The influence of sexual orientation and sexual role on male grooming-related injuries and infections

Penile Trauma Burden and Aetiology in the Paediatric and Adult Population: A Scoping Review and Critical Analysis of the Literature

Penile trauma is rare. It is associated with the impairment of physiological functions and deterioration in patients' quality of life. Currently, the relevance of age demographics in the occurrence of this debilitating injury has not been well discussed. The objective of this study was to provide a scoping review of penile trauma within the lens of the legal age of maturity. A search of the PubMed, Scopus and Web of Science databases was conducted, and then, the identified publications were used to conduct this scoping review focussing on the study aim. The results identified were categorised into five themes. This included publication information (author, year, country, study duration); demographic information (age of presentation, number of patients, relative burden); penile trauma clinical pattern (type, severity, associated injury), risk factors and clinical consequences. While mobile and active young adults were at risk of outdoor trauma, the report on penile trauma in the paediatric population is rare and usually focussed on sexual trauma. Penetrating trauma has been more extensively studied in comparison to blunt penile trauma despite the significance of the latter in the paediatric population. Injury severity classification is not available for most studies limiting their usefulness in the universal comparison of trauma severity and injury prognostication. There is a diversity in the burden and presentation of penile trauma. Available research studies are limited in the paediatric population, mostly focussed on penile fracture in adults and generally devoid of a standardised penile trauma severity description. Additional studies with a specific focus on penile trauma are required to characterise aetiological risks and injury severity across the legal age of maturity.

Addressing urologic health disparities in sexual and gender minority communities through patient-centered outcomes research

Sexual and gender minority (SGM) communities face stigma and discrimination that impact all aspects of health. To better understand and improve their urologic health outcomes, we must study SGM patients as a distinct population and pursue research on outcomes identified as priorities to SGM communities. Patient-centered outcomes research (PCOR) is a methodology which is increasingly familiar to urologists and is crucial to adequately addressing SGM health in future urological research. We review existing literature focused on urologic outcomes of SGM populations and highlight specific PCOR initiatives built on SGM community engagement.

Pubic Hair Grooming and Sexually Transmitted Infections: A Clinic-Based Cross-Sectional Survey

BACKGROUND

Pubic hair grooming has been correlated with a self-reported history of sexually transmitted infections (STIs). We examined this relationship further in a cross-sectional survey of patients attending an urban STI clinic in San Francisco in 2018.

METHODS

Pubic hair grooming practices and detailed sexual histories were obtained. Sexually transmitted infections were confirmed via laboratory diagnosis or physical examination by a licensed provider.

RESULTS

A total of 314 individuals completed the survey. The median age of participants was 31 years. In total, there were 247 (80%) men, 58 (19%) women, and 5 (2%) transgender participants. Of the 247 men, 177 (72%) identified as gay or bisexual. Twenty-five (82%) of 314 patients reported pubic hair grooming within the past 3 months. Seventy-eight (25%) patients were diagnosed with a new STI during their visit. There were no significant associations between reporting any anal or genital grooming and being diagnosed with an STI. However, anal groomers were 3 times as likely to be diagnosed with a rectal STI after adjustment (adjusted odds ratio, 3.0; 95% confidence interval, 1.2-7.5) compared with genital only groomers and nongroomers. Participants who report removing all of their pubic hair more than 6 times within the past year had higher prevalence of genital STIs (33.3%, 6-10 times; 28.6%, >10 times) compared with participants who never groom all of their pubic hair (15.3%, P = 0.01).

CONCLUSIONS

We found no association between recent grooming and genital STIs. Anal grooming was associated with rectal STIs in gay and bisexual men.

Case-controlled study of skin conditions in HIV-negative men who have sex with men

Most of the dermatological research in men who have sex with men (MSM) has been in the HIV-infected subpopulation. A retrospective case-control study was performed of dermatologic diagnoses in HIV-negative MSM (n = 329) compared with male heterosexual controls (n = 600). HIV-negative MSM had a higher frequency of folliculitis (19/329 vs 12/600; P = 0.004), cutaneous herpes simplex infection (19/329 vs 14/600; P = 0.009), non-melanoma skin cancer (16/329 vs 10/600; P = 0.006) and syphilis (8/329 vs 2/600; P = 0.005) than the control group. The findings suggest that HIV-negative MSM may have a higher burden of certain skin conditions and this appears to be independent of immunosuppression or sexual behaviours.

Association between pubic hair grooming and prevalent sexually transmitted infection among female university students

Recent findings have suggested an association between pubic hair grooming and self-reported history of sexually transmitted infection (STI), specifically gonococcal infection (GC), chlamydial infection (CT), or human immunodeficiency virus (HIV). We evaluated the association between self-reported extreme grooming and laboratory-confirmed prevalence of GC/CT. Between April 2017 and April 2018, we enrolled English-speaking, adult, female students at a large, Midwestern university who presented on-campus for STI testing. Participants completed a questionnaire on demographics and sexual and grooming behaviors, which was linked to their GC/CT test results based on nucleic acid amplification testing. We defined extreme grooming as removal of all pubic hair either at least weekly in the past 12 months or ≥6 times in the past 30 days. We used two separate logistic regression models to determine whether odds of GC/CT varied by extreme groomer status for either time interval. In the study sample of 214 women, prevalence of GC/CT was 9.8%. Nearly all participants (98.1%) reported ever grooming; 53.6% were extreme groomers in the past year and 18% in the past month. Extreme grooming was not associated with prevalent GC/CT in the past year (odds ratio [OR] = 0.8; 95% confidence interval [CI]: 0.3-1.9; adjusted OR = 0.7; 95% CI: 0.3-2.0) or in the past month (OR = 0.5; 95% CI: 0.1-2.0; aOR = 0.4; 95% CI: 0.1-1.9). Pubic hair grooming was common among female university students attending for STI testing. Findings do not support pubic hair grooming as an STI risk factor in this population.

Prevalence of Pubic Hair Grooming-Related Injuries and Identification of High-Risk Individuals in the United States

Importance

Pubic hair grooming is a common practice that can lead to injury and morbidity.

Objective

To identify demographic and behavioral risk factors associated with pubic hair grooming-related injuries to characterize individuals with high risk of injury and develop recommendations for safe grooming practices.

Design, Setting, and Participants

This cross-sectional study conducted a national survey of noninstitutionalized US adults (aged 18-65 years). The web-based survey was conducted through a probability-based web panel designed to be representative of the US population. Data were collected in January 2014 and analyzed from August 1, 2016, through February 1, 2017.

Main Outcomes and Measures

Grooming-related injury history (yes or no), high-frequency injuries (>5 lifetime injuries), and injury requiring medical attention.

Results

Among the 7570 participants who completed the survey (4198 men [55.5%] and 3372 women [44.5%]; mean (SD) age, 41.9 [18.9] years), 5674 of 7456 (76.1%) reported a history of grooming (66.5% of men and 85.3% of women [weighted percentages]). Grooming-related injury was reported by 1430 groomers (weighted prevalence, 25.6%), with more women sustaining an injury than men (868 [27.1%] vs 562 [23.7%]; P = .01). Laceration was the most common injury sustained (818 [61.2%]), followed by burn (307 [23.0%]) and rashes (163 [12.2%]). Common areas for grooming-related injury for men were the scrotum (378 [67.2%]), penis (196 [34.8%]), and pubis (162 [28.9%]); for women, the pubis (445 [51.3%]), inner thigh (340 [44.9%]), vagina (369 [42.5%]), and perineum (115 [13.2%]). After adjustment for age, duration of grooming, hairiness, instrument used, and grooming frequency, men who removed all their pubic hair 11 times or more during their lifespan had an increased risk for grooming injury (adjusted odds ratio [AOR], 1.97; 95% CI, 1.28-3.01; P = .002) and were prone to repeated high-frequency injuries (AOR, 3.89; 95% CI, 2.01-7.52; P < .001) compared with groomers who did not remove all their pubic hair. Women who removed all their pubic hair 11 times or more had increased odds of injury (AOR, 2.21; 95% CI, 1.53-3.19; P < .001) and high-frequency injuries (AOR, 2.98; 95% CI, 1.78-5.01; P < .001) compared with groomers who do not remove all their pubic hair. In women, waxing decreased the odds of high-frequency injuries (AOR, 0.11; 95% CI, 0.03-0.43; P = .001) compared with nonelectric blades. In total, 79 injuries among 5674 groomers (1.4%) required medical attention.

Conclusions and Relevance

Grooming frequency and degree of grooming (ie, removing all pubic hair) are independent risk factors for injury. The present data may help identify injury-prone groomers and lead to safer grooming practices.

Characterization of Genital Dissatisfaction in a National Sample of U.S. Men

Male genital satisfaction is an important aspect of psychosocial and sexual health. The Index of Male Genital Image (IMGI) is a new scale that measures perceptions of male genitalia. We aim to characterize genital satisfaction using the IMGI and correlate dissatisfaction with sexual activity. We conducted a nationally representative survey of non-institutionalized adults aged 18-65 years residing in the U.S. In total, 4198 men completed the survey and 3996 (95.2 %) completed the IMGI. Men reported highest satisfaction with the shape of their glans (64 %), lowest satisfaction with the length of their flaccid penis size (27 %), and neutrality with the scent of their genitals (44 %). No demographic characteristics (age, race, sexual orientation, education, location, and income) were significantly associated with genital dissatisfaction. Men who were dissatisfied with their genitals were less likely to report being sexually active (73.5 %) than those who were satisfied (86.3 %). Penetrative vaginal sex (85.2 vs. 89.5 %) and receptive oral intercourse (61.0 vs. 66.2 %) were reported less by dissatisfied men. Overall, most U.S. men were satisfied with their genitals; however, a subset (14 %) report low genital satisfaction, which included men of all ages, races, and socioeconomic groups. Low genital satisfaction is associated with a decrease in sexual activity. These results provide clinicians and health educators a baseline of genital satisfaction to provide education and reassurance.

Correlation between pubic hair grooming and STIs: results from a nationally representative probability sample

OBJECTIVE

STIs are the most common infections among adults. Concurrently, pubic hair grooming is prevalent. Small-scale studies have demonstrated a relationship between pubic hair grooming and STIs. We aim to examine this relationship in a large sample of men and women.

DESIGN

We conducted a probability survey of US residents aged 18-65 years. The survey ascertained self-reported pubic hair grooming practices, sexual behaviours and STI history. We defined extreme grooming as removal of all pubic hair more than 11 times per year and high-frequency grooming as daily/weekly trimming. Cutaneous STIs included herpes, human papillomavirus, syphilis and molluscum. Secretory STIs included gonorrhoea, chlamydia and HIV. We analysed lice separately.

RESULTS

Of 7580 respondents who completed the survey, 74% reported grooming their pubic hair, 66% of men and 84% of women. After adjusting for age and lifetime sexual partners, ever having groomed was positively associated with a history of self-reported STIs (OR 1.8; 95% CI 1.4 to 2.2), including cutaneous STIs (OR 2.6; CI 1.8 to 3.7), secretory STIs (OR 1.7; CI 1.3 to 2.2) and lice (OR 1.9; CI 1.3 to 2.9). These positive associations were stronger for extreme groomers (OR 4.4; CI 2.9 to 6.8) and high-frequency groomers (OR 3.5; CI 2.3 to 5.4) with cutaneous STIs, and for non-extreme groomers (OR 2.0; CI 1.3 to 3.0) and low-frequency groomers (OR 2.0; CI 1.3 to 3.1) with lice.

CONCLUSIONS

Among a representative sample of US residents, pubic hair grooming was positively related to self-reported STI history. Further research is warranted to gain insight into STI risk-reduction strategies.

Prevalence and Motivation: Pubic Hair Grooming Among Men in the United States

Pubic hair grooming is a growing phenomenon and is associated with body image and sexual activity. A nationally representative survey of noninstitutionalized adults aged 18 to 65 years residing in the United States was conducted. Differences in demographic and sexual characteristics between groomers and nongroomers were explored. Four thousand one hundred and ninety-eight men completed the survey. Of these men, 2,120 (50.5%) reported regular pubic hair grooming. The prevalence of grooming decreases with age, odds ratio = 0.95 (95% confidence interval [0.94, 0.96]), p < .001. Adjusting for sexual frequency and sexual orientation, grooming is associated with performing and receiving oral sex. The majority of men report grooming in preparation for sexual activity with a peak prevalence of 73% among men aged 25 to 34 years, followed by hygiene (61%) and routine care (44%). The majority of men who remove their pubic hair groom the hair above the penis (87%), followed by the scrotum (66%) and the penile shaft (57%). Overall, pubic hair grooming is common among men aged 18 to 65 years in the United States. Younger ages are associated with greater rates of pubic hair grooming. Many men groom for sex, in particular oral sex, as well as for routine care and hygiene.