Doula Support Challenges and Coping Strategies during the COVID-19 Pandemic: Implications for Maternal Health Inequities

Prevalence of Sexual Strangulation/Choking Among Australian 18-35 Year-Olds

In Australia, strangulation has been explicitly criminalized in all states and territories. However, it continues to be a "normalized" sexual practice despite its potentially fatal consequences and associated short and long-term sequelae. This research aimed to establish the prevalence of strangulation during sex and examine predictors of positive perceptions toward sexual strangulation in Australia. Confidential, cross-sectional online surveys were conducted with 4702 Australians aged 18-35 years. Participants were 47% cis-men, 48% cis-women, and 4% trans or gender diverse. A total of 57% reported ever being sexually strangled (61% women, 43% men, 79% trans or gender diverse) and 51% reported ever strangling a partner (40% women, 59% men, 74% trans or gender diverse). Differences were found across genders on all variables of sexual strangulation, including frequency of engagement, level of pressure on the neck, consequences, wanting and enjoyment, and how consent was given/received. However, when split by gender, sexual orientation of men and women revealed further differences in behaviors, consequences, and wanting, particularly among straight and bisexual women. After accounting for exposure to strangulation in pornography and previous experience of sexual strangulation, positive perceptions of being strangled (R2 = .51) and strangling a partner (R2 = .53) were predicted by ratings that it could be done safely and social normative factors. These findings suggest strangulation is common during sex among young Australians. Non-stigmatizing education strategies are needed to engage with young people so they have a better understanding of the risks involved and how to negotiate consent and safety regarding sexual strangulation.

Pornography, identification, alcohol, and condomless sex

Using national probability data from the 2022 National Survey of Sexual Health and Behavior, the present study evaluated whether moderators of the association between frequency of pornography exposure and condomless sex are consistent with the sexual script acquisition, activation, application model's (3AM) suppositions about the facilitating effects of wishful identification and decreased self-regulation and forethought capacity. Consistent with the 3AM, two-way interaction effect analysis indicated that the strength of the positive association between exposure frequency and condomless sex increased as identification intensified. Inconsistent with the 3AM, two-way interaction effect analysis indicated that the association between exposure frequency and condomless sex was not significantly different among those who had and had not consumed alcohol before their last sexual encounter. However, the three-way interaction between exposure frequency, identification, and alcohol use did suggest a role for each 3AM moderator, as the catalyzing effect of identification was operable among those who had consumed alcohol only.

Pornography Consumption, Sexual Attitude, and Condomless Sex in China

Studies have found that pornography consumption is associated with a higher likelihood of having condomless sex. Past research was primarily conducted with Western populations from developed countries. Consequently, less is known about sexual and reproductive health in developing countries and regions. A national sample of 11,957 university-level students was used to investigate the association between pornography consumption, sexual attitudes, and condomless sex. Our findings suggest that a higher frequency of pornography consumption is associated with an increased likelihood of having condomless sex and more positive attitudes toward premarital sex and one-night stand.

Context Matters: Moderating Effects in the Associations between Pornography Use, Perceived Addiction, and Relationship Well-being

While perceived addiction and religiosity have been key contextual factors in understanding the link between pornography use and personal distress, these contextual factors have been explored less in the relational literature. Using a large nonprobability convenience sample from the United States, a moderated mediation model of the association between pornography use alone and two key indicators of relationship quality (relationship satisfaction and relationship stability) was explored. Results suggested that both general and aggressive pornography use alone were associated with less relationship satisfaction and relationship stability even when accounting for a range of potentially confounding variables. Perceived addiction partially mediated these associations, while both religiosity and gender moderated them. Generally, higher religiosity and being male were linked to compounding negative associations between pornography use and lower relationship quality. Findings suggest the importance of considering both religiosity and perceived addiction as important contextual factors when studying associations between pornography use and both relational and individual outcomes.

#ChokeMeDaddy: A Content Analysis of Memes Related to Choking/Strangulation During Sex

Recent research indicates that some young people initially learn about sexual choking through Internet memes. Thus, a qualitative content analysis was performed on 316 visual and textual memes collected from various social media websites and online searches to assess salient categories related to choking during sex. We identified nine main categories: communication, gendered dynamics, choking as dangerous, choking as sexy, sexualization of the nonsexual, shame and worry, romance/rough sex juxtaposition, choking and religious references, instructional/informational. Given that memes, through their humor, can make difficult topics more palatable and minimize potential harm in the phenomenon they depict, more concerted, synergistic effort that integrates media literacy into sexuality education programming on the potential risks that may ensue for those engaging in sexual choking is warranted.

U.S. Parents Underestimate Their Children's Pornography Use and Learning

Research on parental knowledge and positive adolescent adjustment suggests that more accurate levels of the former increase the likelihood of the latter. Despite a significant body of literature correlating adolescent pornography use with negative adolescent adjustment, however, only a handful of studies have compared parents' beliefs about their children's pornography use with adolescents' reports and just a few of these have been carried out in the U.S. The present study employed national probability data gathered from 614 parent-adolescent dyads in the U.S. as a further step toward bolstering this important area of parent-child research. Parents were 44.78 years old on average (SD = 7.76). Mothers comprised 55.80% of parents (fathers were 44.20%). Children were 15.97 years old on average (SD = 1.38). Daughters comprised 50.20% of children (sons were 49.80%). Boys were more likely to report pornography use and learning across a range of pornography genres and sexual domains. Parents accurately estimated the direction of many of these gender differences, but still consistently underestimated both sons' and daughters' exposure to and socialization from pornography. Interestingly, although parents were more likely to believe that sons than daughters had viewed and learned from pornography, their degree of underestimation was larger for sons. Mothers' and fathers' beliefs were consistently indistinguishable at the main effect level and interacted with child gender in only one instance. Results are discussed in relation to the moral panic and risk underestimation perspectives on youth and media effects.

Frequent and Recent Non-fatal Strangulation/Choking During Sex and Its Association With fMRI Activation During Working Memory Tasks

Being strangled, or “choked,” by a sexual partner has emerged as a prevalent, often wanted and consensual sexual behavior among adolescent and young adult women, yet the neurological consequences of repeated exposure to this behavior are unknown. The objective of the study was to examine the association between a history of repeated, recent choking/strangling episodes during sex and fMRI activation during working memory tasks in young adult women. This case-control study involved young adult women (18–30 years old) at a large, public university, and consisted of two study groups: a choking group consisting of participants who were recently and frequently choked/strangled during sex by a partner (≥4 times in the past 30 days) and a choking-naïve (control) group who had never been choked/strangled during sex. Participants completed two variations of the N-back (0-back, 1-back, and 2-back) working memory task during functional magnetic resonance imaging (fMRI): verbal and visual N-back tasks. Data from 20 participants per group were available for analysis. Between-group differences for accuracy and reaction time were not significant for either variation of the N-back task. Significant differences in fMRI activation patterns were detected between the choking and the choking-naïve groups for the three contrasts of interest (1-back > 0-back, 2-back > 0-back, and 2-back > 1-back). The choking group exhibited increased activation in multiple clusters relative to the choking-naïve group for the contrasts between the 1-back and 2-back conditions compared to the 0-back conditions (e.g., superior frontal gyrus, corpus callosum). However, the choking-naïve group exhibited increased activation relative to the choking group in several clusters for the 2-back > 1 back contrast (e.g., splenium, middle frontal gyrus). These data indicate that recent, frequent exposure to partnered sexual strangulation is associated with different neural activation patterns during verbal and visual working memory tasks compared to controls, suggesting that being choked/strangled during sex may modify the allocation of neural resources at increasing levels of cognitive load. Further investigation into the neurologic effects of this sexual behavior is warranted, given the prevalence of sexual choking among adolescent and young adult women.

"Don't Just Randomly Grab Someone's Neck during Intercourse!" An Analysis of Internet Articles about Choking/Strangulation during Sex

Sexual choking/strangulation has become prevalent among young U.S. adults, yet little is known about media articles that teach readers about choking. We conducted a content analysis of 27 Internet articles, examining how choking is described, information related to health risks and healthcare, and article accuracy. Most articles described choking in positive terms and indicated choking can be done safely or properly, even while acknowledging potential dangers. Only two articles indicated having undergone expert/medical review. Few gave information about signs that would warrant seeking healthcare. Sexuality professionals need to be aware of choking-related information and misinformation in online media articles.

Sexual Addiction, Hypersexual Behavior and Relative Psychological Dynamics during the Period of Social Distancing and Stay-at-Home Policies Due to COVID-19

During the COVID-19 pandemic, increased stress factors affected people's motivations to engage in potentially addictive behaviors. Sexuality, understood as one of the psychological aspects to be investigated to explore the level of psychological well-being of a person, has suffered considerable repercussions due to the pandemic. A growing body of evidence suggests an unprecedented increase in Internet use and online pornography consumption during the pandemic. Since March 2020, during the lockdown period, Pornhub has seen a worldwide increase in pornography use of 11.6% compared to the previous average days. This research was conducted with the aim of exploring the possible increasing use of pornographic material during the lockdown period, in order to assess whether dysfunctional behaviors, such as compulsive behaviors, and thoughts of sex-related obsessives can lead to hypersexual behavior or a more severe Sexual Addiction. The individuals who participated in our research were 18 years of age or older (mean 23.1, s.d. 5.8), and 48% male and 52% females and were recruited online to complete a self-report questionnaire in the period between April 2020 and April 2021. The questionnaires were delivered via main social networks. The tool used for our survey was the SAST (Sexual Addiction Screening Test), a questionnaire including socio-demographic data and data relating to sexual practices, such as sexual orientation and time spent on the Internet for sexual activities. The results revealed significant differences concerning the various factors investigated such as loss of control, addictive symptoms and hide score.