2024; 21:296-303. [PMID: 38410029 DOI: 10.1093/jsxmed/qdae008] [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: 04/26/2023] [Revised: 12/04/2023] [Accepted: 01/05/2024] [Indexed: 02/28/2024]
Abstract
BACKGROUND There has been a great deal of public speculation regarding a surge in erectile dysfunction (ED) in younger men despite data consistently indicating that the ED prevalence rates increase with age. AIM In this study we sought to assess the prevalence and risk of experiencing ED in a nationally representative sample of men in the United States across various social groups, describe comorbidities, and examine barriers to treatment. METHODS Data from the 2021 National Survey of Sexual Wellbeing were analyzed by utilizing the Ipsos KnowledgePanel®, a probability-based online panel, for the purpose of obtaining US nationally representative data of adults aged 18 years and older. The analytic sample consisted of 1822 cisgender men ranging in age from 18 to 87 years, with a mean age of 47.5 years. OUTCOMES Study outcomes were ED as measured by the 5-item version of the International Index of Erectile Function (IIEF-5), as well as self-reported diagnosis by a medical professional, comorbidities with other health issues, medications taken for ED, and barriers to treatment. RESULTS The ED prevalence rate based on IIEF-5 scores was 24.2%. Prevalence increased with age: 52.2% of the 75+ age group, and 48.0% of the 65-74 age group meeting diagnostic criteria for ED. Diagnostic criteria were met for more participants in the 18-24 age group (17.9%) than the 25-34 (13.3%) or 35-44 (12.7%) age groups, but less than the 45-54 (25.3%) or 55-64 (33.9%) age groups. Only 7.7% (n = 141) of the sample reported having been diagnosed by a provider (n = 4 in 25-34, n = 6 in 35-44, n = 13 in 45-54, n = 39 in 55-64, n = 44 in 65-74, and n = 34 in ≥75-year olds), indicating a gap in access to treatment. The most common reason selected for not accessing care for ED concerns was a lack of need to see a provider in the past year. CLINICAL IMPLICATIONS The discrepancy between ED self-report and medical diagnosis is critical, given that ED can be an indication of underlying health risks. STRENGTHS AND LIMITATIONS This study is the first nationally representative update to information regarding the prevalence of ED in almost 2 decades. Standard administration of the IIEF-5 is limited to participants who have had sex in the last 6 months, so these rates do not include those men with ED who have been avoiding penetrative sex for a significant time. CONCLUSION The results indicate that ED prevalence and severity remain highest in older age groups and that most individuals who meet criteria for ED have not sought medical care related to this concern.
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Affiliation(s)
- Kristen P Mark
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
| | - Kat Arenella
- California School of Professional Psychology, Alliant International University, Los Angeles, CA 91803, United States
| | - Abby Girard
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
| | - Debby Herbenick
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN 47405, United States
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Jane Fu
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN 47405, United States
- The Center for Sexual Health Promotion, Indiana University School of Public Health, Indiana University, Bloomington, IN 47405, United States
| | - Eli Coleman
- Institute for Sexual & Gender Health, Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
- Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, MN 55454, United States
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18
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Lewis R, Bosó Pérez R, Maxwell KJ, Reid D, Macdowall W, Bonell C, Fortenberry JD, Mercer CH, Sonnenberg P, Mitchell KR. Conceptualizing Sexual Wellbeing: A Qualitative Investigation to Inform Development of a Measure (Natsal-SW). JOURNAL OF SEX RESEARCH 2024:1-19. [PMID: 38517458 DOI: 10.1080/00224499.2024.2326933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Despite increasing scientific and policy interest in sexual wellbeing, it remains poorly conceptualized. Many studies purporting to measure it instead measure related but distinct concepts, such as sexual satisfaction. This lack of conceptual clarity impedes understanding, measuring, and improving sexual wellbeing. We present qualitative research from multi-stage, mixed-methods work to develop a new measure of sexual wellbeing (Natsal-SW) for the fourth British National Survey of Sexual Attitudes & Lifestyles. Literature review and discussion generated a conceptual framework with seven proposed domains: respect, self-esteem, comfort, self-determination, safety and security, forgiveness, and resilience. Semi-structured interviews with 40 adults aged 18-64 then explored whether and how these domains aligned with participants' own understandings, experiences, and language of sexual wellbeing. Data were analyzed thematically. Participants conceptualized sexual wellbeing as distinct from sexual satisfaction and sexual health and as multidimensional, dynamic, and socially and structurally influenced. All seven proposed domains resonated with accounts of sexual wellbeing as a general construct. The personal salience of different domains and their dimensions varied between individuals (especially by gender and sexual orientation) and fluctuated individually over time. This study clarifies dimensions of domains that participants considered important, providing an empirical basis to inform development of a new measure of sexual wellbeing.
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Affiliation(s)
- R Lewis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - R Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - K J Maxwell
- Research Centre for Health, Glasgow Caledonian University
| | - D Reid
- Institute for Global Health, University College London
| | - W Macdowall
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine
| | - C Bonell
- Faculty of Public Health & Policy, London School of Hygiene & Tropical Medicine
| | - J D Fortenberry
- Department of Pediatrics, Indiana University School of Medicine
| | - C H Mercer
- Institute for Global Health, University College London
| | - P Sonnenberg
- Institute for Global Health, University College London
| | - K R Mitchell
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
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Balén Z, Pliskin E, Cook E, Manlove J, Steiner R, Cervantes M, Garrido M, Nuñez-Eddy C, Day M. Strategies to develop an LGBTQIA+-inclusive adolescent sexual health program evaluation. FRONTIERS IN REPRODUCTIVE HEALTH 2024; 6:1327980. [PMID: 38590517 PMCID: PMC11000634 DOI: 10.3389/frph.2024.1327980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 03/12/2024] [Indexed: 04/10/2024] Open
Abstract
Introduction Adolescent sexual health interventions are increasingly incorporating content that is inclusive of LGBTQIA+ youth (lesbian, gay, bisexual, transgender, queer/questioning, intersex, asexual, and other marginalized sexualities and genders). Evaluations of such programs must also be inclusive to enhance the validity of evaluation results and avoid further marginalization. We present strategies for increasing LGBTQIA+-inclusivity based on our evaluation of SafeSpace, a sexual health curriculum. Methods To design an LGBTQIA+-inclusive program evaluation, we leveraged LGBTQIA+ research staff's insights, pursued a parental consent waiver, developed an inclusive recruitment plan, and crafted demographic and sexual behavior survey measures with input from youth and equity experts. We conducted a pilot study with 42 youth ages 14-17 to assess the feasibility and efficacy of our strategies. Results We obtained a parental consent waiver and recruited a majority LGBTQIA+ pilot study sample (62%). Using themes from cognitive interviews with youth and experts regarding inclusive framing and use of plain language, we refined demographic measures and expanded sexual behavior measures. Conclusion Findings suggest that the strategies used to enhance LGBTQIA+-inclusivity in our evaluation of SafeSpace were effective in respectfully and more accurately capturing a fuller range of experiences and identities of LGBTQIA+ and cis-straight youth. The strategies and survey measures developed for this study can be applied to increase LGBTQIA+-inclusivity in other adolescent sexual health program evaluations.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Maeve Day
- Child Trends, Rockville, MD, United States
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20
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Strong J. "Even when you write with a pencil there is an eraser to clean it": Examining men's conceptualisations of and involvement in emergency contraceptive use in Accra, Ghana. Soc Sci Med 2024; 344:116635. [PMID: 38324975 DOI: 10.1016/j.socscimed.2024.116635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 12/01/2023] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
Emergency contraceptive pills are an essential and unique post-coital method to avoid a pregnancy, with evidence showing the significant role men can have in procurement and decisions to use. Global Health recommendations specify that emergency contraceptive pills be used sparingly and under specific conditions. This increasingly misaligns with the myriad conceptualisations and rationales among the public for why they choose to use emergency contraceptive pills. There has been a paucity of research aiming to understanding men's involvement and how they shape women's access, choice, and autonomy. This study interrogates how emergency contraceptive pills are conceptualised by men in James Town, Ghana, and how this intersects with their motivations to be involved in its use. Mixed method data from a survey (n = 270) and in-depth interviews (n = 37) were collected between July 2020 and January 2021. The analysis examines men's framings of emergency contraceptive pills and how these shape their involvement in its use. Men's knowledge of post-coital contraceptives was high, while knowledge of the specific term 'emergency contraception' was lower. While some men understood the pills in ways that aligned to Global Health framings, many more men saw emergency contraceptive pills as another means of pregnancy prevention in line with other contraceptives. This included its conceptualisation as a contraceptive that facilitates pleasurable (condomless) and spontaneous sex. Gendered perceptions of women who use emergency contraceptive pills were bound in sexual stigma, and men indicated that emergency contraceptive pills were a directly observable form of contraception that they could pressure their partner into using. Understanding plural conceptualisations away from 'emergency' are necessary to create policies and programmes that account for men's involvement. This includes understanding how emergency contraceptive pills are located within people's sexual and reproductive lives and gendered power dynamics, to reflect the public's own rationales for and experiences using post-coital contraceptives.
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Affiliation(s)
- Joe Strong
- Department of Social Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
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21
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Bond KT, Radix AE. Sexual Health and Well-Being: A Framework to Guide Care. Med Clin North Am 2024; 108:241-255. [PMID: 38331477 DOI: 10.1016/j.mcna.2023.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
Although the acceptance of sex positivity centering pleasure and justice has grown, clinical and public health strategies for sexually transmitted infection management have remained focused on risk and adverse outcomes. To promote sex-positive health care practice in clinical settings and beyond, health care practitioners should use an integrated, patient-centered approach to sexual health. These strategies include initiating discussions, continued sexual health education, providing informative material for patients, and knowledge of different communication strategies. Patient-provider interactions might be enhanced by using such methods.
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Affiliation(s)
- Keosha T Bond
- Department of Community Health and Social Medicine, CUNY School of Medicine, 160 Convent Avenue, Harris Hall, New York, NY 10031, USA; Center for Interdisciplinary Research on AIDS at Yale University, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510-2483, USA.
| | - Asa E Radix
- Center for Interdisciplinary Research on AIDS at Yale University, Yale University School of Public Health, 135 College Street, Suite 200, New Haven, CT 06510-2483, USA; Department of Epidemiology, Columbia University Mailman School of Public Health, 722 West 168th Street, New York, NY 10032, USA
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22
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Shigeto A, Anders KM. "It's Almost Boring When It Should Be Enjoyable and Fun": College Students' Definitions of Bad Sex. JOURNAL OF SEX RESEARCH 2024:1-13. [PMID: 38411575 DOI: 10.1080/00224499.2024.2319258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
Some of the primary reasons for sexual activities among college students include self-focused motives such as pleasure, along with other-focused motives that facilitate relatedness such as intimacy and emotional connection. However, college students' motivations for sex (or lack thereof) may also be impacted by the meaning they make of their own or peers' experience of "bad sex" - sex that is consensual yet "bad" or "negative" in some way. Therefore, the current study qualitatively explored college students' definitions of "bad sex." A total of 300 college-attending emerging adults (ages 18-25) provided open-ended responses regarding their definition of "bad sex" that is not sexual assault or rape. Using a thematic analytic approach, we identified six main themes on how participants defined what constituted "bad sex": (1) Lack of Pleasure, (2) Negative Outcomes (3) Unmet Expectations, (4) Sexual Violence, (5) Lack of Connection, and (6) Bad Partner. Additionally, the themes were examined based on gender identity, sexual activity status, sexual orientation, and relationship status. Implications for college sex education along with areas of future research with diverse populations and qualitative methodology are discussed.
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Affiliation(s)
- Aya Shigeto
- Department of Psychology and Neuroscience, Nova Southeastern University
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23
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Lazar A, Gewirtz-Meydan A, Rosenbaum TY. War-Time Stress and Sexual Well-Being in Israel. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2024; 36:1-14. [PMID: 38596811 PMCID: PMC10903651 DOI: 10.1080/19317611.2024.2317169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 02/03/2024] [Indexed: 04/11/2024]
Abstract
Objective This study explored the relationship between war-related stressors and sexual well-being among a civilian population during the 2023 Israel-Hamas War, emphasizing a comprehensive assessment of sexual satisfaction, function, and distress. We aimed to investigate how direct exposure, media exposure, and acute stress symptoms during the war contribute to various dimensions of sexual well-being using a quasi-longitudinal online survey method. Methods An online survey with a convenience sample of 1033 Israeli adults, utilizing measures of direct and media exposure to war stress, acute stress symptoms, and various aspects of sexual well-being, both pre-war and present was distributed. Data analysis involved Pearson correlations and hierarchical regression. Results There were significant associations between stress-related variables and sexual well-being, highlighting the differential contribution of direct exposure, media exposure, and acute stress symptoms. Direct exposure to stress was uniquely associated with sexual dysfunction, while media exposure and acute stress symptoms contributed significantly to predicting various aspects of sexual well-being. Conclusions Recognizing the multifaceted impact of stress during wartime on sexual well-being is crucial for developing comprehensive mental health interventions that address individual and societal factors. This study contributes valuable insights into the relationships between stress-related variables and sexual well-being during wartime, emphasizing the need for holistic approaches in addressing the intimate challenges individuals face during times of conflict.
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Affiliation(s)
- Aryeh Lazar
- Department of Psychology, Faculty of Humanities and Social Sciences, Ariel University, Ariel, Israel
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
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24
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Arends SAM, van Rossum CE, Eeltink CM, Robertus JE, Schoonmade LJ, Francke AL, Jongerden IP. Feasibility and effectiveness of communication tools for addressing intimacy and sexuality in patients with cancer: a systematic review. Support Care Cancer 2024; 32:109. [PMID: 38231322 PMCID: PMC10794301 DOI: 10.1007/s00520-024-08308-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 01/05/2024] [Indexed: 01/18/2024]
Abstract
PURPOSE Patients diagnosed with cancer might experience changes in intimacy and sexuality due to the illness itself, treatment, or psychological and social factors. Healthcare professionals (HCPs) often feel reluctant to discuss these changes. This study aimed to provide an overview of the feasibility and effectiveness of communication tools that support communication regarding changes in intimacy or sexuality among patients with cancer. METHODS This is a systematic review. Databases are PubMed, Embase, CINAHL, PsycInfo, Web of Science and Cochrane Library from inception to June 2023. The Mixed Methods Appraisal Tool was used to assess included studies. Data were summarized in data charting forms. RESULTS In total 35 studies were included, published between 2001 and 2023. Most had a quantitative design and moderate methodological quality. In 11 studies, the PLISSIT model (Permission, Limited Information, Specific Suggestions, Intensive Therapy) was used. Tools were integrated in counselling sessions or training programmes for individual patients, couples, groups of patients, or HCPs. All tools were considered feasible by patients or HCPs. Twenty studies reported significant improvement in sexual functioning, quality of life, quality of care or combined outcomes. CONCLUSION Tools to support communication about changes in intimacy and sexuality among patients with cancer seem feasible and effective. The most commonly used tool, the PLISSIT model, proved to be feasible for HCPs and to have a positive effect on patients' and partners' sexual functioning and quality of life. Giving attention to changes in intimacy and sexuality seems to be important in itself, regardless of the communication tool or approach used.
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Affiliation(s)
- Susanne A M Arends
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands.
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands.
| | - Carlijn E van Rossum
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | - Corien M Eeltink
- Oncology Daycare Center, Dijklander Hospital, Hoorn, the Netherlands
| | - Jantien E Robertus
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
| | | | - Anneke L Francke
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
- NIVEL. Netherlands Institute for Health Services Research, Utrecht, the Netherlands
| | - Irene P Jongerden
- Department of Public and Occupational Health, Amsterdam UMC, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Amsterdam Public Health Research Institute, Van Der Boechorststraat 7, NL-1081 BT, Amsterdam, the Netherlands
- Center of Expertise in Palliative Care, VU University Medical Center, Amsterdam, the Netherlands
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25
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Nimbi FM, Cavagnis S, Eleuteri S. Changes in Sexual Behavior and Satisfaction and Violent Behavior during COVID-19 Lockdown: Explorative Results from the Italian Cross-Sectional Study of the I-SHARE Multi-Country Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:96. [PMID: 38248559 PMCID: PMC10815040 DOI: 10.3390/ijerph21010096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND The COVID-19 pandemic has had effects on sexual and reproductive health and intimate partner violence (IPV). This study aims to describe changes in sexual health and IPV in the Italian population both during and after the lockdowns. METHODS This cross-sectional online study was conducted, as part of the I-SHARE multicountry project, between June 2020 and January 2021. Recruitment was carried out through convenience sampling; a total of 329 participants were included in the analysis. A generalized linear model was used to analyze the difference in sexual health and IPV variables before, during, and after the lockdown. RESULTS Fifty-three percent of the participants reported having sexual problems during the first wave of the pandemic. Sexual satisfaction decreased during the first wave, and then, returned to the pre-lockdown level. While during the lockdown, some activities were reduced (such as kissing, cuddling, and sexual activities with a steady partner), for other activities, no difference was reported (such as masturbation, sexual activities with casual partners, or sexting). Few participants reported having issues accessing HIV testing and contraception. There was no difference in terms of physical and sexual violence, while there was a significant decrease in feeling vulnerable to sexual or physical assault during the first wave. CONCLUSIONS The first wave of the pandemic has had significant effects on sexual health. This should be taken into consideration when preparing for future epidemics and health emergencies.
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Affiliation(s)
- Filippo Maria Nimbi
- Department of Dynamic and Clinical Psychology and Health Studies, Sapienza University of Rome, 00185 Rome, Italy;
| | - Sara Cavagnis
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy
| | - Stefano Eleuteri
- Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
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26
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MacGilleEathain R, Smith T, Steele I. Sexual well-being among young people in remote rural island communities in Scotland: a mixed methods study. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:7-12. [PMID: 37295934 PMCID: PMC10850708 DOI: 10.1136/bmjsrh-2023-201822] [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: 02/07/2023] [Accepted: 05/24/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND It has been identified that rural young people face barriers to accessing support for their sexual well-being such as availability and transport, knowing healthcare staff personally, and fear of being judged negatively within their community. These factors may contribute to widening health inequalities and expose young people living in rural areas to increased risk of poor sexual well-being. Little is known about the current needs of adolescents residing in remote rural island communities (RRICs). METHODS A cross sectional mixed methods study was conducted with 473 adolescents aged 13-18 across the islands of the Outer Hebrides of Scotland. Analysis included descriptive, inferential statistics and thematic analysis. RESULTS 59% (n=279) of participants held the perception there was no support, or did not know if there was support, about condoms and contraception in their local area. 48% (n=227) said that free condoms were not easily available for local young people. 60% (n=283) said they would not use youth services if they were locally available. 59% (n=279) said they did not receive enough relationships, sexual health and parenthood (RSHP) education. Opinion differed significantly by gender, school year group, and sexual orientation. Qualitative analysis identified three key themes: (1) alone yet visible, (2) silence and disapproval, and (3) safe spaces, with an underpinning theme of island cultures. CONCLUSIONS A need for further sexual well-being support that addresses the complexities and challenges for young people residing in RRICs is identified. The intersectionality of being LGBT+ and residing in this context may increase the experience of inequality in sexual well-being support.
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Affiliation(s)
- Rebecah MacGilleEathain
- Division of Rural Health and Wellbeing, Institute of Health, Research and Innovation, University of the Highlands and Islands, Inverness, UK
| | - Tamsin Smith
- School of Health, Wellbeing and Social Care, The Open University in Scotland, Edinburgh, UK
| | - Isabel Steele
- Division of Public Health & Health Strategy, NHS Western Isles, Balivanich, UK
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27
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Trapani A, Giordani MS, Notari MM. Teaching of sexual medicine and gender issues in medical courses: students' perception. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2024; 70:e20231075. [PMID: 38198395 PMCID: PMC10768678 DOI: 10.1590/1806-9282.20231075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 01/12/2024]
Abstract
INTRODUCTION In addition to reproductive purposes, human sexuality and sexual health are matters of great importance in the medical office. Despite this, there is still a deficiency in the training of Brazilian medical students regarding sexual medicine and gender issues. OBJECTIVE The objective of this study was to analyze the perception of fifth- and sixth-year students in relation to the teaching of sexual medicine and gender issues in medical courses. METHODS This is a descriptive and cross-sectional study with students from the last 2 years of medical schools in the State of Santa Catarina (internship classes), through the application of a self-administered, semi-structured online questionnaire. RESULTS A total of 164 students answered the questionnaire, with 83.5% (137/164) saying they had taken classes on sexual medicine and 47% (77/164) saying they had taken classes on gender issues. The participants judged the teaching inadequate in most of the topics addressed, and there was no significant difference between students from public and private schools. Notably, 79.9% (131/164) of the students considered the teaching of sexual medicine insufficient or inadequate, while 87.8% (144/164) considered the teaching of gender issues insufficient or inadequate. CONCLUSION The vast majority of students consider the teaching of sexual medicine and gender issues insufficient and inadequate.
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Affiliation(s)
- Alberto Trapani
- Universidade Federal de Santa Catarina, Universidade do Sul de Santa Catarina, Brazilian Federation of Gynecology and Obstetrics Associations, São José Regional Hospital Dr. Homero de Miranda Gomes, Palhoça Medicine Course
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28
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Rao TSS, Tripathi A, Manohar S, Tandon A. Promoting sexual well-being. Indian J Psychiatry 2024; 66:S262-S271. [PMID: 38445287 PMCID: PMC10911331 DOI: 10.4103/indianjpsychiatry.indianjpsychiatry_612_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 12/08/2023] [Accepted: 01/05/2024] [Indexed: 03/07/2024] Open
Affiliation(s)
| | - Adarsh Tripathi
- Department of Psychiatry, King George's Medical University, Lucknow, Uttar Pradesh, India E-mail:
| | - Shivanand Manohar
- Department of Psychiatry, JSS Medical College, Mysore, Karnataka, India
| | - Abhinav Tandon
- Department of Psychiatry, MLN Medical College, Prayagraj, Uttar Pradesh, India
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29
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Chang YC. Effectiveness of Integrated Mindfulness-Based Fitness Training Program in Ameliorating Physical Symptoms and Survivor Concerns in Patients With Breast Cancer: A Randomized Clinical Trial. Cancer Nurs 2023:00002820-990000000-00175. [PMID: 38158601 DOI: 10.1097/ncc.0000000000001285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
BACKGROUND Patients with breast cancer typically experience both mental and physical distress after aggressive treatments. Some studies have explored the use of integrated interventions, such as mindfulness-based or exercise-based approaches, to reduce these symptoms. However, the results of these studies have been conflicting. OBJECTIVE The aim of this study was to evaluate the effectiveness of an integrated mindfulness-based fitness training (MBFT) program in addressing overactive bladder, fear of cancer recurrence, and female sexual function in patients with breast cancer. METHODS Fifty patients with breast cancer were either assigned to an 8-week MBFT group or a waitlist control group. The postintervention and preintervention scores were compared using descriptive analysis of the data set, as well as paired and independent t tests. RESULTS There was no significant improvement in overactive bladder symptoms. Significant differences were observed in survivor concerns for items related to future diagnostic tests (t = 2.667, P = .024; 95% confidence interval [CI], 0.120-1.335), another type of cancer (t = 2.667, P = .024; 95% CI, 0.120-1.335), cancer coming back (t = 4.183, P = .002; 95% CI, 0.297-0.975), dying (t = 2.609, P = .026; 95% CI, 0.093-1.180), and my health (t = 2.887, P = .016; 95% CI, 0.104-0.805). A significant difference was found in the item measuring overall sexual life satisfaction (t = -3.162, P = .013) and sexual desire (MBFT vs waitlist control group, 2.00 vs 1.18; P = .023). CONCLUSION Mindfulness-based fitness training interventions were effective in enhancing the well-being of patients with breast cancer by reducing fear of recurrence and enhancing sexual function. These findings support the use of MBFT as complementary therapy. IMPLICATIONS FOR PRACTICE Healthcare providers should carefully assess the individual needs and preferences of each patient and tailor interventions accordingly. In addition, integrating multiple approaches may be more effective in reducing distress.
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Affiliation(s)
- Yun-Chen Chang
- Author Affiliations: School of Nursing and Graduate Institute of Nursing, China Medical University; and Nursing Department, China Medical University Hospital, Taichung, Taiwan
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30
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Mitchell KR, Palmer MJ, Lewis R, Bosó Pérez R, Maxwell KJ, Macdowall W, Reid D, Bonell C, Mercer CH, Sonnenberg P, Fortenberry JD. Development and Validation of a Brief Measure of Sexual Wellbeing for Population Surveys: The Natsal Sexual Wellbeing Measure (Natsal-SW). JOURNAL OF SEX RESEARCH 2023:1-11. [PMID: 38127808 DOI: 10.1080/00224499.2023.2278530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Sexual wellbeing is an important aspect of population health. Addressing and monitoring it as a distinct issue requires valid measures. Our previous conceptual work identified seven domains of sexual wellbeing: security; respect; self-esteem; resilience; forgiveness; self-determination; and comfort. Here, we describe the development and validation of a measure of sexual wellbeing reflecting these domains. Based on the analysis of 40 semi-structured interviews, we operationalized domains into items, and refined them via cognitive interviews, workshops, and expert review. We tested the items via two web-based surveys (n = 590; n = 814). Using data from the first survey, we carried out exploratory factor analysis to assess and eliminate poor performing items. Using data from the second survey, we carried out confirmatory factor analysis to examine model fit and associations between the item reduced measure and external variables hypothesized to correlate with sexual wellbeing (external validity). A sub-sample (n = 113) repeated the second survey after 2 weeks to evaluate test-retest reliability. Confirmatory factor analysis indicated that a "general specific model" had best fit (RMSEA: 0.064; CFI: 0.975, TLI: 0.962), and functioned equivalently across age group, gender, sexual orientation, and relationship status. The final Natsal-SW measure comprised 13 items (from an initial set of 25). It was associated with external variables in the directions hypothesized (all p < .001), including mental wellbeing (0.454), self-esteem (0.564), body image (0.232), depression (-0.384), anxiety (-0.340), sexual satisfaction (0.680) and sexual distress (-0.615), and demonstrated good test-retest reliability (ICC = 0.78). The measure enables sexual wellbeing to be quantified and understood within and across populations.
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Affiliation(s)
| | - Melissa J Palmer
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - Ruth Lewis
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | - Raquel Bosó Pérez
- MRC/CSO Social and Public Health Sciences Unit, University of Glasgow
| | | | - Wendy Macdowall
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - David Reid
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
| | - Chris Bonell
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine
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Bittleston H, Hocking JS, Coombe J, Temple-Smith M, Goller JL. Young Australians' receptiveness to discussing sexual health with a general practitioner. Aust J Prim Health 2023; 29:587-595. [PMID: 37614041 DOI: 10.1071/py23083] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 07/24/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND Most sexual health care in Australia is provided through general practice. However, many young Australians experience barriers to accessing sexual health care. This research examines young Australians' receptiveness to discussing sexual health with a general practitioner (GP). METHODS We conducted an anonymous online sexual health survey (open 2 May to 21 June 2022). Anyone living in Australia aged 16-29years was eligible to participate. Participants were recruited via social media and asked whether they agreed with five statements exploring their receptivity to discussing sexual health with GPs. We explored characteristics associated with responses using multivariable logistic regression. RESULTS Among 1915 participants, 69.3% were cisgender women, with a median age of 20years; 48.5% were heterosexual. Approximately one-fifth agreed they might not tell a GP the whole truth about their sexual history, would be worried about confidentiality when discussing their sexual history and would be too embarrassed to see their usual GP if they thought they had a sexually transmitted infection. Over half (55.8%) agreed they would be comfortable with a GP bringing up sexual health in an unrelated consultation, but 39.6% would be nervous to bring up sexual health in case they needed an intimate examination. Multivariate regression identified several characteristics associated with responses. Notably, having a school-based sex education and a usual GP were factors associated with increased receptivity to discussing sexual health. CONCLUSIONS Young Australians were generally open to discussing sexual health with a GP. School-based sex education and GP-patient relationships are key to promoting sexual health among young people.
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Affiliation(s)
- Helen Bittleston
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Vic. 3010, Australia
| | - Jane S Hocking
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Vic. 3010, Australia
| | - Jacqueline Coombe
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Vic. 3010, Australia
| | - Meredith Temple-Smith
- Department of General Practice, The University of Melbourne, Carlton, Vic. 3010, Australia
| | - Jane L Goller
- Melbourne School of Population and Global Health, The University of Melbourne, Carlton, Vic. 3010, Australia
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Goold P, Mitchell K, Ahmed N, Andrews S. Sexual Function and Well-being Special Interest Group: what is in a name? Sex Transm Infect 2023; 99:576. [PMID: 37977658 DOI: 10.1136/sextrans-2023-055930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Affiliation(s)
- Penny Goold
- GU Medicine, Whittall Street Clinic, Birmingham, UK
| | - Kirstin Mitchell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Nadia Ahmed
- Sexual Health and HIV, Central and North West London NHS Foundation Trust, London, UK
| | - Shalini Andrews
- Sexual Health and HIV, Central and North West London NHS Foundation Trust, London, UK
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Castro Á, Correa AB. Psychological and Psychosexual Adjustment in University Students as a Function of Sexual Activity and Relationship Type. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:543-554. [PMID: 38601808 PMCID: PMC10903592 DOI: 10.1080/19317611.2023.2264285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 09/23/2023] [Indexed: 04/12/2024]
Abstract
The objective of the present study was to examine the differences in some variables of psychological (depression, anxiety, physical self-esteem) and psychosexual (self-esteem as a sexual partner, satisfaction with sexual life, sexual preoccupation) adjustment in a sample of university students, as a function of gender, and divided into three groups: (1) those who had a stable partner; (2) those who did not have a stable partner but did have casual sexual relations; and (3) those who had neither a stable partner nor casual relationships. Participants were 980 students from a mid-size Spanish university, of both sexes (71.3% women, 28.7% men), aged between 18 and 26 years (M = 20.87, SD = 1.88), who completed an online battery of questionnaires. Differences were found in psychological and psychosexual adjustment variables depending on the reference group and both in men and women. Some of these differences were explained by having a partner and others by having sexual relations, regardless of the partner with whom they had sex. These differences and their impact on young people's psychological adjustment and wellness should be taken into account when designing sexual health prevention and promotion programs.
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Affiliation(s)
- Ángel Castro
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
| | - Ana Belén Correa
- Department of Psychology and Sociology, University of Zaragoza, Teruel, Spain
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Ventura-Aquino E, Ågmo A. The elusive concept of sexual motivation: can it be anchored in the nervous system? Front Neurosci 2023; 17:1285810. [PMID: 38046659 PMCID: PMC10691110 DOI: 10.3389/fnins.2023.1285810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 10/16/2023] [Indexed: 12/05/2023] Open
Abstract
Sexual motivation is an abstract concept referring to the mechanisms determining the responsivity to sexually relevant stimuli. This responsivity determines the likelihood of producing a sexual response and the intensity of that response. Both responsivity to stimuli and the likelihood of making a response as well as the intensity of response are characteristics of an individual. Therefore, we need to assume that the concept of sexual motivation materializes in physiological mechanisms within the individual. The aim of the present communication is to analyze the requisites for the endeavor to materialize sexual motivation. The first requisite is to provide an operational definition, making the concept quantifiable. We show that parameters of copulatory behavior are inappropriate. We argue that the intensity of sexual approach behaviors provides the best estimate of sexual motivation in non-human animals, whereas the magnitude of genital responses is an exquisite indicator of human sexual motivation. Having assured how to quantify sexual motivation, we can then proceed to the search for physiological or neurobiological underpinnings. In fact, sexual motivation only manifests itself in animals exposed to appropriate amounts of gonadal hormones. In female rats, the estrogen receptor α in the ventrolateral part of the ventromedial nucleus of the hypothalamus is necessary for the expression of sexual approach behaviors. In male rats, androgen receptors within the medial preoptic area are crucial. Thus, in rats sexual motivation can be localized to specific brain structures, and even to specific cells within these structures. In humans, it is not even known if sexual motivation is materialized in the brain or in peripheral structures. Substantial efforts have been made to determine the relationship between the activity of neurotransmitters and the intensity of sexual motivation, particularly in rodents. The results of this effort have been meager. Likewise, efforts of finding drugs to stimulate sexual motivation, particularly in women complaining of low sexual desire, have produced dismal results. In sum, it appears that the abstract concept of sexual motivation can be reliably quantified, and the neurobiological bases can be described in non-human animals. In humans, objective quantification is feasible, but the neurobiological substrate remains enigmatic.
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Affiliation(s)
- Elisa Ventura-Aquino
- Escuela Nacional de Estudios Superiores, Unidad Juriquilla, UNAM, Juriquilla, Mexico
| | - Anders Ågmo
- Department of Psychology, University of Tromsø, Tromsø, Norway
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35
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Borgmann M, Brandner LM, D'Urso D, Gonin-Spahni S, Znoj HJ, Werner MA. A Psychometric Study of a Trait and State Assessment of Sexual Pleasure - The Amsterdam Sexual Pleasure Inventory. JOURNAL OF SEX RESEARCH 2023:1-27. [PMID: 37971277 DOI: 10.1080/00224499.2023.2261439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
We studied the Amsterdam Sexual Pleasure Inventory's (1.0) psychometric properties. The ASPI, a revised self-report battery designed to measure domains of state and trait sexual pleasure in diverse gender, sex, and relationship populations, is based on a recently proposed conceptual framework of sexual pleasure. We collected quantitative (n = 1371) and qualitative data (n = 637) using a cross-sectional multi-method design targeting the general (German-speaking) population. After pre-processing, we conducted analyses on a sample of n = 706 participants. The theory-based 5-factor exploratory structural equation model and the principal component analyses of the two general exploratory index-scales showed good and acceptable structural validity evidence respectively. Measurement invariance was confirmed separately for male and female participants and for those with sexually functional-scoring and dysfunctional-scoring levels. Coefficient omega indicated that all scales, except those of one facet, showed acceptable to very good internal consistency. The ASPI's convergent and discriminant associations with sexological and psychological constructs demonstrated good overall construct validity. Participants understood the items as intended and felt that the ASPI covered relevant facets of sexual pleasure. The ASPI might help understand how individuals differ in experiencing sexual pleasure and how different contexts enable some people to experience pleasure while disadvantaging others.
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Affiliation(s)
- M Borgmann
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - L M Brandner
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - D D'Urso
- Department of Methodology and Statistics, School of Social and Behavioral Sciences, Tilburg University
| | - S Gonin-Spahni
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - H J Znoj
- Institute of Psychology, Department of Health Psychology and Behavioral Medicine, University of Bern
| | - M A Werner
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam Reproduction & Development, Cancer Center Amsterdam, Amsterdam University Medical Center, University of Amsterdam
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36
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Towler LB, Graham CA, Bishop FL, Hinchliff S. Sex and Relationships in Later Life: Older Adults' Experiences and Perceptions of Sexual Changes. JOURNAL OF SEX RESEARCH 2023; 60:1318-1331. [PMID: 35852483 DOI: 10.1080/00224499.2022.2093322] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The aim of this study was to explore the sexual lives of older adults in the UK to elucidate their experiences of sexual changes and problems, and the role of intimacy and interpersonal support in coping with these changes. We conducted in-depth semi-structured interviews with 31 participants (aged 66-92, mean = 74, 16 women and 15 men), analyzed using reflexive thematic analysis. Our analysis generated three themes: Sexual Changes are "Natural," Sex is the Icing on the Cake, and Maintaining Sexual Connection and Relationship Satisfaction. The participants often rationalized and accepted sexual changes and problems as part of the natural aging process, or as a consequence of other age-related health issues. Sexual activity was seen by many as the "icing on the cake" of a satisfying romantic relationship, built on strong foundations of intimacy, connection, and companionship. Relationship satisfaction and sexual wellbeing can be maintained despite changes to sexual function by retaining a sexual connection through shared experiences, emotional closeness, and support. The findings have important implications for researchers and health providers, and suggest that adopting an "affirmative older age" perspective would be useful for not only future research but also when providing support for older adults with sexual difficulties.
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Affiliation(s)
| | | | | | - Sharron Hinchliff
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield
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37
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James H, Nazroo J, Chatzi G, Simpson P. How Do Women and Men Negotiate Sex in Later Life Relationships? A Qualitative Analysis of Data from the English Longitudinal Study of Aging. JOURNAL OF SEX RESEARCH 2023; 60:1332-1344. [PMID: 36043890 DOI: 10.1080/00224499.2022.2112934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Later life relationships and in particular the role of sex within them, have often been neglected in research due to assumptions of decline and sexlessness. We contribute to a growing body of work which counters these stereotypes by examining sexual scripts within the socio-cultural context of later life relationships. We analyzed open-text comments from the English Longitudinal Study of Aging (ELSA) collected as part of a self-completion questionnaire. In Wave 6, 1065 participants (M age 67.5, SD 9.6 years) and in Wave 8, 922 participants (M age 69.1, SD 9.01 years) responded to an open-text box question. Across both waves, 38% of respondents were men and 62% were women. The analysis used a coding template developed from existing literature and adjusted to accommodate emerging topics. A gendered analysis of the interrelated topics of relationships, sex and sexuality resulted in themes which illustrate similarities and differences in how men and women negotiate sex in later life relationships. The findings confirm that sex remains integral to intimacy in later life relationships for many men and women. However, they also demonstrate that norms of age and gender interact to shape sex and relationship practices in later life. These norms limit some people's experiences, for example, preventing them from seeking new relationships, as well as creating challenges for intimacy in partnerships. These findings extend the theoretical understanding of relationships and sex in later life.
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Affiliation(s)
- Hayley James
- School of Social Policy, Social Work and Social Justice, University College Dublin
| | - James Nazroo
- Manchester Institute for Collaborative Research on Ageing, School of Social Sciences, The University of Manchester
| | - Georgia Chatzi
- Social Statistics Cathie Marsh Institute for Social Research, School of Social Sciences, The University of Manchester
| | - Paul Simpson
- Sociology, School of Social Sciences, The University of Manchester
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38
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Lorimer K, Greco G, Lorgelly P. A new sexual wellbeing paradigm grounded in capability approach concepts of human flourishing and social justice. CULTURE, HEALTH & SEXUALITY 2023; 25:1402-1417. [PMID: 36565149 DOI: 10.1080/13691058.2022.2158236] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
Over the last twenty years, there has been a growing interest in measuring sexual wellbeing, including by a WHO/UNFPA working group in 2007, which sought clarity on key dimensions and asked for indicators of these to be devised. However, there remains a lack of conceptual clarity surrounding the concept of sexual wellbeing, which may create variation in what is being assessed and to what we are referring. This paper proposes one way in which to achieve conceptual clarity might be through the utilisation of a Capability Approach, thereby posing a new set of normative questions about what sexual wellbeing is. The central argument in this paper is for researchers, theorists and practitioners to focus more fully on a person's freedom to achieve sexual wellbeing within a particular social and cultural context. We suggest the kinds of data that might need to be captured to operationalise and measure such an understanding. By offering new critical insights, we hope to drive forward empirical and methodological development in the evaluation of sexual wellbeing.
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Affiliation(s)
- Karen Lorimer
- School of Health & Life Sciences, Glasgow Caledonian University, Glasgow, Scotland, UK
| | - Giulia Greco
- Department for Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Paula Lorgelly
- Department of Economics, University of Auckland, Auckland, New Zealand
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39
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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.
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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
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40
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Beaulieu N, Bergeron S, Brassard A, Byers ES, Péloquin K. Toward an Integrative Model of Intimacy, Sexual Satisfaction, and Relationship Satisfaction: A Prospective Study in Long-Term Couples. JOURNAL OF SEX RESEARCH 2023; 60:1100-1112. [PMID: 36205506 DOI: 10.1080/00224499.2022.2129557] [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
Sexual and relationship well-being are strongly intertwined in couple relationships. However, relationship quality is generally examined through relationship satisfaction only, neglecting the importance of sexual satisfaction as an aspect of relationship quality for many couples. Moreover, considering the role of interpersonal processes, such as intimacy, in relationship quality seems essential to better understand couples' optimal functioning. Although the Vulnerability-Stress-Adaptation Model posits bidirectional associations between interpersonal processes and relationship quality, few studies have tested such models. This dyadic study examined the longitudinal associations between the process of intimacy and sexual and relationship satisfaction in 145 long-term mixed-gender/sex couples. Participants completed online questionnaires three times over 13 months. A cross-lagged panel model revealed bidirectional associations between intimacy behaviors and both sexual and relationship satisfaction. Findings suggest that intimacy behaviors could foster both sexual and relationship satisfaction in couples, and that higher sexual and relationship satisfaction could also promote intimacy behaviors over time. These results highlight that satisfaction may not only be an outcome of positive interpersonal processes, but also a facilitator of these interpersonal processes over time. This study underscores the need to consider the complex interplay of interpersonal processes and satisfaction to foster relationship quality in long-term couples over time.
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41
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de Graaf H, Mitchell K, Clifton S, Lara MF, Dewaele A, Dupont J, Klapilova K, Lazdāne G, Briken P, Træen B, Bajos N, Ljungcrantz D, Kontula O. Sex Surveys in Europe: Reflections on over Four Decades of Sexual Behavior and Sexual Health Surveillance. JOURNAL OF SEX RESEARCH 2023; 60:1020-1033. [PMID: 37339272 DOI: 10.1080/00224499.2023.2222403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2023]
Abstract
Sexual expression is fundamental to human existence and an important topic of enquiry in its own right. Understanding sexual behavior is also essential to establish effective sexual health prevention activities (e.g., education), services and policies, and to assess the progress of policies and action plans. Questions on sexual health are rarely included in general health surveys, and therefore dedicated population studies are required. Many countries lack both funding and sociopolitical support to conduct such surveys. A tradition of periodic population sexual health surveys exists in Europe but the methods used (e.g., in questionnaire construction, recruiting methods or interview format) vary from one survey to another. This is because the researchers within each country are confronted with conceptual, methodological, sociocultural and budgetary challenges, for which they find different solutions. These differences limit comparison across countries and pooling of estimates, but the variation in approaches provides a rich source of learning on population survey research. In this review, survey leads from 11 European countries discuss how their surveys evolved during the past four decades in response to sociohistorical and political context, and the challenges they encountered. The review discusses the solutions they identified and shows that it is possible to create well designed surveys which collect high quality data on a range of aspects of sexual health, despite the sensitivity of the topic. Herewith, we hope to support the research community in their perennial quest for political support and funding, and ongoing drive to advance methodology in future national sex surveys.
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Affiliation(s)
- Hanneke de Graaf
- National Programmes, Rutgers, Dutch Centre of Expertise on Sexual and Reproductive Health
| | | | - Soazig Clifton
- Centre for Health at NatCen, the Institute for Global Health at University College London
| | - Maria Fernanda Lara
- Departamento de Especialidades Quirúrgicas, Bioquímica, Ginecología y Obstetrician, Universidad de Málaga
| | - Alexis Dewaele
- Faculty of Psychology and Educational Sciences, Ghent University
| | - Joke Dupont
- Faculty of Psychology and Educational Sciences, Ghent University
| | - Katerina Klapilova
- National Institute of Mental Health, Klecany, and Faculty of Humanities, Charles University
| | - Gunta Lazdāne
- Institute of Public Health, Rīga Stradiņš University
| | - Peer Briken
- Institute for Sex Research, Sexual Medicine, and Forensic Psychiatry, University Centre Hamburg-Eppendorf
| | - Bente Træen
- Faculty of Social Sciences, Department of Psychology, University of Oslo
| | - Nathalie Bajos
- IRIS U997, Institut National de la Santé et de la Recherche Médicale (INSERM)
| | - Desiree Ljungcrantz
- Unit for Sexual Health and HIV prevention, The Public Health Agency of Sweden
| | - Osmo Kontula
- Population Research Institute, Family Federation of Finland
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42
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Emerson A, Valleroy E, Knittel A, Ramaswamy M. Sex and aging: Perspectives of older adult women with experience of incarceration. J Women Aging 2023; 35:487-503. [PMID: 36840534 PMCID: PMC10450097 DOI: 10.1080/08952841.2023.2180246] [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: 08/26/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/26/2023]
Abstract
To explore perspectives on sexuality, sexual health, and sexual health care of older adult women with a history of criminal legal system involvement, we conducted phone interviews with women aged 50 years or older who were living in the community but had a history of jail and/or prison incarceration. Interview questions and initial analysis were guided by the sexual health framework for public health and Mitchell's sexual wellness model. Data analysis followed a framework method. Nine women, aged 53-66, participated in phone interviews between December 2020 and December 2021. Slightly over half the participants were Black; none were Hispanic. Most were single. We formulated a sex-in-aging (SAGE) framework comprising three categories and two overarching themes. Women with a history of criminal-legal system involvement have heterogeneous views on sex and sexual health and describe a range of desire and sexual activity as they age, including shifting ideas about what they expect from partners, how they keep themselves safe in sexual and intimate relationships, and how life circumstances that are often associated with criminal legal system involvement (substance use, trauma) impact their interest in sex as they age. The SAGE framework integrates these categories and themes and offers a starting point for further research and intervention development.
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Affiliation(s)
- Amanda Emerson
- School of Nursing and Health Studies, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Ella Valleroy
- School of Biological and Chemical Sciences, University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Andrea Knittel
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA
| | - Megha Ramaswamy
- Department of Population Health, University of Kansas Medical Center, Kansas City, Kansas, USA
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Ågmo A, Laan E. The Sexual Incentive Motivation Model and Its Clinical Applications. JOURNAL OF SEX RESEARCH 2023; 60:969-988. [PMID: 36378887 DOI: 10.1080/00224499.2022.2134978] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Sexual motivation (desire) requires the simultaneous presence of an active central motive state and a stimulus with sexual significance. Once activated, sexual motivation leads to visceral responses and approach behaviors directed toward the emitter of the sexual stimulus. In humans, such behaviors follow cognitive evaluation of the context, including predictions of the approached individual's response. After successful approach and establishment of physical contact, manifest sexual activities may be initiated. Sexual interaction is associated with and followed by a state of positive affect in most animals, whereas aversive consequences may be experienced by humans. The affective reactions may become associated with stimuli present during sexual interaction, and these stimuli may thereby alter their incentive properties. Here we show how the incentive motivation model can be used to explain the origins and possible treatments of sexual dysfunctions, notably disorders of desire. We propose that associations formed between negative outcomes of sexual interaction and the salient stimuli, for example, the partner, underlies hypoactive desire disorder. Highly positive outcomes of sexual interaction enhance the incentive value of the stimuli present, and eventually lead to hyperactive sexual desire. Treatments aim to alter the impact of sexual incentives, mainly by modifying cognitive processes.
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Affiliation(s)
- Anders Ågmo
- Department of Psychology, University of Tromsø
| | - Ellen Laan
- Department of Sexology and Psychosomatic Gynaecology, Amsterdam UMC, University of Amsterdam
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Smith MS, South SC. Risky Sexual Behaviors as a Transaction of Individual Differences and Situational Context. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:2539-2560. [PMID: 37103633 DOI: 10.1007/s10508-023-02592-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 02/21/2023] [Accepted: 03/19/2023] [Indexed: 06/19/2023]
Abstract
Risky sexual behaviors (RSBs) incur large societal and personal costs. Despite widespread prevention efforts, RSBs and associated consequences (e.g., sexually transmitted infections) continue to rise. A proliferation of research has emerged on situational (e.g., alcohol use) and individual difference (e.g., impulsivity) factors to explain this rise, but these approaches assume an unrealistically static mechanism underlying RSB. Because this prior research has resulted in few compelling effects, we sought to innovate by examining the interaction of situation and individual differences in explaining RSBs. A large sample (N = 105) completed baseline reports of psychopathology and 30 daily diary reports of RSBs and associated contexts. These data were submitted to multilevel models including cross-level interactions to test a person-by-situation conceptualization of RSBs. Results suggested that RSBs are most strongly predicted from interactions of person- and situation-level factors in both protective and facilitative directions. These interactions outnumbered main effects and commonly included partner commitment as a central mechanism. These results point to theoretical and clinical gaps in preventing RSB and urge a departure from prior ways of conceptualizing sexual risk as a static outcome.
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Affiliation(s)
- Madison Shea Smith
- Department of Psychological Sciences, Purdue University, 703 3rd Street, West Lafayette, IN, USA.
| | - Susan C South
- Department of Psychological Sciences, Purdue University, 703 3rd Street, West Lafayette, IN, USA
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Kılıç D, Armstrong HL, Graham CA. The Role of Mutual Masturbation within Relationships: Associations with Sexual Satisfaction and Sexual Self-Esteem. INTERNATIONAL JOURNAL OF SEXUAL HEALTH : OFFICIAL JOURNAL OF THE WORLD ASSOCIATION FOR SEXUAL HEALTH 2023; 35:495-514. [PMID: 38596452 PMCID: PMC10903564 DOI: 10.1080/19317611.2023.2237950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 07/13/2023] [Indexed: 04/11/2024]
Abstract
Objectives We explored mutual masturbation among women and men and investigated associations with sexual satisfaction and sexual self-esteem. Methods 117 women and 151 men (Mage = 29.7 years), mostly heterosexual, all in current relationships, completed an online survey covering experiences of solo and partnered sexual activities, feelings about mutual masturbation, sexual self-esteem, and sexual satisfaction. Results Mutual masturbation was common among both genders. Men reported significantly higher positive feelings about mutual masturbation than women. Recent mutual masturbation was positively associated with sexual satisfaction but not with sexual self-esteem. Conclusions These findings have implications for sex and couple therapy and research.
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Affiliation(s)
- Dilan Kılıç
- Department of Psychology, University of Southampton, Southampton, UK
| | | | - Cynthia A. Graham
- Department of Gender Studies and The Kinsey Institute, Indiana University, Bloomington, IN, USA
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Walker LM, Santos-Iglesias P. Sexual satisfaction in prostate cancer: a multi-group comparison study of treated patients, patients under active surveillance, patients with negative biopsy, and controls. J Cancer Surviv 2023:10.1007/s11764-023-01420-2. [PMID: 37365387 DOI: 10.1007/s11764-023-01420-2] [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: 01/30/2023] [Accepted: 06/15/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE Erectile function changes after prostate cancer (PCa) treatment are well documented, but less understood is the relative impact of prostate biopsy and active surveillance on sexual well-being. It is unknown whether potential negative impacts are exclusive to patients who have been treated for PCa, or whether the diagnosis itself or the experience of biopsy may also impact sexual well-being. Sexual satisfaction is an important yet understudied indicator of sexual well-being in this population. This study examines sexual satisfaction and its predictors across several comparison groups to explore relative impact. METHODS At baseline and 12 months, questionnaire data was collected in four samples: (1) following PCa treatment, (2) active surveillance, (3) negative prostate biopsy result, and (4) controls receiving no biopsy or treatment. Predictors assessed included group, erectile function, communication style, and partner involvement. RESULTS Sexual satisfaction declined in the active treatment group, no changes were observed in active surveillance or non-PCa control, and improvements were observed in the biopsy group. Predictors of sexual satisfaction over and above erectile function included restrictive communication (i.e. protective buffering) and perceived partner involvement. For higher levels of erectile function, a higher perceived degree of partner involvement was protective of sexual satisfaction. CONCLUSION Sexual satisfaction is an important indicator of sexual well-being and is negatively impacted following PCa treatment, but not active surveillance or prostate biopsy. IMPLICATIONS FOR CANCER SURVIVORS Communication and partner involvement are potentially modifiable factors to be considered for intervention and may promote sexual satisfaction following PCa treatment. Patients experiencing negative biopsy, who note lower sexual satisfaction may experience improved satisfaction with time, and those under active surveillance who worry about sexual satisfaction may find reassurance from these results.
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Affiliation(s)
- Lauren M Walker
- Department of Oncology and Psychology, University of Calgary. Tom Baker Cancer Centre - Holy Cross Site, Psychosocial Resources, 2202 - 2nd St SW, Calgary, AB, T2S 3C1, Canada.
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Tavares IM, Rosen NO, Heiman JR, Nobre PJ. Biopsychosocial Predictors of Couples' Trajectories of Sexual Function and Sexual Distress Across the Transition to Parenthood. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:1493-1511. [PMID: 36459350 DOI: 10.1007/s10508-022-02480-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 09/22/2022] [Accepted: 11/11/2022] [Indexed: 06/17/2023]
Abstract
The prevailing narrative about sexual declines during the transition to parenthood is largely based on studies assessing the average couple, but there is increasing evidence of variability in the sexual well-being of new parents. We sought to establish distinct subgroups of couples based on sexual function and sexual distress trajectories and examine biopsychosocial risk and protective factors of these trajectories. A prospective cohort of 257 first-time parent couples reported on sexual function and sexual distress from 20-week pregnancy (baseline) to 6 months postpartum across four time-points. Biopsychosocial factors were assessed at baseline and 3 months postpartum. Dyadic latent class growth analysis identified two distinct sexual function classes (high, 85%; discrepant, 15%) and three sexual distress classes (low, 77%; moderate, 12%; discrepant, 11%). We identified biomedical (vaginal delivery, perineal tear, breastfeeding) and psychosocial (fatigue, stress, anxiety, depression, attitudes toward sex during pregnancy, relationship quality, perceived partner support) factors that can be assessed at critical time-points (i.e., 20-week pregnancy and 3 months postpartum) to identify high-risk couples. Current results indicate that the course of change in sexual well-being for new parents is heterogeneous, with most new parents retaining high function and low distress and only a minority showing trajectories in which mothers, but not fathers, experience clinically significant and persistent levels of low sexual function and high sexual distress. These results may facilitate more nuanced approaches to the assessment and intervention of new parents' sexual well-being.
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Affiliation(s)
- Inês M Tavares
- SexLab, Faculty of Psychology and Educational Sciences, Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal.
| | - Natalie O Rosen
- Departments of Psychology and Neuroscience and Obstetrics and Gynaecology, Dalhousie University, Halifax, NS, Canada
| | - Julia R Heiman
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, USA
| | - Pedro J Nobre
- SexLab, Faculty of Psychology and Educational Sciences, Center for Psychology at the University of Porto, Rua Alfredo Allen, 4200-135, Porto, Portugal
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Simon KA, Hanna-Walker V, Clark AN, Driver R, Kalinowski J, Watson RJ, Eaton LA. "This Is To Help Me Move Forward": The Role of PrEp in Harnessing Sex Positivity and Empowerment Among Black Sexual Minority Men in the Southern United States. JOURNAL OF SEX RESEARCH 2023; 60:741-751. [PMID: 36239604 PMCID: PMC10102248 DOI: 10.1080/00224499.2022.2131704] [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] [Indexed: 05/12/2023]
Abstract
In the United States (U.S.), Black sexual minority men (BSMM) are disproportionately burdened by HIV. Prevention advances, such as HIV pre-exposure prophylaxis (PrEP), play a key role in reducing HIV transmission and improving our understanding of sexual expression and health. Despite these advances, little is known regarding the potential link between PrEP use and positive sexuality, including the benefits that BSMM see in accessing PrEP. We conducted a thematic analysis of 32 interviews with BSMM in the Southern U.S. regarding their PrEP beliefs. We developed five themes: (1) Sexual freedom, (2) Agency and empowerment, (3) Making PrEP normative, (4) Behavioral health practices, and (5) Committed relationship tensions. Our findings suggest that BSMM are increasingly concerned about freedom of choice and invested in sexual empowerment as related to their PrEP use. Further, unanticipated benefits, community support, and relationship tensions are salient factors in considerations of PrEP use among BSMM. These findings have implications for how we might understand a broader movement toward sexual empowerment and positivity, and the pivotal role that PrEP serves in this movement.
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Affiliation(s)
- Kay A. Simon
- Department of Family Social Science, University of Minnesota, St. Paul, MN, USA
| | - Veronica Hanna-Walker
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Alyssa N. Clark
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Redd Driver
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, New York, NY, USA
| | - Jolaade Kalinowski
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Ryan J. Watson
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
| | - Lisa A. Eaton
- Department of Human Development and Family Sciences, University of Connecticut, Storrs, CT, USA
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Martin GM, Tremblay J, Gagnon-Girouard MP. Sexual self-concept, functioning, and practices of women with binge eating episodes. Eat Weight Disord 2023; 28:37. [PMID: 37069446 PMCID: PMC10108796 DOI: 10.1007/s40519-023-01565-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/21/2023] [Indexed: 04/19/2023] Open
Abstract
PURPOSE Positive sexuality has received little empirical attention in relation to eating disorders. Two tendencies related to sexuality have been identified among women with anorexia nervosa (avoidance) and bulimia nervosa (disinhibition), but it is unclear if they also apply to women with binge eating episodes without compensatory behaviors. This study aimed at (1) exploring the sexual self-concept, functioning, and practices of women with binge eating episodes with or without comorbid restrictive and/or compensatory behaviors, considering past experiences of violence, and (2) verifying the presence of distinct profiles of sexual dispositions among this population. METHODS In total, 253 women reporting recurrent episodes of loss of control related to food intake in the past 5 years, completed a web-based questionnaire. Descriptive and correlational analyses were conducted to outline participants' sexual self-concept, functioning, and practices and to examine the relationship between these factors. A two-step cluster analysis was also performed to determine whether participants presented distinct profiles of sexual dispositions. RESULTS Participants were generally characterized by a negative sexual self-concept and poor sexual functioning. While a first subgroup of participants displayed a pattern of sexual difficulties and avoidance, a second subgroup had a positive sexual self-concept, better sexual functioning and a wider range of sexual practices. Subgroups did not differ relative to binge eating. CONCLUSIONS Sexuality offers a platform for positive embodiment, which can lead to the improvement of body image and mind-body connection and may thus constitute an essential clinical target to improve treatment related to binge eating episodes. LEVEL OF EVIDENCE Level II: The experimental study is a non-randomized controlled trial.
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Affiliation(s)
- Geneviève Manuela Martin
- Department of Psychiatry and Neurosciences, Faculty of Medicine, Université Laval, 1050 Avenue de la Médecine, G1V 0A6, Québec, Canada.
| | - Jérôme Tremblay
- Department of Sexology, Université du Québec à Montréal, Montréal, Canada
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Hinchliff S, Mawson RL, Malta S, Cliff G. How to support the sexual wellbeing of older patients. BMJ 2023; 380:e072388. [PMID: 36972919 DOI: 10.1136/bmj-2022-072388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
Affiliation(s)
- Sharron Hinchliff
- Division of Nursing and Midwifery, Health Sciences School, University of Sheffield, Sheffield, UK
| | - Rebecca L Mawson
- The Academic Unit of Primary Medical Care, University of Sheffield, Sheffield
- GPwER SRH, Valley Medical Centre, Stocksbridge, Sheffield
| | - Sue Malta
- Sexual Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Gilli Cliff
- South Yorkshire Housing Association Limited, Sheffield
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