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Meehan C. 'They're Much Too young': The Entanglement of Porn, Pleasure and Age in Sex Education. JOURNAL OF SEX RESEARCH 2024:1-9. [PMID: 38588605 DOI: 10.1080/00224499.2024.2326960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Most debates around the place of porn in the classroom focus on abstaining from porn through sex education. Any inclusion of pleasure often entails lengthy consideration of discourses of pornification and sexualization more broadly. In this study, I aimed to elicit young people's and teachers' views, concerns and suggestions about the place of porn, and pleasure more broadly, in sex education. I present a thematic content analysis of small friendship group interviews with 106 young people aged 12-16, who self-identified as boys or girls, and semi-structured interviews with six teachers in New Zealand. I argue that by politicizing age, we continue to view young people as an at risk population. In doing so, we miss the nuance of young people's engagements with porn and pleasure, which denies scope to understand the role of porn in young people's lives. This is a missed opportunity to interrogate and understand porn as a resource through which young people construct and express their sexual subjectivities and social roles.
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Paulus FW, Nouri F, Ohmann S, Möhler E, Popow C. The impact of Internet pornography on children and adolescents: A systematic review. L'ENCEPHALE 2024:S0013-7006(24)00045-9. [PMID: 38519310 DOI: 10.1016/j.encep.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 12/19/2023] [Indexed: 03/24/2024]
Abstract
OBJECTIVES Young people's exposure to online pornographic material has increased in the past years. Its impact is a complex topic but an important issue due to growing concerns. Therefore, we reviewed the literature on Internet pornography consumption and its impact on children and adolescents. Furthermore, we examined young people's thoughts about pornography and their reasons for consumption. METHOD We performed a systematic literature search in the online databases ERIC, PsycARTICLES, PsycINFO, and PSYNDEX for peer-reviewed articles in English, published between 2000 and 2022 and additionally identified secondary references. RESULTS We could determine associations between pornography consumption and demographic variables (e.g., age, gender), personal characteristics (e.g., [sexual] sensation seeking, sexual interest and experience, general risk behavior), environmental variables (e.g., peers, family), attitudes (e.g., gender role attitudes, permissive sexual attitudes), behavior (e.g. sexual risk behaviour, sexting) and sexual aggression (e.g., sexual cybervictimization, grooming). Moreover, we found that girls have a more negative attitude towards pornography than boys who have an ambivalent opinion on the subject. Most adolescents are aware that the majority of pornographic material is exaggerated and unrealistic. Furthermore, pornography is not only watched out of curiosity and for sexual arousal but also used as a source of sexual information, especially by minority groups. DISCUSSION Many effects that impair children's development have been documented. The results found in this review are often contradictory. Therefore, further replication studies are needed. In addition, we propose several preventive measures, e.g., sexual health education at schools for both heterosexuals and LGBT (Lesbian, Gay, Bisexual, and Transgender) people.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg/Saar, Germany.
| | - Foujan Nouri
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg/Saar, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Saarland University Hospital, Homburg/Saar, Germany
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria
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3
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Petrizzo K, Moxie J. Past experiences and preferences for LGBTQ + sex education among LGBTQ + college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-11. [PMID: 38442354 DOI: 10.1080/07448481.2024.2317173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 01/30/2024] [Indexed: 03/07/2024]
Abstract
Background: Lesbian, gay, bisexual, transgender, queer, and others (LGBTQ+) students experience more negative sexual health outcomes than their cisgender, heterosexual peers and do not have access to relevant sex education. This denial necessitates comprehensive sex education in college for LGBTQ + students. Objective: Given the rise of online learning and that LGBTQ + students are already drawn to online spaces, this research seeks to determine preferences in virtual LGBTQ + sexuality education content and delivery LGBTQ + college students. Methods: We conducted a survey with US college students who identified as LGBTQ+ (N = 91) to identify past experiences with sex education, desires for future sex education, and preferences for online learning. Results: Past sex education, resources used, consequences, preferences for LGBTQ + sexuality and online education are discussed. Conclusions: Overall, we find high comfort with online learning, heteronormative and cisnormative past sex education courses created negative physical and mental health outcomes, and desires for tailored sex education.
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Affiliation(s)
- Kristen Petrizzo
- Department of Sociology, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
| | - Jessamyn Moxie
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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4
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Javidi H, Widman L, Maheux AJ, McCrimmon J, Evans-Paulson R, Becker W. PACT: Developing and Evaluating a Digital Sexual Consent Program for Youth. JOURNAL OF SEX RESEARCH 2024; 61:466-480. [PMID: 37186689 DOI: 10.1080/00224499.2023.2208560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Understanding affirmative sexual consent is crucial for violence prevention and health promotion, yet few adolescents receive adequate consent education. The current study aimed to evaluate the acceptability and preliminary efficacy of a brief online program designed to teach adolescents information and skills about communicating and interpreting affirmative sexual consent (PACT: Promoting Affirmative Consent among Teens) in a randomized controlled trial with a national sample of 833 U.S. adolescents (ages 14-16; 42% White, 17% Asian, 17% Black, 13% Latinx; 53% girls, 31% boys, 12% non-binary; 45% heterosexual; 29% sexually active). PACT, grounded in health behavior change and persuasion theories, was developed using feedback from youth advisors and usability testers. Participants considered the program generally acceptable. Compared to youth who completed a control program, PACT was efficacious at shifting three measures of affirmative consent cognitions (i.e., knowledge, attitudes, self-efficacy) from baseline to immediate posttest. Youth who completed PACT also demonstrated more accurate affirmative consent knowledge at 3 months post-baseline. PACT's effects on consent cognitions were generally similar among youth with various gender, racial/ethnic, and sexual identities. We discuss next steps for this program, including the possibilities of expanding to include additional concepts and tailoring to address the unique needs of specific youth.
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Affiliation(s)
- Hannah Javidi
- Department of Applied Health Science, Indiana University School of Public Health
- Department of Psychology, North Carolina State University
| | - Laura Widman
- Department of Psychology, North Carolina State University
| | - Anne J Maheux
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill
- Department of Psychology, University of Pittsburgh
| | | | | | - Whitney Becker
- Department of Psychology, North Carolina State University
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5
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Fritz N, Bowling J. Sexual Behaviors and Aggression in Gay Pornography. JOURNAL OF HOMOSEXUALITY 2023; 70:3353-3373. [PMID: 35759678 DOI: 10.1080/00918369.2022.2093688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Previous studies have suggested a substantial number of men who have sex with men (MSM) have consumed and used pornography to learn about same-sex sexual behaviors. Yet, past research has focused almost exclusively on condom-use in the category of Gay pornography and ignored the types of sexual behaviors and aggression depicted within the content. This study examined aggression and sexual behaviors depicted in Gay online pornography (N = 415). We found fellatio and anal sex were the most common behaviors, occurring in roughly two-thirds of scenes, while kissing occurred in less than a third of scenes. Additionally, sexual aggression occurred in 31% of scenes, with spanking being the most common, occurring in 20% of scenes. Anal sex and forced fellatio were found to be predictors of physical aggression. These findings point to normalization of aggression and narrow sexual behaviors in Gay pornography, which may have implications for MSM's norm perceptions related to sexuality.
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Affiliation(s)
- Niki Fritz
- The Media School, Indiana University Bloomington, Bloomington, Indiana, USA
| | - Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, North Carolina, USA
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Peragine DE, Kim JJ, Maxwell JA, Skorska MN, Impett EA, Cunningham WA, VanderLaan DP. Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3405-3427. [PMID: 37697094 DOI: 10.1007/s10508-023-02667-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 07/15/2023] [Accepted: 07/15/2023] [Indexed: 09/13/2023]
Abstract
Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut.
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Affiliation(s)
- Diana E Peragine
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road North, Mississauga, ON, L5L 1C6, Canada.
| | - James J Kim
- Department of Psychology, Western University, London, ON, Canada
| | | | - Malvina N Skorska
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Emily A Impett
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road North, Mississauga, ON, L5L 1C6, Canada
| | | | - Doug P VanderLaan
- Department of Psychology, University of Toronto Mississauga, 3359 Mississauga Road North, Mississauga, ON, L5L 1C6, Canada
- Child and Youth Psychiatry, Centre for Addiction and Mental Health, Toronto, ON, Canada
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Diaz JE, Preciado E, Chiasson MA, Hirshfield S. Association Between Age of Anal Sex Debut and Adult Health Behaviors Among Sexual Minoritized Men Living with HIV. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3565-3575. [PMID: 37378702 PMCID: PMC11034742 DOI: 10.1007/s10508-023-02642-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 06/01/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023]
Abstract
Earlier age of anal sex debut (ASD) has been linked with contemporary and long-term health outcomes, including vulnerability to HIV acquisition. The goal of this study was to utilize a life course approach to examine associations between earlier ASD and recent health behaviors among sexual minoritized men (SMM) living with HIV. A total of 1156 U.S. SMM living with HIV recruited from social and sexual networking apps and websites completed online surveys as part of a longitudinal eHealth intervention. Data from baseline surveys were analyzed to determine associations between age of ASD and adult health outcomes, including mental health, HIV viral load, and substance use. The median age of ASD among these participants was 17 years old, consistent with other work. Earlier ASD was significantly associated with a greater likelihood of past 2-week anxiety (AOR = 1.45, 95% CI 1.07-1.97) and past 3-month opioid use (AOR = 1.60, 95% CI 1.13-2.26); no significant associations were found for recent depression, HIV viral load, or stimulant use. Earlier ASD may function as an important proxy measure for deleterious health outcomes in adulthood, particularly recent anxiety and opioid use. Expansion of comprehensive and affirming sexual health education is critical to early engagement of individuals with a higher risk of HIV acquisition, with plausible downstream health benefits lasting into adulthood among SMM living with HIV.
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Affiliation(s)
- José E Diaz
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA
| | | | - Mary Ann Chiasson
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
- Division of Infectious Diseases, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Sabina Hirshfield
- Department of Medicine, STAR Program, SUNY Downstate Health Sciences University, 450 Clarkson Avenue, Brooklyn, NY, 11203, USA.
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Astle SM, Anders KM. The Relationship Between Topic-Specific Quality of Parent-Child Sexual Communication and Measures of Sexual Self-Concept and Sexual Subjectivity. JOURNAL OF SEX RESEARCH 2023; 60:1055-1067. [PMID: 35699390 DOI: 10.1080/00224499.2022.2081312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
As primary influences in children's sexual socialization, parents have the potential to help children develop psychological sexual well-being as they model and discuss sexuality together. Based on social cognitive theory, this study examined the understudied relationship between perceived quality of parent-child sexual communication (PCSC) about sensitive, value, and risk topics and measures of psychological sexual well-being (sexual self-concept and sexual subjectivity) in a sample of 278 U.S. undergraduate college students. Results of a path analysis showed that higher perceived quality of PCSC about sensitive topics (e.g., sexual pleasure, masturbation) was associated with increased sexual self-efficacy, body esteem, sexual assertiveness, and sexual self-esteem. Higher perceived quality of PCSC about values (e.g., monogamy, abstinence) was associated with increased entitlement to partner pleasure and decreased sexual self-efficacy and entitlement to self-pleasure. Perceived quality of PCSC about risk (e.g., sexually transmitted diseases [STDs], condom use) was not significantly associated with any measure of psychological sexual well-being. Findings from this study have important implications for sexual education programs, including informing parent education and the importance of including discussion of psychological sexual well-being in programs.
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9
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Gaither TW, Siapno AED, Kianian R, Vincent N, Williams KC, Piquerias E, Russell MM, Litwin MS. Relationship between pelvic sensations and lifetime exposure to receptive anal intercourse among people with prostates. J Sex Med 2023; 20:1195-1205. [PMID: 37548267 DOI: 10.1093/jsxmed/qdad099] [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: 03/11/2023] [Revised: 06/06/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023]
Abstract
BACKGROUND Despite the negative stigma on receptive anal intercourse (RAI), this behavior has a positive influence on individuals' sexual and relationship health. No large studies have previously looked at specific sensations experienced during RAI and how these sensations may change with experience. AIM In this study we aimed to quantify commonly reported pelvic sensations during RAI and determine whether their presentation changes with increasing experience of RAI. METHODS An internet survey was conducted on sensations felt during RAI among people with prostates from July 2022-January 2023. The survey content was developed based on a mixed-methods qualitative study and inquired about demographic and sexual histories as well as sensations (pleasure, pain, urinary, and bowel) experienced during RAI. We used descriptive statistics to describe demographic and sexual histories. All data were stratified by lifetime exposure to RAI. OUTCOMES The primary outcomes assessed included the quantification of both the primary sensations experienced during RAI and the associated bother. RESULTS In total, 975 participants completed the survey. The median age was 32 (range 18-78) years. The average age of first participation in RAI was 21 ± 6.6 years. Most respondents were having sex at least once a week (65%). Nine percent of respondents reported fewer than 10 experiences with RAI, 26% reported 11-50 RAI experiences, 32% reported 51-200 experiences, 16% reported 201-500 experiences, and 18% reported >500 experiences. As the number of experiences with RAI increased (from <10 to >500 exposures), the reported frequency of pleasurable sensation increased from 41% to 92% (P < .0001), whereas severe insertional pain and symptoms of bowel urgency decreased from 39% to 13% and from 21% to 6%, respectively (P < .0001). Urinary urgency sensation did not differ by lifetime RAI experience. CLINICAL IMPLICATIONS Lifetime RAI exposure can be readily assessed and correlates not only with pelvic sensation but also many other aspects of sexual health. These results imply that the etiology of dissatisfaction with pleasure or anodyspareunia during RAI may differ by lifetime RAI exposure. STRENGTHS AND LIMITATIONS This is the first study to our knowledge to assess pelvic sensations experienced during RAI among a large sample of individuals. This is a cross-sectional study, and we cannot conclude how pelvic sensations change over time among individuals. Internet-based participants may not be representative of clinical populations. CONCLUSION Lifetime exposure to RAI is positively associated with pleasure and is negatively associated with pain and bowel urgency. Pelvic sensations experienced during RAI appear to be dependent on lifetime RAI exposure history regardless of age.
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Affiliation(s)
- Thomas W Gaither
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Allen E D Siapno
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Reza Kianian
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | | | - Kristen C Williams
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Eduardo Piquerias
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
| | - Marcia M Russell
- Department of Surgery, Section of Colorectal Surgery, David Geffen School of Medicine, Los Angeles, CA 90095, United States
- Surgical and Perioperative Careline, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, United States
| | - Mark S Litwin
- Department of Urology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, United States
- Department of Health Policy and Management, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA 90095, United States
- School of Nursing, University of California Los Angeles, Los Angeles, CA, United States
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10
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Flores D, Kornides M, Meanley S. Inclusive and Age-Appropriate Timing of Sexual Health Discussions at Home According to Gay, Bisexual, and Queer Adolescent Males. J Adolesc Health 2023; 72:754-762. [PMID: 37062572 PMCID: PMC10111203 DOI: 10.1016/j.jadohealth.2022.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 02/10/2023]
Abstract
PURPOSE The exclusion of gay, bisexual, and queer (GBQ) adolescent males' specific sexuality concerns in standard classroom education heightens the need for parents to be primary sources of trusted sexual health information. The aim of this study was to collect GBQ adolescent males' suggestions for a comprehensive list and age-appropriateness of topics that parents may use for inclusive discussions at home throughout the elementary, middle school, and high school years. METHODS Semistructured interviews and card sorts of 48 topics were conducted with a sample of 30 racial and ethnic diverse GBQ adolescents in central North Carolina. Thematic analysis of the interview transcripts and a calculation of card sort responses followed. RESULTS Topics chosen for elementary-age GBQ youth were focused on core issues about human anatomy, safety, and the continuum of sexual orientations and gender identities. Participants designated the majority of topics for home-based discussions in middle school and emphasized considerations for engaging in sex, relating with others socially, options for HIV/STI risk reduction, issues around interpersonal safety, and pleasure. They reserved topics for high school focused on complex sociorelational issues and technology-based concerns. DISCUSSION Participants' varied rationale for timing of topics centered on the age-appropriateness and level of details that they deemed acceptable for discussions with parents. To address disproportionate negative sexual and mental health outcomes noted in this youth subgroup, parents should focus on being supportive by providing factual and sequential information crucial for their GBQ childrens' anticipated developmental needs and sexual identity milestones.
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Affiliation(s)
- Dalmacio Flores
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania.
| | - Melanie Kornides
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Steven Meanley
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania
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O'Byrne P, McCready L, Tigert J, Musten A, Orser L. First-time testers in the GetaKit study: conceptualizing new paths to care for gbMSM. Health Promot Int 2023; 38:7143325. [PMID: 37099678 PMCID: PMC10132581 DOI: 10.1093/heapro/daad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/28/2023] Open
Abstract
When analyzing the data for Ontario, Canada, HIV rates continue to be highest among gay, bisexual and other men who have sex with men (gbMSM). Since HIV diagnosis is a key component of HIV care, self-testing has provided options for allowing this population to access care, resulting in a significant number of first-time testers. Between 1 April 2021 and 31 January 2022, 882 gbMSM participants ordered an HIV self-test through GetaKit. Of these, 270 participants reported that they had never undergone HIV testing previously. Our data showed that first-time testers were generally younger, members of BIPOC (Black, Indigenous and people of color) communities and they reported more invalid test results than those who had tested previously. This suggests that HIV self-testing may be a more successful and appealing component of the HIV prevention armamentarium for this population, but one that is not without its shortcomings as an entry to care.
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Affiliation(s)
| | - Lance McCready
- Leadership, Higher & Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Jason Tigert
- Leadership, Higher & Adult Education, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | | | - Lauren Orser
- School of Nursing, University of Ottawa, Ottawa, ON, Canada
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12
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Testa G, Mestre-Bach G, Chiclana Actis C, Potenza MN. Problematic Pornography Use in Adolescents: From Prevention to Intervention. CURRENT ADDICTION REPORTS 2023. [DOI: 10.1007/s40429-023-00469-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
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13
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Haupt KR, Stout CD, Simmons J, Nelson KM. Differences in the sexual health information parents/guardians give their adolescent sexual minority sons by outness. JOURNAL OF LGBT YOUTH 2023; 21:132-149. [PMID: 38434757 PMCID: PMC10906741 DOI: 10.1080/19361653.2023.2176399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/30/2023] [Indexed: 03/05/2024]
Abstract
Introduction Parents and guardians are a potentially valuable source of sexual health information for adolescent sexual minority males (ASMM). The current study examines what sexual health topics ASMM report discussing with a parent/guardian and whether topics differ by outness about sexual attraction to other males. Methods ASMM (N=154; ages 14-17) in the United States completed the baseline of an online sexual health intervention pilot in 2020. They reported which of twelve sexual health topics they discussed with a parent/guardian and if they had disclosed their sexual attraction to other males. Associations between topics discussed and outness to a parent/guardian were examined with Firth logistic regression. Results Eighty-eight (57%) participants reported being out to a parent/guardian. Six sexual health topics were significantly more likely to be discussed if participants were out. The three categories with the largest differences by outness were how to: discuss with a partner what they would not like to do sexually (aOR = 7.0, 95% CI: 2.0-24.6), use condoms (aOR = 5.9, 95% CI: 2.3-15.1), and prevent HIV/AIDS (aOR = 3.5, 95% CI = 1.4-8.7). Conclusions Interventions on parental/guardian provision of sexual health information are needed to ensure ASMM receive relevant sexual health knowledge.
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Affiliation(s)
- Kaitlin R Haupt
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Claire D Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Journey Simmons
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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14
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Gesselman AN, Kaufman EM, Marcotte AS, Reynolds TA, Garcia JR. Engagement with Emerging Forms of Sextech: Demographic Correlates from a National Sample of Adults in the United States. JOURNAL OF SEX RESEARCH 2023; 60:177-189. [PMID: 35104185 DOI: 10.1080/00224499.2021.2007521] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Social technology is ever-evolving, and increasingly offers novel domains for sexual experiences. In the current study, we investigated demographic correlates of engagement with emerging forms of sextech, defined here as internet-based applications, platforms, or devices used for sexual pleasure. Our web-based, demographically representative sample included 7,512 American adults aged 18-65 years, with a near-even gender split of men/women and moderate racial diversity (63% White). Participants indicated their engagement with eight forms of sextech, including six emerging forms of sexual technology (visiting erotic camming sites, participating in camming streams, teledildonic use, accessing virtual reality pornography, playing sexually explicit video games, and sexual messaging with chatbots or artificially intelligent entities) as well as two more common domains (online pornography and sexting). Participants who were younger, were men, had higher income, and were sexual minorities reported more frequent engagement with all forms of sextech assessed. Unlike prior work on pornography, religious individuals were more likely to engage with emerging sextech. Beyond online pornography (50%) and sexting (29%), visiting camming sites (18%) and playing sexually explicit video games (13%) were relatively common. Findings may contribute to the destigmatization of sextech engagement and forecast future norms in technologically-facilitated sexual behavior.
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Affiliation(s)
| | - Ellen M Kaufman
- The Kinsey Institute, Indiana University
- Luddy School of Informatics, Computing, and Engineering, Indiana University
| | | | - Tania A Reynolds
- The Kinsey Institute, Indiana University
- Department of Psychology, University of New Mexico
| | - Justin R Garcia
- The Kinsey Institute, Indiana University
- Department of Gender Studies, Indiana University
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15
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Bond KT, Mansour M, Kershaw T, Flores DD. "Whenever you're ready to talk about it": Prompts and barriers to inclusive family sex communication with gay, bisexual, and queer sons. AMERICAN JOURNAL OF SEXUALITY EDUCATION 2022; 18:569-593. [PMID: 38213905 PMCID: PMC10783024 DOI: 10.1080/15546128.2022.2141935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
Despite growing evidence that parent-child sex communication (PCSC) is a positive strategy for adolescent sexual health outcomes, there is little research about what prompts and impedes these conversations among parents of gay, bisexual, and queer (GBQ) adolescent sons. Using interview data from a multi-method qualitative study, we analyzed parental perspectives (N=15) on non-heteronormative sex communication with GBQ adolescent sons. Our results revealed that parents are most likely to engage in sex communication if they established open communication with their child, accepted their child's sexual orientation, encouraged safe sex practices, and were knowledgeable about LGBTQ issues. Conversely, parents who experience communication discomfort were unable to engage in inclusive and comprehensive sex conversations, thus creating a barrier to effective sex-positive communication. These findings have implications for future research and interventions that promote parents' ability to successfully facilitate conversations about sexual health with their sexuality diverse children.
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Affiliation(s)
- Keosha T Bond
- Department of Community Health and Social Medicine, CUNY School of Medicine, New York, NY
- Department of Public Health, New York Medical College, Valhalla, NY
| | - Maikel Mansour
- Department of Public Health, New York Medical College, Valhalla, NY
| | - Trace Kershaw
- Department of Social and Behavioral Sciences, Yale University School of Public Health, Hartford CT
| | - Dalmacio D Flores
- Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia PA
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Mutchler MG, Wagner GJ, McDavitt B, Woldetsadik MA, Kegeles SM, El-Khoury C, Nogg KA, Klinger IA, Mokhbat J, Ballan EG. Psychometric Properties of a Scale on Judgmental Communication with Peers About Sex Among YMSM and Their Close Friends in Lebanon. AIDS Behav 2022; 26:3089-3098. [PMID: 35322311 PMCID: PMC10234618 DOI: 10.1007/s10461-022-03640-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2022] [Indexed: 11/29/2022]
Abstract
We are not aware of any validated sexual health communication scales for use with young men who have sex with men (YMSM). We used data from an HIV prevention study in Lebanon with 226 YMSM aged 18-29 to assess the psychometric characteristics of our scale, Judgmental Communication with Peers about Sex (JCPS). The construct validity of the JCPS scale was supported by it being negatively correlated with general social support, percentage of alters perceived to be supportive, and the percentage of peers who are perceived to use condoms. The scale was positively correlated with gay-related discrimination, feeling part of the gay community, and gay social integration. These findings reflect a reliable, valid measure to assess judgmental sexual health communication between YMSM.
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Affiliation(s)
- Matt G Mutchler
- Department of Health Science, California State University, Dominguez Hills, 1000 E. Victoria Street, Carson, CA, 90747, USA.
- Community-Based Research, AIDS Project Los Angeles (APLA Health), Los Angeles, USA.
| | | | - Bryce McDavitt
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine of the University of Southern California, Los Angeles, USA
| | | | - Susan M Kegeles
- University of California San Francisco School of Medicine, San Francisco, USA
| | | | | | - Ian A Klinger
- Community-Based Research, AIDS Project Los Angeles (APLA Health), Los Angeles, USA
- Department of Sociology, California State University, Dominguez Hills, Carson, USA
| | | | - Elie G Ballan
- The Arab Foundation for Freedoms and Equality, Beirut, Lebanon
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Litam SDA, Speciale M, Balkin RS. Sexual Attitudes and Characteristics of OnlyFans Users. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:3093-3103. [PMID: 35900676 PMCID: PMC9330933 DOI: 10.1007/s10508-022-02329-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 02/19/2022] [Accepted: 03/12/2022] [Indexed: 06/15/2023]
Abstract
As new forms of sexually explicit material (SEM) platforms emerge, sex research and sexuality-based studies must also evolve. Although the subscription-based platform OnlyFans has become an increasingly popular way for content creators to share and access SEM, the demographic information and sexual attitudes of users across sex have not yet been reported. The present study contributes to the existing body of SEM literature by providing a demographic analysis of OnlyFans users and an assessment of sexual attitudes between users and nonusers across sex. In this study, participants from a US-based sample (n = 718, Mage = 29.46, male [n = 335, 46.7%], female [n = 383, 53.3%]) were solicited using the Mechanical Turk platform. Participants were predominately White (n = 475, 66.2%); additional representation of ethnic/racial groups included Black/African-American (n = 121; 16.9%), American Indian/Alaskan Native (n = 10; 1.4%), Asian-American/Asian (n = 32; 4.4%), Hispanic/Latinx (n = 53; 7.3%), Arab American/Arab (n = 10; 1.4%), and biracial or multiracial (n = 17; 2.4%). Based on our findings, OnlyFans users were predominantly married, white, males who identified as heterosexual or bisexual/pansexual. Our findings also revealed that OnlyFans users and nonusers endorsed similar sexual attitudes related to permissiveness, communion, instrumentality, and birth control across sex. Findings from this study may be helpful for future studies on OnlyFans and other forms of subscription-based platforms.
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Affiliation(s)
- Stacey Diane Arañez Litam
- Counseling, Administration, Supervision, and Adult Learning Department, Cleveland State University, 2121 Euclid Avenue, Julka Hall 275, Cleveland, OH, 44115, USA.
| | - Megan Speciale
- Department of Counseling, Palo Alto University, Palo Alto, CA, USA
| | - Richard S Balkin
- Department of Leadership & Counselor Education, The University of Mississippi, Oxford, MS, USA
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Newton JDA, Halford WK, Oviedo-Trespalacios O, Barlow FK. Performer Roles and Behaviors in Dyadic Sexually Explicit Media Featuring Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:2437-2450. [PMID: 35727464 DOI: 10.1007/s10508-021-02238-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/16/2021] [Accepted: 11/17/2021] [Indexed: 06/15/2023]
Abstract
Heterosexual gender roles are not directly relevant to gay romantic relationships, but gay men often take on different relationship roles depending on their sexual roles. In the present paper, we argue that gay men might draw on sexually explicit media (SEM) featuring men who have sex with men (MSM) to get information about how insertive sexual partners ("tops") and receptive sexual partners ("bottoms") typically behave. For this to be the case, however, we would have to reliably observe different behavior in SEM performers acting as tops vs. bottoms. We examined 220 of the most viewed online dyadic MSM SEM videos to determine whether performed verbal and physical intimacy, victimization, and sexual behaviors depended on the sexual role taken. We found that tops and bottoms engaged in similar amounts of intimacy behaviors, but that bottoms were depicted as initiating sexual activity more than tops. Tops enacted physical and psychological victimization more than bottoms, although these behaviors were rare. Tops were shown taking the insertive role across all sexual acts and versatile performers (i.e., those taking both insertive and receptive roles) were rarely depicted. The present study adds to the literature about the complexity of sexual-self-labels, and suggests that MSM SEM depictions of intimacy and sexual decision-making depend on the sexual role taken.
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Affiliation(s)
| | - W Kim Halford
- School of Psychology, The University of Queensland, St Lucia, QLD, 4067, Australia
| | | | - Fiona Kate Barlow
- School of Psychology, The University of Queensland, St Lucia, QLD, 4067, Australia
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Mata D, Korpak AK, Sorensen B, Dodge B, Mustanski B, Feinstein BA. A mixed methods study of sexuality education experiences and preferences among bisexual, pansexual, and queer (bi+) male youth. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2022; 19:806-821. [PMID: 35756362 PMCID: PMC9230504 DOI: 10.1007/s13178-021-00593-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/16/2021] [Indexed: 06/03/2023]
Abstract
Introduction Bisexual male youth are more likely to engage in certain behaviors that contribute to HIV/STI transmission (e.g., substance use) than are heterosexual and gay male youth. However, sexuality education rarely addresses the unique needs of sexual minority youth, especially bisexual, pansexual, and queer (bi+) youth, and little is known about their sexuality education experiences and preferences. As such, the goal of this study was to examine bi+ male youth's experiences learning about sex and their preferences for sexuality education. Methods In 2019, 56 bi+ male youth ages 14-17 were surveyed and interviewed about their sexuality education experiences and preferences. Participants identified as bisexual (64%), pansexual (27%), and queer (9%), were racially/ethnically diverse (39% white, 32% Latinx, 20% Black, 9% other races), and included cisgender (79%) and transgender (21%) male youth. Results Participants described varied experiences with school-based sexuality education (e.g., none, abstinence only, covered sexual health in some way), but it rarely addressed their unique needs. They typically learned about sex by searching for information online and from sexually explicit media. Participants identified several topics they wanted to learn more about (e.g., sex with same-gender partners, anal sex, consent), but they typically believed they were prepared to have sex. Finally, some participants described benefits of tailoring sexuality education to their unique needs, while others described benefits of more inclusive programs. Conclusions and Policy Implications Findings suggest that bi+ male youth do not receive adequate sexuality education to make informed decisions about safer sex, highlighting the critical need for reform.
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Affiliation(s)
- David Mata
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
| | - Aaron K. Korpak
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Feinberg School of Medicine, Northwestern University
| | | | - Brian Dodge
- Center for Sexual Health Promotion, Indiana University Bloomington
| | - Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University
- Feinberg School of Medicine, Northwestern University
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20
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Herbenick D, Patterson C, Khan S, Voorheis E, Sullivan A, Wright P, Keene S. "Don't Just Randomly Grab Someone's Neck during Intercourse!" An Analysis of Internet Articles about Choking/Strangulation during Sex. JOURNAL OF SEX & MARITAL THERAPY 2022; 49:41-55. [PMID: 35570586 DOI: 10.1080/0092623x.2022.2065392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
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.
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Affiliation(s)
- Debby Herbenick
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Callie Patterson
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Shahzarin Khan
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Eva Voorheis
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Anne Sullivan
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
| | - Paul Wright
- The Center for Sexual Health Promotion, School of Public Health, Indiana University, Bloomington, IN, USA
- The Media School, Indiana University, Bloomington, IN, USA
| | - Samantha Keene
- School of Social and Cultural Studies, The Institute of Criminology, Te Herenga Waka - Victoria University of Wellington, Wellington, New Zealand
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21
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Kutner BA, Perry NS, Stout C, Norcini Pala A, Paredes CD, Nelson KM. The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males. J Sex Med 2022; 19:521-528. [PMID: 35090838 PMCID: PMC9115869 DOI: 10.1016/j.jsxm.2021.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 11/16/2021] [Accepted: 12/16/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Knowledge about sexual health is a key determinant of sexual behavior among adolescent sexual minority males (ASMM). No measures exist to assess anal sex knowledge, even though anal sex is the primary route by which ASMM acquire sexually transmitted infections (STIs), including a disproportionate burden of human immunodeficiency virus (HIV). AIM We developed a new measure as a first step toward assessing the prevalence and correlates of anal sex knowledge and potential effects of interventions to improve knowledge. METHODS Two coders independently outlined domains of knowledge within 2 sex education videos designed to address anal sex knowledge among ASMM. An initial set of 56 items, some duplicative, encompassed all domains. A larger team, including a psychometrician, then iteratively revised and reduced the set of items, and assessed construct validity via cognitive testing among ASMM (N = 4, aged 16-17 years old, 75% identifying as racial/ethnic minorities). For the final set of 10 items, factor structure and convergent and divergent validity were assessed using baseline responses to an online survey within a randomized controlled pilot trial among 154 ASMM. Open-ended questions assessed their comprehension and the acceptability of items. OUTCOMES We examined correlates that we anticipated would be theoretically related (ie, the HIV Knowledge Questionnaire [HIV-KQ-18] and the STD-Knowledge Questionnaire [STD-KQ]) and theoretically distinct (ie, the Patient Health Questionnaire [PHQ-2], Generalized Anxiety Disorder scale [GAD-2], and employment status). RESULTS The one-factor model explained 42% of the items' common variance and demonstrated acceptable internal reliability (Cronbach's alpha = 0.72). The measure withstood tests of convergent and divergent validity when compared to current measures (HIV knowledge, r = 0.35 and STI knowledge, r = 0.24, both P < .05; internalizing mental health symptoms, r = -0.07 and employment status, r = 0.13, both P > .05). Few respondents found words unfamiliar or uncomfortable. CLINICAL IMPLICATIONS A method for assessing anal sex knowledge may offer opportunities to intervene to lessen harmful sequelae of a lack of knowledge. STRENGTH & LIMITATIONS We developed a brief, psychometrically valid measure of anal sex knowledge. The measure may neither generalize to all anal health knowledge nor to more sexually experienced, older SMM. CONCLUSION The resulting 10-item, single-factor measure, the Inventory of Anal Sex Knowledge (iASK), is psychometrically sound and addresses the lack of anal sex knowledge measures among ASMM. The iASK can function to assess the prevalence and sequelae of anal sex knowledge among ASMM as well as the impact of interventions targeting anal sex knowledge. Kutner BA, Perry N, Stout C, et al. The Inventory of Anal Sex Knowledge (iASK): A New Measure of Sexual Health Knowledge Among Adolescent Sexual Minority Males. J Sex Med 2022;19:521-528.
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Affiliation(s)
- Bryan A Kutner
- HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA.
| | | | - Claire Stout
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Andrea Norcini Pala
- Social Intervention Group (SIG), Columbia School of Social Work, New York, NY, USA
| | - Christian D Paredes
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA
| | - Kimberly M Nelson
- Department of Community Health Sciences, Boston University School of Public Health, Boston, MA, USA; Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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22
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Dawson K, Nic Gabhainn S, Willis M, MacNeela P. Development of a Measure to Assess What Young Heterosexual Adults Say They Learn About Sex from Pornography. ARCHIVES OF SEXUAL BEHAVIOR 2022; 51:1257-1269. [PMID: 34761345 PMCID: PMC8888499 DOI: 10.1007/s10508-021-02059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 04/21/2021] [Accepted: 05/21/2021] [Indexed: 06/13/2023]
Abstract
This study involved the development of two new measures to assess what some young heterosexual-identifying adults report learning about sex from pornography. Inventory items were generated from an extensive literature review and six qualitative focus group sessions with young adults (N = 54) aged 18-29 which explored how pornography could be used as a source of sexual information. A total of 135 items pertaining to sexual learning from pornography were produced, reviewed and categorized by a sample of young adults (n = 9), and finally reviewed for item and construct relevance by a panel of pornography, sex education and scale development experts (n = 6). Inventory items were administered to a sample of young adult university students (n = 1306). Two separate exploratory factor analyses were conducted for the female and male datasets. The final factors were reviewed by a panel of young adults = 8) to identify the theme of each factor. Both the SIPI-F and SIPI-M yielded three factors: (1) How to be a good sexual partner, (2) Body aesthetic, and (3) Sexual exploration. Results show that pornography provides information about a range of sex-related topics. Findings also show that more frequent female pornography users reported learning more about how to be a good sexual partner and body aesthetic than less frequent pornography users. The SIPI-F and SIPI-M can be useful for examining a variety of questions regarding the use of pornography as an informal source of sexual information and its correlates.
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Affiliation(s)
- Kate Dawson
- School of Psychology, National University of Ireland, Galway, Ireland.
| | | | - Malachi Willis
- Social and Public Health Sciences Unit Institute of Health & Wellbeing, University of Glasgow, Glasgow, Scotland
| | - Pádraig MacNeela
- School of Psychology, National University of Ireland, Galway, Ireland
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Flores DD, Greene MZ, Taggart T. Parent-Child Sex Communication Prompts, Approaches, Reactions, and Functions According to Gay, Bisexual, and Queer Sons. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:74. [PMID: 35010332 PMCID: PMC8751024 DOI: 10.3390/ijerph19010074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/14/2021] [Accepted: 12/18/2021] [Indexed: 06/14/2023]
Abstract
Minimal research on parent-child sex communication between parents and gay, bisexual, and queer (GBQ) adolescent sons prevents the formulation of interventions that would buffer or brake this youth population's risks for HIV/STI. We sought to describe the perspectives of GBQ adolescent males on this process and the potential ways they think parents can address their sons' informational needs, including countering youth access of sexually explicit media. We conducted 30 semi-structured interviews with GBQ male youth aged 15-20 years. Thematic and content analysis revealed four central themes: prompts and triggers, parents' approaches, sons' reactions, and the functions assigned to sex communication. Parents can be sources of reliable sexual health information and may be leveraged for future HIV/STI risk reduction work.
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Affiliation(s)
- Dalmacio D. Flores
- Department of Family and Community Health, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Madelyne Z. Greene
- School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA;
| | - Tamara Taggart
- Department of Prevention and Community Health, George Washington University, Washington, DC 20052, USA;
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT 208034, USA
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Brown E, Lo Monaco S, O’Donoghue B, Nolan H, Hughes E, Graham M, Simmons M, Gray R. Improving the Sexual Health of Young People (under 25) in High-Risk Populations: A Systematic Review of Behavioural and Psychosocial Interventions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179063. [PMID: 34501652 PMCID: PMC8430747 DOI: 10.3390/ijerph18179063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/18/2021] [Accepted: 08/24/2021] [Indexed: 11/16/2022]
Abstract
Background: Ensuring young people experience good sexual health is a key public health concern, yet some vulnerable groups of young people remain at higher risk of poor sexual health. These individuals require additional support to achieve good sexual health but the best way to provide this remains needs to be better understood. Methods: We searched for randomised controlled trials of behavioural and psychosocial interventions aimed at promoting sexual health in high-risk young populations. Outcomes of interest were indicators of sexual health (e.g., condom use, attitudes to contraception, knowledge of risk). Participants were under 25 years old and in one of the following high-risk groups: alcohol and other drug use; ethnic minority; homeless; justice-involved; LGBTQI+; mental ill-health; or out-of-home care. Results: Twenty-eight papers from 26 trials met our inclusion criteria, with all but one conducted in North America. Condom use was the most frequently reported outcome measure along with knowledge and attitudes towards sexual health but considerable differences in measures used made comparisons across studies difficult. Change in knowledge and attitudes did not consistently result in long-term change in behaviours. Conclusions: There remains a dearth of research undertaken outside of North America across all high-risk groups of young people. Future interventions should address sexual health more broadly than just the absence of negative biological outcomes, with LGBTQI+, homeless and mental ill-health populations targeted for such work. An international consensus on outcome measures would support the research field going forward, making future meta-analyses possible.
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Affiliation(s)
- Ellie Brown
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
- Correspondence: ; Tel.: +61-3-9966-9100
| | - Samantha Lo Monaco
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Brian O’Donoghue
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Hayley Nolan
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Elizabeth Hughes
- School of Healthcare University of Leeds, Woodhouse, Leeds LS2 9JT, UK;
| | - Melissa Graham
- College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Australia; (M.G.); (R.G.)
| | - Magenta Simmons
- Orygen, 35 Poplar Road, Parkville, VIC 3052, Australia; (S.L.M.); (B.O.); (H.N.); (M.S.)
- Centre for Youth Mental Health, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052, Australia
| | - Richard Gray
- College of Science, Health and Engineering, La Trobe University, Bundoora, VIC 3086, Australia; (M.G.); (R.G.)
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Jia RM, Du JT, Zhao YC. Characteristics of the health information seeking behavior of LGBTQ+ individuals: a systematic review on information types, information sources and influencing factors. JOURNAL OF DOCUMENTATION 2021. [DOI: 10.1108/jd-03-2021-0069] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Purpose
Lesbian, gay, bisexual, transgender and queer/questioning (LGBTQ+) individuals' health information seeking is an important topic across multiple disciplines and areas. The aim of this systematic review is to create a holistic view of sexual and gender minority individuals' health information seeking reported in multidisciplinary studies, with regard to the types of health information LGBTQ+ individuals sought and information sources they used, as well as the factors influencing their health information seeking behavior.
Design/methodology/approach
The review is based on the literature search in 10 major academic databases. A set of inclusion and exclusion criteria was applied to identify studies that provide evidence on LGBTQ+ individuals' health information seeking behavior. The studies were first screened by title and abstract to determine whether they met the inclusion criteria. The full texts of each relevant study were obtained to confirm whether the exclusion criteria were met. The reference lists of the included studies were manually scanned. The relevant information was then extracted from selected articles and analyzed using thematic content analysis.
Findings
A seed set of 3,122 articles published between 1997 and 2020 was evaluated, and 46 total articles were considered for further analysis. The review results show that two major categories of health information sought by LGBTQ+ individuals were sexual and nonsexual, which were further classified into 17 specific types. In terms of health information sources, researchers have reported that online resources, interpersonal sources and traditional media were frequently used. Moreover, 25 factors affecting LGBTQ+ individuals' health information seeking were identified from the literature.
Originality/value
Through evidence-based understanding, this review preliminarily bridged the knowledge gap in understanding the status quo of studies on LGBTQ+ individuals' health information seeking and proposed the potential research directions that information science researchers could contribute to this important area.
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Pampati S, Johns MM, Szucs LE, Bishop MD, Mallory AB, Barrios LC, Russell ST. Sexual and Gender Minority Youth and Sexual Health Education: A Systematic Mapping Review of the Literature. J Adolesc Health 2021; 68:1040-1052. [PMID: 33162290 PMCID: PMC8121450 DOI: 10.1016/j.jadohealth.2020.09.032] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 08/09/2020] [Accepted: 09/22/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE To synthesize the diverse body of literature on sexual and gender minority youth (SGMY) and sexual health education. METHODS We conducted a systematic search of the literature on SGMY and sexual health education, including SGMY perspectives on sexual health education, the acceptability or effectiveness of programs designed for SGMY, and SGMY-specific results of sexual health education programs delivered to general youth populations. RESULTS A total of 32 articles were included. Sixteen qualitative studies with SGMY highlight key perspectives underscoring how youth gained inadequate knowledge from sexual health education experiences and received content that excluded their identities and behaviors. Thirteen studies examined the acceptability or effectiveness of sexual health interventions designed for SGMY from which key characteristics of inclusive sexual health education relating to development, content, and delivery emerged. One study found a sexual health education program delivered to a general population of youth was also acceptable for a subsample of sexual minority girls. CONCLUSIONS Future research on SGMY experiences should incorporate populations understudied, including younger adolescents, sexual minority girls, and transgender persons. Further, the effectiveness of inclusive sexual health education in general population settings requires further study.
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Affiliation(s)
- Sanjana Pampati
- Oak Ridge Institute for Science and Education (ORISE), Oak Ridge, Tennessee.
| | - Michelle M Johns
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Leigh E Szucs
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Meg D Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas; University of Texas Population Research Center, Austin, Texas
| | - Allen B Mallory
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas; University of Texas Population Research Center, Austin, Texas
| | - Lisa C Barrios
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen T Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, Austin, Texas; University of Texas Population Research Center, Austin, Texas
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Kutner BA, Simoni JM, Aunon FM, Creegan E, Balán IC. How Stigma Toward Anal Sexuality Promotes Concealment and Impedes Health-Seeking Behavior in the U.S. Among Cisgender Men Who Have Sex with Men. ARCHIVES OF SEXUAL BEHAVIOR 2021; 50:1651-1663. [PMID: 32020349 PMCID: PMC7398831 DOI: 10.1007/s10508-019-01595-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 11/12/2019] [Accepted: 11/25/2019] [Indexed: 05/23/2023]
Abstract
Gay, bisexual, and other men who have sex with men (MSM) experience alarming HIV disparities alongside sub-optimal engagement in HIV interventions. Among MSM, stigma toward anal sexuality could interfere with engagement in HIV prevention, yet few studies have examined MSM perspectives on anal sex stigma or its health-related sequelae. Guided by theory, we aimed to characterize anal sex stigma, related sexual concerns, and barriers to health seeking, like concealment. We elicited community input by purposively interviewing 10 experts in MSM health and then 25 racially, ethnically, and geographically diverse cisgender MSM. Participants reported experienced, internalized, and anticipated forms of anal sex stigma that inhibited health seeking. Experienced stigma, including direct and observed experiences as well as the absence of sex education and information, contributed to internalized stigma and anticipation of future devaluation. This process produced psychological discomfort and concealment of health-related aspects of anal sexuality, even from potentially supportive sexual partners, social contacts, and health workers. Participants characterized stigma and discomfort with disclosure as normative, pervasive, and detrimental influences on health-seeking behavior both during sex and within healthcare interactions. Omission of information appears to be a particularly salient determinant of sexual behavior, inhibiting prevention of harm, like pain, and leading to adverse health outcomes. The development of measures of anal sex stigma and related sexual concerns, and testing their impact on comfort with disclosure, sexual practices, and engagement in health services could identify modifiable social pathways that contribute to health disparities among MSM, like those seen in the HIV epidemic.
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Affiliation(s)
- Bryan A Kutner
- The HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Frances M Aunon
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Emma Creegan
- School of Public Health, Brown University, Providence, RI, USA
| | - Ivan C Balán
- The HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute, Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
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Bishop MD, Mallory AB, Gessner M, Frost DM, Russell ST. School-based Sexuality Education Experiences across Three Generations of Sexual Minority People. JOURNAL OF SEX RESEARCH 2021; 58:648-658. [PMID: 32486928 PMCID: PMC7708407 DOI: 10.1080/00224499.2020.1767024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sexual minority people face greater risk for compromised sexual health than their heterosexual peers, yet school-based sexuality education often excludes them. Little is known about whether or how sexual minority people's sexuality education experiences have varied across sociohistorical contexts of rapid social change in both sexuality education and sexual minority visibility. Semi-structured qualitative interviews were conducted among 191 sexual minority people from three distinct sociohistorical generations (ages 18-25, 34-41, and 52-59, respectively) and four geographic regions of the United States. Data were analyzed using thematic content analysis following a consensual qualitative protocol. Fifty-one participants (i.e., 27%) discussed school-based sexuality education experiences despite the lack of an explicit question in the interview protocol prompting them to do so. Four distinct yet overlapping themes emerged in participants' experiences of sexuality education: 1) Silence; 2) The profound influence of HIV/AIDS; 3) Stigma manifest through fear, shame, and prejudice; and, 4) Comparing school-based experiences to sexuality education outside of school. The presence of themes varied across groups defined by sociohistorical generation. The implications of sexuality education experiences for the wellbeing of sexual minority people are discussed.
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Affiliation(s)
- Meg D. Bishop
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
| | - Allen B. Mallory
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
| | - McKenna Gessner
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
| | - David M. Frost
- Department of Social Science, University College London, 27-28 Woburn Square, London, WC1H 0AA
| | - Stephen T. Russell
- Department of Human Development and Family Sciences, University of Texas at Austin, 108 E. Dean Keaton Street, Austin, Texas 78712, U.S.A
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Javidi H, Widman L, Lipsey N, Brasileiro J, Javidi F, Jhala A. Redeveloping a Digital Sexual Health Intervention for Adolescents to Allow for Broader Dissemination: Implications for HIV and STD Prevention. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:89-102. [PMID: 33821678 DOI: 10.1521/aeap.2021.33.2.89] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
HIV/STDs and unintended pregnancy persist among adolescents in the United States; thus, effective sexual health interventions that can be broadly disseminated are necessary. Digital health interventions are highly promising because they allow for customization and widespread reach. The current project involved redeveloping and expanding HEART (Health Education and Relationship Training)-a brief, digital sexual health intervention efficacious at improving safer sex knowledge, self-efficacy, and behavior-onto an open-source platform to allow for greater interactivity and accessibility while reducing long-term program costs. The authors describe the process of adapting, reprogramming, and evaluating the new program, which may serve as a guide for investigators seeking to adapt behavioral interventions onto digital platforms. The final product is an open-source intervention that can be easily adapted for new populations. Among 233 adolescents (Mage = 15.06; 64% girls), HEART was highly acceptable and generally feasible to administer, with no differences in acceptability by gender or sexual identity.
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Affiliation(s)
- Hannah Javidi
- North Carolina State University, Department of Psychology, Raleigh, North Carolina
| | - Laura Widman
- North Carolina State University, Department of Psychology, Raleigh, North Carolina
| | - Nikolette Lipsey
- North Carolina State University, Department of Psychology, Raleigh, North Carolina
| | - Julia Brasileiro
- North Carolina State University, Department of Psychology, Raleigh, North Carolina
| | - Farhad Javidi
- Central Piedmont Community College, Simulation and Game Development, Charlotte, North Carolina
| | - Arnav Jhala
- North Carolina State University, Department of Computer Science, Raleigh, North Carolina
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30
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Newton JDA, Halford WK, Barlow FK. Intimacy in Dyadic Sexually Explicit Media Featuring Men Who Have Sex with Men. JOURNAL OF SEX RESEARCH 2021; 58:279-291. [PMID: 32975464 DOI: 10.1080/00224499.2020.1817837] [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
Sexually explicit material (SEM) featuring men who have sex with men (MSM) may be a source of information about intimacy in same-sex male relationships for MSM. However, little is known about how MSM SEM depicts intimacy between male performers. The current study examined the 220 most viewed dyadic scenes of MSM SEM videos for the presence of verbal intimacy (compliments, personal disclosure, and expressions of care) and physical intimacy (kissing, cuddling, affectionate touch, and genital touch before and after sex) between performers. At least one example of physical and verbal intimacy was present in the majority of videos (91% and 68% of videos, respectively). Most forms of physical and verbal intimacy occurred before or during sex, with intimacy being least evident post-sex. We also tested if the presence of intimacy was associated with viewer interactions with videos (likes and dislikes) and number of views. Only one of seven forms of intimacy, care (verbal), was associated with more interactions (i.e., likes and dislikes per 100,000 views), and there was no association with the number of views. Potential implications for MSM's understandings of intimacy are recognized and discussed with reference to sexual script theory.
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31
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Tabaac AR, Benotsch EG, Agénor M, Austin SB, Charlton BM. Use of media sources in seeking and receiving sexual health information during adolescence among adults of diverse sexual orientations in a US cohort. SEX EDUCATION 2021; 21:723-731. [PMID: 34899055 PMCID: PMC8659378 DOI: 10.1080/14681811.2021.1873122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 01/05/2021] [Indexed: 06/14/2023]
Abstract
The objective in this study was to examine the association between sexual orientation and seeking/receiving sexual and reproductive health (SRH) information from media sources during adolescence. We analysed data from male and female participants (aged 23-35 years) from the U.S.-based Growing Up Today Study (GUTS) in 2016. Sex-stratified, multivariable log-binomial models adjusted for age, cohort and race/ethnicity were used to examine sexual orientation differences in retrospective self-reported seeking/receipt of SRH media information before age 18. Sexual minority (e.g., mostly heterosexual, bisexual, gay) men and women were more likely than same-gender individuals who identified as completely heterosexual to seek/receive SRH information about contraceptive methods (e.g., condom use), sexually transmitted infections, and HIV and AIDS. Although lesbians were more likely than completely heterosexuals to seek/receive SRH information from media about each topic, they were the sexual minority subgroup with the smallest proportion seeking/receiving SRH information. Sexual minorities may passively and/or actively receive SRH information pertaining to a wide range of topics, including skills-based sex education, from media sources more frequently than heterosexuals, which may influence safe-sex decision-making. Lesbians in particular may benefit from media information dissemination focusing on their specific SRH needs, as current media sources do not seem to be well-utilised by this group.
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Affiliation(s)
- Ariella R. Tabaac
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Center for Gender Surgery, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Eric G. Benotsch
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Madina Agénor
- Department of Community Health, Tufts University, Medford, MA, USA
- Department of Obstetrics/Gynecology, Tufts University School of Medicine, Boston, MA, USA
| | - S. Bryn Austin
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
| | - Brittany M. Charlton
- Division of Adolescent/Young Adult Medicine, Boston Children’s Hospital, Boston, MA, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Brief Report: Sexual Debut Among 14- to 17-year-old Sexual Minority Males: A Preliminary Investigation of Early HIV Risk and Sexual Health Needs. J Acquir Immune Defic Syndr 2021; 84:280-284. [PMID: 32149857 DOI: 10.1097/qai.0000000000002342] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Adolescent sexual minority males (ASMM) are disproportionately at risk of HIV. PURPOSE This study documents the sexual debut behaviors of ASMM, tests whether sexual debut and sexual behavior differed by race/ethnicity, and explores the association between early anal sex debut and engaging in condomless anal sex. METHODS Sexually active ASMM (N = 118; ages 14-17) in the United States completed an online sexual health survey. We used Fisher exact tests to explore differences by race/ethnicity in sexual debut characteristics and hypothesized relationships between sexual debut and risk behavior. RESULTS The average age of sexual debut with a male partner was 14 years (SD = 2.4). Approximately one-third (31%) reported anal sex at their sexual debut, with non-Latino black/African American ASMM more likely to report anal sex at debut (63%) compared with non-Latino white (28%), Latino (21%), or mixed race/other identified youth (19%; χ = 12.1, P = 0.01). All participants (100%) who reported an anal sex debut before the age of 14 years reported engaging in condomless anal sex in their lifetime, compared to 60% of those who reported an anal sex debut when they were 14 years old or older (χ = 5.6, P = 0.03). Participants wanted information about how to safely and comfortably have anal sex (59%) and skills around partner communication (>50%) before debut. CONCLUSION Sexually active ASMM begin engaging in sexual behavior with other males early and with incomplete knowledge and skills regarding sexual health and safety.
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Flores DD, Meanley SP, Bond KT, Agenor M, Relf MV, Barroso JV. Topics for Inclusive Parent-Child Sex Communication by Gay, Bisexual, Queer Youth. Behav Med 2021; 47:175-184. [PMID: 32027581 PMCID: PMC7416429 DOI: 10.1080/08964289.2019.1700481] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The purposes of this study were to identify the sexuality-related topics parents and gay, bisexual, or queer (GBQ) adolescent males discussed at home and to describe the topics GBQ adolescent males recommend for parents to discuss with future cohorts of GBQ youth. Minimal research on parent-child sex communication with sexual minority adolescents prevents the development of interventions that would benefit adolescent males with same-sex attractions, behaviors and identities. As part of a multimethod qualitative study, we interviewed 30 GBQ adolescent males ages 15-20 and asked them to perform card sorts. From a list of 48 topics, we explored sexuality-related issues GBQ males were familiar with, the topics they discussed with a parent, and topics they suggested parents address with GBQ males at home. Most participants reported that parents assumed them heterosexual during sex talks prior to GBQ adolescent males' coming out. Participants challenged the heteronormative scripts used by parents when discussing sex and health. Participants identified sexuality topics that parents did not routinely cover during sex talks, but that GBQ youth felt would have been useful for them growing up with emergent identities. A non-heteronormative approach to parent-child sex communication is recommended to provide appropriate guidance about sex and HIV/STI prevention to this youth population. Our findings highlight a need to reconfigure parental sexuality scripts to be more inclusive when assisting GBQ males navigate adolescence.
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Affiliation(s)
| | - Steven P. Meanley
- School of Nursing, University of Pennsylvania (Philadelphia, PA, 19104)
| | - Keosha T. Bond
- School of Public Health, New York Medical College (Valhalla, NY, 10595)
| | | | | | - Julie V. Barroso
- College of Nursing, Medical University of South Carolina (Charleston, SC, 29425)
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Kaufman MR, Casella A, Wiginton JM, Xu W, DuBois DL, Arrington-Sanders R, Simon J, Levine D. Mentoring Young African American Men and Transgender Women Who Have Sex With Men on Sexual Health: Formative Research for an HIV Mobile Health Intervention for Mentors. JMIR Form Res 2020; 4:e17317. [PMID: 33331822 PMCID: PMC7775199 DOI: 10.2196/17317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 06/30/2020] [Accepted: 10/02/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND African American men who have sex with men (MSM) and transgender women bear a disproportionate burden of HIV. Young MSM account for 75% of this burden for youth. When youths lack socially protective resources such as strong networks of adults, including parents, teachers, or community members, mentors may play a critical role in promoting health behaviors. This is especially true for youth at risk for HIV, such as African American youth with sexual and gender minority (SGM) identities. In the past decade, natural mentoring and mentoring programs have proliferated as a key prevention and intervention strategy to improve outcomes for young people at risk for poor academic, social, and health issues. Mentors appear to be able to facilitate health promotion among young SGM by modeling healthy behaviors; however, mentors' knowledge and resource needs regarding sexual health topics including HIV are understudied, as is the potential role of mobile technology in enhancing mentoring relationships and the ability of mentors to learn about sensitive issues faced by youth. OBJECTIVE The aim of this study is to explore how mentoring plays a role in the sexual health of African American SGM youth and understand how mentoring relationships can be strengthened through mobile technology to promote youth HIV prevention behaviors. METHODS In-depth interviews were conducted with African American SGM youth mentees (n=17) and mentors (n=20) to such youths in 3 Mid-Atlantic cities. Mentee interviews focused on discussions regarding sexual health and HIV and how a mentor could broach such topics. Mentor interviews explored whether sexual health and HIV are currently mentoring topics, mentors' knowledge and confidence in mentoring on these issues, and barriers to discussions. All participants were asked if a mobile app could help facilitate mentoring on sensitive health issues, particularly HIV and sexual health. Data were transcribed, coded, and analyzed for relevant themes. RESULTS Sexual health was a common topic in mentoring relationships, occurring more in natural mentorships than in mentoring program pairs. Mentors and mentees felt positive about such discussions. Mentors expressed having limited knowledge beyond condom use and HIV testing, and expressed a need for more complete resources. Both mentors and mentees had mixed comfort levels when discussing sexual health. Sufficient trust and shared lived experiences made discussions easier. Mentees have multifaceted needs; however, mentors stated that an app resource that provided self-training, resources, support from other mentors, and tips for better mentoring could prove beneficial. CONCLUSIONS For the African American SGM community, access to natural mentors is crucial for young people to learn healthy behaviors. A mobile resource to assist mentors in confidently having discussions with mentees may be a promising way to promote healthy practices.
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Affiliation(s)
- Michelle R Kaufman
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Albert Casella
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - John Mark Wiginton
- Department of Health, Behavior & Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Wenjian Xu
- Department of Sociology & Psychology, School of Public Administration, Sichuan University, Chengdu, China
| | - David L DuBois
- Division of Community Health Sciences and Institute for Health Research and Policy, University of Illinois Chicago, Chicago, IL, United States
| | | | | | - Deb Levine
- DKF Consulting, Oakland, CA, United States
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Lee-Foon NK, Logie CH, Siddiqi A, Grace D. “I just trust what Google says, it’s the Bible”: Exploring young, Black gay and other men who have sex with men’s evaluation of sexual health information sources in Toronto, Canada. THE CANADIAN JOURNAL OF HUMAN SEXUALITY 2020. [DOI: 10.3138/cjhs.2020-0026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
While sexual health literature identifies youths’ sexual health information sources and its impact on their sexual practices, little is known about the way youth evaluate the credibility of this information. This knowledge gap is significant among young, Black gay and other men who have sex with men (YBGM) who belong to intersectional populations disproportionately impacted by HIV and other STIs. We conducted a qualitative study using constructivist grounded theory to explore YBGM’s approaches to evaluating sexual health information sources’ credibility. Intersectionality and the socioecological model informed our analysis. We explored connections between social locations (e.g., race, sexual orientation) and socio-ecological environments and how their impact shaped YBGM’s evaluation of sexual health information. Findings revealed evaluation strategies varied by source: friends, the internet and healthcare providers. Friends’ information was deemed credible if they were older, shared social locations and provided embodied testimonials. Testimonials mirrored oral-traditions specific to Black populations where oral narratives help disseminate sensitive information in a culturally relevant way. Website selection was informed by YBGM’s social locations and ranged from being implicitly trusted to assessed by its association with established healthcare organizations. Many participants’ acceptance of healthcare providers’ information revealed patient-client power imbalances and a perception that providers’ actions reflected their institutions’ sexual health policies. Findings highlight a need for sexual health services to create culturally effective ways to disseminate information that accounts for the histories, contexts, and approaches YBGM use to identify credible sources of sexual health information.
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Affiliation(s)
- Nakia K. Lee-Foon
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Carmen H. Logie
- Factor-Inwentash School of Social Work, University of Toronto, Toronto, ON
| | - Arjumand Siddiqi
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
| | - Daniel Grace
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON
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Kutner BA, King KM, Dorsey S, Creegan E, Simoni JM. The Anal Sex Stigma Scales: A New Measure of Sexual Stigma Among Cisgender Men Who have Sex with Men. AIDS Behav 2020; 24:2666-2679. [PMID: 32198561 DOI: 10.1007/s10461-020-02824-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We conducted a series of studies to validate a new scale of stigma toward anal sex, culturally tailored to cisgender men who have sex with men (MSM). In Study 1 we conducted in-depth interviews (N = 35) to generate items. In Study 2, we reduced the item pool through an online survey (N = 268), testing scale performance, dimensionality, and convergent and discriminant validity. For Study 3, we recruited another online sample (N = 1605), randomized to exploratory or confirmatory factor analyses to finalize item reduction, then assessed validity among sexually active MSM (n = 1263). Final subscales encompassed self-stigma (6 items, Cronbach's α = .72), provider stigma (5 items, Cronbach's α = .79), and omission of information (6 items, Cronbach's α = .73; full 3-factor scale = .80). We developed a 17-item measure, grounded in the lived experience of cisgender MSM. Future work should examine associations with health-seeking behavior.
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Affiliation(s)
- Bryan A Kutner
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA.
| | - Kevin M King
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Shannon Dorsey
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Emma Creegan
- Brown University School of Public Health, Providence, RI, USA
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
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Mustanski B, Moskowitz DA, Moran KO, Newcomb ME, Macapagal K, Rodriguez-Díaz C, Rendina HJ, Laber EB, Li DH, Matson M, Talan AJ, Cabral C. Evaluation of a Stepped-Care eHealth HIV Prevention Program for Diverse Adolescent Men Who Have Sex With Men: Protocol for a Hybrid Type 1 Effectiveness Implementation Trial of SMART. JMIR Res Protoc 2020; 9:e19701. [PMID: 32779573 PMCID: PMC7448177 DOI: 10.2196/19701] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 07/07/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Adolescent men who have sex with men (AMSM), aged 13 to 18 years, account for more than 80% of teen HIV occurrences. Despite this disproportionate burden, there is a conspicuous lack of evidence-based HIV prevention programs. Implementation issues are critical as traditional HIV prevention delivery channels (eg, community-based organizations, schools) have significant access limitations for AMSM. As such, eHealth interventions, such as our proposed SMART program, represent an excellent modality for delivering AMSM-specific intervention material where youth are. OBJECTIVE This randomized trial aimed to test the effectiveness of the SMART program in reducing condom-less anal sex and increasing condom self-efficacy, condom use intentions, and HIV testing for AMSM. We also plan to test whether SMART has differential effectiveness across important subgroups of AMSM based on race and ethnicity, urban versus rural residence, age, socioeconomic status, and participation in an English versus a Spanish version of SMART. METHODS Using a sequential multiple assignment randomized trial design, we will evaluate the impact of a stepped-care package of increasingly intensive eHealth interventions (ie, the universal, information-based SMART Sex Ed; the more intensive, selective SMART Squad; and a higher cost, indicated SMART Sessions). All intervention content is available in English and Spanish. Participants are recruited primarily from social media sources using paid and unpaid advertisements. RESULTS The trial has enrolled 1285 AMSM aged 13 to 18 years, with a target enrollment of 1878. Recruitment concluded in June 2020. Participants were recruited from 49 US states as well as Puerto Rico and the District of Columbia. Assessments of intervention outcomes at 3, 6, 9, and 12 months are ongoing. CONCLUSIONS SMART is the first web-based program for AMSM to take a stepped-care approach to sexual education and HIV prevention. This design indicates that SMART delivers resources to all adolescents, but more costly treatments (eg, video chat counseling in SMART Sessions) are conserved for individuals who need them the most. SMART has the potential to reach AMSM to provide them with a sex-positive curriculum that empowers them with the information, motivation, and skills to make better health choices. TRIAL REGISTRATION ClinicalTrials.gov Identifier NCT03511131; https://clinicaltrials.gov/ct2/show/NCT03511131. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19701.
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - David A Moskowitz
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kevin O Moran
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Michael E Newcomb
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Kathryn Macapagal
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Carlos Rodriguez-Díaz
- Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC, United States
- Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - H Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| | - Eric B Laber
- Department of Statistics, North Carolina State University, Raleigh, NC, United States
| | - Dennis H Li
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Margaret Matson
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, United States
| | - Ali J Talan
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
| | - Cynthia Cabral
- Department of Psychology, Hunter College of the City University of New York (CUNY), New York, NY, United States
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Flores DD, Meanley SP, Wood SM, Bauermeister JA. Family Characteristics in Sex Communication and Social Support: Implications for Emerging Adult Men Who Have Sex with Men's PrEP Engagement. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:2145-2153. [PMID: 32222853 PMCID: PMC7781437 DOI: 10.1007/s10508-020-01648-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 01/20/2020] [Accepted: 01/27/2020] [Indexed: 05/29/2023]
Abstract
While emerging adulthood (ages 18-25) is marked by increased independence from parents, parental support remains a strong correlate of positive sexual health outcomes for heterosexual youth. With the emergence of pre-exposure prophylaxis (PrEP), few studies have examined the potential for parent-child sex communication and PrEP adoption among emerging adult men who have sex with men (MSM). We aimed to describe the extent to which parents/family characteristics play supportive roles in emerging adult MSM's current PrEP use. PrEP-indicated participants (N = 222) were recruited via social media to complete an online survey. Multivariable logistic regression assessed associations between emerging adult MSM's current PrEP use and comfort with parent-child sex communication, family social support, family outness, and family prioritization, adjusted for sociodemographic variables. Thirty percent of participants reported current PrEP use. Only 20% reported moderate/high comfort with parent sex communication, 80% reported any family sexual identity disclosure, 70% reported moderate/high family social support, and 70% ranked family as a high/very high priority. Our multivariable model demonstrated an association between comfort with parent-child sex communication with current PrEP use only (AOR= 1.55, 95% CI 1.04-2.32). Our findings support that parents of emerging adult MSM possess a critical potential to reduce their sons' risk of HIV and promote PrEP uptake. Interventions that facilitate parents' efficacy to foster affirming, non-judgmental environments and discussions about their child's sexual behaviors, attractions/relationships, and health (e.g., PrEP) may be impactful in reducing the high HIV incidence rate that burdens emerging adult MSM.
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Affiliation(s)
- Dalmacio D Flores
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 223L, Philadelphia, PA, 19104, USA.
| | - Steven P Meanley
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 223L, Philadelphia, PA, 19104, USA
| | - Sarah M Wood
- Craig Dalsimer Division of Adolescent Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Jose A Bauermeister
- School of Nursing, University of Pennsylvania, 418 Curie Blvd., Suite 223L, Philadelphia, PA, 19104, USA
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Russell S, Mallory A, Bishop M, Dorri A. Innovation and Integration of Sexuality in Family Life Education. FAMILY RELATIONS 2020; 69:595-613. [PMID: 34588714 PMCID: PMC8478349 DOI: 10.1111/fare.12462] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 05/09/2020] [Indexed: 05/25/2023]
Abstract
As a fundamental aspect of the human experience, sexuality is experienced at every stage in the lifespan. Sexual values, behaviors, and health are important components of individual and family well-being. Educating about such a fundamental aspect of life is both obvious and crucial. In this article, we consider the potential of sexuality education in the field and profession of family life education (FLE). We critique sexuality education in the United States, and we critique the marginal place of human sexuality in the FLE field. We then offer recommendations for incorporating lifespan, socio-ecological, family systems and intersectionality into sexuality education, and recommendations for FLE and sexuality education research and practice. We argue that educating about sexuality in the context of FLE-and activating the profession of FLE for sexuality education-will strategically advance sexuality education, sexual health, and the field of FLE.
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40
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Davis AC, Wright CJ, Murphy S, Dietze P, Temple-Smith MJ, Hellard ME, Lim MS. A Digital Pornography Literacy Resource Co-Designed With Vulnerable Young People: Development of "The Gist". J Med Internet Res 2020; 22:e15964. [PMID: 32348268 PMCID: PMC7296407 DOI: 10.2196/15964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 11/17/2019] [Accepted: 02/24/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The impact of viewing pornography at a young age on the sexual health of subgroups of young people is an important public health issue. However, the topic is complex and extremely sensitive, and best practices for research and harm reduction are yet to be defined. Drawing on cross-disciplinary approaches, such as co-design, is one way to achieve a better understanding of the issue among vulnerable young people and to create needs-based and evidence-informed digital resources to promote pornography literacy. OBJECTIVE The objective of this study was to co-design a relevant, usable, and acceptable digital prototype to address the pornography literacy needs of vulnerable young people. METHODS In total, 17 young people aged between 14 and 23 years who were engaged in youth services programs or alternative education programs were recruited to participate in 4 co-design workshops with a multidisciplinary design team. RESULTS Although the participants could identify problems with pornography and critique its messages, they lacked the information to understand alternative healthy attitudes and behaviors. A digital resource that provides detailed and practical information about sex, sexual ethics, and relationships may help vulnerable young people to identify and contrast with any problematic messages they receive from both pornography and society. Embedding this information with pornography literacy messages may be a more effective way of addressing underlying attitudes. Acknowledging information-seeking patterns and leveraging user interaction patterns from commonly used digital platforms among users may enhance engagement with resources. Importantly, digital platforms are perceived among this group as a source of anonymous secondary information but would not be organically accessed among this group without face-to-face conversations as an access point. CONCLUSIONS This paper highlights the potential for pornography literacy to be embedded within real and practical information about having sex, navigating sexuality, and healthy relationships. The study findings include important recommendations for the conceptualization of digital pornography literacy programs and opportunities for cross-disciplinary co-design research to address complex and emerging health issues.
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Affiliation(s)
- Angela C Davis
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cassandra Jc Wright
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Australia
| | | | - Paul Dietze
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Meredith J Temple-Smith
- Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia
| | - Margaret E Hellard
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Department of Infectious Diseases, The Alfred Hospital, Melbourne, Australia
| | - Megan Sc Lim
- Burnet Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
- Melbourne School of Population and Global Health, Department of General Practice, University of Melbourne, Melbourne, Australia
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Exposure to sexually explicit media in early adolescence is related to risky sexual behavior in emerging adulthood. PLoS One 2020; 15:e0230242. [PMID: 32275669 PMCID: PMC7147756 DOI: 10.1371/journal.pone.0230242] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Accepted: 02/26/2020] [Indexed: 11/19/2022] Open
Abstract
Background Sexually explicit media exposure during early adolescence has been found to be associated with risky sexual behavior. However, previous study suffered from methodological issue, such as selection bias. Furthermore, little is known about the effect of multi-modality sexually explicit media exposure on risky sexual behavior, and how this relationship can be applied to non-western societies. Objectives This study aimed to improve upon previous studies by using instrumental variable estimation. In addition, this study also included multi-modality of sexually explicit media and three risky sexual behavior measure from a sample of Taiwanese adolescents. Methods Participants were recruited from a prospective longitudinal study (Taiwan Youth Project). All were in 7th grade (mean age = 13.3) when the study was initiated in 2000. Sexually explicit media exposure, including ever-exposure and number of modalities exposed to, was measured in wave 2 (8th grade). Risky sexual behavior was measured in waves 8 (mean age = 20.3) and 10 (mean age = 24.3). A two-stage least squares regression was employed, with pubertal timing as the instrumental variable. Results About 50% of participants had been exposed to sexual media content by 8th grade, from an average of one modality. Sexually explicit media exposure predicted early sexual debut, unsafe sex, and multiple sexual partners (all: p < .05). Furthermore, exposure to more media modalities increased the likelihood of risky sexual behaviors. However, only the effect on early sexual debut was gender invariant. Conclusions Exposure to sexually explicit media in early adolescence had a substantive relationship with risky sexual behavior in the emerging adulthood. Knowledge of this causal like effect provides a basis for building better preventive programs in early adolescence. One prominent way is early education on media literacy, and physicians themselves may need to be familiar with such content to initiate it.
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Mustanski B, Moskowitz DA, Moran KO, Rendina HJ, Newcomb ME, Macapagal K. Factors Associated With HIV Testing in Teenage Men Who Have Sex With Men. Pediatrics 2020; 145:peds.2019-2322. [PMID: 32047100 PMCID: PMC7049943 DOI: 10.1542/peds.2019-2322] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Adolescent men who have sex with men (AMSM) have a high rate of HIV diagnoses. An estimated 14.5% of HIV infections in the United States are undiagnosed; but among 13- to 24-year-olds, the rate is 51.4%. We describe HIV testing rates and identifies salient individual, family, school, and health care influences among AMSM. METHODS Data were collected as part of SMART, an ongoing pragmatic trial of an online HIV prevention intervention for AMSM (N = 699). Measures included lifetime HIV testing, demographics, sexual behaviors, condom use, HIV education from school and family, sexual health communication with doctors, HIV knowledge, and risk attitudes. RESULTS Only 23.2% of participants had ever had an HIV test. Rates of testing increased with age (5.6% in 13- to 14-year-olds; 15.8% in 15- to 16-year-olds; 37.8% in 17- to 18-year-olds), and sexual experience was a strong predictor of testing (odds ratio: 6.54; 95% confidence interval: 3.95-11.49; P < .001). Most participants had a regular doctor (67.5%), but few had conversations about same-sex sexual behaviors (21.3%), HIV testing (19.2%), or sexual orientation (29.2%). Speaking to a doctor about HIV testing had a large effect (odds ratio: 25.29; confidence interval: 15.91-41.16; P < .001), with 75.4% who had such conversations having been tested, compared to only 10.8% of those who had not had such conversations. CONCLUSIONS Despite higher risk, few participants reported ever having received an HIV test. Data indicate pediatricians are an important, but largely untapped, source of testing and could be integral to achieving testing rates needed to end the epidemic.
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Affiliation(s)
- Brian Mustanski
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and .,Departments of Medical Social Sciences and
| | - David A. Moskowitz
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - Kevin O. Moran
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - H. Jonathon Rendina
- Department of Psychology, Hunter College of the City University of New York, New York, New York
| | - Michael E. Newcomb
- Departments of Medical Social Sciences and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
| | - Kathryn Macapagal
- Departments of Medical Social Sciences and,Psychiatry and Behavioral Sciences, Feinberg School of Medicine and,Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, Illinois; and
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43
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Kutner BA, Simoni JM, King KM, Goodreau SM, Norcini Pala A, Creegan E, Aunon FM, Baral SD, Rosser BRS. Does Stigma Toward Anal Sexuality Impede HIV Prevention Among Men Who Have Sex With Men in the United States? A Structural Equation Modeling Assessment. J Sex Med 2020; 17:477-490. [PMID: 31932256 DOI: 10.1016/j.jsxm.2019.12.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 11/21/2019] [Accepted: 12/04/2019] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Men who have sex with men (MSM) are suboptimally engaged in efficacious HIV interventions, due in part to stigma. AIM We sought to validate the Anal Health Stigma Model, developed based on theory and prior qualitative data, by testing the magnitude of associations between measures of anal sex stigma and engagement in HIV prevention practices, while adjusting for covariates. METHODS We conducted a cross-sectional online survey of 1,263 cisgender MSM living in the United States and analyzed data with structural equation modeling. We tested a direct path from Anal Sex Stigma to Engagement in HIV Prevention alongside 2 indirect paths, 1 through Anal Sex Concerns and another through Comfort Discussing Anal Sexuality with Health Workers. The model adjusted for Social Support, Everyday Discrimination, and Sociodemographics. MAIN OUTCOME MEASURE Engagement in HIV Prevention comprised an ad hoc measure of (i) lifetime exposure to a behavioral intervention, (ii) current adherence to biomedical intervention, and (iii) consistent use of a prevention strategy during recent penile-anal intercourse. RESULTS In the final model, anal sex stigma was associated with less engagement (β = -0.22, P < .001), mediated by participants' comfort talking about anal sex practices with health workers (β = -0.52; β = 0.44; both P < .001), adjusting for covariates (R2 = 67%; χ2/df = 2.98, root mean square error of approximation = 0.040, comparative fit index = 0.99 and Tucker-Lewis index = 0.99). Sex-related concerns partially mediated the association between stigma and comfort (β = 0.55; β = 0.14, both P < .001). Modification indices also supported total effects of social support on increased comfort discussing anal sex (β = 0.35, P < .001) and, to a lesser degree, on decreased sex-related concerns (β = -0.10; P < .001). CLINICAL IMPLICATIONS Higher stigma toward anal sexuality is associated with less engagement in HIV prevention, largely due to discomfort discussing anal sex practices with health workers. STRENGTH & LIMITATIONS Adjustment for mediation in a cross-sectional design cannot establish temporal causality. Self-report is vulnerable to social desirability and recall bias. Online samples may not represent cisgender MSM in general. However, findings place HIV- and health-related behaviors within a social and relational context and may suggest points for intervention in health-care settings. CONCLUSION Providers' willingness to engage in discussion about anal sexuality, for example, by responding to questions related to sexual well-being, may function as social support and thereby bolster comfort and improve engagement in HIV prevention. Kutner BA, Simoni JM, King KM, et al. Does Stigma Toward Anal Sexuality Impede HIV Prevention Among Men Who Have Sex With Men in the United States? A Structural Equation Modeling Assessment. J Sex Med 2020;17:477-490.
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Affiliation(s)
- Bryan A Kutner
- The HIV Center for Clinical and Behavioral Studies at the New York State Psychiatric Institute and Columbia University, New York, NY, USA.
| | - Jane M Simoni
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Kevin M King
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Steven M Goodreau
- Department of Anthropology, University of Washington, Seattle, WA, USA
| | | | - Emma Creegan
- Brown University School of Public Health, Providence, RI, USA
| | - Frances M Aunon
- Department of Psychology, University of Washington, Seattle, WA, USA
| | - Stefan D Baral
- Department of Epidemiology, Center for Public Health and Human Rights, Johns Hopkins University, Baltimore, MD, USA
| | - B R Simon Rosser
- Division of Epidemiology and Community Health University of Minnesota School of Public Health, Minneapolis, MN, USA
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Valencia R, Wang LY, Dunville R, Sharma A, Sanchez T, Rosenberg E. Sexual Risk Behaviors in Adolescent Sexual Minority Males: A Systematic Review and Meta-Analysis. J Prim Prev 2019; 39:619-645. [PMID: 30446869 PMCID: PMC6267112 DOI: 10.1007/s10935-018-0525-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Although adolescent sexual minority males (ASMM) are at increased risk for human immunodeficiency virus (HIV) in the United States (US), studies that estimate sexual risk behaviors that contribute to HIV risk in ASMM are limited. We completed a systematic review and meta-analysis to compile available data and estimate the prevalence of risk behaviors in this population. We searched four databases for key terms related to ASMM, defined as males aged 14 through 19 who identified as gay or bisexual, reported sex with a male in their lifetime, and/or were considered sexual minority by the study. Articles eligible for inclusion were in English, from US studies, and reported quantitative data on sexual risk behaviors among ASMM. We extracted data from eligible articles and meta-analyzed outcomes reported in three or more articles using random effects. Of 3864 articles identified, 21 were eligible for data extraction. We meta-analyzed nine outcomes. Sixty-two percent of adolescent males self-identifying as gay or bisexual ever had sex with a male, and 67% of participants from ASMM studies recently had sex. Among ASMM who had sex in the last 6 months or were described as sexually active, 44% had condomless anal intercourse in the past 6 months, 50% did not use a condom at last sex, and 32% used alcohol or drugs at their last sexual experience. Available data indicate that sexual risk behaviors are prevalent among ASMM. We need more data to obtain estimates with better precision and generalizability. Understanding HIV risk in ASMM will assist in intervention development and evaluation, and inform behavioral mathematical models.
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Affiliation(s)
- Rachel Valencia
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA.
| | - Li Yan Wang
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Richard Dunville
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, 30329, USA
| | - Akshay Sharma
- Department of Health Behavior and Biological Sciences, University of Michigan School of Nursing, Ann Arbor, MI, 48109, USA
| | - Travis Sanchez
- Department of Epidemiology, Emory University Rollins School of Public Health, 1518 Clifton Road NE, Atlanta, GA, 30322, USA
| | - Eli Rosenberg
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, SUNY, Albany, NY, 12144, USA
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45
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Nelson KM, Perry NS, Carey MP. Sexually Explicit Media Use Among 14-17-Year-Old Sexual Minority Males in the U.S. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:2345-2355. [PMID: 31506866 PMCID: PMC6759372 DOI: 10.1007/s10508-019-01501-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 05/22/2019] [Accepted: 06/17/2019] [Indexed: 05/28/2023]
Abstract
Adolescent sexual minority males (ASMM; < 18 years old) do not typically receive sexual education that addresses male-male relationships from traditional sources (i.e., school, parents). Therefore, many rely on sexually explicit online media (SEOM; i.e., pornography) to find sexual health information. The current study describes SEOM use by ASMM in the U.S. and examined the association between exposure to condomless anal sex (CAS) in SEOM and engagement in CAS. In 2017, ASMM (N = 206; M age = 16, range: 14-17; 51% racial/ethnic minorities) from across the U.S. completed an online sexual health survey, including questions about SEOM use and sexual behaviors. Most (86%) reported that they had viewed SEOM. Engagement with SEOM was frequent (86% reported viewing ≥ one time per week) and lengthy (70% reported viewing for ≥ 15 min per session). Youth perceived that SEOM influenced how they, and other ASMM, think and behave sexually. Further, exposure to risky sexual behavior in SEOM appeared to be associated with youths' dyadic sexual behavior. To support the healthy sexual development of ASMM, it is important to acknowledge the near-universal use of SEOM by ASMM, to identify ways to maximize its potential value, and to minimize potential harms.
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Affiliation(s)
- Kimberly M Nelson
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA.
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA.
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA.
| | - Nicholas S Perry
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Michael P Carey
- Centers for Behavioral and Preventative Medicine, The Miriam Hospital, Coro West, Suite 309, 164 Summit Ave., Providence, RI, 02906, USA
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
- Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
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Maitino EM, Shafir SC, Beymer MR, Shover CL, Cunningham NJ, Flynn RP, Bolan RK. Age at first HIV test for MSM at a community health clinic in Los Angeles. AIDS Care 2019; 32:186-192. [PMID: 31663365 DOI: 10.1080/09540121.2019.1683806] [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: 10/25/2022]
Abstract
Young MSM, especially ethnic and racial minority young MSM, bear a disproportionate burden of new HIV infections. This group also has the highest rates of undiagnosed infection and lowest rates of viral suppression. Previous research indicates that young MSM are testing for HIV too late, which may explain why rates of new HIV infection are rising in young Hispanic MSM and not falling in young Black and White MSM despite advances in preventive medications. Analysis of our sample showed an overall average age at first HIV test of approximately 26. The average age at first HIV test was 25.5 years for Black/African American individuals, 24.7 years for Hispanic individuals, and 28 years for White individuals. More testing resources and innovative outreach methods are needed to increase rates of testing among young MSM.
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Affiliation(s)
- Emily M Maitino
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Johnathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | | | - Matt R Beymer
- Johnathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Los Angles LBGT Center, Los Angeles, CA, USA
| | - Chelsea L Shover
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - Nicole J Cunningham
- Johnathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Risa P Flynn
- Johnathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Robert K Bolan
- Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Johnathan and Karin Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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47
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Problematic and Non-Problematic Pornography Use Among LGBTQ Adolescents: a Systematic Literature Review. CURRENT ADDICTION REPORTS 2019. [DOI: 10.1007/s40429-019-00289-5] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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48
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Flores D, Docherty SL, Relf MV, McKinney RE, Barroso JV. "It's Almost Like Gay Sex Doesn't Exist:" Parent-Child Sex Communication According to Gay, Bisexual, and Queer Adolescent Sons. JOURNAL OF ADOLESCENT RESEARCH 2019; 34:528-562. [PMID: 34054207 PMCID: PMC8159159 DOI: 10.1177/0743558418757464] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sex communication interventions facilitate positive sexual health outcomes with heterosexual adolescents. The same has yet to be established for male youth with same-sex attractions, behaviors, and identities. Our study describes the experiences of gay, bisexual and queer-identifying adolescent males with parent-child sex communication. We conducted 30 in-depth semi-structured interviews with a diverse group of 15 to 20 year-old gay, bisexual, and queer (GBQ) males. Interview transcripts were coded and themes were identified using thematic and content analysis. Narratives revealed that sex communication with parents occurs rarely, is heteronormative in content prior to adolescent males' disclosure as GBQ, and after disclosure is reactionary and based on stereotypes that associate this population with negative health outcomes. Parents were rated poorly as sex educators by adolescent males and the findings are mixed regarding perception of parents' knowledge about GBQ-specific information. Parents and healthcare providers were identified as preferred sources of sex information by GBQ adolescent males. Sex communication with parents throughout adolescence that excludes GBQ males' same-sex concerns is a missed opportunity for targeted sexual risk reduction. There are multiple ways healthcare providers can assist parents to plan age-appropriate, sexuality-inclusive, home-based discussions about sex for this group.
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Affiliation(s)
- Dalmacio Flores
- University of Pennsylvania School of Nursing, Philadelphia PA
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49
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Anders KM, Olmstead SB. A Qualitative Examination of the Sexual Possible Selves and Strategies of First-Semester College Students: How Sexual Possible Selves are Developed During the Transition to College. ARCHIVES OF SEXUAL BEHAVIOR 2019; 48:1859-1876. [PMID: 30911872 DOI: 10.1007/s10508-018-1332-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 09/06/2018] [Accepted: 10/09/2018] [Indexed: 06/09/2023]
Abstract
According to the possible selves theory, individuals have possible selves that they hope to attain, or feared selves they hope to avoid, in the proximal future. In addition, individuals may have strategies they use to help them attain these possible selves or avoid their feared selves. Recent work has applied this theory to the realm of sexuality (i.e., sexual possible selves; SPS) in the developmental period of emerging adulthood, as this period is considered a time of increased sexual identity development. The purpose of this study was to extend this research by conducting semi-structured qualitative interviews with a sample of first-semester college-attending emerging adults (N = 35) at a 4-year university. We examined the developmental influences on expected and feared SPS to better understand why various internalized expectations develop. Interviews were conducted during the first four weeks of the Fall 2016 semester and were analyzed using applied thematic analysis. Prominent themes that emerged within the expected SPS included: sex and commitment, taking a passive approach, delaying sex and relationships, plans for hooking up, and abstinence. Feared SPS themes that emerged included: non-committed sexual avoidance, sexual assault/coercion, reputation, and sexual health. Prominent influences on participants' SPS included: family, alcohol and parties, peers/friends, past experiences, changes in expectations, college culture, and religion. Implications for sexuality research, education, and intervention are discussed.
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Affiliation(s)
- Kristin M Anders
- College of Human Ecology, Kansas State University, 1324 Lover's Lane, Manhattan, KS, 66506, USA.
| | - Spencer B Olmstead
- Department of Child and Family Studies, College of Education, Health, and Human Sciences, The University of Tennessee, Knoxville, TN, USA
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50
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Nelson KM, Carey MP, Fisher CB. Is Guardian Permission a Barrier to Online Sexual Health Research Among Adolescent Males Interested in Sex With Males? JOURNAL OF SEX RESEARCH 2019; 56:593-603. [PMID: 29952665 PMCID: PMC6310663 DOI: 10.1080/00224499.2018.1481920] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Institutional review boards (IRBs) that refuse to grant waivers of guardian permission may hinder research to inform needed online sexual health interventions for adolescent males interested in sex with males (AMSM). Information on the challenges of obtaining (or waiving) guardian permission is imperative. In June and July 2017, AMSM (N = 206; ages 14 to 17) in the United States completed an online survey on sexual behaviors, sexually explicit media use, and sexual education exposure/needs. A mixed-methods approach assessed attitudes toward guardian permission for the current survey and future online sexual health intervention research. Logistic regression models assessed differences by "outness" to a guardian. A framework matrix analysis was conducted to summarize, then aggregate, qualitative responses. Findings indicated that most AMSM would not participate if guardian permission was required (current: 83%; future: 87%). Youth who were not out were more likely to say they would not participate (current: adjusted odds ratio [AOR] = 2.8, 95% confidence interval [CI]: 1.2 to 6.8); future: AOR = 4.7, 95% CI: 1.6 to 13.5). Participants reported that guardian permission would be an invasion of their privacy, lead to involuntary outing, and endanger participants. Overall, guardian permission appears to be a barrier to AMSM participation in online sexual health research. Investigators and IRBs should consider alternative practices and policies to facilitate such research.
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Affiliation(s)
- Kimberly M Nelson
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital
- b Department of Psychiatry and Human Behavior , Brown University
- c Department of Behavioral and Social Sciences , Brown University
| | - Michael P Carey
- a Centers for Behavioral and Preventive Medicine , The Miriam Hospital
- b Department of Psychiatry and Human Behavior , Brown University
- c Department of Behavioral and Social Sciences , Brown University
| | - Celia B Fisher
- d Department of Psychology , Center for Ethics Education, Fordham University
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