How Sexual Information Sources are Related to Emerging Adults' Sex-Positive Scripts and Sexual Communication

Prior research suggests that parents, peers, and media are popular sources of sexual information and beliefs among emerging adults. Sex-positivity is an orientation toward sex that emphasizes open-minded beliefs and communication about varying sexual behaviors, preferences, and orientations. The current study investigated whether these sexual information sources were associated with emerging adults' endorsement of sex-positive and sexual orientation-related sexual scripts, and if these sources and scripts were associated with sexual communication among a sample of college students ages 18-22 (n = 341). Results indicate that learning from television was positively related to sex-positive sexual script endorsement, and that sex-positive scripts were associated with more positive sexual communication. An interaction also emerged between gender and learning from television on sex-positive script endorsement, and between gender and learning from social media on sexual orientation-related script endorsement. The implications of these findings are contextualized within emerging adults' sexual agency and behavior. Future directions of research are also discussed.

Sex-Positivity, Medical Mistrust, and PrEP Conspiracy Beliefs Among HIV-Negative Cisgender Black Sexual Minority Men in Atlanta, Georgia

Because the public health response to the disproportionate HIV burden faced by Black sexual minority men (BSMMM) has focused on sexual risk reduction and disease prevention, other vital components of sexual health (e.g., intimacy, pleasure, benefits of sex) have been often overlooked. Sex-positive describes a more open, holistic approach toward sex and sexuality that prioritizes these other components, though such an approach is rarely applied to BSMM's sexual health. For sex-positive BSMM, risk/preventive discourse may foster or exacerbate medical mistrust as a reaction to the dissonance between how these men view sexual health and how the medical establishment views it, which may discourage sexual healthcare-seeking. We assessed sex-positivity and its association with medical mistrust and PrEP conspiracy beliefs among 206 HIV-negative cisgender BSMM in Atlanta, Georgia. We performed exploratory factor analytic procedures on responses to a sex-positivity scale, followed by multivariable linear regressions to determine sex-positivity's associations with medical mistrust and PrEP conspiracy beliefs. We extracted two sex-positivity factors: sexual freedom (α = 0.90), reflecting openness toward casual sex and rejection of sexual mores, and essence of sex (α = 0.77), reflecting the intimate, relational, and pleasurable qualities of sex. Sexual freedom was independently associated with perceived provider deception (β = 0.19, CI = 0.04, 0.34). Essence of sex was independently associated with PrEP conspiracy beliefs (β = 0.16, CI = 0.02, 0.31) and marginally associated with perceived provider deception (β = 0.14, CI = - 0.00, 0.29). Healthcare providers and public health practitioners may cultivate greater trust with BSMM by incorporating a sex-positive approach into patient/participant interactions, clinical decision-making, and interventions. Improving access to sexual pleasure acknowledges BSMM's right to optimal, holistic sexual health.

Focusing the Conceptualization of Erotophilia and Erotophobia on Global Attitudes Toward Sex: Development and Validation of the Sex Positivity-Negativity Scale

Previous measures of erotophobia/erotophilia like the Sexual Opinion Survey (SOS) assessed gut-level positive-negative affective and evaluative reactions to a wide range of sexual stimuli, resulting in purposefully diverse item content. Although an effective strategy, the item content of existing erotophilia/erotophobia scales is now potentially too generalized, encompassing what have since developed as an array of more focused constructs in the current literature like attitudes toward (1) casual sex, (2) pornography, (3) non-heterosexual orientations (e.g., homophobia), and (4) masturbation. The current study therefore sought to evaluate existing scales and to develop a conceptually focused measure of sex-positivity and sex-negativity using a distinct strategy designed to obviate the need for overly generalized (and potentially imbalanced or confounding) item content. Using responses from 2205 online respondents (82% Caucasian, 66% heterosexual, and 50% female) completing an item pool of 158 items, the current study employed a combination of classic test-theory analyses (e.g., exploratory and confirmatory factor analyses) and item response theory analyses to develop a psychometrically optimized scale-the Sex Positivity-Negativity (SPN) scale. The SPN scale demonstrated: (1) a stable 2-subscale structure distinguishing sex-negativity from sex-positivity, (2) consistently high levels of internal consistency across 31 demographic subsamples, (3) more discriminant than convergent validity with existing erotophilia scales given its novel focus, (4) discriminant validity with more specific sexual attitudes, (5) greater levels of power and precision for detecting differences between individuals, (6) stronger links to individual, sexual, and relationship functioning than existing scales, and (7) incremental validity over the SOS for predicting change in relationship dynamics over 6 months. The findings therefore suggested that the SPN scale is a conceptually focused measure of sex-positivity and sex-negativity offering researchers a comparatively short and effective tool. Implications are discussed.