Sexual behaviour and social class in Australian women

Prevalence of sexual dysfunction after breast cancer compared to controls, a study from CONSTANCES cohort

PURPOSE

Sexuality, a substantial factor in quality of life, may be altered after breast cancer (BC) treatments as they intimately afflict femininity. This study aimed to assess the prevalence of sexual dysfunction in women with a history of BC and to compare it with women without a BC history.

METHODS

The French general epidemiological cohort CONSTANCES includes more than 200,000 adults. All inclusion questionnaires from CONSTANCES non-virgin adult female participants were analyzed. Women reporting a history of BC were compared to controls in univariate analysis. Multivariate analysis was performed to highlight any demographic risk factor for sexual dysfunction.

RESULTS

Among the 2,680 participants who had a history of BC, 34% did not engage in sexual intercourse (SI) in the month preceding the completion of the questionnaire (n = 911), 34% had pain during SI (n = 901) and 30% were not satisfied with their sex life (n = 803). Sexual dysfunction was significantly more frequent in women who had a history of BC: they had less sexual interest (OR 1.79 [1.65;1.94], p < 0.001), experienced more pain during SI (OR 1.10 [1.02;1.19], p < 0.001) and were more dissatisfied with their sex life (OR 1.58 [1.47;1.71], p < 0.001). This stayed true after adjustment on multiple demographic factors such as age, menopausal status, body mass index and depression.

CONCLUSIONS

Overall, in this real-life study in a large national cohort, history of BC appeared to be a risk factor for sexual disorders.

IMPLICATIONS FOR CANCER SURVIVORS

Efforts to detect sexual disorders in BC survivors and offer quality support must be pursued.

Sexuality after breast cancer, how to provide a global and contemporary approach

Patients' sexuality is one of the major and most neglected impact of breast cancer (BC) and its treatment. Even though research is ongoing on the subject, sexuality issues are rarely taken into account and efficiently dealt with in clinical practice. The objective is to review the impact of BC and its treatment on modern women sexuality. In the literature, a heterogeneous level of advancement is notable in the different publishing countries depending on the cultural background; some countries simply do not publish on the matter, others mainly discuss the male partners and practicians experience, and lastly, the most progressive countries have moved up to studying niches of patients such as sexual and gender minorities. A multidisciplinary approach, including pharmacologic and nonpharmacologic management, appears most efficient. There is a need for greater inclusion of partners and for providing a specific training to first-line health care providers. This review provides a general contemporary worldwide overview of the state of the art in sexuality issues in BC patients and survivors.

Upstairs and downstairs: socio-economic and gender interactions in herpes simplex virus type 2 seroprevalence in australia

BACKGROUND

This study investigates socio-economic differentials in herpes simplex virus type 2 (HSV-2) seroprevalence in Australian men and women using individual and geographic measures of socio-economic status.

METHODS

HSV-2 seropositivity among men and women aged over 25 years was investigated by levels of individual and area-based measures of socio-economic status (SES) in a series of Poisson regression models, variously adjusting for age, country of birth, marital status, indigenous status, and urban/rural residence as potential confounders. Serum and socio-demographics were collected during 1999 and 2000 in a population-based Australia-wide prevalence survey.

RESULTS

HSV-2 seroprevalence was significantly lower in areas of low SES than in high SES areas among both men (P for trend <0.001) and women (P for trend = 0.004) for all ages. A similar pattern was evident for individual education level for men with lower rates of HSV-2 in respondents with lower educational achievement (relative risk = 0.77, 95% CI 0.61-0.97, P = 0.024). In contrast, HSV-2 prevalence was higher for women with lower individual levels of education for all ages (relative risk = 1.22, 95% CI 1.04-1.44, P = 0.017). Analyses stratifying HSV-2 prevalence for individual education level by area-based SES showed the highest prevalence of HSV-2 in women with the lowest education level residing in the highest SES areas. This pattern was not evident in men, with a greater concordance between individual and area-based SES.

CONCLUSION

HSV-2 seroprevalence is not consistently distributed across individual and area measures of SES, suggesting that upward and downward mixing between social strata in men and women is an important mode of HSV-2 transmission.

A population-based study of 18-year old Swedish youths and factors correlated with their total number of lifetime sexual partners

The number of sexual partners has in studies been shown to be a factor correlated with STI but there is little published knowledge on what factors are associated with number of sexual partners.

OBJECTIVES

To examine which variables are correlated with the number of lifetime sexual partners (NLSP) among youths.

STUDY GROUP

All 18-year old girls and boys in four cities in northern Sweden.

METHODS

A population-based study where participants answered a questionnaire regarding their social lifestyle, psychological and sexual health. The associations between these independent variables and the dependent variable (NLSP) were investigated by multivariate linear regression analysis.

RESULTS

The boy and girl median NLSP was 2.0 (P25 =1.0, P75=3.0). The final model explained 29% of the total boy NLSP variation and 46% of the total girl NLSP variation. Eight boy variables and thirteen girl variables significantly correlated with NLSP were found. The two strongest variables associated with increased NLSP among boys and girls, was feelings of guilt or shame after sex and smoking regularly. Variables prior associated with an increased risk of acquiring STI's were associated with increased NLSP. The study found new gender differed behaviour variables correlated to NLSP not previously considered to be risk factors for STI.

CONCLUSIONS

To prevent the spread of STI it is important that persons with many partners are identified, treated if necessary and possible, or encouraged to change their behaviour. The study found several boy and girl variables associated with increased NLSP, which could facilitate both primary- and secondary preventions.

Gender differed factors affecting male condom use. A population-based study of 18-year-old Swedish adolescents

Despite preventive measures promoting the condom as a good barrier method and a good preventive measure for STIs, teenage abortions and STIs are increasing in our society.

OBJECTIVE

The aim of this study was to explore which male factors are associated with non-condom use and also which female factors are associated with non-condom use among their sexual partners.

STUDY GROUP

A population-based study, among all 18-year old girls and boys in four cities in northern Sweden.

METHOD

The participants answered a questionnaire regarding their social lifestyle, psychological-, and sexual health. The associations between the independent variables and the dependent variable (non-condom use) were investigated by multivariate logistic regression analysis.

RESULTS

Four significant (p<0.05) male variables associated with non-condom use were identified: living with partner during the weekends, feeling depressed, being a party smoker, and girl partner taking oral contraceptives. Two significant (p<0.05) female variables were associated with non-condom: using oral contraceptives and feeling forced into sex. Having TV and movie watching as favourite free time activity was identified as a significant protective female variable associated with condom use.

CONCLUSION

The study found several male and female factors associated with non-condom use, where the usage of oral contraception was the strongest indicator for non-condom use. The study showed a gender difference in the variables associated with condom use and the results have been suggested as useful in future preventive measures promoting condom usage.