Sexual Functioning and Satisfaction Among College Survivors of Sexual Violence: Examining PTSD Symptoms and Sexual Schemas

Low uptake of gynecological consultation following domestic or sexual violence: A case-control study during pregnancy follow-up

OBJECTIVE

The aim of this study was to examine the association between exposure to domestic and sexual violence and low uptake of gynecological consultation.

STUDY DESIGN

Between October 2021 and October 2022, a case-control studywas conducted in mother andchild centers and sexual health centers in the Paris, France area. The case group included pregnant women who did not have a scheduled gynecological consultation in the past two years. The control group included pregnant women who had a scheduled gynecological consultation in the past two years. Pregnant women were interviewed using a standardized questionnaire about a history of domestic and sexual violence, the date of their last gynecological consultation and the gynecological health.

RESULTS

A total of 405 pregnant women were included in the case group (n = 129) or in the control group (n = 276). After adjustment for age, couple, social security, supplementary health insurance, dyspareunia, abnormal vaginal discharge, dysmenorrhea, regular pelvic pain, mastodynia, vulvodynia and history of difficult delivery, a history of intimate partner violence was associated with the absence of a gynecological consultation in the past two years (OR 2.13; CI95% 1.21-3.73, p = 0.008). A history of sexual violence, regardless of age, was associated with the absence a gynecological consultation in the past two years (OR 1.92; CI95% 1.05-3.49, p = 0.03). The absence of a gynecological consultation was associated with dyspareunia and domestic or sexual violence (p < 0.0001 and p < 0.0001, respectively).

CONCLUSIONS

This study highlighted the association between domestic and sexual violence and the absence of gynecological consultations in the past two years. It underlines the importance of screening for domestic and sexual violence during gynecological consultations and its impacts on mental health, in particular psychotraumatic symptoms, and on gynecological health, in particular dyspareunia.

Sexual Satisfaction of Midlife Women Living With HIV in Canada: A Prospective Cohort Analysis

BACKGROUND

Although sexual activity and function decline in older women living with HIV, positive dimensions of sexual health, such as satisfaction, are relatively unexplored. We evaluated the prevalence of sexual satisfaction for midlife women with HIV and assessed its relation to women's physical, mental, and sociostructural experiences.

SETTING

We studied women in the Canadian HIV Women's Sexual and Reproductive Health Cohort Study (CHIWOS) over 3 survey waves (2013-2018).

METHODS

We included women living with HIV aged ≥45 years who reported ever having consensual sex. Sexual satisfaction was assessed using an item from the Sexual Satisfaction Scale for Women and was dichotomized into satisfactory ("completely/very/reasonably satisfactory") and not satisfactory ("not very/not at all satisfactory"). Probable depression was based on CES-D ≥10. Multivariable logistic regression and fixed effects models determined correlates of sexual satisfaction. Reasons for sexual inactivity and alternate forms of sexual expression were also explored.

RESULTS

Among 508 midlife women, 61% were satisfied with their sexual lives at baseline. Women with probable depression had lower odds of sexual satisfaction than those without (aOR: 0.44; 95% CI: 0.27 to 0.71) and worsening depressive symptoms over time were associated with poorer sexual satisfaction ( P = 0.001). Increased sexual activity was associated with higher sexual satisfaction (aOR: 2.75; 95% CI: 1.54 to 4.91); however, 51% of women reporting sexual satisfaction were sexually inactive. Sexually inactive women engaged in alternate forms of sexual expression such as self-pleasure (37%) and intimate relationships without sex (13%).

CONCLUSION

Midlife women with HIV have high rates of sexual satisfaction, even in the absence of sexual activity. Depressive symptoms were closely associated with sexual dissatisfaction, alerting providers to the importance of screening for depression and sexual health together.

"Everyone Saw Me Differently Like It Was My Fault or I Wanted It": Acquaintance Stalking Victim Experiences of Sexual Assault, Sexual Harassment, and Sexual Autonomy

Although the stalking research literature has grown over time, there is more limited research focused on acquaintance stalking victim experiences and harms. The current study used online surveys with women stalked by acquaintances who had (n = 193), and who had not (n = 144), been sexually assaulted by the stalker to examine differences in stalking course of conduct (including jealousy and control, sexual harassment) and victim harms (resource losses, social identity perceptions, sexual autonomy, sexual difficulties, and safety efficacy). Results found that many of the acquaintance stalking victims in the current study experienced all three types of sexual harassment (verbal harassment, unwanted sexual advances, sexual coercion) and had negative social identity perceptions (e.g., how they felt about themselves, how they felt about their ability to be a good partner). More women who were sexually assaulted, compared to those who were not, experienced threats, jealous and controlling behavior, severe physical violence, stalking-related fear, sexual harassment, negative social identity perceptions, and lower sexual autonomy. Multivariate analysis found that sexual assault, more unwanted sexual attention, increased sexual coercion, lower safety efficacy, and more negative social identity perceptions were associated with sexual difficulties while sexual assault, higher safety efficacy, fewer resource losses, and fewer negative social identity perceptions were associated with increased sexual autonomy. Sexual assault, verbal sexual harassment, and resource losses were associated with more negative social identity perceptions. Understanding the full scope of stalking victimization and the negative impacts can inform the recovery journey and safety planning interventions.