Integrating HIV Prevention and Relationship Education for Young Same-Sex Male Couples: A Pilot Trial of the 2GETHER Intervention

Young men who have sex with men are at high risk for HIV, and most new HIV infections occur in serious relationships. This pilot study assessed the feasibility, acceptability and preliminary efficacy of the 2GETHER couples-based HIV prevention and relationship education intervention for young same-sex male couples. We enrolled 57 young male couples (N = 114) into a four-session hybrid group and individual intervention. We assessed acceptability via post-session surveys and exit interviews, and we examined preliminary efficacy at a two week posttest. The vast majority of participants (93%) reported exclusively positive impressions of 2GETHER, and all components received high mean ratings. We observed decreases in HIV risk behavior, increases in information, motivation and behavioral skills related to HIV prevention, and improvement in relationship investment between pretest and posttest. Integrating relationship education and sexual health programming may be an effective way to reduce HIV transmissions in young male couples.

To have sex or not to have sex? An online focus group study of sexual decision making among sexually experienced and inexperienced gay and bisexual adolescent men

Adolescent gay and bisexual men (AGBM) are at disproportionately high risk for HIV and other sexually transmitted infections, yet healthy sexuality and HIV prevention programs grounded in experiences unique to AGBM (e.g., coming out) are lacking, as is the formative work necessary to inform such programs. A richer understanding of factors informing AGBM's decisions to have or not have sex is needed. To fill this gap in the literature, we conducted qualitative and mixed-methods analyses of data collected in online focus groups with 75 ethnically diverse 14-18-year-old AGBM across the United States. Findings suggest that many reasons why AGBM choose to have or abstain from sex mirror those noted in the previous literature as influential for heterosexual adolescents (e.g., temptation, "horniness"). AGBM conveyed additional experiences/concerns that appeared unique to their sexual identity, particularly fears about pain during anal sex, and difficulties safely and accurately identifying same-sex partners. Both sexually experienced and inexperienced youth voiced reasons to wait or stop having sex. Sexually inexperienced youth said their motivations centered on wanting to avoid STIs and HIV, a desire to wait for the right partner, and the specialness of sex. On the other hand, sexually experienced AGBM said they stopped having sex if there was not an available partner they had interest in, or to improve their romantic relationship. Thus, while our findings suggest that there may be common factors across sexual identities that impact youth's sexual decision making, healthy sexuality programs for AGBM also need to address issues specific to being gay and bisexual.

Clinician perceptions of operating room to intensive care unit handoffs and implications for patient safety: a qualitative study

BACKGROUND

Operating room (OR) to the intensive care unit (ICU) handoffs are known sources of medical error, yet little is known about the relationship between process failures and patient harm.

METHODS

Interviews were conducted with clinicians involved in the OR-to-ICU handoff to characterize the relationship between handoff process failures and patient harm. Qualitative analysis was used to inductively identify key themes.

RESULTS

A total of 38 interviews were conducted. Dominant themes included early communication from the OR to the ICU, team member participation in the handoff, and relationships between clinicians; clinician perspectives varied depending substantially on role within the team.

CONCLUSIONS

The findings suggest that ambiguous roles and conflicting expectations of team members during the OR-to-ICU handoff can increase risk of patient harm. Future studies should investigate early postoperative ICU care as outcome markers of handoff quality and the effect of interprofessional education on clinician adherence to interventions.

Student perspectives on sexual health: implications for interprofessional education

Interprofessional collaboration requires that health professionals think holistically about presenting concerns, particularly for multimodal problems like sexual dysfunction. However, health professions students appear to receive relatively little sexual health education, and generally none is offered on an interprofessional basis. To assess current degree of interprofessional thinking in sexual health care, 472 health professions students in Georgia, United States, were presented with a sexual dysfunction vignette and asked to rate the relevance of, and their familiarity with, interventions offered by several professionals. They also were asked to identify the most likely cause of the sexual dysfunction. Students rated relevance and familiarity with interventions as highest for physicians and lowest for dentists, with higher ratings of nurses by nursing students. More advanced students reported greater familiarity with mental health, physician, and physical therapy interventions. Finally, nursing students were less likely to attribute the dysfunction to a physical cause. These findings indicate that students may prioritize biomedical approaches in their initial assessment and may need additional supports to consider the spectrum of biopsychosocial factors contributing to sexual functioning. To encourage interprofessional critical thinking and prepare students for interprofessional care, sexual health curricula may be improved with the inclusion of interprofessional training. Specific recommendations for curriculum development are offered.

Individual differences in the effects of mood on sexuality: the revised Mood and Sexuality Questionnaire (MSQ-R)

Previous research using the Mood and Sexuality Questionnaire (MSQ) has revealed substantial variability in how negative mood impacts sexual response and behavior. However, the MSQ does not address differences between desire for solo or partnered sexual activity, examine the effects of sexual activity on mood, or assess the effects of positive mood. This article presents the development and factor structure of the Revised Mood and Sexuality Questionnaire (MSQ-R). An exploratory factor analysis in a sample of heterosexual men, homosexual men, and heterosexual women (N = 1,983) produced eight factors. Considerable variability was found in how moods influence sexual desire and arousal, in the effects of mood on sexual behavior, and in the reciprocal effects of sexual activity on mood. Among other findings, heterosexual women were less likely than heterosexual men and homosexual men to experience increased sexual desire and arousal when anxious or stressed, whereas homosexual men and heterosexual women were less likely than heterosexual men to experience increased desire when sad or depressed. Heterosexual men and heterosexual women were more likely than homosexual men to report increased desire when in a positive mood. Intercorrelations and correlations with various sexual behaviors varied by group. Limitations and implications of the findings are discussed.

The valence of sex:Automatic affective associations in erotophilia and erotophobia

Sexual stimuli may elicit positive and negative emotions that can impact sexual thoughts, responses, and behavior. To date, most research on affect and sexuality has focused on conscious processes and affective states. Less is known about how automatic and trait-level affective processes influence our reactions to sexual stimuli. This study used a priming task with backward masking and a trait measure of erotophobia-erotophilia - the tendency to respond to sex on a negative-to-positive continuum - to improve our understanding of the role of automatic and affective processes in response to sexual stimuli. Erotophilic individuals demonstrated automatic associations between sexual primes and positively-valenced targets, whereas erotophobic individuals classified negatively-valenced targets faster regardless of whether primes were sexual or neutral. The findings suggest that the valence of sexual stimuli can be processed automatically and is associated with trait-level affective responses to sex. Implications for research on risky sexual behavior and sexual dysfunction are discussed.

The effects of impulsivity, sexual arousability, and abstract intellectual ability on men's and women's go/no-go task performance

While a number of studies have assessed the role of personality traits, situational variables, and drug use on sexual risk behaviors, fewer studies have employed experimental methods to examine cognitive processes that may underlie risky sexual decision making. This study used a go/no-go paradigm to examine how individual difference variables and sexual arousal influence discrimination learning and sexual and nonsexual decision making. A total of 28 men (M age = 20 years) and 25 women (M age = 19 years) completed self-report measures of impulsivity, abstract intellectual ability, and sexual excitation and inhibition and participated in a laboratory experiment. The experiment consisted of two go/no-go tasks with sexual stimuli and two tasks with neutral stimuli, preceded by either sexually arousing or sexually neutral stimulus presentations. Task performance was measured by totals of false alarms and misses. Individuals high in impulsivity and low in abstract intellectual ability committed more false alarms in conditions involving sexually arousing stimuli. Furthermore, higher sexual excitation scores were linked to more misses. These findings indicate that cognitive processes associated with decision making that occurs in the "heat of the moment" are influenced by a combination of situational and sexual and nonsexual individual difference variables.

Influences of observer sex, facial masculinity, and gender role identification on first impressions of men's faces

Evaluations of male faces depend on attributes of the observer and target and may influence future social and sexual decisions. However, it is unknown whether adherence to hypertraditional gender roles may shape women's evaluations of potential sexual partners or men's evaluations of potential competitors. Using a photo task, we tested participants' judgments of attractiveness, trustworthiness, aggressiveness, and masculinity of male faces altered to appear more masculine or feminine. Findings revealed that higher hypermasculinity scores in male observers were correlated with higher attractiveness and trustworthiness ratings of the male faces; conversely, higher hyperfemininity scores in female observers were associated with lower ratings on those traits. Male observers also rated the faces as more aggressive than did female observers. Regarding ratings by face type, masculinized faces were rated more aggressive than feminized faces, and women's ratings did not discriminate between altered faces better than men's ratings. These results suggest that first impressions of men can be explained in part by socioculturally- and evolutionarily-relevant factors such as the observer's sex and gender role adherence, as well as the target's facial masculinity.