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Flores RJ. Improving sexual health through medical education. J Am Geriatr Soc 2024; 72:649-653. [PMID: 38258946 DOI: 10.1111/jgs.18773] [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: 08/11/2023] [Revised: 12/11/2023] [Accepted: 12/16/2023] [Indexed: 01/24/2024]
Abstract
This editorial comments on the article by Burton et al. in this issue.
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Affiliation(s)
- Renee J Flores
- Joan and Stanford Alexander Division of Geriatric & Palliative Medicine, Department of Internal Medicine, University of Texas Health Science Center at Houston McGovern Medical School, Houston, Texas, USA
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2
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Grey W, Harris EA, Kalokerinos EK, Griffiths S. On liking how you look and feeling sexy: Quantifying the overlap between sexual desirability and body satisfaction in a sample of Australian Grindr users. Body Image 2024; 48:101676. [PMID: 38194815 DOI: 10.1016/j.bodyim.2023.101676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 12/14/2023] [Accepted: 12/19/2023] [Indexed: 01/11/2024]
Abstract
The body image field aims to cultivate positive body image. To do so, it must appreciate factors contributing to positive body image. Sexual desirability is one such factor. Using experience sampling data from Australian Grindr users, we aimed to quantify the overlap between sexual desirability and body satisfaction. We found sexual desirability and body satisfaction correlated strongly between- (r = .90) and within-persons (rMedian =.60). Using dynamic structural equation modeling, we analyzed 238 participants' data (T = 9058), finding that sexual desirability and body satisfaction were bidirectionally related - previous sexual desirability predicted current body satisfaction (β = 0.22) and vice versa (β = 0.17). Participants' average body satisfaction tended to be higher when sexual desirability contributed more to body satisfaction (r = .31) and was more stable across time (r = .19). We found sexual desirability and body satisfaction overlap considerably and that sexual desirability may contribute more to body satisfaction than vice versa. Our results suggest that (1) sexual desirability and its dynamics across time influence body satisfaction, and (2) research on sexual desirability and its relationship with body image should be a focus for the field. We discuss avenues for future research on sexual desirability.
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Affiliation(s)
- Wesley Grey
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.
| | - Emily A Harris
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Elise K Kalokerinos
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Scott Griffiths
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
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Vytniorgu R. Coming to Voice as Total Top or Total Bottom: Autobiographical Acts and the Sexual Politics of Versatility on Reddit. JOURNAL OF HOMOSEXUALITY 2024:1-18. [PMID: 38266184 DOI: 10.1080/00918369.2024.2307544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
For gay, bisexual, and men who have sex with men (GBMSM), sexual versatility encompasses both insertive (top) and receptive (bottom) sexual practices. By contrast, "total top" and "total bottom" roles are often marginalized by those who advocate versatile roles for GBMSM. This article explores how GBMSM "come to voice" as total tops and total bottoms on the social media platform, Reddit. Reading posts and comments as autobiographical acts, the article analyses how total tops and bottoms assert the validity of their claim to sexual knowledge as total top or total bottom while negotiating the sexual politics of versatility on Reddit and beyond.
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Affiliation(s)
- Richard Vytniorgu
- School of Health and Social Work, University of Hertfordshire, Hatfield, UK
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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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Goldstein I, Gelbard MK, Lipshultz LI. Clinical Significance of Shortened Penile Length and Alterations in Penile Length Following Treatment for Peyronie's Disease. Sex Med Rev 2022; 10:409-420. [PMID: 35772849 DOI: 10.1016/j.sxmr.2021.12.005] [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: 04/10/2021] [Revised: 12/15/2021] [Accepted: 12/20/2021] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Across many cultures, penis size has been associated with virility, and concerns about penile length are commonplace. Peyronie's disease (PD) is a known acquired cause of penile shortening. OBJECTIVES This paper describes the psychosocial impacts of penile length on men and their partners, both generally and in men with PD, and evaluates the effect of PD treatments (eg, collagenase clostridium histolyticum , surgery, mechanical therapy) on this outcome measure. METHODS A PubMed database search was performed for English language articles through July 2021. Main outcome measures were association of penile length with emotional well-being, selfesteem, and relationship satisfaction in men with PD, and change from baseline penile length after treatment. RESULTS Shortened penile length caused by PD can negatively impact patient and partner quality of life, including effects on body image, emotional well-being, sexual function, and interpersonal relationships. In men with PD, studies have demonstrated an association between loss of penile length and emotional problems, reduced satisfaction with sexual performance, poor self-esteem, depression, and relationship difficulties. Loss of penile length can frequently occur after surgery for PD (including plication, plaque incision/excision with grafting, and penile implant). Advanced surgical techniques may preserve/increase penile length, but the increased risks associated with these complex procedures must be carefully considered. Treatment with collagenase clostridium histolyticum does not appear to negatively impact penile length, and 5-year follow-up data suggest potential longterm posttreatment improvements in this outcome measure. Penile traction therapy, either alone or as adjunctive therapy, may increase penile length in men with PD, but nonadherence may limit improvement. CONCLUSION Changes in penile length are important to many men, particularly those with PD, and should be considered during PD treatment selection. Penile length should be measured objectively before and after treatment for PD and should be included as an outcome measure in future studies on treatment effectiveness. Goldstein I, Gelbard MK, Lipshultz LI. Clinical Significance of Shortened Penile Length and Alterations in Penile Length Following Treatment for Peyronie's Disease. Sex Med Rev 2022;10:409-420.
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Selice L, Morris KL. Mindfulness and Sexual Dysfunction: A Systematic Research Synthesis. JOURNAL OF SEX & MARITAL THERAPY 2021; 48:323-342. [PMID: 34693896 DOI: 10.1080/0092623x.2021.1991536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Throughout the previous decade, research exploring the associations between mindfulness and sexual dysfunction has grown exponentially. Researchers have highlighted inverse associations between mindfulness and various sexual dysfunctions, including erectile dysfunction, hypersexuality, and sexual distress, as well as positive associations between mindfulness and sexual desire, sexual satisfaction, and overall sexual functioning. This study sought to describe the state of extant literature exploring the association between mindfulness and sexual dysfunction, identify areas for future study within this area of research, and inform clinical practice when working with those experiencing sexual dysfunction. A systematic search of peer-reviewed journal articles revealed a final sample of 18 articles. After collecting data from all included articles, results support the inverse association between mindfulness and various sexual dysfunctions. Additionally, results highlight that current mindfulness and sexual dysfunction literature focuses more on the individual's experience and does not fully consider how the couple system is often impacted by, and may contribute to, the maintenance of sexual dysfunction. Furthermore, results demonstrate the importance of including LGBTQ + populations in future research, as extant literature in this area has focused primarily on the heterosexual experience.
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Affiliation(s)
- Lauren Selice
- Department of Human Development and Family Science, Florida State University, Tallahassee, Florida, USA
| | - Katherine L Morris
- Department of Human Development and Family Science, Florida State University, Tallahassee, Florida, USA
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Rowland DL, Roberson CB. Do the diagnostic criteria for premature ejaculation apply to non-straight men and to sexual activities other than penile-vaginal intercourse? Int J Impot Res 2021; 34:730-732. [PMID: 34504313 DOI: 10.1038/s41443-021-00467-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 08/16/2021] [Accepted: 08/26/2021] [Indexed: 11/09/2022]
Abstract
Professional standards committees have generally applied the diagnostic criteria for premature ejaculation only to situations involving (presumed) heterosexual men having penile-vaginal intercourse. This paper reviews the existing evidence supporting expansion of the criteria for use among non-straight men engaging in sexual activities that do not include vaginal intercourse. In brief, estimated ejaculation latencies appear similar across men identifying with different sexual orientations, and various partnered sexual activities (oral, vaginal, and manual) tend to be well correlated. In contrast, masturbation latency patterns are different between men with and without premature ejaculation, and ejaculatory control and bother/distress may be less critical to gay men than straight men during partnered sex. Finally, it should be noted that existing patient report outcomes (PROs) require modification for use with non-straight men.
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Affiliation(s)
- David L Rowland
- Department of Psychology, Valparaiso University, Valparaiso, IN, USA.
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Emetu RE, Brandt AS, Forster M. Sexual self-concepts among sexual minority men with childhood sexual abuse histories. JOURNAL OF GAY & LESBIAN MENTAL HEALTH 2021. [DOI: 10.1080/19359705.2020.1838379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Roberta E. Emetu
- Department of Health Sciences, California State University, Northridge, College of Health & Human Development, Northridge, California, USA
| | - Alexis S. Brandt
- Department of Health Sciences, California State University, Northridge, College of Health & Human Development, Northridge, California, USA
| | - Myriam Forster
- Department of Health Sciences, California State University, Northridge, College of Health & Human Development, Northridge, California, USA
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9
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Sexual Dysfunction in Men Who Have Sex With Men. Sex Med Rev 2021; 10:130-141. [PMID: 33931381 DOI: 10.1016/j.sxmr.2021.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 01/09/2021] [Accepted: 01/10/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Historically, sexual health research has focused on men who have sex with women (MSW) and most research examining the sexual health of men who have sex with men (MSM) has focused on HIV transmission. Despite a high prevalence of sexual health disorders among MSM, there is limited research that has evaluated the diversity of sexual issues in these patients. OBJECTIVES The purpose of this review is to describe the unique sexual behaviors, concerns, and dysfunctions of MSM by evaluating the literature on sexual health in this specific patient population. METHODS A PubMed literature search was conducted through December 2020 to identify all relevant publications related to the sexual health, sexual practices, and sexual dysfunction of MSM. Original research, review articles, and meta-analyses were reviewed, including comparisons of sexual behavior and dysfunction between MSM and non-MSM populations and between gay/bisexual men and heterosexual men. Approximately 150 relevant articles were reviewed and 100 were included in the manuscript. RESULTS Minority stress can lead to an increase in high-risk sexual behavior, sexual dysfunction, and mental health disorders in MSM. MSM engage in a variety of sexual behaviors, which can lead to differences in sexual dysfunction, such as anodyspareunia during receptive anal intercourse. MSM have higher rates of erectile dysfunction than non-MSM counterparts. MSM have unique activators of sexual pathologies, such as insertive anal intercourse for Peyronie's disease. Prostate cancer treatment may cause MSM to change sexual roles and practices following treatment due to ED, anodyspareunia, or decrease in pleasure from receptive anal intercourse after prostatectomy. CONCLUSION MSM have been neglected from sexual medicine research, which translates to disparities in health care. Further research that focuses on the MSM population is necessary to better educate healthcare practitioners so that MSM patients can receive adequate care that is tailored to their specific needs. PJ Cheng, Sexual Dysfunction in Men Who Have Sex With Men. Sex Med Rev 2021;XX:XXX-XXX.
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Traeen B, Hansen T, Štulhofer A. Silencing the sexual self and relational and individual well-being in later life: a gendered analysis of North versus South of Europe. SEXUAL AND RELATIONSHIP THERAPY 2021. [DOI: 10.1080/14681994.2021.1883579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Bente Traeen
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Thomas Hansen
- Norwegian Institute of Public Health and Oslo Metropolitan University, Oslo, Norway
| | - Aleksandar Štulhofer
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
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Metacognitions in heterosexual, bisexual, and homosexual men: with or without premature ejaculation and erectile dysfunction. Behav Cogn Psychother 2020; 49:612-625. [PMID: 33334382 DOI: 10.1017/s1352465820000879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Premature ejaculation (PE) and erectile dysfunction (ED) are prevalent sexual problems, with evidence to suggest variation across sexual orientation. Contributing factors have traditionally been divided into organic and psychological categories. While limited research has found support for the influence of metacognitive beliefs, these studies did not investigate potential differences in sexual orientation. AIM The current study aimed to investigate the differences in metacognitive beliefs in men with or without PE and/or ED and whether these varied according to sexual orientation. METHOD A sample of 531 men was recruited (65 met criteria for PE only, 147 for ED, 83 with PE and ED, and 236 healthy controls). Within this sample, 188 men identified as heterosexual, 144 as bisexual, and 199 as homosexual. Participants completed a cross-sectional online survey consisting of psychometric measures. RESULTS Participants with PE and ED were significantly higher in cognitive confidence, thoughts concerning uncontrollability and danger, and need to control thoughts than PE only, ED only, and healthy controls. Furthermore, the PE only group was significantly higher than healthy controls for cognitive confidence, with the ED significantly higher for thoughts concerning uncontrollability and danger. There were no significant differences between differing sexual orientations for men with/or without PE and/or ED. CONCLUSIONS Congruent with previous research, metacognitive beliefs play a role in PE and/or ED, although this is not exclusive to sexual orientation. The findings highlight that assessment and intervention regarding metacognitive beliefs may be beneficial for men of all sexual orientations with PE and/or ED.
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Wallach I, Beauchamp J, Alarie M, Miller G. Between Exploration, Pleasure, and Performance: Sexual Enhancement Medication Use among Older Gay and Heterosexual Men. JOURNAL OF SEX RESEARCH 2020; 57:1069-1077. [PMID: 32615808 DOI: 10.1080/00224499.2020.1786661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Pharmaceutical marketing campaigns and biomedical discourses tend to oppose two types of sexual enhancement medication (SEM) use. While "therapeutic" use is associated with older heterosexual men in committed relationships, "recreational" use is associated with young gay men, and with the context of casual sex. However, little is known about the real objectives of older men (especially older gay men) who use SEM or the contexts in which they use such drugs. Furthermore, SEM conveys representations of masculinity and sexuality that focus on performance and youth, and the influence of these representations on SEM users remains unexplored. Based on semi-structured interviews conducted, in French, in 2015-2016, with 27 Canadian men (12 heterosexual, 15 gay) aged 65 to 84 years, we examined the context in which older men used such medication and the reasons why they used it, and we explored how older men's notions of sexuality, masculinity, and aging influenced their experiences with SEM use. Our participants' narratives focused on three themes: exploring sexual possibilities/improving one's sex life, restoring sexual capacities, and masculinity and aging. This study improves our understanding of older men's use of SEM and contributes to the deconstruction of normative models of older men's masculinity and sexuality.
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Affiliation(s)
- I Wallach
- Sexology Department, Université du Québec à Montréal
| | - J Beauchamp
- Department of Psychiatry and Neurosciences, Université Laval
| | - M Alarie
- Urbanisation Culture Société Research Centre, Institut national de la recherche scientifique (INRS)
| | - G Miller
- Sexology Department, Université du Québec à Montréal
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McDonagh LK, Harwood H, Saunders JM, Cassell JA, Rait G. How to increase chlamydia testing in primary care: a qualitative exploration with young people and application of a meta-theoretical model. Sex Transm Infect 2020; 96:571-581. [PMID: 32471931 PMCID: PMC7677464 DOI: 10.1136/sextrans-2019-054309] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 04/01/2020] [Accepted: 04/18/2020] [Indexed: 11/21/2022] Open
Abstract
Objective The objective of this study was to explore young people’s perspectives barriers to chlamydia testing in general practice and potential intervention functions and implementation strategies to overcome identified barriers, using a meta-theoretical framework (the Behaviour Change Wheel (BCW)). Methods Twenty-eight semistructured individual interviews were conducted with 16–24 year olds from across the UK. Purposive and convenience sampling methods were used (eg, youth organisations, charities, online platforms and chain-referrals). An inductive thematic analysis was first conducted, followed by thematic categorisation using the BCW. Results Participants identified several barriers to testing: conducting self-sampling inaccurately (physical capability); lack of information and awareness (psychological capability); testing not seen as a priority and perceived low risk (reflective motivation); embarrassment, fear and guilt (automatic motivation); the UK primary care context and location of toilets (physical opportunity) and stigma (social opportunity). Potential intervention functions raised by participants included education (eg, increase awareness of chlamydia); persuasion (eg, use of imagery/data to alter beliefs); environmental restructuring (eg, alternative sampling methods) and modelling (eg, credible sources such as celebrities). Potential implementation strategies and policy categories discussed were communication and marketing (eg, social media); service provision (eg, introduction of a young person’s health-check) and guidelines (eg, standard questions for healthcare providers). Conclusions The BCW provided a useful framework for conceptually exploring the wide range of barriers to testing identified and possible intervention functions and policy categories to overcome said barriers. While greater education and awareness and expanded opportunities for testing were considered important, this alone will not bring about dramatic increases in testing. A societal and structural shift towards the normalisation of chlamydia testing is needed, alongside approaches which recognise the heterogeneity of this population. To ensure optimal and inclusive healthcare, researchers, clinicians and policy makers alike must consider patient diversity and the wider health issues affecting all young people.
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Affiliation(s)
- Lorraine K McDonagh
- Research Department of Primary Care and Population Health, University College London, London, UK .,National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
| | - Hannah Harwood
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - John M Saunders
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.,National Chlamydia Screening Programme, PHE, London, UK
| | - Jackie A Cassell
- National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK.,Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, Brighton and Hove, UK
| | - Greta Rait
- Research Department of Primary Care and Population Health, University College London, London, UK.,National Institute for Health Research Health Protection Research Unit in Blood Borne and Sexually Transmitted Infections at University College London, London, UK
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Li DH, Newcomb M, Macapagal K, Remble T, Mustanski B. Condom-Associated Erectile Function, But Not Other Domains of Sexual Functioning, Predicts Condomless Insertive Anal Sex Among Young Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:161-174. [PMID: 31980999 PMCID: PMC7018619 DOI: 10.1007/s10508-020-01642-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 05/09/2023]
Abstract
Condoms effectively prevent against HIV, especially when used in conjunction with biomedical strategies such as PrEP and viral suppression. However, consistent use of condoms in the real world has been a continual health promotion challenge, even among populations at highest risk, such as young men who have sex with men (YMSM). Inconsistent condom use may be related to poor sexual functioning, but limited research exists. The analytic sample comprised 688 racially diverse YMSM aged 16-29 (M = 22.9 years) living in Chicago, IL (19.2% living with HIV). Using multivariable logistic regression, we examined longitudinal associations between condom-associated sexual functioning (erectile function, orgasm satisfaction, global satisfaction, and anal discomfort) and condomless insertive anal sex (CIAS) and condomless receptive anal sex (CRAS) 6 months later. CIAS at Time 2 was associated with condom-associated erectile function at the bivariate and multivariable levels, even after controlling for CIAS at Time 1 (p < .05). Condom-associated erectile function, orgasm satisfaction, and global satisfaction predicted Time 2 CRAS in bivariate models, but none remained significant in the multivariable models. Age, having had a serious partner in the past 6 months, and HIV/PrEP status at Time 2 were significant predictors of CIAS/CRAS in some but not all models. Future interventions to improve consistent condom use should specifically highlight information and skills on how to use condoms within real-world contexts rather than from a clinical perspective. Our results also support the importance of biomedical strategies for those who have continued problems with sexual functioning when using condoms.
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Affiliation(s)
- Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA.
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| | - Michael Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Thomas Remble
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, 625 N. Michigan Ave., Suite 1400, Chicago, IL, 60611, USA
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
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Li DH, Remble TA, Macapagal K, Mustanski B. Stigma on the Streets, Dissatisfaction in the Sheets: Is Minority Stress Associated with Decreased Sexual Functioning Among Young Men Who Have Sex with Men? J Sex Med 2019; 16:267-277. [PMID: 30674424 PMCID: PMC6414215 DOI: 10.1016/j.jsxm.2018.12.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/21/2018] [Accepted: 12/17/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Sexual function and satisfaction are understudied aspects of adolescent and young adult sexual wellbeing, and even less is known about sexual minority youth who are vulnerable to unique lesbian, gay, bisexual, and transgender (LGBT)-related stigma. AIM We aimed to describe sexual functioning (sexual interest, erectile function, orgasm satisfaction, global satisfaction with one's sex life, and anal discomfort) and examine its associations with demographics, sexual and relationship behavior, and minority stressors (internalized stigma, victimization, microaggressions, and perceived LGBT acceptance within residential neighborhood) among a cohort of young men who have sex with men (YMSM) aged 16-29. METHODS Data for this cross-sectional analysis came from an ongoing longitudinal study of HIV and substance use among YMSM (analytic N = 678). We conducted univariate and bivariate analyses and multivariable linear regression, controlling for age, race/ethnicity, and sexual orientation as well as sexual and relationship characteristics that were significant at the bivariate level. MAIN OUTCOME MEASURE We assessed sexual functioning in the previous 30 days using the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction Measures Brief Profile for Males. RESULTS YMSM in our sample reported high levels of sexual functioning that were significantly greater than an adult clinical reference population. However, 13.9% of the sample reported having any difficulty with erections, 6.9% reported having less than "good" satisfaction with orgasms, 20.0% reported being "somewhat" or less satisfied with their sex lives, and 9.1% reported experiencing problems during receptive anal sex at least "sometimes." Most associations between minority stressors and sexual functioning domains that were significant at the bivariate level attenuated to non-significance in multivariable analyses. Internalized stigma remained negatively associated with global satisfaction, whereas perceived neighborhood acceptance remained positively associated with orgasm satisfaction. Being sexually active was significantly associated with increased sexual interest and orgasm satisfaction. Having had a recent serious partner was significantly associated with sexual interest and global satisfaction. Negative effects were found for having had casual partners and being HIV positive. CLINICAL IMPLICATIONS Although most YMSM have high sexual functioning, a minority report problems and dissatisfaction that may warrant intervention. STRENGTHS & LIMITATIONS Our study was limited by its cross-sectional design, measurement limitations, and generalizability to other populations, but it is one of the first to examine sexual functioning among YMSM, using a large, diverse community sample. CONCLUSION Public health research and practice must continue to combat LGBT stigma and include sexual functioning as integral to healthy sexuality. Li DH, Remble TA, Macapagal K, et al. Stigma on the Streets, Dissatisfaction in the Sheets: Is Minority Stress Associated with Decreased Sexual Functioning Among Young Men Who Have Sex with Men? J Sex Med 2019;16:267-277.
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Affiliation(s)
- Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Thomas A Remble
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA; Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
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