I wanna hold your hand: the progression of social, romantic and sexual events in adolescent relationships

Orgasm and Sexual Behavior Among Adolescents: Differences Across Genders and Dyad Configurations

Despite recurring calls for diversity and inclusion in adolescent sexuality research, our understanding of adolescents' sexual experiences beyond heteronormative vaginal intercourse remains limited. The current study examined orgasm (during masturbation and with a partner) and sexual behaviors (providing and receiving manual and oral stimulation) in middle adolescents. We conducted logistic regression and path analyses separately for cisgender (n = 2738) and transgender/non-binary (TNB) youth (n = 62) to explore gender and dyad type (intersection between gender and partner gender) differences among 2800 Canadian adolescents (51.4% cisgender girls, Mage = 16.41, SDage = 0.55). With cisgender boys as reference, cisgender girls had lower odds of experiencing orgasm during masturbation, reported more difficulties with orgasm during partnered sex, received more manual sex, and less oral sex. TNB individuals assigned male at birth received more manual stimulation, and TNB assigned female at birth received less oral sex. For dyad type, compared to cisgender boys partnered with a girl, cisgender girls partnered with a boy and cisgender girls with a gender diverse partner (i.e., non-binary, trans, genderfluid or agender) had lower odds of having ever experienced orgasm during masturbation, reported more difficulties experiencing orgasm during partnered sex, and received oral stimulation less often. Cisgender girls who were partnered with a girl did not differ from cisgender boys who were partnered with a girl. Findings may inform programs that promote sexual wellbeing among youth.

Sexuality, intimacy, and body image among adolescents and young adults with cancer: a qualitative, explorative study

AIM

The aim of this study was threefold: (1) to explore Danish adolescents and young adults' (AYAs) thoughts concerning sexual health particularly focusing on sexuality, intimacy, and body image throughout a cancer trajectory, (2) to investigate how AYAs experience healthcare professionals address of- and respond to sexual health issues, and (3) to identify AYAs' suggestions on how to support conversation about sexual health.

METHODS

A qualitative, single-center study was conducted, including AYAs (18-29 years) diagnosed with cancer recruited at the University Hospital of Copenhagen, Rigshospitalet. Individual semi-structured interviews were conducted from January-February 2023, recorded, transcribed verbatim, and analyzed using thematic analysis.

RESULTS

Twelve participants were interviewed, aged 20-29; five were diagnosed with hematological- and seven with oncological cancer. Our analyses yielded three themes: (1) sexuality and body image as part of the identity, (2) excluding relatives in conversations about sexual health, and (3) uncertainty how to discuss sexual health with healthcare professionals. Finally, the AYAs' suggestions to support conversations about sexual health were organized into six thematic categories.

CONCLUSION

In this study, participants experienced altered sexual subsequent impacts on body image and self-esteem during their cancer trajectory. While some adapted to these changes, discussing them with healthcare providers was difficult, especially in the presence of relatives, as the AYAs wanted to shield them from additional concerns. To enhance support, AYAs suggest regular discussions on sexual health and the use of a dialog tool by healthcare professionals.

How Does Sexual Subjectivity Vary on the Basis of Gender and Sexual Orientation? Validation of the Short Sexual Subjectivity Inventory (SSSI-11) in Cisgender, Heterosexual and Sexual and Gender Minority Adolescents

Through sexual exploration, adolescents learn that they are sexual beings with choices, desires, and are deserving of pleasure, which corresponds to sexual subjectivity. However, the two measures of this construct (i.e., Female Sexual Subjectivity Inventory and Male Sexual Subjectivity Inventory) have not been validated with younger adolescents and have different items for boys and girls (with no scale available for gender diverse individuals), limiting gender comparisons. This study examined (1) the factor structure of the adapted Short Sexual Subjectivity Inventory-11 items (SSSI-11) in a large sample of young cisgender, heterosexual and sexual and gender minority adolescents, (2) measurement invariance across language (English and French), gender, and sexual orientation, (3) validity with sexuality-related outcomes, and (4) one-year temporal stability. Results of a confirmatory factor analysis among 2001 adolescents (Mage = 15.5 years, SD = 0.60) revealed a multidimensional factor structure. The SSSI-11, in both English and French, showed adequate reliability and one-year temporal stability, and was invariant across genders, sexual orientations, and languages. Girls had lower scores on the entitlement to self-pleasure and self-efficacy in achieving pleasure factors, and higher scores on the entitlement to pleasure from a partner factor. No significant differences were observed on the basis of language or between heterosexual and sexual minority adolescents. The SSSI-11 correlated positively with sexuality-related variables. Findings support the strong psychometric properties of the SSSI-11, rendering it of considerable use in clinical, education, and research applications.

Can I Love My Body Even if It Doesn't Look Like the Porn Stars'? Longitudinal Associations Between Pornography Use Frequency and Body Appreciation in a Diverse Sample of Adolescents

Online technologies could play an important role in the sexual development of adolescents as they watch more pornography than before. Pornography may relate to adolescents' perceptions of their bodies, especially among those identifying as a sexual and/or gender minority (SGM) as they have an increased risk of body image concerns compared to their heterosexual, cisgender (HC) peers. The present study examined the cross-sectional and longitudinal associations over 3 years between adolescents' pornography use frequency and body appreciation, considering potential gender and sexual orientation-based differences. Results from linear univariate and parallel processes latent growth curve models with a multi-group approach among 2904 adolescents (MageT1 = 14.5 years, SD = 0.61; 51.4% girls, 16.3% sexual minority) demonstrated that HC and SGM girls' body appreciation slightly decreased over time. Moreover, HC boys, HC girls and SGM girls' pornography use frequency slightly increased over time. Cross-sectionally, greater pornography use frequency was associated with lower levels of body appreciation in HC girls and SGM boys, with a small effect size. However, longitudinally, pornography use frequency and body appreciation were not related to each other in either group. Our findings support that pornography use, in the short term, is negatively associated with adolescents' body appreciation, although these associations might not hold in the long term. Adolescents may be more critical of body ideals represented in pornography as they learn to think with more discernment about the pornographic depictions of bodies and sexuality.

Romanticizing the Stolen Kiss: Men's and Women's Reports of Nonconsensual Kisses and Perceptions of Impact on the Targets of Those Kisses

Stolen kisses are often portrayed as resulting from uncontrollable passion and a need to connect intimately with another. This study examined stolen kisses, defined as kissing someone for the first time when the kisser perceived the kiss recipient was not expecting it, and had not provided consent for the kiss. These kisses were examined from the perspective of the individual initiating the kiss. Participants (N = 130; Mage = 32.27; 67% identified as male) completed an anonymous online survey assessing kissing experiences of having stolen a kiss and their open-ended responses were analyzed here. Men were more likely than women to report having stolen a kiss in line with traditional heterosexual scripts. Three scenarios emerged through content analysis: mutual attraction leading to a new relationship; no known mutual attraction but a positive outcome; and no known mutual attraction and a negative outcome. Stealing a kiss from someone for whom there was mutual attraction often led to the onset of an intimate relationship; thus, the kiss constituted a relationship catalyst. When there was no known shared attraction, some interactions ended positively, but others resulted in an end to cordial relations and often strong negative reactions. Findings are discussed in terms of the limited literature on kissing generally and the nonconsensual nature of these events.

Adolescents' Love Lives: Heterogeneity in Relationship Status Trajectories and Links with Affect

Romantic experiences are more fluid and heterogeneous during middle adolescence than at any other life stage, but current understanding of this heterogeneity and flux is limited because of imprecise measurement. A sample of 531 adolescents (55% female; 28% non-Hispanic White; 32% Black; 27% Hispanic; 14% Other) recruited from an ongoing birth cohort study (Mean age = 16.7 years, SD = 0.358), was administered bi-weekly diaries over 52 weeks to prospectively record transitions in and out of romantic and sexual relationships and to assess links with positive affect (frequency of happiness) and negative affect (frequency of sadness). Relationship statuses considered included not only dating, but also liminal and asymmetrical statuses such as talking/flirting and crushes. Latent profile analyses revealed six relationship status trajectories, or love life profiles, based on the number of intra-year partners and on the extent of involvement in each of the relationship statuses. Approximately half of teens either were in stable dating relationships or uninvolved romantically during the year; however, half experienced variable levels of flux in their love lives. Relationship instability, not romantic involvement per se, was associated with higher levels of sadness and lower levels of happiness. Snapshots of teen romantic involvement based on one or two points in time obscure the extent of relationship heterogeneity and flux and how relationship status trajectories are associated with positive and negative affect.

Differences/Disorders of Sex Development: Medical Conditions at the Intersection of Sex and Gender

Defined as congenital conditions in which development of chromosomal, gonadal, or anatomic sex is atypical, differences or disorders of sex development (DSDs) comprise many discrete diagnoses ranging from those associated with few phenotypic differences between affected and unaffected individuals to those where questions arise regarding gender of rearing, gonadal tumor risk, genital surgery, and fertility. Controversies exist in numerous areas including how DSDs are conceptualized, how to refer to the set of conditions and those affected by them, and aspects of clinical management that extend from social media to legislative bodies, courts of law, medicine, clinical practice, and scholarly research in psychology and sociology. In addition to these aspects, this review covers biological and social influences on psychosocial development and adjustment, the psychosocial and psychosexual adaptation of people born with DSDs, and roles for clinical psychologists in the clinical management of DSDs. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Sexual Orientation Identity Development Milestones Among Lesbian, Gay, Bisexual, and Queer People: A Systematic Review and Meta-Analysis

This paper is a systematic review and meta-analysis on sexual orientation identity development milestones among people who are lesbian, gay, bisexual, or another sexual minority identity (LGB+). Common milestones measured in the 30 studies reviewed were becoming aware of queer attractions, questioning one's sexual orientation, self-identifying as LGB+, coming out to others, engaging in sexual activity, and initiating a romantic relationship. Milestones occurred in different sequences, although attraction was almost always first, often followed by self-identification and/or sexual activity; coming out and initiating a romantic relationship often followed these milestones. Meta-analysis results showed that the mean effect sizes and 95% confidence intervals varied by milestone: attraction [M _age=12.7 (10.1, 15.3)], questioning one's orientation [M _age=13.2 [12.8, 13.6]), self-identifying [M _age=17.8 (11.6, 24.0)], sexual activity [M _age=18.1 (17.6, 18.6)], coming out [M _age=19.6 (17.2, 22.0)], and romantic relationship [M _age=20.9 (13.2, 28.6)]. Nonetheless, results also showed substantial heterogeneity in the mean effect sizes. Additional meta-analyses showed that milestone timing varied by sex, sexual orientation, race/ethnicity, and birth cohort. Although patterns were found in LGB+ identity development, there was considerable diversity in milestone trajectories.

Adolescents who solely engage in online sexual experiences are at higher risk for compulsive sexual behavior

In addition to its expression offline, sexual behavior is frequently expressed online. Some adolescents solely engage in online sexual activities, whereas others in offline and online activities, or have no sexual experience at all. In the current research, we examined whether those who solely engage in online sexual activities are at greater risk for compulsive sexual behavior. In Study 1 (n = 164), we examined differences in compulsive sexual behavior (CSB) and risky sexual action tendencies between study groups. In Study 2 (n = 713), we statistically replicated the classification into different sexual behaviors and examined differences between the clusters in CSB, social tendencies and socio-demographic measures. Results indicated that adolescents who only engaged in online sexual activities had significantly higher percentage of clinical CSB, were less likely boys and more likely to be religious. There were not more prone to risky sexual behavior, however. The current research expands the knowledge about offline or online sexually related activities among adolescence.

Youth's Socio-Sexual Competences With Romantic and Casual Sexual Partners

We investigated youth's self-reported socio-sexual competences (esteem, assertiveness, control, communication) within their most recent sexual partnerships, and explored disparities in these competences between romantic versus casual sexual partnerships, including age and gender differences therein. Data were used from 6,098 Dutch adolescents and young adults (12.1-26.1 years), who participated in a national study on sexual health. Results indicated that being in love and sexual activity frequency were significant confounders for the associations between sexual partnership typology and youth's socio-sexual competence levels. After controlling for confounding relationship characteristics and sociodemographics, no differences were found between sexual partnership types in youth's sexual esteem, assertiveness, and control. However, romantic sexual partnerships were characterized by more frequent sexual communication than casual sexual partnerships. This pattern was gender-consistent, but for young adults, this difference in sexual communication across sexual partnership types was larger than for adolescents. Our findings emphasize that considering the relationship context (e.g., romantic, casual) for the development, utilization, and evaluation of young people's socio-sexual competences - particularly sexual communication - is a vital task for parents, educators, clinicians, and researchers. Individual (person-centered) versus relational (dyad-centered) differences in youth's socio-sexual competences require further exploration, as does the link between socio-sexual competences and sexual health and satisfaction.

Human papilloma viruses infection among adolescent females perinatally infected with HIV in Côte d'Ivoire

BACKGROUND

Cervical cancer prevention strategies recommend human papilloma virus (HPV) vaccination for female adolescents prior to their sexual debut. While HIV is a major risk factor for HPV infection in women of childbearing age, its prevalence among HIV-infected adolescent female is mostly unknown. This study aimed to describe the HPV prevalence and correlates among perinatally HIV-infected adolescent females prior to HPV immunisation.

METHODS

A cross-sectional survey was conducted from January to June 2016, in the four major paediatric HIV clinics of Abidjan, Côte d'Ivoire. All HIV-infected females aged 11-16 years were approached to participate in the study. A questionnaire assessing sexual behaviours and genital hygiene practices was administered to participants completed with a systematic vaginal swab collection. HPV genotyping was performed using the Anyplex II HPV28 Detection (Seegene). A logistic regression analysis was performed to identify factors associated with the presence of HPV infection. HPV immunisation was proposed free of charge to all participants.

RESULTS

A total of 250 participants were included, with a median age of 13 years (IQR 11-14). Among them, 237 (94.8%) were on antiretroviral treatment with a median CD4 count of 660 (IQR 439-914) cells/mm³. The overall prevalence of at least one HPV was 3.6% (95% CI 1.6 to 6.7) and the prevalence of at least one carcinogenic HPV was 2.8% (95% CI 0.7 to 4.8). Vaginal cleansing was reported by 75 (30%) of participants, with a median age at initiation of 12 years (IQR 10-13). Sexual activity was self-reported by 12 (4.8%) participants with a median age at sexual debut of 11 years (IQR 10-14). HPV infection was associated with vaginal cleansing (adjusted OR=7.0 (95% CI 1.4 to 31.6)).

CONCLUSION

The reported low prevalence of carcinogenic HPV infections supports the appropriateness of HPV immunisation in this population. The reported association between cleansing practices and HPV infection deserves further prospective longitudinal studies.

Tapping into Community Resiliency in Rural Adolescent Pregnancy Prevention: An Implementation Sciences Approach

Although rural youth experience marked inequities in adolescent pregnancy, there is little guidance for implementing evidence-based programs (EBPs) in rural settings. When implementation occurs in rural communities, it frequently focuses on deficits, rather than strengths or capacity for growth. Using the consolidated framework for implementation research (CFIR), we describe a resiliency-focused implementation of two middle school EBPs in rural Midwestern communities, including the intervention, outer and inner settings, individuals, implementation processes and preliminary outcomes. Data included program staff interviews, feedback from local partners, community meetings notes, and participant surveys. Using the CFIR, we describe the engagement of rural communities themselves in a resilience-based implementation of adolescent pregnancy prevention EPBs. Communities self-described as rural, traditional and religious. They identified adolescent pregnancy, substance use, and academic success as priorities. To address infrastructure needs and build on local strengths, funds were used to hire local partners to implement the program. As small communities, stakeholders were closely networked and wanted to address local needs. Local partners selected the EBP based upon community values and priorities. Champions, including local partner organizations and schools were locally based and were well connected. Intensive training of local staff and piloting with adaptation assured fidelity and sustainability, while increasing community implementation skills and comfort. In Clinton County, enrollment was 1946 with students receiving the program in 6th, 7th, and/or 8th grades. In Southern Indiana, 7275 students received the program once in either 6th, 7th, or 8th. We conclude that the CFIR can facilitate the implementation of a community resilience-focused adolescent pregnancy prevention intervention in rural communities.

Insight into Informant Discrepancies Regarding Psychosexual Functioning of Adolescents with and without Autism Spectrum Disorder

The private nature of psychosexual functioning leads adolescents and their parents to have different perspectives, which highlights studying parent-child informant discrepancies in this domain. We investigated informant discrepancy in psychosexual functioning, using the self-report and parent report versions of the Teen Transition Inventory (TTI), of adolescents with autism spectrum disorder (ASD; 136 parent-child dyads) compared to adolescents from the general population (GP; 70 parent-child dyads). Significantly larger informant discrepancies exist in ASD dyads than GP dyads in most domains of psychosexual functioning, except for Body image, Sexual behavior, and Confidence in the future. It is important to use and pay attention to both informants, as discrepancies are relevant for both research and clinical practice regarding psychosexual functioning.

Moving the prevention timeline: A scoping review of the literature on precursors to sexual risk in early adolescence among youth of color

INTRODUCTION

Sexual health disparities are leading causes of morbidity among youth of color in the United States. We conducted a scoping review of the literature on precursors to sexual risk-taking among young adolescents of color (ages 10-14) to assess precedents of sexual experience and their utility as measurable proximal constructs and behaviors gauging sexual risk and sexual risk prevention efforts.

METHODS

This study was conducted using the PRISMA extension for scoping reviews (PRISMA-ScR) guidelines. We searched for quantitative studies that assessed the relationships between precursors and subsequent sexual behaviors, incorporated youth of color, and specified young adolescents as the study sample. All articles were in English, however we explored both U.S. and International databases.

RESULTS

The database search yielded 11 studies published between 2000 and 2017. Most literature focused on youth in urban settings, and on Black and Latinx youth, while only two addressed the special circumstances of American Indian and Alaska Native youth. Sex expectancies outcomes for youth of color were likely to predict sexual risk taking and self-efficacy about sex was related to abstinence.

CONCLUSIONS

Etiologic studies that seek to understand precursors to sexual risk taking among youth of color are limited and this paucity truncates the ability to develop sexual risk prevention programs for the age group in which prevention is most needed.

Adolescents' Sexual Encounters With Either Romantic or Casual Partners and the Quality of Their Romantic Relationships Four Years Later

Adolescent sexual behavior was examined within a health perspective. Assuming a developmental perspective, the current study investigated the associations between sexual behavior in either stable relationships or in casual encounters, and the quality of romantic relationships and affect 4 years later. Data were collected from 144 Israeli adolescents aged 16-18 years (mean age 16.57 years). Participants completed diary data over a period of 10 days and reported on the quality of their romantic encounters and their emotions, and on their sexual behavior in stable relationships or casual encounters. Four years later, they were asked to complete diary data again for 10 consecutive days and report on the quality of their romantic relationships and their positive and negative affect. Findings indicate that involvement in sexual behavior in stable romantic relationships was associated only with future romantic partner support. In contrast, earlier involvement in casual sexual behavior was associated with a number of future indices: lower partner support, greater negative affect as well as greater relationship tension, and dyadic hurtful behavior 4 years later. The differential role of sexuality within a stable relationship or casual encounters among adolescents for their future romantic development is discussed within a developmental framework.

Age, ethnic and travel-related disparities in kissing and sexual practices among heterosexual men in Melbourne, Australia

Background The kissing practices of heterosexual men are not well understood, despite the potential of kissing to be a significant risk factor for gonorrhoea transmission. This study aimed to explore kissing and sex practices among heterosexual men. Methods: A cross-sectional survey among heterosexual men attending the Melbourne Sexual Health Centre in 2016–2017 was conducted. Men were asked to report their number of kissing-only (in the absence of sex), sex-only (in the absence of kissing) and kissing-with-sex partners in the last 3 months. The mean number of each partner type was calculated, and multivariable negative binomial regression was used to investigate associations between the number of different types of partners and demographic characteristics. Results: Of the 2351 heterosexual men, men reported a mean of 2.98 kissing-only, 0.54 sex-only and 2.64 kissing-with-sex partners in the last 3 months. Younger men had a mean higher number of kissing-only partners than older men (4.52 partners among men aged ≤24 years compared with 1.75 partners among men ≥35 years, P < 0.001). Men born in Europe had the most kissing-only partners (mean: 5.16 partners) and men born in Asia had the fewest kissing-only partners (mean: 1.61 partners). Men recently arrived in Australia, including travellers from overseas, had significantly more kissing-only partners (adjusted incidence rate ratio (aIRR): 1.53; 95% CI: 1.31–1.80) than local men. Conclusions: This study provides novel data about kissing practices of heterosexual men. Studies assessing oropharyngeal gonorrhoea should include measurements of kissing until studies can clarify its contribution to transmission risk.

Onset Trajectories of Sexting and Other Sexual Behaviors Across High School: A Longitudinal Growth Mixture Modeling Approach

Sexting is receiving substantial scholarly attention and is now considered commonplace in adolescence. Little is known, however, about the normative contexts and the development of adolescent sexting behavior, including the initiation of sexting in relation to other sexual behaviors. In this study, we used growth mixture modeling to identify classes of onset trajectories for sexual behaviors across high school. Participants included 429 high school students (54% female) who completed annual assessments of sexual behavior over a three-year period. We identified four distinct classes: postponement (9%) with no behaviors other than hand-holding and kissing initiated by Grade 11, gradual onset (44%) with sexting and other sexual behaviors emerging incrementally across high school, continuous onset (32%) with sexting and other sexual behaviors within the first three years of high school, early onset (15%) with initiation of sexting and all other sexual behaviors prior to or by the end of Grade 9. Boys were more likely than girls to be members of the postponement versus gradual onset class, while Black students were more likely than White students to be members of the early versus gradual onset class. Sexting behavior appears to be common in adolescence and co-emerges with genital contact behavior across varying trajectories of sexual development. These findings provide the foundation for contextualizing sexting within normative sexual development. Further, this information can inform efforts to promote sexual health.

Changes in Diverse Sexual and Contraceptive Behaviors Across College

Researchers have made repeated calls for a better understanding of normative sexuality development during adolescence and young adulthood. We examined how the occurrence of seven penetrative, nonpenetrative, and contraceptive behaviors changed longitudinally across seven waves, and how individual (gender) and contextual (romantic relationship status) factors related to these changes in a sample of college students (N = 730, M age = 18.4 at Semester 1; 51% female; 26% Hispanic/Latino American, 22% Black/African American, 30% Asian American/Pacific Islander, 45% White/European American). Across college, reported kissing, touching, performing and receiving oral sex, and penetrative sex rates increased, and contraception use (any type) and condom use (in particular) rates decreased, demonstrating changes with age independent of young adults' romantic relationship experiences. Rates of all sexual behaviors were higher, and of contraception use lower, when students were in serious romantic relationships. Contraception use decreased more for men than for women, particularly in semesters men were not in serious relationships. Condom use decreased for men, and for women in semesters they were in serious relationships. Findings demonstrate normative trends in sexuality development, as well as suggesting the value of enhanced sexual health promotion programming, with a particular focus on contraceptive behaviors, across college.

Adolescents' compulsive sexual behavior: The role of parental competence, parents' psychopathology, and quality of parent-child communication about sex

BACKGROUND AND AIMS

Compulsive sexual behavior (CSB) has implications for clinical and non-clinical adult populations. Disposition to CSB has been shown to influence adolescence sexual behaviors, but the development of adolescents' disposition toward CSB has yet to be examined in the family context. In this study, we investigated whether parent-adolescent communication mediates the links between parental characteristics and adolescents' CSB.

METHODS

The sample included 275 Israeli families [triad of mothers (age = 34-63 years, M = 45.48, SD = 5.46), fathers (age = 36-83 years, M = 48.33, SD = 6.63), and one adolescent (48.2% boys, 51.1% girls; age = 14-18 years, M = 16.23, SD = 1.18)]. Parents completed measures of psychopathology, parental self-esteem, and parental self-efficacy, and adolescents completed measures of quality of sex-related communication and CSB.

RESULTS

The results indicate that, for girls, higher maternal self-esteem and lower psychopathology were linked with better sex-related communication and so with lower CSB. For boys, only parental religiosity was linked with the quality of sex-related communication and CSB, with religious parents having better communication than secular ones.

DISCUSSION

The findings provide an opportunity for researchers to gain a better insight into the dynamics of familial factors in the development of CSB among adolescents.

Sexuality and cancer in adolescents and young adults - a comparison between reproductive cancer patients and patients with non-reproductive cancer

BACKGROUND

Sexuality is an important aspect of quality of life for adolescent and young adults that remains understudied in cancer patients. Most current knowledge about how cancer and cancer treatments can affect patients' sexuality pertains to reproductive cancer patients (breast, gynecological, male reproductive organs), whereas only little is known about how the disease affects the sex lives of patients with other types of cancer. This study examined sexual satisfaction and sexual supportive care needs among adolescent and young adult cancer patients, with a particular focus on how the type of cancer a person has is associated with these issues differently.

METHODS

Five hundred seventy-seven (n = 424 females, 73.5%) patients between 18 and 39 years of age at diagnosis and representing all major tumor entities completed the standardized questionnaire. The analysis addressed the following topics: sexual satisfaction (Life Satisfaction Questionnaire), sexual supportive care needs (Supportive Care Needs Survey), and changes in sexuality (Questions on Life Satisfaction Modules). These topics were tested by mean differences between reproductive and non-reproductive cancer, equivalence testing and regression analyses.

RESULTS

About one third of the patients reported being dissatisfied with their sexuality and having supportive care needs in this area. Changes in sexuality were significantly more common in women with reproductive cancers than in those who had other types of cancer (t = - 2.693, p = .007), while both groups had equivalence in scores for sexual satisfaction and sexual supportive care needs. Reproductive cancers are not more associated with deterioration of sexual satisfaction (R2 = .002, p = .243), changes in sexuality (R2 = .006, p = .070) or increased sexual supportive care needs than non-reproductive cancers (R2 = .004, p = .131).

CONCLUSIONS

The results indicate that about a third of adolescents and young adults with both reproductive but also with non-reproductive cancer experience sexual dissatisfaction in similar measure. An equal percentage of these patients also express a desire to receive supportive care in this area. Consequently, health care professionals should address issues of sexuality and cancer as a matter of routine when caring for young adults even when patients have a non-reproductive cancer.

Attached at the lips: The influence of romantic kissing motives and romantic attachment styles on relationship satisfaction

Although romantic kissing is an important part of relationship functioning, little research has focused on motives for romantic kissing and how they may relate to other aspects of romantic relationships. To understand how romantic kissing impacts romantic relationship functioning, the current study assessed the relationship between romantic attachment, romantic kissing motives, and relationship satisfaction. Overall, it was hypothesized that (a) those reporting more sexual/explicit kissing motives and fewer goal attainment/insecurity motives would report higher relationship satisfaction, (b) those reporting a more secure attachment style would report higher relationship satisfaction, and (c) the relationship between romantic kissing motives and relationship satisfaction would vary according to one’s romantic attachment styles. Results from a hierarchical linear regression with 286 adults, all of whom were currently in romantic relationships, revealed that sexual/relational (β = 0.25) and goal attainment/insecurity kissing motives (β = -0.35) predicted relationship satisfaction. However, the impact of kissing motives on relationship satisfaction varied according to one’s romantic attachment. Specifically, the influence of sexual/relational motives was only significant for avoidantly attached individuals, whereas the influence of goal attainment/insecurity motives was significant for avoidantly and anxiously attachment individuals. Overall, this suggests that sexual/explicit romantic kissing motives serve to enhance the relationships of insecurely attached individuals, but not securely attached individuals. Furthermore, goal attainment/insecure motives had a negative effect on the relationship satisfaction of insecurely attached individuals, but not securely attached individuals. This study has important implications for both practitioners working with romantic couples and researchers studying romantic relationships.

Never Been Kissed: Correlates of Lifetime Kissing Status in U.S. University Students

Kissing a partner occurs relatively early during adolescence. Thus, young adults who have never kissed are off-time from their peers. Substantial exploration in the areas of identity and intimacy occur during this period, and kissing may fulfill both of these functions, addressing autonomy and relatedness motives for sexual behaviors. We examined the prevalence and personal, contextual, and adjustment/health predictors of delayed onset of kissing. An ethnically and racially diverse sample of traditionally aged first year university students (N = 738; 50.7% female) completed online surveys. Only 14.2% of young adults had never kissed a partner on the lips. Compared to their peers who had kissed partners, young adults who had never kissed were more likely to be Asian-American, less likely to be in a romantic relationship, were less extraverted, were more likely to be in the Honors College, and drank alcohol less frequently. In bivariate models but not the multivariate model, young adults who had never kissed were more neurotic, had mothers who were less facilitating of independence, and had lower self-esteem. Findings inform understanding of normative sexuality development, and inform future research on normative and off-time sexual behaviors in young adulthood.

Normative and Clinical Self-Perceptions of Sexuality and Their Links to Psychopathology among Adolescents

BACKGROUND

Compulsive sexual behavior (CSB) has been linked to psychopathology among adults. Only preliminary research has been conducted on adolescents. In our study, we examined whether CSB is linked to psychopathology among adolescents or whether it is a part of normal sexual development. We also, examined potential risk and resiliency factors that might influence this link.

METHODS

The study population included 311 high school students (184 males and 127 females) aged 16-18 years who completed self-report measures regarding CSB, psychopathology, temperament, and attachment orientations.

RESULTS

Adolescents with clinical CSB had more severe psychopathologies than nonclinical ones (with moderate and low levels of CSB) and were unable to utilize resilience factors (i.e., low negative affectivity, high effortful control, and/or attachment security).

CONCLUSIONS

Low and moderate levels of CSB seem to be part of the normal development of sexuality among adolescents. Clinical CSB seems to be a deviation from this normal development.

Psychosexual Functioning of Cognitively-able Adolescents with Autism Spectrum Disorder Compared to Typically Developing Peers: The Development and Testing of the Teen Transition Inventory- a Self- and Parent Report Questionnaire on Psychosexual Functioning

To gain further insight into psychosexual functioning, including behaviors, intrapersonal and interpersonal aspects, in adolescents with Autism Spectrum Disorder (ASD), comprehensive, multi-informant measures are needed. This study describes (1) the development of a new measure of psychosexual functioning in both parent- and self-reports (Teen Transition Inventory; TTI) covering all three domains of psychosexual functioning (i.e. psychosexual socialization, psychosexual selfhood, and sexual/intimate behavior). And (2) the initial testing of this instrument, comparing adolescents with ASD (n = 79 parent-report; n = 58 self-report) to Typically Developing (TD) adolescents (n = 131 parent-report; n = 91 self-report) while taking into account gender as a covariate. Results from both informants indicate more difficulties regarding psychosexual socialization and psychosexual selfhood in the ASD group. With regard to sexual/intimate behavior, only parents reported significantly more problems in adolescents with ASD.

Links among Familial Gender Ideology, Media Portrayal of Women, Dating, and Sexual Behaviors in African American, and Mexican American Adolescent Young Women: A Qualitative Study

Utilizing grounded theory methodology and drawing from sexual script theory as a research lens, we examined familial gender ideologies, media portrayals of Black and Latina women, dating attitudes, and sexual behaviors among 33 low-income early adolescent (aged 11-14) African American and Mexican American young women. Themes revealed divergent experiences for African American and Mexican American young women. In particular, African American participants reported egalitarian familial gender ideologies and sexual objectification of Black women, as well as more open and positive attitudes toward dating and sexuality. In contrast, Mexican American participants reported patriarchal familial gender ideologies and the portrayed mistreatment of Latinas in telenovelas and Spanish language songs, along with cautious attitudes towards dating and sexuality. Additionally, Mexican American participants reported that they censored their communication about sexual matters with their family. Overall, findings suggest that interventions should be tailored accordingly for African American and Mexican American youth. Interventions with African American young women should focus on providing accurate information on safer sexual practices, whereas interventions with Mexican American young women should focus on promoting constructive conceptualizations of gender roles, which could help foster self-efficacy around sexual communication with parents and potential partners.

Is Sexual Activity During Adolescence Good for Future Romantic Relationships?

Past research has consistently shown that romantic experiences during adolescence affect the nature and quality of romantic relationships during emerging adulthood. However, less is known about the role of adolescent sexual experiences in future sexual and romantic relationships. The current study examined the impact of different forms of sexual activity at age 16 (within a romantic relationship or casual encounters) on the nature and quality of sexual experiences in romantic relationships at age 23. One hundred and forty four (59.7% females) 16 year olds reported on their sexual activity within a romantic relationship or sexual encounters. In addition they reported on the quality of relationships they were involved in and their tendency to suppress emotions (included as an aspect of personality). At age 23 they reported on their romantic and sexual experiences during the past 2 years (number of short lived relationships, numbers of friends with benefits, casual sex encounters) and the quality of their romantic relationships (the duration of their longest relationship, partner support and feelings of certainty in the relationships). Findings showed that the tendency to suppress emotions was associated with lower likelihood to engage in casual sex at age 23. However, greater sexual experience in casual encounters during adolescence was consistently longitudinally associated with different forms of casual sexual encounters and short romantic involvements above and beyond the contribution of personality. In contrast, sexual activity within a romantic relationship predicted only a few indices of the quality of romantic involvement at age 23. The distinctive role of casual sexual activity and sexual activity within a romantic relationship for future sexual and romantic activities is discussed.

Latent classes of sexual behaviors: Prevalence, predictors, and consequences

Scholars of adolescent and emerging adult sexuality have recently begun to study how diverse patterns of sexual behaviors contribute to development and well-being. A person-oriented approach to studying sexual behaviors provides a nuanced understanding of sexual repertoires. The goals of this paper were to document patterns of sexual behaviors ranging from kissing to penetrative sex, and to examine how latent classes of behaviors, gender, and partner type (romantic vs. nonromantic) predict intra- and interpersonal consequences of sexual behaviors. Latent class analysis of a stratified random sample of U.S. college students revealed four classes of sexual behaviors: Kissing Only, Kissing and Touching, All Behaviors, and Oral and Penetrative Only. Compared to individuals in the All Behaviors class, individuals in the Kissing Only class were less likely to experience a positive or a negative intrapersonal consequence of sexual behaviors. Men were less likely to report a negative intrapersonal consequence than women were. Partner type predicted negative interpersonal consequences for the All Behaviors class. Implications are discussed in terms of normative sexual development, prevention, and sexual and relationship education.

Is a Kiss Just a Kiss?: Predicting Variations in Motives for Romantic Kissing

Romantic kissing is vastly understudied in scientific research, with only one study systematically examining romantic kissing motives and associated gender differences. The current study explored motives for romantic kissing in greater detail by examining whether gender, age, relationship status, sexual attitudes, and personality predicted variations in adults’ romantic kissing motives. Hierarchical multiple regression analyses (N = 461) revealed that those with more permissive sexual attitudes, higher levels of extraversion, those currently in committed relationships and those younger in age were most likely to endorse relational/sexual motives for romantic kissing. Goal attainment/insecurity motives were most frequently endorsed by men and those with more permissive sexual attitudes, higher levels of extraversion, lower levels of agreeableness, and lower levels of conscientiousness. Results emphasise the importance of a variety of variables in understanding motives for romantic kissing.

You can't always get what you want: Network determinants of relationship inactualization in adolescence

Despite widespread interest in the link between social and sexual networks, little research has focused on how social networks influence the progression of intimate relationships (e.g., from holding hands to sexual intercourse). I argue that social networks not only affect individuals' opportunities to meet romantic partners, but also shape the ideal and actual progressions of intimate acts within their relationships. Using data from the National Longitudinal Survey of Adolescent to Adult Health (Add Health), I conduct an optimal matching analysis of adolescents' purported ideal versus actual relationship sequences, which are comprised of romantic and sexual events. Low discrepancy scores indicate that intimate acts in one's recent relationship were sequenced much as one had desired. Results demonstrate that how students are situated within their schools' broader friendship networks affects their experiences with intimacy: high rank prestige individuals are better able to achieve their ideal relationships, as are individuals with densely knit friendship networks. Additionally, increased gender salience among boys within the socio-centric friendship network is associated with increased discord between desired and actual relationship progressions, but this relationship is mediated by the rareness of the individual's ideal relationship trajectory.

A Prospective Study of Adolescents' Sexual Partnerships on Emerging Adults' Relationship Satisfaction and Intimate Partner Aggression

We examined whether the influence of adolescents' sexual partnerships, both dating and casual, carried over to affect emerging adults' relationship satisfaction and experiences of intimate partner aggression. Analyses of longitudinal data from the Toledo Adolescent Relationships Study (n = 294) showed that net of control variables (delinquency, depression, family violence, relational and sociodemographic characteristics), adolescents' number of dating, but not casual, sexual partners led to greater odds of intimate partner aggression during emerging adulthood. Further, relationship churning (breaking-up and getting back together) and sexual non-exclusivity during emerging adulthood mediated the influence of adolescents' number of dating sexual partnerships on intimate partner aggression. The positive effect of dating sexual partnerships on intimate partner aggression was stronger for women compared with men. These findings confirm the long reach of adolescent experiences into emerging adulthood.

Latent Classes of Adolescent Sexual and Romantic Relationship Experiences: Implications for Adult Sexual Health and Relationship Outcomes

Adolescents' sexual and romantic relationship experiences are multidimensional but often studied as single constructs. Thus, it is not clear how different patterns of sexual and relationship experience may interact to differentially predict later outcomes. In this study we used latent class analysis to model patterns (latent classes) of adolescent sexual and romantic experiences, and then examined how these classes were associated with young adult sexual health and relationship outcomes in data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). We identified six adolescent relationship classes: No Relationship (33%), Waiting (22%), Intimate (38%), Private (3%), Low Involvement (3%), and Physical (2%). Adolescents in the Waiting and Intimate classes were more likely to have married by young adulthood than those in other classes, and those in the Physical class had a greater number of sexual partners and higher rates of sexually transmitted infections (STIs). Some gender differences were found; for example, women in the Low-Involvement and Physical classes in adolescence had average or high odds of marriage, whereas men in these classes had relatively low odds of marriage. Our findings identify more and less normative patterns of romantic and sexual experiences in late adolescence and elucidate associations between adolescent experiences and adult outcomes.

Sexuality (and Lack Thereof) in Adolescence and Early Adulthood: A Review of the Literature

Youth sexuality has been primarily studied with a focus on its potential public health issues, such as sexually transmitted infections and unwanted pregnancies, and its comorbidity with other risky behaviors. More recently, it has been studied as a normative step in romantic partnerships, either pre- or post-marital, as well as outside the context of romantic involvement. In this paper, we review the extensive literature on sexuality in adolescence and early adulthood both within and outside romantic relationships (i.e., casual sexual relationships and experiences; CSREs). Furthermore, the recent recognition of youth sexuality as a developmental task has led to a renewed interest from scholars in youth who abstain from sexual encounters, whether deliberately or not. A brief overview of the literature on cultural differences in sexuality, and sexual-minority youth sexual development is also provided. This paper concludes by suggesting future directions to bring the field of youth sexuality and romantic relationships forward.

Perceived Discrimination, Peer Influence and Sexual Behaviors in Mexican American Preadolescents

Both discrimination and sexual health disparities have significant negative health implications for Latina/o preadolescent youth, including negative mental health outcomes, STIs/HIV, unintended pregnancy, and ongoing poverty. Studying these links within this population, therefore, has significant public health relevance, both in terms of promoting sexual health in general as well as serving the specific needs of Latina/o youth. This study explored the relationship between perceived discrimination, peer influence and sexual behaviors among 438 Mexican American preadolescents in the Southwest United States (55.3 % male). Additionally, this study examined whether psychological distress, substance use, and sexual motives mediated and whether gender moderated these relations. A multiple-group path analysis of the analytical model was performed to examine the hypothesized relations between perceived discrimination, peer influence, psychological distress, substance use, sexual motives and sexual behaviors. The findings indicated that perceived discrimination was directly linked to sexual behaviors among participants and indirectly linked via substance use. The findings also indicated that peer influence was indirectly linked to sexual behaviors via substance use among participants and via sexual motives among boys. This study underscores the importance of substance use in the perceived discrimination, peer influence and sexual behavior link in Mexican American preadolescents. Additionally, it highlights the importance of sexual motives in the link between peer influence and sexual behaviors of Mexican American boys.

Demographic and developmental differences in the content and sequence of adolescents' ideal romantic relationship behaviors

This study utilizes data from 18,392 respondents (aged 12-19) in Wave 1 of the National Longitudinal Study of Adolescent to Adult Health (Add Health) to provide a detailed descriptive analysis of U.S. adolescents' desired behaviors in their ideal romantic relationships. Age, gender, and ethnic group differences in the desire for--and preferred sequence of--a set of activities that could occur in a hypothetical romantic relationship were explored within subsets of heterosexual (n = 17,274) and sexual minority adolescents (n = 1118). Non-sexual behaviors were more commonly desired compared to sexual behaviors. The typical desired behavioral sequence was: holding hands, going out alone, telling others they were a couple, kissing, saying "I love you," sexual touching, and finally having sex. Overall, more similarities than differences emerged across groups, with some notable differences in the percentages who desired sexual behaviors. Results provide a nuanced picture of adolescent relationship scripts, with implications for education and prevention.

Relationship Involvement Among Young Adults: Are Asian American Men an Exceptional Case?

Asian American men and women have been largely neglected in previous studies of romantic relationship formation and status. Using data from the first and fourth waves of the National Longitudinal Study of Adolescent to Adult Health (Add Health), we examine romantic and sexual involvement among young adults, most of who were between the ages of 25 to 32 (N=11,555). Drawing from explanations that focus on structural and cultural elements as well as racial hierarchies, we examine the factors that promote and impede involvement in romantic/sexual relationships. We use logistic regression to model current involvement of men and women separately and find, with the exception of Filipino men, Asian men are significantly less likely than white men to be currently involved with a romantic partner, even after controlling for a wide array of characteristics. Our results suggest that the racial hierarchy framework best explains lower likelihood of involvement among Asian American men.

Ideals as Anchors for Relationship Experiences

Research on young-adult sexuality in sub-Saharan Africa typically conceptualizes sex as an individual-level risk behavior. We introduce a new approach that connects the conditions surrounding the initiation of sex with subsequent relationship well-being, examines relationships as sequences of interdependent events, and indexes relationship experiences to individually held ideals. New card-sort data from southern Malawi capture young women's relationship experiences and their ideals in a sequential framework. Using optimal matching, we measure the distance between ideal and experienced relationship sequences to (1) assess the associations between ideological congruence and perceived relationship well-being, (2) compare this ideal-based approach to other experience-based alternatives, and (3) identify individual- and couple-level correlates of congruence between ideals and experiences in the romantic realm. We show that congruence between ideals and experiences conveys relationship well-being along four dimensions: expressions of love and support, robust communication habits, perceived biological safety, and perceived relationship stability. We further show that congruence is patterned by socioeconomic status and supported by shared ideals within romantic dyads. We argue that conceiving of ideals as anchors for how sexual experiences are manifest advances current understandings of romantic relationships, and we suggest that this approach has applications for other domains of life.

Sexual communication intervention for African American mothers & daughters

BACKGROUND

African American girls ages 13-19 comprised nearly 3 out of 4 new cases of HIV in 2009. The goal of this study was to deliver a theoretically-driven intervention to test the feasibility for recruitment and retention of mother-daughter dyads.

METHODS

Twenty mother-daughter dyads were recruited from a community health center between February-April 2014. Comparisons were made between pre- and post-intervention scores using percent change.

RESULTS

Twelve dyads (60%) completed the intervention. There were no demographic differences between completers and noncompleters. Notable post-intervention percent increases in scores were observed in the domains: Sexual knowledge (15%), confidence to talk (23.2%); and openness of sexual communication (26.4%).

CONCLUSION

Our small-sized study showed promise in the intervention. Increasing sexual communication between African American mothers and daughters is likely to be sustainable over time and across relationships, and thus have a greater impact on HIV-prevention behaviors later in life.

The role of sexual behavior in head and neck cancer: implications for prevention and therapy

HPV-positive oropharyngeal squamous cell carcinoma (HPV-OSCC) is associated with oral sexual behaviors. The sharp rise in incidence of HPV-OSCC in the USA has been attributed to changes in sexual norms over the past five decades, with lower age at sexual debut and higher numbers of sexual partners per individual. In addition, variations in HPV-OSCC prevalence by race, age cohort and gender may be attributable to differences in oral sexual behaviors among these groups. Oral HPV infection is the putative precursor to HPV-OSCC. Risk factors for oral HPV incidence, prevalence, clearance and persistence are crucial to understanding how, and in whom, oral HPV infection progresses to malignancy. Future investigation should focus on elucidating the natural history of oral HPV infection persistence and malignant transformation, developing effective screening tools and exploring opportunities for prevention such as vaccination and public health education.

Urban adolescent girls' perspectives on romantic relationships: initiation, involvement, negotiation, and conflict

The purpose of this paper was to describe romantic relationships from the perspective of urban, adolescent girls, to address gaps in our understanding of their relationship dimensions. Minority adolescent girls (n  =  17) participated in private semi-structured interviews aimed to elicit the understanding of the adolescents' perspectives on their own relationship experiences and dynamics. The research team conducted conventional content analysis of the interview transcripts. Four major themes emerged about romantic relationships: (1) influence of male pursuit and social norms on relationship initiation factors; (2) a romantic partner is a confidant, friend, and companion; (3) negotiating intimacy respectfully; and (4) relationship conflict through control and abuse. Adolescents described sub-themes of social norms of male pursuit and relationship pressures that dictated relationship initiation. Relationships were depicted by emotional support, caring, and companionship. Adolescents described positive negotiation skills. However, relationship conflict, including controlling behaviors and violence, was illustrated in these same relationships. This study provides a rich description of romantic relationships from the perspectives of urban, adolescent girls. Most salient findings included social pressures and a combination of both positive and negative attributes. Implications include the need for intervention development at the community level to address social pressures, recognition of positive adolescent relationship attributes, and facilitation of skills to identify and address low-quality relationship characteristics.

The Emotional Experiences of Early First Intercourse

The experience of the first intercourse at an early age is a well-established sexual risk behavior as it is related to adverse physical and mental health outcomes. However, the diversity within the group of early starters as well as the actual processes that make early first-time intercourse (potentially) more harmful remain understudied. The goal of this research is to understand the mechanisms that make an early experience of the first intercourse either more or less emotionally harmful. Therefore, a combination of quantitative and qualitative data are used. The quantitative data stem from a population survey (ages 14-35 years; N = 705); the qualitative data were gathered by in-depth interviews among 24 young people (ages 16-18 years) with an early first-time intercourse (at age 14 years or younger). Quantitative analyses show that the age at first-time intercourse is positively related to the feeling of readiness. For the male respondents only, it is also positively related to the general experience of the first intercourse. For female respondents, the age at the first intercourse is only related to the general experience of it in interaction with the age difference with the first partner. Qualitative analyses show that much variation goes behind these statistical regularities. Successful early starters can be differentiated from problematic early starters based on relationship characteristics, the preceding sexual trajectory, and the preceding sexual decision making. Practical implications are described, and recommendations for further research are made.