Predicting disclosure of MSM status to providers in a primarily socially conservative state

ABSTRACT

Purpose: This study aimed to determine what predicts a man who identifies as MSM living in a conservative state to inform his provider of his sexual behaviors and/or his sexual orientation. Methods: We administered an anonymous online survey to 148 men who reported seeing a general medical provider in the last 12 months. All participants resided in Oklahoma. Results: When controlling for HIV status, previous STI diagnosis, and age, logistic regression modeling yielded significant results (x²(9) = 31.22, p <.001) predicting 70.3% of cases. Age and overall disclosure of sexual orientation and/or sexual behaviors were significant predictors. Conclusion: Individuals who did not disclose their sexual orientation or same-sex behaviors to friends and family members were less likely to inform their providers of their sexual orientation. Disclosure of MSM status provides additional opportunities to enhance primary and secondary prevention strategies in rural and conservative areas that are necessary to optimize health, including but not limited to HIV screening and discussion of pre-exposure prophylaxis that their counterparts in urban settings more readily receive.     

Use of Drinking Protective Behavioral Strategies and Sexual Perceptions and Behaviors in U.S. College Students

Alcohol use among college students is linked to an increased likelihood of engaging in risky sexual behaviors, including casual sex and unprotected sex. These behaviors increase college students' risks for negative social and health-related consequences. This study examined the relationship between drinking behaviors and protective behavioral strategies (PBS), expectancies and perceptions of sexual risk, and actual alcohol-related sexual behaviors and consequences. Sexually active college students completed Web-based self-report measures of drinking behaviors and use of PBS, alcohol expectancies and perceptions of risk, and sexual behaviors and related consequences (n = 524; 57.1% women). Findings indicated that PBS were related to lower expectancies of sexual risk and sexual disinhibition, and among lighter drinkers, lower expectancies of sexual enhancement from alcohol. PBS were also related to decreased perceptions of sexual-related risks, some alcohol-related sexual behaviors, including number of drinks before/during sex, and number of sexual consequences, but were not related to abstaining during sex, frequency of alcohol-related sexual behaviors, or general condom use. These findings demonstrate a disconnect between perceived and actual risks among college students, such that decreased perceptions of risk may not be associated with protective behaviors. Prevention and intervention implications are discussed.     

Masturbation as a Means of Achieving Sexual Health

Abstract

Research on masturbation has indicated that, contrary to traditional beliefs, masturbation has been found to be a common sexual behavior and linked to indicators of sexual health. While there are no general indicators of ill health associated with masturbation, it can be powerfully negative or positive for many individuals. As an example, it is widely used in sex therapy as a means of improving the sexual health of the individual and/or relationship. Promoting masturbation as a means of a public health strategy for sexual health is highly controversial; however, there are arguments and evidence that suggest that this may be an important part of any public health approach to improving sexual health. There is a need for more research on the impact of masturbation on self-esteem, body image, sexual functioning and sexual satisfaction and methods for using masturbation to promote sexual health. There is also a need for more of a theoretical approach to the formation of hypotheses to be tested.     

POLITICAL BUSINESS CYCLES IN THE NEW KEYNESIAN MODEL

This paper tests various political business cycle theories in a New Keynesian model with a monetary and fiscal policy mix. All the policy coefficients, the target levels of inflation and the budget deficit, the firms' frequency of price setting, and the standard deviations of the structural shocks are allowed to depend on “political” regimes: a preelection versus postelection regime, a regime that depends on whether the president (or the Fed chairman) is a Democrat or a Republican, and a regime under which the president and the Fed chairman share party affiliation in preelection quarters or not. The results provide evidence that several coefficients are influenced by political variables. The best‐fitting specification, in fact, is one that allows coefficients to vary according to a regime that depends on whether the economy is in the few quarters before a presidential election or not. Monetary policy becomes considerably more inertial before elections and fiscal policy deviations from a simple rule are more common. There is some evidence that policies become more expansionary before elections, but this evidence disappears for monetary policy in the post‐1985 sample. (JEL C11, D72, E32, E52, E58, E63)     

Contraceptive self‐efficacy: A perspective on teenage girls' contraceptive behavior

This research investigated the relationship between the social‐psychological theory of self‐efficacy and teenage girls' contraceptive behavior. Data were obtained from 258 female clients, aged 20 or younger, of a family planning clinic. Four factors were extracted from the contraceptive self‐efficacy (CSE) scale developed for this investigation. Regression analyses were used to determine whether CSE scores distinguished patterns of contraceptive use when the effects of the influential demographic, sexual experience, and psychosocial variables were controlled. Two of the four CSE factors contributed significantly new information in accounting for the variance in the contraceptive use measure, semipartial R = .26, semipartial R² (4, 163) = .07, p < .01. The relationship between study variables and the four CSE factor scores were examined in a canonical correlation analysis to understand better the characteristics of the contraceptively self‐efficacious teenager. The results support the proposition that girls with a high CSE orientation think that they should and can be responsible for their sexual activity and act accordingly to achieve contraceptive protection. Girls with a low CSE orientation may be ineffective contraceptors, because they experience conflict regarding their strong sexual feelings and activities. Implications for interventions are discussed.     

eDiary and Female Sexual Distress Scale© in Evaluating Distress in Hypoactive Sexual Desire Disorder (HSDD)

Sex-related distress is integral to the diagnosis of hypoactive sexual desire disorder (HSDD). This article describes the results of three prospective, non-treatment validation studies (two North American and one European), each testing over 200 participants with HSDD, other types of female sexual dysfunction (FSD), or no FSD in which the 12-item Female Sexual Distress Scale^© (FSDS^©), the 13-item FSDS–Revised^©(FSDS–R^©), and a single question asked using a daily electronic diary (the eDiary For HSDD Trials^©; eDiary) were used to measure sex-related distress. FSDS results with 30- and seven-day recall were equivalent. The results observed with FSDS–R Item 13 (a single question assessing concern due to low sexual desire) were comparable to the FSDS. Mean eDiary monthly distress scores were closer to the minimum possible score (equivalent to “a little bit” of distress) and were about twice as variable as FSDS or FSDS–R Item 13 scores in participants with HSDD. All three measures confirmed that there is more distress in women with HSDD compared to women with no sexual dysfunction at all time points, demonstrating discriminant validity.     

Exploring U.S. Social Work Students’ Sexual Attitudes and Abortion Viewpoints

Social workers frequently engage with sexual and reproductive health topics, yet a notable paucity of social work research exists regarding abortion. Informed by overlapping theoretical frameworks of human rights and reproductive justice, this study examined a large, nationwide survey of social work students in the United States (N = 504). Linear regressions indicated that students’ endorsements of permissive sexual attitudes and support for birth control are inversely associated with holding anti-choice abortion views. Moreover, distinct relationships were found among sociodemographic characteristics and abortion attitudes and knowledge, suggesting that social work education efforts regarding contentious reproductive and sexual health topics should also focus on nuances of cultural competence and diversity, as well as general human rights principles and professional ethics.     

Child Maltreatment in Remote Aboriginal Communities and the Northern Territory Emergency Response: A Complex Issue

Abstract

Forty years after the 1967 Referendum and 10 years after the Bringing Them Home inquiry published its report into the Stolen Generations, in June 2007 the Howard Federal Government launched an Emergency Response intervention in the Northern Territory, having recognised the urgent need to reduce the incidence of child maltreatment in remote Aboriginal communities. This intervention was developed in response to the Northern Territory Government report on child sexual abuse in Indigenous children that described the urgency of the situation. In the present review of the literature, the complexity of the issue of child maltreatment, in particular child sexual abuse, in Indigenous Australia is explored. The Northern Territory Emergency Response1 ¹The current Rudd Federal Government has adopted most of the policies involved in the Northern Territory Emergency Response and has called for a comprehensive and independent review to be completed by 30 September 2008. is examined in the light of research evidence, detailed in numerous government reports, that reducing child maltreatment in Aboriginal communities necessitates both Aboriginal self-determination and extensive consultation between Indigenous and non-Indigenous people working in the field. The extent to which the Emergency Response is evidence based and the complexity of making a report about child maltreatment, in particular child sexual abuse, in a remote Aboriginal communities are explored. Implications for policy and practice are also discussed.     

SAME-GENDER SEX AMONG U.S. ADULTS: TRENDS ACROSS THE TWENTIETH CENTURY AND DURING THE 1990s

Trends in reporting of same-gender sex are assessed using datafrom the 1998–2002 General Social Surveys (Ns = 9,487males and 12,336 females). Analyses indicate that the reportedprevalence of female-female sexual contact increased substantiallyand monotonically across twentieth-century birth cohorts, risingfrom 1.6 percent (Standard error [SE] = 0.60) for the cohortof U.S. women born prior to 1920 to 6.9 percent (SE = 0.81)for women born in 1970 and afterward. Increases in the reportedprevalence of female-female contacts also occurred within the1990s. These trends persist when statistical controls are introducedfor changes in attitudes toward same-gender sexual behavior.No parallel trend is observed in the reporting of male-malesexual contacts during adulthood, although the proportion ofU.S. men reporting such contacts in the past year and in thepast five years increased during the 1990s.     

Abstracts of sexuality articles by medical,nursing, and social work students: Preferences for journal and topic

Theories of gender transpositions are fundamentally flawed because they often fail to comprise biological, social, familial, and cultural variables which influence the development of sexual behavior and identities in humans. These theories are reminiscent of 19th century views of sexuality which relied on the notion of biological determinism. This approach has been considered reductionistic and has led to conclusions that variations of human sexual expression, such as homosexuality, are deviations from the heterosexual norm. That heterosexuality is considered to be the norm originates from the equation of sexuality to reproductive biology in biomedicine. While there is an impressive body of information on hormonal influence on sexual brain differentiation, prenatal life, and later sexual motor behavior in lower mammals, these findings have not been clearly replicated in primates or humans. Yet, there have been forceful extrapolations to the human from lower mammals (e.g., theories of gender transpositions). Upon critical analyses of hormonal theories of heterosexuality and transsexualism, there are no robust data to support the role of hormones in the development of these behaviors or identities among humans. While an understanding of the etiology of these phenomena, including heterosexuality, is intriguing, we need to be cautious in our zeal to find simplistic explanations and not to retreat to oversimplified notions.     

Parenting Practices and Adolescent Sexual Behavior: A Longitudinal Study

The effects of parental attitudes, practices, and television mediation on adolescent sexual behaviors were investigated in a study of adolescent sexuality and media (N = 887). Confirmatory factor analyses supported an eight‐factor parenting model with television mediation factors as constructs distinct from general parenting practices. Logistic regressions indicated that adolescents reporting greater parental disapproval and limits on viewing at Wave 1 were less likely to initiate oral sex between Waves 1 and 2. Adolescents who reported more sexual communication with parents were more likely to initiate oral sex. Results for vaginal intercourse were similar to those for oral sex. Coviewing was a significant negative predictor of initiation of sexual behavior. Parental attitudes and television mediation can delay potentially risky adolescent sexual behaviors.     

Sexual Behavior in Dutch and Belgian Children as Observed by Their Mothers

Abstract

Mothers' observations (N = 670) of child sexual behavior have been collected using an adapted version of the Child Sexual Behavior Inventory as developed by Friedrich et al. (1991). The ages of the boys (N = 351) and girls (N = 319) observed range from 0 to 11 years. The results show that there is a lot of variance in the frequency with which specific sexual behaviors are observed. The occurrence of specific behaviors varies with age. While some behaviors are observed more frequently as the child gets older, others are observed less frequently. Boys and girls only differ in a few behaviors. The finding that the behavioral items form an internally consistent scale suggests that there is a general tendency to show sexually related behaviors, which is more or less strongly present in children, which might be a precursor of differential levels of sexual desires in adults.     

Prevalence of Sexual Trauma History Using Behaviorally Specific Methods of Assessment in First Year College Students

There are several challenges associated with evaluating the prevalence of sexual trauma, including child sexual abuse and adult sexual assault. The aim of this study was to assess sexual trauma prevalence rates among first year college students (N = 954) using behaviorally specific questions and a more representative recruitment sample that did not rely on self-selection. Participants completed a list of sexual trauma questions, including general questions containing labels such as “rape” or “abuse” as well as behaviorally specific questions that describe specific behaviors that qualify as sexual trauma without labels. Results indicated that 6.7% of the sample reported at least one incident of child sexual abuse, with similar rates for men and women. Women were more likely to report a history of adult sexual assault, which was reported by 12.4% of the total sample. Participants were also more likely to endorse a history of sexual trauma when answering behaviorally specific rather than general “label” questions. Women survivors in particular were more likely than men to identify their experiences as abuse/assault (66.7% versus 21.1% for child sexual abuse), which may help explain prevalence differences between men and women in prior research. Men may be less likely than women to label their experiences as abuse and may be underidentified in sexual trauma research without the use of behaviorally specific questions. Overall, the results of this study suggest that the prevalence of sexual trauma is better assessed using behaviorally specific questions and that this is an important topic of study among both men and women.     

The Sexual Health of Transgender Men: A Scoping Review

There is a general paucity of research concerning the sexual health of transgender individuals, and most existing research focuses on transgender women. A scoping review concerning the sexual health of transgender men was conducted to identify gaps in the literature and to highlight opportunities for future research and intervention. A comprehensive search of seven databases was conducted. The Joanna Briggs Institute Reviewers’ Manual was used as a framework. Some 7,485 articles were initially identified using a search strategy applied to seven online databases: 54 articles were identified as relevant to the research questions and reviewed in detail; of those, 33 were included in the final analysis. Studies were conceptualized into four broad themes: sexual behaviors, sexual identity, sexual pleasure and sexual function, and transactional sex. Besides an overall lack of research, existing studies were often characterized by small convenience samples that do not allow for generalization to the larger population of transgender men. Significant gaps in the literature regarding sexual coercion, sexual and intimate partner violence, and relationship quality and functioning among transgender men exist. There is a need to improve the scope and depth of research examining the sexual health of this population, especially concerning sexual risk behaviors and structural barriers to sexual health care access.     

Factors associated with general sexual permissiveness

This study examines the predictors of premarital, extramarital, and homosexual permissiveness in an attempt to arrive at a framework of general sexual permissiveness. Data from a national probability sample were used. The results indicate that the three types of permissivieness are strongly correlated with one another and have some common predictors. Age and religiosity are found to be negative predictors and education and freedom of expression are found to be positive predictors. A potential framework of general sexual permissivieness emerges from these results.     

Brief Emotion Regulation Training Facilitates Arousal Control During Sexual Stimuli

Disgust, a negative emotion which evokes strong behavioral avoidance tendencies, has been associated with sexual dysfunction. Recently, it was postulated that healthy sexual functioning requires a balance between excitatory (increased sexual arousal) and inhibitory processes (lowered disgust levels). This suggests that amplification of excitatory processes (like sexual arousal) could be a valuable addition to treatments for affect-based sexual dysfunctions. The major aim of the present study was to establish whether up-regulation could effectively enhance arousal levels during sexual stimuli, and whether such a training would simultaneously reduce disgust. Students (N = 163, mean age = 20.73 years, SD = 2.35) were trained in up-regulation of affect using either a sexual arousal film (i.e., female-friendly erotic movie) or a threat arousal film clip (i.e., horror movie), while control groups viewed the films without training instructions. Following this, participants viewed and rated state emotions during a series of pictures (sexual, disgusting, or neutral). Up-regulation of mood successfully enhanced general arousal in both groups, yet these arousal levels were not paralleled by reductions in disgust. Overall, the findings indicate that emotion regulation training by maximizing positive affect and general arousal could be an effective instrument to facilitate affect-related disturbances in sexual dysfunctions.