Masturbation and Sexual Health

Abstract

In this study we applied research examining the hypothesized benefits of masturbation in dealing with sexual problems to the urgent health crisis posed by the HIV/AIDS pandemic. This is the first study to test the hypothesized relationship between masturbation and HIV risk as predicted by the Sexual Health Model, a sex-positive approach to sexual health developed in response to the need for a more explicit focus on sexuality and relationships in HIV prevention. This is also the first study to examine the relationship between several masturbation variables (i.e., masturbation guilt, lifetime masturbation, and current masturbation) and HIV-related sexual behaviors and attitudes in a sample of African American women (N =239). Data was collected using face-to-face structured interviews as part of the Women's Initiative for Sexual Health (WISH), a randomized, controlled trial of an HIV prevention intervention based on the Sexual Health Model, targeting low income, adult African American women. Contrary to expectations, results showed that participants who reported masturbating were more likely to report having multiple partners, being in a nonmonogamous relationship and engaging in high-risk sexual behaviors. There was no significant relationship between level of masturbation guilt and HIV risk nor between masturbation and consistent condom use or attitudes toward condoms. This study adds to the growing empirical support for associations between sexual health variables and safer sex and argues for a more explicit focus on sexuality in HIV prevention.     

Patterns of Masturbatory Behaviour

Abstract

In 1966, 1981 and 1996 the Department of Sex Research at Hamburg University, Germany, carried out three surveys into the sexual behavior of university students. Taken as a longitudinal study they provide information on the social history of sexuality over the past three decades for well-educated young adults (20 to 30 years old) in Germany. The samples consist of 8,641 men and women. In this paper data from the studies is analyzed under two aspects:

1. Shifts in masturbatory behavior 1966–1981–1996. Men and especially women begin to masturbate considerably earlier than used to be in the eighties, not to mention in the sixties. As a consequence, most young women nowadays have already experienced masturbation when having their first heterosexual intercoursethus following a pattern of sexual socialization that traditionally was typical for boys. In addition, in 1996, more students of both sexes had masturbated in the year preceding the investigation. The more relevant point is, however, that young adults (according to active incidence during the last 12 months) now masturbate almost irrespective of whether they have intercourse often or rarely, whether they are singles or live in a steady relationship or whether or not they are satisfied with their current relationship. So masturbation peacefully coexists with sex between partners and a loving relationship more often than it did in 1981 and 1966.

2. Masturbation in steady relationships, 1996. A detailed analysis of masturbation frequencies during the last four weeks also shows small differences between students who live in a sexually satisfying relationship and those without relationship. Only a minority feels the need to justify masturbation on the grounds that they lack sex with their partner. Three-quarters expressly state that masturbation is a form of sex in its own right and, therefore, does not interfere with partner sex. Furthermore, there is a tendency that students living in steady relationships experience masturbation slightly more positively than those living alone.     

Sexual Risk Behavior Among Women with Injected Drug Use Histories

This study documents the sexual risk, behavior for HIV infection and transmission in inner-city women with a history of injected drug use (IDU). The sample consists of N = 38 HIV+ and N = 37 HIV- women who were demographically comparable. A surprisingly high number of women in both. groups reported both male and female sex partners during their lifetime, and significantly more HIV+ women currently identified as bisexual and lesbian. Overall, HIV+ women had had more lifetime male and female sex partners, although the two groups did not differ in their current sexual behavior regarding numbers of partners and sex occasions. Both groups of women had little information about risk characteristics of their male sex partners, except for a history of IDU that was common among partners of both HIV+ and HIV- women. Sex for money was practiced by a subgroup of women in both groups and sex in exchange for drugs by very few women. A disturbingly high number of HIV+ and HIV- women reported occasions of unprotected sex during the past six months (86% vs. 97%), a finding that suggests that educational efforts for behavior change in IDU women need to be intensified.     

Sexual diversity in urban Norwegians

The purpose of this study is to describe homosexual and heterosexual experiences in terms of sexual fantasies, sexual attraction, sexual conduct, and falling in love in an urban Norwegian population. In 1997, a random sample of 5,000 persons (18-49 years) was drawn from the population register in Oslo to participate in a sexual behavior survey. Data collection was carried out by means of postal questionnaires and 45% responded. The results indicated that exclusive homosexuality was rare in the population. One exception was the prevalence of homosexual fantasies in women. Compared to respondents who had had exclusively heterosexual contact, respondents reporting bisexual contacts had a significantly higher number of lifetime sex partners, higher frequency of anal and oral sex and masturbation, and lower age at orgasm and masturbation debut. What significantly separated the groups of exclusive heterosexuals, bisexuals, and exclusive homosexuals were attitudes towards various expressions of sexuality and number of lifetime sex partners.     

Women in India: The Context and Impact of HIV/AIDS

ABSTRACT

The response to the HIV/AIDS epidemic on the Indian subcontinent has been hampered by several factors, including societal stigma, lack of educational resources, lack of economic opportunities, and the competing priorities for a nation just growing and developing an infrastructure for education, industry, and health. In particular, Indian women are silent victims in this epidemic because they do not readily have a respected voice in decision making and priority setting for the government. The epidemic is increasingly affecting and infecting Indian women (e.g., female commercial sex workers, married women, and pregnant women). The status of Indian women has placed them at extreme disadvantage because India is a country with socially progressive laws but has been slow to change its social norms. The reported HIV prevalence is low although many researchers agree a large amount of underreporting occurs. For India to address this emerging epidemic among women appropriately, it should focus on three intervention areas: (1) short-term solutions such as treatment options for those already infected with HIV to prevent further infection to sexual partners and children; (2) intermediate solutions such as education for those who are uninfected but engaging in behaviors that may put them at risk, such as injection drug use, engaging in commercial sex work, engaging in extramarital sexual relations, and having sexual partners who are not monogamous; and 3) long-term solutions such as addressing the root causes of inequality (e.g., disparities in education and employment and unwillingness to change social norms).     

Sexual diversity in Urban Norwegians

The purpose of this study is to describe homosexual and heterosexual experiences in terms of sexual fantasies, sexual attraction, sexual conduct, and falling in love in an urban Norwegian population. In 1997, a randam sample of 5,000 persons (18–49 years) was drawn from the population register in Oslo to participate in a sexual behavior survey. Data collection was carried out by means of postal questionnaires and 45% responded. The results indicated that exclusive homosexuality was rare in the population. One exception was the prevalence of homosexual fantasies in women. Compared to respondents who had had exclusively heterosexual contact, respondents reporting bisexual contacts had a significantly higher number of lifetime sex partners, higher frequency of anal and oral sex and masturbation, and lower age at orgasm and masturbation debut. What significantly separated the groups of exclusive heterosexuals, bisexuals, and exclusive homosexuals were attitudes towards various expressions of sexuality and number of lifetime sex partners.     

Sexual self control as a mediator of high risk sexual behavior in a New York city cohort of HIV+ and HIV‐ gay men

This paper describes the development of the Perceived Sexual Control inventory (PSC) and a study investigating the relationship between an individual's perception of control over sexual behavior and actual sexual risk behavior in a New York City cohort of 108 HIV+ and 48 HIV‐ gay men. Correlational analysis indicated that reported difficulty controlling sexual behavior was associated with having more male sex partners and sex occasions over lifetime and in the 6 months prior to interview, with a greater number of one‐time partners and out‐of‐home partners, with less monogamy, and with being abstinent in the prior 6 months. Those who perceived difficulty with sexual control were significantly more likely to use cocaine or amyl nitrate (poppers) during sex, to do so on more occasions and to use more drugs overall. Additionally, perceptions of sexual control were found to relate to high risk sexual practices. Those lower in perceived sexual control reported more occasions of receiving anal ejaculation than those who reported greater sexual control. Two subscales (Perceived Control Over Sex Drive and Perceived Control Over Risk Behavior), derived via factor analysis from the 20‐item inventory used to assess perceived sexual control, were also examined in relation to the above variables, and differential findings are discussed. The overall pattern of findings supports the construct validity of the PSC.     

Predictors of Safer Sex on the College Campus: A Social Cognitive Theory Analysis

Abstract

In April and May 1989, the authors surveyed a sample of students enrolled on four college campuses in New Jersey (N ? 923) concerning their HIV transmission-related behavior, knowledge, and a variety of conceptual variables taken primarily from social cognitive theory that were thought to be potentially predictive of safer sexual behavior. Analyses of sexually active, unmarried students' responses indicated that men expected more negative outcomes of condom use and were more likely to have sexual intercourse while under the influence of alcohol or other drugs, whereas women reported higher perceived self-efficacy to practice safer sex. Regression analyses indicated that, among the factors assessed, stronger perceptions of self-efficacy to engage in safer behavior, expecting fewer negative outcomes of condom use, and less frequency of sex in conjuction with alcohol or other drug use significantly predicted safer sexual behavior. Enhanced self-efficacy to discuss personal history with a new partner was associated with a greater number of risky encounters. Implications of these findings for intervention efforts with students are discussed.     

Theoretical Factors Influencing Adolescent Sexual Behavior: Evidence from a Rural Sample Living in Poverty

ABSTRACT

This study of 414 adolescents who resided in rural Arkansas families receiving AFDC was designed to investigate what theoretical factors predicted frequency of sexual intercourse in the past year prior to the study and number of lifetime sexual partners among males and females. Multivariate analyses indicated that elements of bonding were important to the sexual behavior of females, but not males. On the other hand, feelings of frustration influenced male sexual behavior only. The number of sex partners was increased by associations with sexually active peers for both genders while only females made excuses. The only factor which was associated with both sexual behaviors among both genders was having sex to have a baby to love or to draw a partner closer. The family social work implications of these findings were discussed.     

Supporting the Sexual Rights of Women Living With HIV: A Critical Analysis of Sexual Satisfaction and Pleasure Across Five Relationship Types

In the context of human immunodeficiency virus (HIV), a focus on protecting others has overridden concern about women’s own sexual well-being. Drawing on feminist theories, we measured sexual satisfaction and pleasure across five relationship types among women living with HIV in Canada. Of the 1,230 women surveyed, 38.1% were completely or very satisfied with their sexual lives, while 31.0% and 30.9% were reasonably or not very/not at all satisfied, respectively. Among those reporting recent sexual experiences (n = 675), 41.3% always felt pleasure, with the rest reporting usually/sometimes (38.7%) or seldom/not at all (20.0%). Sex did not equate with satisfaction or pleasure, as some women were completely satisfied without sex, while others were having sex without reporting pleasure. After adjusting for confounding factors, such as education, violence, depression, sex work, antiretroviral therapy, and provider discussions about transmission risk, women in long-term/happy relationships (characterized by higher levels of love, greater physical and emotional intimacy, more equitable relationship power, and mainly HIV-negative partners) had increased odds of sexual satisfaction and pleasure relative to women in all other relational contexts. Those in relationships without sex also reported higher satisfaction ratings than women in some sexual relationships. Findings put focus on women’s rights, which are critical to overall well-being.     

Multiple sex partners among college women and men: Sexual behaviors and sexual satisfaction revisited

The purpose of this investigation was to examine the effects of number of lifetime sex partners on sexual behaviors, sexual attitudes, and sexual satisfaction for never‐married college women and men. An anonymous questionnaire was administered in select classes at a midwestern state university. One‐partner group (one sex partner) women, in comparison to few‐partner (two to five sex partners) and many‐partner (six or more sex partners) group women, were more likely to have been older at first intercourse and to report psychological sexual satisfaction, mastur‐batory guilt, and commitment and love as conditions for sexual intercourse. For men, one‐partner group respondents were also more likely than few‐partner and many‐partner group respondents to report older age at first intercourse, masturbatory guilt, and commitment and love as conditions for sexual intercourse. In an era in which early sexual fulfillment clashes with concerns over unsafe sexual practices, these data provide insights into the influence of multiple partner experience on the sexual behavior patterns of young adults.     

A longitudinal examination of risk and protective factors associated with drug use and unsafe sex among young African American females

This study prospectively examined associations among multiple theoretically informed risk (e.g., depression, sexual sensation seeking, and risky peers norms) and protective factors (e.g., social support, STI knowledge, and refusal to have sex self efficacy) on unsafe sex among 715 African American adolescent females aged 15–21 who participated in an STI/HIV prevention intervention. Generalized estimating equation models were used to assess associations between baseline characteristics and sexual risk over a 12-month follow-up period. Overall risk in this population was high: at baseline, nearly a third of women reported sex under the influence of alcohol or substances; ≥ 2 partners for vaginal sex, and casual sex partners in the 60 days prior to baseline, and nearly 75% of those reporting vaginal sex used condoms inconsistently. In multivariable analysis, when risk and protective factors were simultaneously considered, higher levels of sexual sensation seeking were associated with having multiple sex partners and inconsistent condom use. Greater perception of risky peer norms was associated with a higher risk of having sex under the influence of alcohol or drugs. In addition, higher sex refusal self-efficacy was protective against having multiple; casual; and concurrent sex partners. Incorporating these salient factors into prevention programs may be critical to the development of targeted interventions for this population.     

Positive Feelings After Casual Sex: The Role of Gender and Traditional Gender-Role Beliefs

The purpose of this study was to identify predictors of positive and negative affect following casual sex. Specifically, the primary goal was to investigate how traditional gender-role beliefs, peer approval of casual sex, perceptions of others, sexual assertiveness, and sexual pleasure influence affective experiences. Second, we aimed to determine the extent to which these associations were comparable for men and women. Although we expected mean differences on many of these constructs (e.g., men perceiving more peer approval), we expected the relationships between these constructs to be comparable for women and men. Participants ages 18 to 35 (N = 585) were recruited from a large university and Amazon Mechanical Turk (MTurk) and described their most recent casual sex experience in a self-report questionnaire. Structural equation modeling (SEM) analyses indicated that gender-role beliefs were significantly associated with less sexual assertiveness and more negative perceptions of others; for women they were also associated with less peer approval of casual sex. For women and men, sexual assertiveness predicted sexual pleasure; and sexual pleasure was associated with affect. To decrease the gender discrepancy in positive affect and sexual pleasure, it is important to develop a comprehensive understanding of the interrelationships among norms, casual sex experiences, and affect.     

Masturbation Experiences of Swedish Senior High School Students: Gender Differences and Similarities

Research about masturbation tends to be limited to the assessment of masturbation incidence and frequency. Consequently, little is known about what people experience connected to masturbation. This might be one reason why theoretical approaches that specifically address the persistent gender gap in masturbation frequency are lacking. The aim of the current study was to explore several aspects of masturbation in young men and women, and to examine possible associations with their social backgrounds and sexual histories. Data from 1,566 women and 1,452 men (ages 18 to 22) from 52 Swedish senior high schools were analyzed. Comparisons between men and women were made regarding incidence of and age at first masturbation, the use of objects (e.g., sex toys), fantasies, and sexual functioning during masturbation, as well as about their attitudes toward masturbation and sexual fantasies. Cluster analysis was carried out to identify similarities between and differences within the gender groups. While overall more men than women reported experience with several of the investigated aspects, cluster analyses revealed that a large proportion of men and women reported similar experiences and that fewer experiences are not necessarily associated with negative attitudes toward masturbation. Implications of these findings are discussed in consideration of particular social backgrounds.     

Adaptive training for existing male transsexual gender role: A case history

The development of AIDS interventions for adolescents is hindered by the lack of data on the conditions that influence high‐risk sexual behavior. We examined psychosocial correlates of condom use and multiple partner sex for a sample of sexually‐active heterosexual adolescent women. Respondents reported higher levels of vaginal intercourse than the “average” adolescent. A minority were engaging in anal intercourse. Condom use was associated with perceived enjoyment of condoms and communication skills. Number of sexual partners was associated with susceptibility beliefs, social norms, and sexual communication skills. The findings support the general observation that AIDS interventions with adolescents should build sexual communication skills, address motivational issues, and teach people how to enjoy safe‐sex activities.     

Human Papillomavirus Vaccine Intention Among College Men: What's Oral Sex Got to Do With It?

Abstract

Objective: To identify associations between engaging in oral sex and perceived risk of oral cancer among college men. Also, to identify associations, and their moderating factors, between oral sex and human papillomavirus (HPV) vaccine acceptance. Methods: Young men were recruited from 2 university campuses in the South (N = 150). Men completed an audio computer-assisted self-administered interview. Results: With the exception of receiving fellatio, each measure of oral sex behavior was significantly associated with greater perceived risk of oral cancer. Four oral sex behaviors evidenced significant associations with vaccine acceptance. Men engaging in recent oral sex or reporting oral sex behaviors with more than 2 partners were more likely to indicate vaccine intent. African American/black race, communication with parents about sex-related topics, and HPV-related stigma/shame were identified as moderating factors. Conclusion: Young college men giving or receiving oral sex with multiple partners may be predisposed to HPV vaccination.     

The Evolution of Sexual Pleasure

Abstract

Sexual pleasure is an innate component of human sexuality. Although disdained throughout history by religious groups and variably explained by theories, philosophers, and societies, sexual pleasure permeates human experience. Traditional evolutionists explain this preoccupation via the development of sexual mating strategies and the human desire to propagate one's genes; however, here I will argue that the saturation of sexual pleasure suggests that sexual activity is no longer pursued solely to ensure reproductive success. Rather, humans engage in sexual behavior to achieve sexual pleasure—a proposition supported by widespread non-procreative sex in mammals, divergent cultural norms, and humans' evolved capacity to experience heightened sexual pleasure. I will address the nature and evolution of sexual pleasure with a cross-cultural findings culled from ethology, anthropology, primatology, and evolutionary theories.     

Would You Say You “Had Masturbated” If … ?: The Influence of Situational and Individual Factors on Labeling a Behavior as Masturbation

The term masturbation is often not clearly defined despite its prevalent use in sex education, sex research, and clinical settings. The purpose of this study was to understand what behaviors are typically considered to be masturbation as well as the situational and individual variables that may affect the labeling of a behavior as such. An online study of 564 individuals demonstrated that a wide variety of behaviors were considered to be masturbation by a majority of participants. No difference was found between men and women in the total number of behaviors labeled as masturbation. Both men and women were more likely to label a behavior as masturbation (1) if there was no sexual partner present than if there was and (2) if an orgasm occurred than if it did not. In addition, women were more likely than men to label a behavior as masturbation if they were alone and if no orgasm occurred. Younger age was associated with labeling more behaviors as masturbation, but sexual identity, self-pleasuring experience, partnered sexual experience, and attitudes toward masturbation were not related to the number of behaviors labeled as masturbation. Results speak to the importance of behavioral specificity when discussing masturbation with students, clients, and in sex research.     

Predictors of HIV Sexual Risk Behavior Among Men Who Have Sex with Men,Men Who Have Sex with Men and Women,and Transgender Women

ABSTRACT

Men who have sex with men, men who have sex with men and women, and transgender women are at high risk for HIV infection. This study seeks to clarify which known HIV risk factors (partner type, sex location, serodiscordance, multiple sex partners, substance use during sex) contribute to engagement in high-risk (unprotected receptive anal) sex in each population. Data collected from June 2005 through June 2008 indicate all three populations display different HIV sexual risk profiles. The data suggest that HIV-prevention interventions should be individually tailored to address the specific needs of these three highly vulnerable and impacted populations.