Context counts: long-term sequelae of premarital intercourse or abstinence

Sexual Victimization in Adolescence: Pathways of Risk from Sexual Harassment via Risky Alcohol Use and Delinquency Among U.S. Adolescents

Sexual harassment is a common, yet understudied form of peer victimization experienced by adolescents during a critical period in the development of sexual identity. Adverse sexual experiences early in life (e.g., child sexual abuse) can increase risk of future sexual assault victimization; however, it is unclear as to whether sexual harassment victimization is also a risk factor for sexual assault. We examined the prospective association between peer sexual harassment and experiencing sexual victimization in the following year among a community sample of 13-15-year-old adolescents (N = 800, 57% female) from the northeastern USA. We also examined whether risky alcohol use and delinquency mediated the association between sexual harassment and sexual assault victimization, as well as whether the paths differed by gender. Results indicated that sexual harassment victimization prospectively predicted later sexual victimization for both girls and boys. Using a parallel mediation path model, we determined that for girls, sexual harassment victimization predicted both risky alcohol use and delinquency, but only risky alcohol use was predictive of sexual victimization. For boys, sexual harassment victimization predicted delinquency but not risky alcohol use. Risky alcohol use was not associated with sexual victimization for boys. Findings indicate that sexual harassment victimization increases risk of later sexual victimization in adolescence, but the pathways differ by gender.

A Learning Experience? Enjoyment at Sexual Debut and the Gender Gap in Sexual Desire among Emerging Adults

Gender differences in experience of first intercourse are among the largest in sexuality research, with women recalling less pleasure and satisfaction than men. This "enjoyment gap" has not been considered in explanations of gender differences in sexual desire. Yet, reinforcement and incentive learning feature prominently in recent models of women's sexual desire, and nonhuman animal models demonstrate their impact at sexual debut. We examined whether women's lower sexual desire is explained by their gender or by gendered experience of enjoyment at sexual debut. Emerging adults (N = 838) provided retrospective accounts of physical (orgasm) and affective (satisfaction) enjoyment at (hetero)sexual debut. We replicated gender differences across behavioral, general, and multidimensional measures of trait sexual desire; however, they were contingent on experience and measurement method. When its cognitive multidimensional properties were appreciated, women's sexual desire varied with experience of orgasm at sexual debut and diverged from men's only when orgasm did not occur. Such effects were not observed for satisfaction, nor for men. Nor did effects of a control event - masturbatory debut - extend beyond solitary sexual desire. Findings underscore the importance of orgasm equality, and suggest its absence at sexual debut may play an unacknowledged role in differentiating sexual desire.

Exploring Reflections, Motivations, and Experiential Outcomes of First Same-Sex/Gender Sexual Experiences among Lesbian, Gay, Bisexual, and Other Sexual Minority Individuals

First sex is an important event in an individual's sexual development. Previous literature has, however, primarily investigated first heterosexual sex, overlooking important contextual factors specific to same-sex/gender sexual experiences. Seventeen in-depth semi-structured interviews were conducted with lesbian, gay, bisexual, and other sexual minority (LGB+) individuals, ages 18-23 years. Four themes emerged from thematic analysis of reported thoughts, affect, and behavior. First, participants reported difficulty defining sex between same-sex/gender partners, especially women who reported that this undermined their personal relationships and identity. Second, participants met partners through several means; however, it was almost exclusively men who reported meeting their first partners online. Third, motivations for first same sex/gender sex included affirmation of personal sexual identity, sexual exploration, social expectation, and spontaneity. Fourth, participants felt underprepared for their first same-sex/gender sex, noting that their earlier sex and relationship education had not included information on same-sex/gender sex or LGB+ identities. Consequently, participants reported relying on experienced partners and seeking information on the internet, including pornography and social media. Greater cultural representation and more comprehensive sex education that recognizes sexual diversity is needed to better prepare LGB+ young people for early sexual encounters.

Perhaps It Was Too Soon: College Students' Reflections on the Timing of Their Sexual Debut

Early sexual debut has been a focus of social scientific research due to its association with adverse circumstances and negative outcomes. However, there has been a recent shift to considering not only chronological age, but also the degree to which the event is viewed to be optimally timed (i.e., the perception that it occurred at the "right time" versus too soon). The purpose of this study was to assess how individual/family background variables and contextual aspects of the experience (including partner and relationship aspects) are associated with both the actual age at sexual debut and the perceived acceptability of the timing of the event. Using data collected from students at a U.S. university between 1990 and 2019 (N = 6,430), several factors (in addition to chronological age) were associated with the perceived acceptability of the timing of sexual debut. Strong gender differences were found - women perceived their timing to be less acceptable, even though they did not differ from men in actual age at sexual debut. Other robust predictors of perceived acceptability included (lower) religious involvement and recalling desire (for the experience), pleasure, and lower guilt at the time. Only slight changes occurred over the 30-year period in age at sexual debut and perceived acceptability of the timing. Suggestions for future research are provided and implications for sex education/sexual health interventions are discussed.

Links between Virginity Beliefs, Negative Feelings after Virginity Loss and Sexual Performance Anxiety in a Sample of German-Speaking Heterosexual-Identified Women and Men

Gender norms can influence women and men adopting different beliefs toward their own virginity. The current online cross-sectional questionnaire study was applied in a sample of German-speaking heterosexual-identified women (n = 536) and men (n = 181; M_age = 23.6, SD = 3.7). In men negative virginity loss experiences and sexual performance anxiety were especially prevalent when virginity loss occurred at an age that was inconsistent with men's virginity beliefs. In women age at virginity loss was not linked to virginity loss experiences or sexual performance anxiety, but the holding of virginity beliefs that deviated from gender norms was associated with those variables.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2021.1958963 .

Does regretting first vaginal intercourse have an effect on young adults' sexual behaviour?

Background The aims of this research were to determine personal differences depending on the reason for regretting or not first vaginal intercourse and its effects on sexual behaviour later on among young adults, and to assess the association between reasons for engaging in first vaginal intercourse and regretting it. Methods: Data were drawn from the 2017 Swiss national survey on youth sexual behaviours among young adults (mean age 26 years) living in Switzerland. Out of the 7142 participants, 4793 (51% females) answered the question ‘Looking back now to the first time you had vaginal intercourse, do you think that…’ with five possible answers: (1) I should not have done it (6.7%); (2) I should have waited longer (7.7%); (3) I should have done it earlier (7.4%); (4) It was about the right time (67.9%); and (5) I don’t know (10.3%). The five groups were compared on sociodemographic and sex behaviour-related variables, analysed separately by gender. Results: One-third of participants regretted their first experience. In the multivariate analysis, compared with the ‘right time’ group, all other groups were more likely to find their first experience unpleasant and to have done it with a casual partner. Those in the ‘I should not have done it’ and ‘I should have waited longer’ groups were also more likely to have done it because of external pressure, especially among females. Conclusions: The study results underline the significance to choose the right time and the right partner for first vaginal intercourse and the importance of including partner respect and avoiding external pressure as part of sexual education.

Sexual health services in the Arab region: Availability, access, and utilisation

Sexual health is shaped by cultural, economic, and social norms in society. In the Arab region, cultural sensitivities and taboos surrounding sexuality are prominent and may prevent individuals from accessing and utilising sexual health services. It is important to map out available sexual health services to identify the challenges in availability, access, and treatment, and determine opportunities for improvement. We collected data on sexual health services through (1) relevant published and unpublished literature, (2) Arab media which included forums, websites, blogs and posts, and online surveys conducted in the Arab region, (3) a questionnaire emailed to sexual and reproductive health experts, organisations, clinics, and non-governmental organisations (NGOs), (4) phone and in-person formal and informal interviews with sexual health experts in the field, and (5) advice and recommendations from sexual health experts attending a World Health Organization (WHO) consultation meeting in Dubai related to sexual health in the Arab region. Although there is significant progress when it comes to the availability and provision of sexual health services in Arab countries, there is still a lot to be done to ensure that appropriate needs are met. This study discusses the implication of findings to inform programme and policy implementation in the region.

Prevalence and correlates of 'sexual competence' at first heterosexual intercourse among young people in Britain

BACKGROUND

A greater understanding of the circumstances of first sexual intercourse, as opposed to an exclusive focus on age at occurrence, is required in order that sexual health and well-being can be promoted from the onset of sexual activity.

METHODS

We used data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3) conducted in Britain. Participants were categorised as 'sexually competent' at first heterosexual intercourse if the following self-reported criteria applied to the event: contraceptive use, autonomy of decision, both partners 'equally willing', and occurrence at the perceived 'right time'. We examined the prevalence of 'sexual competence', and its component parts, by age at first intercourse among 17-24-year-olds. Using multivariable logistic regression, we explored associations between sexual competence and potential explanatory factors.

RESULTS

Variation in 'sexual competence' and its component parts was associated with, but not fully explained by, age at first sex: 22.4% and 36.2% of men and women who had first sex at age 13-14 years were categorised as 'sexually competent', rising to 63.7% and 60.4% among those aged ≥18 years at first intercourse. Lack of sexual competence was independently associated with: first intercourse before the age of 16 years, area-level deprivation (men only), lower educational level, black ethnicity (women only), reporting 'friends' as main source of learning about sex (women only), non-'steady' relationship at first sex, and uncertainty of first partner's virginity status.

CONCLUSIONS

A substantial proportion of young people in Britain transition into sexual activity under circumstances incompatible with positive sexual health. Social inequalities in sexual health are reflected in the context of first intercourse.

Implications of no recent sexual activity, casual sex, or exclusive sex for college women's sexual well-being depend on sexual attitudes

OBJECTIVE

We examine how sexual activity relates to sexual well-being within the context of sexual attitudes, sexual agency, and sexual desire.

PARTICIPANTS/METHODS

We surveyed 471 college women in 2012-2014 who had ever had sex.

RESULTS

Sexual agency and sexual desire consistently predicted well-being, regardless of recent sexual activity. There was a significant interaction between recent sexual activity (none, casual, or exclusive relationship) and sexual attitudes. Exclusive sex was associated with higher than average sexual well-being, especially for women with permissive attitudes. Women who had casual sex and held permissive to average attitudes had the next highest levels of well-being, but those with non-permissive attitudes fell substantially below the overall mean. Women who had no recent sex were consistently below the mean, especially for women with more permissive attitudes.

CONCLUSIONS

A disconnect between sexual attitudes and recent sexual activity may lower women's sexual well-being.

The Sooner, the Worse? Association between Earlier Age of Sexual Initiation and Worse Adolescent Health and Well-being Outcomes

This cross-sectional study assesses the association between age of sexual initiation during adolescence and a selection of well-being outcomes regarding that first relationship. High-school adolescents from El Salvador (2,686) and from Peru (3,399) replied to a paper-pencil questionnaire. Those who were sexually initiated replied to several questions regarding their age at sexual initiation, condom use, satisfaction and reasons/circumstances for that sexual relationship. Approximately 19% of participants were sexually initiated (n = 1,179). After retaining participants with valid responses and with sexual initiation ages between 13 and 17, the final sample for this paper consisted of 996 sexually initiated participants (526 Salvadorians and 470 Peruvians). Multiple logistic regression analyses showed that those who initiated sex at earlier ages had worse outcomes compared to those who initiated at older ages. Specifically, they had lower odds of having used a condom, of having good memories of that experience and of having had that first relationship because they were in love. Conversely, they had higher odds of having had that first sexual relationship as a result of peer pressure (“Most of my friends already had sex”), because of partner pressure (“I was afraid to lose him/her,” “My partner told me he/she would leave me” or “I did not know how to say no to a person who insisted”), or as a consequence of different forms of impaired autonomy (“I was under the influence of alcohol or drugs” or “As a consequence of seeing sexual images”). Results show that sex at earlier ages is associated with worse adolescent health and well-being outcomes.

Moving Beyond Age: An Exploratory Qualitative Study on the Context of Young African American Men and Women's Sexual Debut

African American youth continue to be disproportionately affected by HIV. Early sexual debut has been identified as a major determinant of HIV risk. However, emerging research suggests that the overarching context in which first sex occurs may have greater implications for sexual health than simply age alone. The purpose of this exploratory, qualitative study was to better understand the broader context of African Americans' sexual debut. In-depth, semi-structured interviews were conducted with 10 African American men and women aged 18-24 years. Thematic analysis was used to analyze the data. The mean age at sexual debut for the sample was 15.4 (SD = 3.3), and youth framed their sexual debut as positive (50%), negative (30%), and both positive and negative (20%). The majority of youth initiated pre-sex conversations with their partners to gauge potential interest in engaging in sexual activity, and all youth utilized at least one HIV/sexually transmitted infection and pregnancy prevention method. However, most youth failed to talk to their partners prior to sex about their past sexual histories and what the experience meant for their relationship. Key differences emerged between youth who framed the experience as positive and those who framed the experience as negative or both positive and negative in terms of their motivations for initiating sex (i.e., readiness to initiate sex, pressure, and emotionally safety) and post-sex emotions (i.e., remorse and contentment). Findings provide further support for examining the broader sexual context of African American's sexual debut. A more comprehensive understanding of sexual debut will aid in the development and tailoring of sexual risk reduction programs targeting African American youth.

Is "Sexual Competence" at First Heterosexual Intercourse Associated With Subsequent Sexual Health Status?

The timing of first sexual intercourse is often defined in terms of chronological age, with particular focus on "early" first sex. Arguments can be made for a more nuanced concept of readiness and appropriateness of timing of first intercourse. Using data from the third National Survey of Sexual Attitudes and Lifestyles (Natsal-3), conducted in 2010-2012, this study examined whether a context-based measure of first intercourse-termed sexual competence-was associated with subsequent sexual health in a population-based sample of 17-to 24-year-olds residing in Britain (n = 2,784). Participants were classified as "sexually competent" at first intercourse if they reported the following four criteria: contraceptive protection, autonomy of decision (not due to external influences), that both partners were "equally willing," and that it happened at the "right time." A lack of sexual competence at first intercourse was independently associated with testing positive for human papillomavirus (HPV) at interview; low sexual function in the past year; and among women only, reported sexually transmitted infection (STI) diagnosis ever; unplanned pregnancy in the past year; and having ever experienced nonvolitional sex. These findings provide empirical support for defining the nature of first intercourse with reference to contextual aspects of the experience, as opposed to a sole focus on chronological age at occurrence.

Context of First Same-Sex Condom Use and Nonuse in Young Black Gay and Bisexual Males

Despite high human immunodeficiency virus (HIV) rates among young Black men who have sex with men (YBMSM), there are limited data about condom use during first same-sex (FSS). This study sought to understand socio-contextual factors of 50 YBMSM aged 15-19 years that influenced condom use during FSS. Condom use was influenced by individual, partner, and community factors. Individual factors-recent illness or sexually transmitted infections (STI)-prompted condom use, while frequent HIV testing prompted nonuse. Partner factors-proactive encouragement from partners-prompted condom use, while trust and condom discomfort prompted nonuse. Larger community factors-such as presence of females-were key for use, while limited sexual health information combined with peers who discouraged condoms prompted nonuse. A multilevel approach may be useful in developing sexual health programming for these young men.

Sexual Functioning in Adolescents With Major Depressive Disorder

OBJECTIVE

To examine sexual functioning in adolescents with depression.

METHODS

Between September 2010 and March 2014, 235 participants who were between 15 and 20 years old and were unmedicated or within 1 month of beginning antidepressant treatment completed the Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Changes in Sexual Functioning Questionnaire (CSFQ). They were also assessed to establish the presence of a DSM-IV-TR major depressive episode (MDE). The Student t test and χ² test were used to compare continuous and categorical variables, respectively, across participants with versus without MDE. Multivariable linear regression analysis examined the association between depression and sexual functioning.

RESULTS

After the investigators controlled for age, female sex, antidepressant use, and the presence of generalized anxiety disorder, the presence of MDE was associated with a lower score on the CSFQ overall (P < .0007) and on its desire (P < .09), arousal (P < .001), and orgasm (P < .007) subscales. Antidepressants were not associated with sexual functioning either in the sample overall or in those with MDE. Beck Depression Inventory items related to affective symptoms (P < .03), rather than those tapping into neurovegetative or cognitive functioning, accounted for the association between depression and lower sexual functioning. Furthermore, with higher BDI scores, males exhibited a steeper decline than females in both the CSFQ total score and the desire subscale (sex × BDI score interaction effect: P < .03). Anxiety was not significantly associated with sexual functioning.

CONCLUSIONS

Major depressive disorder in older adolescents is associated with lower sexual functioning, particularly in males. This appears most related to affective symptoms. The potential impact of such impairment on future sexual functioning deserves further examination.

TRIAL REGISTRATION

ClinicalTrials.gov identifier: NCT02147184.

Sexual risk at first coitus: Does alcohol make a difference?

This study examines whether use of alcohol at first coitus is associated with increased sexual risk for young women. First coitus is the focus of the investigation because it is a memorable, formative experience that has implications for subsequent sexual health. A community sample of young women ages 18-19 years (N = 227) completed retrospective interviews. Characteristics and perceptions of the first coital event were examined using chi squares and one-way multivariate analysis of variance (MANOVA) to determine if there were differences based on alcohol-involvement. Alcohol-involved first coitus events occurred in social settings with risky partners, were rated less positively, and were non-consensual relative to those that did not involve alcohol. Alcohol use was not related to condom use. Alcohol-involvement was associated with subsequent pairing of alcohol with sex and incapacitated rape. Adolescent alcohol use occurs in contexts that increases young women's sexual risk through exposure to risky partners.

Associations between early first sexual intercourse and later sexual and reproductive outcomes: a systematic review of population-based data

The assumption that early sexual debut leads to adverse outcomes has been used as justification for sexual health interventions and policies aimed at delaying sexual initiation, yet research in the area has been limited. This review identified and synthesized published literature on the association between early first sexual intercourse and later sexual/reproductive outcomes. Literature searches were conducted in Medline, Embase, PsycINFO, and Current Contents. In all, 65 citations met the selection criteria (industrialized, population-based studies). By far the most common sexual behavior to have been investigated has been sexual partners. Studies consistently reported early first intercourse to be associated with more recent, lifetime, and concurrent sexual partners. Early initiators were also more likely to participate in a wider range of sexual practices and report increased sexual satisfaction (among men). Furthermore, early first intercourse, in some studies, was shown to increase the risk of teen pregnancies, teen births, and having an abortion, while findings on STIs and contraceptive use have been mixed. These findings, however, must be interpreted with caution due to methodological problems and limitations present in the research, including a lack of consensus on what constitutes early sexual intercourse and inconsistencies and problems with analyses.

Age, quality, and context of first sex: associations with sexual difficulties

INTRODUCTION

Research consistently indicates an association between a younger age at first sex and poorer sexual health outcomes. However, research addressing associations between age at first sex and sexual difficulties has produced mixed findings. Moreover, little is known about links between the context and quality of first sex and subsequent sexual difficulties.

AIMS

The aims of this study are to examine whether (i) age and (ii) context and quality at first sex are associated with sexual difficulties; (iii) examine whether age at first sex and context and quality variables are independently associated (after mutual adjustment) with sexual difficulties; and (iv) examine whether age at first sex has an indirect effect on sexual difficulties through an effect on context or quality.

METHODS

Data from 388 questionnaires were gathered from students aged 17-21 living in accommodation halls and by postal invitation to adults aged 25-35.

MAIN OUTCOME MEASURES

The main outcome measure was the Golombok-Rust Inventory of Sexual Satisfaction (GRISS), which assesses sexual difficulties via an overall score and seven subscales.

RESULTS

Appraising first sex as emotionally negative was associated with the majority of sexual difficulties. A less stable relationship at first sex was associated with sexual communication problems and dissatisfaction. Greater enjoyment and using substances were associated with a lower likelihood of anorgasmia for women. Age at first sex was directly associated with reduced sexual frequency only. A younger age at first sex was associated with a greater likelihood of negative appraisal and lower likelihood of a stable relationship and thereby indirectly associated with several sexual difficulties.

CONCLUSIONS

Experiencing first sex as emotionally negative was consistently associated with later sexual difficulties. When attending to sexual difficulties, understanding the quality and context of first sex may be more useful than knowing the age at first sex. This research is limited by the retrospective nature of the reports of first sex.

Factors associated with alcohol and/or drug use at sexual debut among sexually active university students: cross-sectional findings from Lebanon

Background

Sexual activity accompanied by substance use can impair youth decision-making and enhance risk-taking behaviors. Less is known, however, about the sexual values, perceptions and subsequent sexual practices of youth whose sexual debut occurs while using alcohol/drugs.

Methods

A cross-sectional anonymous online survey was conducted in April-August 2012 among undergraduate and graduate university students (aged 18 to 30) attending the 4th largest private university in Beirut. Pearson’s Chi-square and regression models were run using Stata/IC 10.0.

Results

940 university students had engaged in oral, anal and/or vaginal sex, of whom 10% admitted to having had consumed alcohol or taken drugs at sexual debut, a behavior that was more common in the males, less religious, non-Arabs, students living alone or who had lived abroad. Students who used alcohol/drugs at sexual debut were twice as likely to have: their first oral and vaginal sex with an unfamiliar partner [odds ratio (OR) = 2.6, 95% confidence interval (CI): (1.6, 4.2) and OR = 2.1 (1.2, 3.5), respectively], controlling for sex, nationality, current relationship status, living abroad after the age of 12, and spirituality. Students who had sex the first time while using alcohol/drugs were three times as likely to report having had 11 or more subsequent sexual partners versus one or two [OR = 3.0 (1.5-6.0)]; and almost twice as likely to ever engage in something sexual they did not want to do [OR = 1.7 (1.1, 2.8)]. Perceived peer pressure to have sex by a certain age [OR = 1.8 (1.1, 2.9)], and perceived peer norms to consume alcohol/drugs before sex [OR = 4.8 (2.3, 9.9)] were also strong correlates of having sex for the first time while using alcohol and/or drugs.

Conclusions

Findings stress the importance of sexuality education for youth, and the need to begin understanding the true interplay – beyond association - between youth sexual practices and substance use behaviors from a broader public health perspective.

Robust but plastic: gender differences in emotional responses to sexual debut

Data reported by Sprecher ( 2014 ) indicate that gender differences in emotional responses to sexual debut should be included among the handful of exceptions to Hyde's ( 2005 ) gender similarities hypothesis, which states that men and women are similar on most but not all psychological variables. While these gender differences have been relatively robust over the three decades of data collection reported by Sprecher ( 2014 ), the evidence of historical change in the magnitude of these gender differences indicates that they are still plastic. The experience of first intercourse has become generally more positive over that time, with more pleasure and less guilt among women and less anxiety among men. In this commentary, gender differences in pleasure, anxiety, and guilt in response to first intercourse are discussed in connection with the system of compulsory heterosexuality.

Prevalence and characteristics of sexual functioning among sexually experienced middle to late adolescents

INTRODUCTION

Little is known about problems in sexual functioning among young people, despite the high rates found in adult samples. It is unclear which problems are most prevalent or how common sexual distress is for young people experiencing problems.

AIMS

This study aims to assess the prevalence, range, and correlates of sexual problems and distress among a sample of adolescents (16-21 years).

METHODS

Participants (mean age 19.2) were recruited from community and area high schools. Male adolescents (n = 114) completed online the International Index of Erectile Function (IIEF) and Premature Ejaculation Diagnostic Tool (PEDT). Female adolescents (n = 144) completed the Female Sexual Function Index (FSFI). Both completed the Female Sexual Distress Scale (FSDS) and the measures of background, relationship characteristics, and sexual histories.

MAIN OUTCOMES MEASURES

Clinical cutoff scores on the IIEF, PEDT, FSFI, and FSDS were used to determine whether there was a significant sexual problem.

RESULTS

Adolescents reported extensive sexual experience, most in relationship contexts. Half of the sample (51.1%) reported a sexual problem; 50.0% reported clinically significant levels of distress associated with it. Similar rates of problems and distress were found among male and female adolescents. For the most part, adolescent characteristics, backgrounds, and experience were not associated with adolescents' sexual problems.

CONCLUSION

Sexual problems are clearly prevalent among adolescents, and distressing to many who experience them, emphasizing a strong need to develop programs to address this issue.

"Did you come?" A qualitative exploration of gender differences in beliefs, experiences, and concerns regarding female orgasm occurrence during heterosexual sexual interactions

This study explored gender differences in young adult heterosexual men's and women's experiences, beliefs, and concerns regarding the occurrence or nonoccurrence of orgasm during sexual interactions, with emphasis on the absence of female orgasm during intercourse. Qualitative reports were obtained from five female focus groups (N = 24, M age = 19.08) and five male focus groups (N = 21, M age = 19.29), involving three to five participants per group. Transcripts of the discussions were analyzed for emerging themes across focus group discussions. Results indicated that, for both male and female participants, the most common concern regarding lack of female orgasm in a partnered context focused on the negative impact this might have on the male partner's ego. Male and female participants also agreed that men have the physical responsibility to stimulate their female partner to orgasm, while women have the psychological responsibility of being mentally prepared to experience the orgasm. Men and women tended to maintain different beliefs, however, regarding clitoral stimulation during intercourse, as well as the importance of female orgasm for a woman's sexual satisfaction in a partnered context. Findings suggest foci for sexual education.

HIV vulnerabilities and coercive sex at same-sex sexual debut among men who have sex with men in Beijing, China

Few studies have examined coercive sex and HIV vulnerabilities among men who have sex with men (MSM) in China. The present study seeks to compare individual characteristics between MSM who did and did not experience coercive sex at their MSM sexual debut and to identify HIV risk factors correlated with coercive sex at MSM sexual debut. In 2007, we recruited 167 MSM in Beijing, China by peer-referred social network sampling. Each participant then completed self-administered questionnaires regarding their sexual experiences and practices. Results show that 14% of participants reported coercive sex at MSM sexual debut, of whom 48% reported recent unprotected anal intercourse (UAI). Coercive sex at MSM sexual debut was significantly associated with UAI [adjusted odds ratio (AOR): 5.38, 95% confidence interval: 1.95-14.87] and lifetime number of male sex partners (AOR: 7.25, 95% CI: 2.39-22.01). Coercive sex is harming MSM in China and should be immediately addressed by researchers, public health officials, and MSM community stakeholders.

Development of the virginity beliefs scale

Past research on first sexual intercourse experiences and virginity has largely focused on using demographics such as age at first intercourse as predictors of future sexual behaviors and beliefs. Carpenter ( 2002 , 2005 ) suggested a model of three virginity metaphors that describe how individuals perceive their virginity: gift, stigma, and process. Using Carpenter's framework as a starting point, scale items were developed based on the conceptual understanding of the three metaphors. In Study 1 (N = 223, mean age = 19.9, SD = 2.4), 50 items were factor analyzed, yielding 22 items found to be strong indicators of the three metaphors; ten items for gift, eight for stigma, and four for process. The three subscales were validated using measures of gender-role beliefs and affective reactions to first intercourse. In Study 2 (N = 359, mean age = 19.7, SD = 2.4), confirmatory factor analysis was used to confirm the 22-item factor breakdown. The resulting Virginity Beliefs Scale is discussed in terms of how it applies to Carpenter's original framework and its future research potential.

Gone but not forgotten: virginity loss and current sexual satisfaction

Although loss of virginity remains a salient experience throughout a person's lifetime, little is known about whether this experience has implications for later sexual functioning (e.g., sexual satisfaction). Previous research tends to ask participants about their first time and their current sexual functioning concurrently, which may lead to spillover effects. The authors investigated the relation between first-time sexual intercourse and current sexual satisfaction using an event-sampling methodology. Participants were 331 undergraduate students who answered questions about their first-time sexual encounter and their current sexual functioning (e.g., sexual satisfaction, sexual depression). Participants then described and rated each of their sexual interactions for 2 weeks. Results show that participants who had more positive first-time sexual experiences (e.g., intimacy, respect) report greater feelings of sexual satisfaction and esteem and less sexual depression. A series of multilevel random coefficient modeling analyses revealed that positive first-time experiences were predictive of physical and emotional satisfaction in their current sexual interactions, even when controlling for global sexual satisfaction. These results suggest that one's first-time sexual experience is more than just a milestone in development. Rather, it appears to have implications for their sexual well-being years later.

Sexual force at sexual debut. Swedish adolescents with disabilities at higher risk than adolescents without disabilities

The aims of this study are first to compare the incidence of force on the first occasion of sexual intercourse reported by participants with disabilities to that of students without disabilities; second to determine whether there are significant differences in mental health, substance abuse, and school performance as reported by participants forced into their sexual debut as opposed to those who were not forced, analysed by gender; and finally to identify the significant variables that predict girls reporting force at sexual debut as opposed to girls not reporting force, as well as to identify similar variables within the male group. There were no data on sexual abuse prior to the first occasion of full sexual intercourse.

METHOD

This cross-sectional study is based on 2 surveys: Life and Health---Young People 2005 and 2007. All 17/18-year-old adolescents in upper-secondary schools in a county in Sweden were asked the same questions both years. A total of 2,254 students completed the survey in 2005 and 2,641 in 2007.

RESULTS

The main finding is that force at sexual debut (intercourse) is more common among adolescents with a disability (4.0%) than those not reporting any disability (1.6%), and is most common among those reporting multiple disabilities (10.4%). This was found both for girls and boys, even if the rates for girls were several times higher. Other findings are that girls and boys reporting force at sexual debut (disability and non-disability groups taken together) reported different profiles. For girls, their country of origin and who they live with are significant. This background data is not significant for boys. Boys report a strong psychosomatic reaction.

CONCLUSION

Culture-, functionality-, and gender-sensitive studies of adolescents' reactions to sexual abuse are needed to help determine relevant and effective interventions.

Looking back: the experience of first sexual intercourse and current sexual adjustment in young heterosexual adults

A young person's first consensual sexual intercourse experience is often a remarkable and memorable experience. However, little systematic information exists regarding contextual factors of first intercourse, the affective salience of the experience, possible effects on sexual attitudes and beliefs, and subsequent sexual development and adjustment. This retrospective study aimed to examine these in a sample of 475 young adults. Overall, young men and women experienced intercourse for the first time around age 17, were in a committed relationship, and reported positive affective responses. Affective reactions to the first sexual intercourse experience, sexual self-efficacy, sexual aversion, and age at first intercourse affected individuals' current sexual adjustment; however, only sexual self-efficacy mediated between first intercourse and current sexual adjustment in young men and women. Older age at first intercourse was associated with less sexual self-efficacy and lower current sexual adjustment for women. This study provides initial data to suggest that the first sexual intercourse experience significantly impacts current sexual adjustment by affecting beliefs about sexual self-efficacy.

Sexual knowledge, attitudes and activity of men conscripted into the military

Background

Military conscripts may experience a change in their attitude towards sex at times when sexual urges are at their peak during their physical growth. This study examines the experience, understanding, knowledge and attitudes regarding sexual activity of the military conscripts.

Methods

Data was obtained from a cross-sectional survey of 1127 young adult military conscripts, and were evaluated in Southern Taiwan from January to July 2009, their demographic data, sexual knowledge, attitudes and activities were assessed.

Results

Nearly 43% of the participants had performed penetrative vaginal intercourse at least once; 34% of the participants performed heterosexual oral sex at least once; almost 7% of participants had had homosexual intercourse, and 7.5% of participants had experienced homosexual oral sex in the past year. The mean sexual knowledge score based on 30 questions was 23.2 ± 4.0. The higher the educational level of the participants, the greater sexual knowledge they had obtained.

Conclusion

This study found that 43% of unmarried young recruits had experienced premarital sexual activity. However, their sexual knowledge was insufficient and should be strengthened by sex education from an earlier age. College aged and adult learners also have sex education needs, especially with regard to integrating sexuality and life, being able to relate responsibly as sexual beings to others, the use of contraception, and about sexually transmitted disease.

Keywords

Young recruits, Sexual behavior, Sexual knowledge, Sex education

Virginity lost, satisfaction gained? Physiological and psychological sexual satisfaction at heterosexual debut

Despite the literature's focus on (hetero)sexual initiation, little is known about the degree to which young people are satisfied by their first vaginal intercourse experience, let alone the factors that predict satisfaction. This study analyzed data from a cross-sectional survey of 1,986 non-Hispanic White and Black 18- to 25-year-old respondents from four university campuses. Respondents were asked to rate the degree to which their first vaginal intercourse was physiologically and psychologically satisfying. Both Black and White women were significantly less likely than Black and White men to experience considerable or extreme satisfaction at first vaginal intercourse, particularly physiological satisfaction. Among all four gender-race groups, being in a committed relationship with one's sexual partner greatly increased psychological satisfaction, particularly among women. Experiencing less guilt at first sexual intercourse was also strongly associated with psychological satisfaction for women. Developing sexual relationships with partners they care for and trust will foster satisfaction among young people at first vaginal intercourse. These findings highlight strong gender asymmetry in affective sexual experience.

Sexual motivations and engagement in sexual behavior during the transition to college

Motivations for and against sex are salient predictors of engaging in or abstaining from sex in cross-sectional studies. Participants (N = 637, 41.4% male) provided data on their motivations for and against sex and lifetime sexual behavior prior to entering college and six months into the first year in college. Longitudinal data were used to examine differences on motivations for and against sex reported the summer before college entrance for students who continued to abstain (Nevers, 44.7%), transitioned to sexual behavior in the following months (Transitioners, 11.0%), and who were previously sexually active (Actives, 44.3%). Multivariate analysis of variance analyses indicated that Transitioners evidenced mean-level differences in motivations surrounding sex (greater intimacy and enhancement motives for sex, lower values motives against sex) prior to their behavioral initiation compared to Nevers. In addition, Transitioners reported greater changes in motivations from pre-college to the six-month follow-up, including increased enhancement motivations for sex and decreased values and not ready motivations against sex. Men reported more important motivations for sex and less important motivations against sex than women, with an interaction showing that sexually experienced women reported more important intimacy motivations and sexually inexperienced men reported more important coping motivations for sex. Identifying salient motivations associated with imminent changes in sexual behavior may support the development of sexual health promotion programs that seek to reach sexually inexperienced individuals at important times of transition.

Who is the 40-year-old virgin and where did he/she come from? Data from the National Survey of Family Growth

INTRODUCTION

Little is known about young and middle aged adults who have never engaged in sexual intercourse. Individuals who have not engaged in sexual activity may theoretically have diminished overall quality of life, as recent evidence suggests that sexual activity may be related to overall health status in adults.

AIM

We sought to identify factors related to sexual abstinence in young and middle-aged adults.

METHODS

We analyzed data from the male and female sample of the 2002 National Survey of Family Growth to examine sexual abstinence among unmarried participants aged 25-45 (men: N = 2,469; women: N = 5,120). Main Outcome Measures. Multivariable logistic regression modeling was used to test for independent associations between demographic, medical, and anthropometric variables and abstinence while adjusting for confounding and mediating variables.

RESULTS

A total of 122 (13.9%) men aged 25-45 reported never having had sex, representing approximately 1.1 million American men in this age cohort. Among female participants, a total of 104 (8.9%) women aged 25-45 reported never having sex, representing approximately 800,000 American women in this age cohort. Both men and women who reported that they attend religious services one or more times per week were more likely to be sexually abstinent, independent of their specific religious beliefs. Virgin status was also significantly associated with drinking alcohol within the past year. While a college degree in women predicted virginity, education was not associated with virginity in men. Men showed lower rates of sexual abstinence if they reported having spent time in prison or serving in the military.

CONCLUSIONS

Amongst young adults, sexual abstinence does not appear to be mediated by health status, anthropometric measures, or age. Attending religious services and avoidance of alcohol consumption are associated with virginity in adults. Other factors associated with abstinence differ between genders and merit further study.

It's better on TV: does television set teenagers up for regret following sexual initiation?

CONTEXT

Two-thirds of sexually experienced teenagers in the United States say they wish they had waited longer to have intercourse for the first time. Little is known about why such a large proportion of teenagers express disappointment about the timing of their initial experience with sex.

METHODS

Data on television viewing, on regret about the timing of first intercourse and on potentially relevant covariates were obtained from a national, three-year (2001-2004) longitudinal survey of adolescents aged 12-17 at baseline. Logistic regression and path analysis were used to examine the association between exposure to sex on television and the likelihood of regret following sexual initiation, the extent to which shifts in expectations about the positive consequences of sex mediate this association and whether these relationships differ by gender.

RESULTS

Sixty-one percent of females and 39% of males who had sex for the first time during the study period reported that they wished they had waited to have sex. Exposure to sexual content on television was positively associated with the likelihood of regret following sexual initiation among males (coefficient, 0.34) but not females. The association among males was partly explained by a downward shift in males' sex-related outcome expectancies following sexual initiation.

CONCLUSIONS

Interventions that limit teenagers' exposure to televised sexual content, that provide a more accurate portrayal of sexuality than typically depicted on television or that help adolescents think critically about televised sexual content may help teenagers make more carefully considered decisions about sexual debut.

A population-based study of childhood sexual contact in China: prevalence and long-term consequences

OBJECTIVES

This study provides national estimates of the prevalence of childhood sexual contact and its association with sexual well-being and psychological distress among adults in China.

METHOD

A national stratified probability sample of 1,519 women and 1,475 men aged 20-64 years in urban China completed a computer-administered survey in 1999-2000. The data from this survey on both adult-to-child and peer-to-peer sexual contact before age 14 were subjected to descriptive and multivariate analyses that were adjusted for both sampling weights and sampling design.

RESULTS

The overall prevalence of reported childhood sexual contact was 4.2%, with prevalence higher among men (5.1%) than among women (3.3%) and higher among those aged 20-29 years (8.3%). Childhood sexual contact was associated with multiplex consequences, including hyper-sexuality (high levels of masturbation, thoughts about sex, varieties of sexual practices, partner turnover), adult sexual victimization (unwanted sex, unwanted sexual acts, sexual harassment), sexual difficulties (genitor-urinary symptoms, sexually transmitted infections, sexual dysfunctions), and psychological distress. Psychological distress was largely mediated by adult sexual victimization, sexual difficulties, and hyper-sexuality.

CONCLUSIONS

Despite the relatively modest prevalence of childhood sexual contact among Chinese adults, the association with multiplex adult outcomes suggests that much as in the West early sexual contact is a significant issue.

PRACTICE IMPLICATIONS

The findings underscore the importance of public education about childhood sexual contact and abuse in China. The findings suggest a need for public health campaigns that tackle the stigma associated with being abused and encourage victims to report abusive behavior to proper sources. The findings are also consistent with new efforts to alleviate the negative long-term impact of childhood sexual abuse.

The opposite of sex? Adolescents' thoughts about abstinence and sex, and their sexual behavior

CONTEXT

Little research has explored how teenagers think about abstinence and how it functions in their lives. These questions are particularly salient in light of widespread funding of abstinence-only programs in the United States.

METHODS

Data on attitudes and intentions related to abstinence and sex were collected from 365 adolescents aged 12-15 who participated in an HIV risk reduction program in Seattle in 2001-2003. Logistic regression analyses assessed associations between these cognitions, as measured six months after the program, and teenagers' likelihood of having vaginal or anal sex in the subsequent six months.

RESULTS

Adolescents who had positive attitudes and intentions about abstinence had a reduced likelihood of subsequently engaging in sex (odds ratio, 0.6 for each), whereas those with positive attitudes and intentions about having sex had an elevated likelihood of engaging in sex (2.2 and 3.5, respectively). A regression model including only sex cognitions accounted for substantially more variation in sexual activity than did one including only abstinence cognitions (15-26% vs. 6-8%). Significant interaction effects were also seen: Among teenagers with low levels of sex intention, greater abstinence intention had little relationship to the predicted probability of having sex, but among teenagers with high levels of sex intention, greater abstinence intention was associated with increases in the predicted probability of having sex.

CONCLUSIONS

Youth do not consider abstinence and sexual activity opposing constructs, and solely instilling positive abstinence attitudes and intentions in youth may not have robust effects in preventing sexual activity.

Abstinence and abstinence-only education

PURPOSE OF REVIEW

To review recent literature on medical accuracy, program effectiveness, and ethical concerns related to abstinence-only policies for adolescent sexuality education.

RECENT FINDINGS

The federal government invests over 175 million dollars annually in 'abstinence-only-until-marriage' programs. These programs are required to withhold information on contraception and condom use, except for information on failure rates. Abstinence-only curricula have been found to contain scientifically inaccurate information, distorting data on topics such as condom efficacy, and promote gender stereotypes. An independent evaluation of the federal program, several systematic reviews, and cohort data from population-based surveys find little evidence of efficacy and evidence of possible harm. In contrast, comprehensive sexuality education programs have been found to help teens delay initiation of intercourse and reduce sexual risk behaviors. Abstinence-only policies violate the human rights of adolescents because they withhold potentially life-saving information on HIV and other sexually transmitted infections.

SUMMARY

Federal support of abstinence-only as an approach to adolescent sexuality education is of much concern due to medical inaccuracies, lack of effectiveness, and the withholding and distorting of health information.

Long-term health correlates of timing of sexual debut: results from a national US study

OBJECTIVES

We explored long-term health consequences of age at sexual initiation and of abstinence until marriage to evaluate empirical support for the claim that postponing sexual initiation has beneficial health effects.

METHODS

We analyzed data from the 1996 National Sexual Health Survey, a cross-sectional study of the US adult population. We compared sexual health outcomes among individuals who had initiated sexual activity at an early or late age versus a normative age. We also compared individuals whose first sexual intercourse had occurred before versus after marriage.

RESULTS

Early initiation of sexual intercourse was associated with various sexual risk factors, including increased numbers of sexual partners and recent sexual intercourse under the influence of alcohol, whereas late initiation was associated with fewer risk factors. However, both early and late initiation were associated with sexual problems such as problems with arousal and orgasm, primarily among men. Relationship solidity and sexual relationship satisfaction were not associated with early or late initiation.

CONCLUSIONS

Early sexual debut is associated with certain long-term negative sexual health outcomes, including increased sexual risk behaviors and problems in sexual functioning. Late initiation was also associated with sexual problems, especially among men. Further research is needed to understand how sexual initiation patterns affect later health outcomes.

Association of sexual abstinence in adolescence with mental health in adulthood

We examined whether adolescent sexual abstinence predicts better adult mental health. 1,917 adolescents, recruited from middle schools at age 13, were surveyed at ages 13, 18, 23, and 29. In bivariate analyses, adolescent sexual abstinence was associated with better mental health at age 29 for females, but not males; three adolescent factors, educational prospects, family bonding, and unconventionality were investigated as explanatory variables of this relationship. The abstinence-mental health relationship was nonsignificant when educational prospects was included in multivariate models, and marginally significant when family bonding and unconventionality were included; all three explanatory factors accounted for significant proportions of the variance in adult mental health. Girls who are uninvolved in school, have weak family backgrounds, and exhibit unconventionality may have poor adult mental health, whether or not they abstain from sex in adolescence. Interventions that strengthen adolescents' connections to families and schools may reduce risk for long-term mental health problems.

Reasons to have sex, personal goals, and sexual behavior during the transition to college

Emerging adults (M = 18.99 years, SD = .50) completed cross-sectional questionnaires (N = 943) and targeted follow-up telephone surveys (N = 202) across the transition to college. Gender, personal goals (dating, friendship, academic), and past sexual behavior were examined as predictors of reasons to have and not to have sex. Men rated Self-focused reasons to have sex as more important; women rated Partner-focused reasons to have sex and Ethical reasons not to have sex as more important. Importance of Pregnancy/STD reasons not to have sex did not differ by gender. Before college entrance, sexual history and personal goals predicted endorsement of reasons for/against sex. Personal goals predicted first intercourse during freshman year. Limitations of the study include the single university sample and use of closed-ended self-report measures. Personal goals and reasons for/against sex are associated with sexual behavior and should be addressed in programs designed to promote sexual health among emerging adult college students.

What is sex and why does it matter? A motivational approach to exploring individuals' definitions of sex

What sexual experiences qualify as "having sex"? We investigated two assumptions apparently underlying research on how individuals make these judgments: that individuals have clear definitions regarding what qualifies as sex and that these judgments depend on how closely the activity being assessed matches their definitions of sex. Using open-ended questionnaires, 100 students, 51 women and 49 men, described their experiences that were "almost but not quite sex" or "just barely sex" and situations where there was uncertainty or disagreement about whether the experience qualified as "sex." In contrast to the above assumptions, many respondents expressed ambiguity about their definitions of sex, and their decisions about labeling an experience as "sex" often seemed influenced by the consequences of applying this label.