Determinants of Vaginal Cleansing,Application, and Insertion in Tete Province,Mozambique, and Products Used

Objective: In this article, we review insertion, application, and cleansing as they include the use of products other than water and have a number of harmful effects. Method: In 2007, a household survey of 919 women carried out in Tete Province, Mozambique, examined 8 vaginal practices. Results: Overall, 10% of the sexually active women reported regularly using these 3 vaginal practices concurrently. Of the women who practiced insertion, 65% used natural substances. A wider variety of products was used for applying substances on the external genitalia and for cleansing purposes. Conclusions: These findings have important implications for future HIV prevention, including in the use of microbicides.     

Sexual practices at last heterosexual encounter and occurrence of orgasm in a national survey

In order to examine factors associated with orgasm in heterosexual encounters, we analyzed data from the Australian Study of Health and Relationships, a national telephone survey of sexual behavior and attitudes and sexual health knowledge carried out in 2001-2002 with a representative sample of 19,307 Australians aged 16 to 59. Respondents were asked whether at their last sexual encounter they gave or received manual stimulation and oral sex, had vaginal intercourse or anal intercourse, and whether they had an orgasm. Vaginal intercourse was the dominant practice: 95% of encounters included it. Of the 64 possible combinations of these practices, 13 account for 93% of encounters: vaginal intercourse alone (12%), vaginal + manual stimulation of the man's and/or woman's genitals (49%), and vaginal intercourse + manual + oral (32%). Encounters may also have included other practices. Men had an orgasm in 95% of encounters and women in 69%. Generally, the more practices engaged in, the higher a woman's chance of having an orgasm. Women were more likely to reach orgasm in encounters including cunnilingus. This is the first large-scale empirical study worldwide to link specific practices with orgasm. Demographic and sexual history variables were comparatively weakly associated with orgasm.     

Wanting to Be Seen: Young People’s Experiences of Performative Making Out

People engage in sexual behavior for many reasons, some of which require an audience (e.g., arousing onlookers, making someone jealous). In this study, we investigated the prevalence, motivations, and outcomes of young people’s experiences with performative making out—making out with someone and wanting others to see. Of the 155 female and 194 male college students who completed the online questionnaire, 32% of the women and 37% of the men reported having done this, often before entering college. Significantly more women than men reported same-sex performative experiences. We used thematic analysis to identify themes in the qualitative data. Participants’ motivations included enhancing their image, causing jealousy or envy, demonstrating a relationship, sexually arousing men, and participating in fun and games. Men reported that their reputations were enhanced more often than damaged; women reported the opposite pattern. These results provide insights into the functions of sexual behavior as a means of communication and highlight gender differences consistent with problematic cultural belief systems such as “slut shaming,” victim blaming, and sexual double standards.     

Perceptions of Men on Puxa-Puxa,or Labia Minora Elongation,in Tete,Mozambique

Labia minora elongation has been documented as being practiced by 98.6% of the women in Tete province, Mozambique. Women engage in this procedure before the first menstruation. In this article we report on the findings from the male respondents from Tete province that participated in the qualitative component of the World Health Organization–supported multicountry Gender, Sexuality, and Vaginal Practices study. The men reported that the main motivation behind labia minora elongation is to enhance the sexual pleasure for both female and male partners. Researching what men know and perceive of labia minora elongation is crucial to understanding the contribution of this practice for sexual health. This knowledge is helpful to inform the development of new human immunodeficiency virus (HIV)/sexually transmitted infection (STI) prevention technologies and culturally appropriate information, education, and communication interventions.     

Vaginal douching among university women in the southeastern United States

OBJECTIVE: The authors assessed the knowledge, beliefs about, and practices of vaginal douching among women attending 2 universities in the southeastern United States. PARTICIPANTS: There were 416 participants in this study; 46.9% were black and 44.5% were white. METHODS: The authors administered a 30-item questionnaire to women enrolled in health-related and social science courses at 2 southeastern universities. RESULTS: Approximately 38% of participants reported vaginal douching, mostly for hygienic reasons (70.7%). Most women first learned about douching from their mother. Douching was more common and more frequent among black women (48%) than among white women (27%). Age of first douche correlated positively with age of first sexual intercourse and age of first period. CONCLUSION: Women who had been informed not to douche by a healthcare professional were less likely to have douched within the past 6 months than were women who were not given this information. Misconceptions about douching are common and should be addressed by healthcare professionals.     

Vaginal reconstruction in gynecologic cancer: A feminist perspective

Vaginal reconstruction is a frequent accompaniment of or sequel to radical surgery for recurrent gynecologic cancers. After reviewing research on vaginal reconstruction, undertaken from a perspective which gives prominence to women's power over decisions concerning the use of their bodies and over the definition of their sexuality, we note that the psychosocial and sexual impact of such surgery for the patient and her partner has often been underestimated, ignored, or misunderstood. We discuss the need for vaginal reconstruction and the definition of its success in terms of researchers' Stereotypic attitudes and assumptions about female sexuality as these are exemplified in their research methodologies. This analysis raises serious concerns about what constitutes informed consent for reconstructive surgery, the medical professionals' biases about female sexuality concerning power over their own bodies, and how best to meet the sexual rehabilitation needs of women with gynecologic cancer.     

Vaginal Douching Among University Women in the Southeastern United States

Objective: The authors assessed the knowledge, beliefs about, and practices of vaginal douching among women attending 2 universities in the southeastern United States. Participants: There were 416 participants in this study; 46.9% were black and 44.5% were white. Methods: The authors administered a 30-item questionnaire to women enrolled in health-related and social science courses at 2 southeastern universities. Results: Approximately 38% of participants reported vaginal douching, mostly for hygienic reasons (70.7%). Most women first learned about douching from their mother. Douching was more common and more frequent among black women (48%) than among white women (27%). Age of first douche correlated positively with age of first sexual intercourse and age of first period. Conclusion: Women who had been informed not to douche by a healthcare professional were less likely to have douched within the past 6 months than were women who were not given this information. Misconceptions about douching are common and should be addressed by healthcare professionals.     

Achieving the Optimal Vaginal State: Using Vaginal Products and Study Gels in Uganda,Zimbabwe, and South Africa

Preferences and practices related to the vaginal condition have implications for the use of vaginal HIV prevention products. The authors used qualitative methods to explore narratives relating to the vaginal state amongst women in South Africa, Uganda, and Zimbabwe who had previously participated in a biomedical HIV prevention trial. They investigated women's behaviors related to optimizing the vaginal state, experiences and perceptions of the gel's effect on the vaginal state and on penile-vaginal intercourse, women's narratives on male partner perceptions, and how preferences relating to the vaginal state may have interfered with gel use.     

Sexual Practices and the Duration of Last Heterosexual Encounter: Findings from the Australian Longitudinal Study of Health and Relationships

This study investigated the association between sexual practices and duration of a sexual encounter. Using data from a population-based computer-assisted telephone survey of 8,656 Australians aged 16 to 64 years, four distinct patterns of sexual practices among respondents were found: “basic sexual encounter” (involving mainly kissing, cuddling, stroking one's partner and being stroked, and vaginal intercourse), “basic sexual encounter plus oral sex,” “all assessed sexual practices” (all sexual behaviors included in the survey), and “mainly vaginal intercourse” (characterized by lower levels of kissing, cuddling, and stroking). For both men and women, respondents classified in the basic sexual encounter plus oral sex, and all assessed sexual practices clusters reported significantly longer durations than those in the basic sexual encounter group, whereas respondents in the mainly vaginal intercourse cluster reported shorter durations. These differences were found even after allowing for demographic differences in sexual duration—specifically, age and partner type of the most recent opposite-sex partner. These findings add to the understanding of what typically happens in a sexual encounter. Overall, longer sexual encounters appear to be associated with the inclusion of the least common sexual practices—namely, oral sex and self-stimulation.     

A Qualitative Assessment of South African Adolescents' Motivations For and Against Substance Use and Sexual Behavior

Focus groups (N=15 groups; 8 with girls, 7 with boys) with adolescents in high schools near Cape Town, South Africa, were used to conduct a qualitative investigation of reported reasons for using and not using substances and for having and not having sex. Adolescents reported Enhancement, Negative States, Social, and Aversive Social motivations for both substance use and sexual behavior. In addition, being addicted as a reason for using drugs and rape as a context for sexual behavior were frequently reported. Motivations against behaviors included Physical/Behavioral Consequences, Ethical Objections, Social Disapproval, and Incompatible Activities and Goals reasons. Preventive interventions should address existing motivations for and against substance use and sexual behavior to acknowledge adolescents' experiences in context.     

Sexual behavior of clients with street prostitutes in Camden,NJ

This paper describes the sexual behaviors of 101 male clients with female street prostitutes. An earlier study (Freund, Leonard, & Lee, 1989) was limited to sexual behaviors of street prostitutes themselves. Interviews were given by 62% of the clients approached. The clients were mature men (mean = 39.8 years), long‐term residents of Camden, NJ (mean = 19.2 years), and currently or previously married (78/101). Racial composition was similar to the general population of the area, 65% white, 33% black, 2% Asian. Clients reported a mean of 5.3 years of using prostitution, with 81% having been clients of Camden prostitutes for more than a year. Most were regular (or repeat) clients; 93% monthly or more frequently, and 63% weekly or more frequently. About one‐half (55%) reported sex with the same prostitute or same small group of prostitutes. The primary meeting place was the street (78/101) and 43% of the sexual encounters took place in the clients' cars. Ejaculation into the vagina was most frequently reported (43/101), followed by ejaculation into the mouth (39/101) Reports of condom use were substantial; 72% for vaginal and 33% for oral intercourse (mean = 58% of encounters).     

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.     

Sexual practices and the duration of last heterosexual encounter: findings from the Australian longitudinal study of health and relationships

This study investigated the association between sexual practices and duration of a sexual encounter. Using data from a population-based computer-assisted telephone survey of 8,656 Australians aged 16 to 64 years, four distinct patterns of sexual practices among respondents were found: "basic sexual encounter" (involving mainly kissing, cuddling, stroking one's partner and being stroked, and vaginal intercourse), "basic sexual encounter plus oral sex," "all assessed sexual practices" (all sexual behaviors included in the survey), and "mainly vaginal intercourse" (characterized by lower levels of kissing, cuddling, and stroking). For both men and women, respondents classified in the basic sexual encounter plus oral sex, and all assessed sexual practices clusters reported significantly longer durations than those in the basic sexual encounter group, whereas respondents in the mainly vaginal intercourse cluster reported shorter durations. These differences were found even after allowing for demographic differences in sexual duration-specifically, age and partner type of the most recent opposite-sex partner. These findings add to the understanding of what typically happens in a sexual encounter. Overall, longer sexual encounters appear to be associated with the inclusion of the least common sexual practices-namely, oral sex and self-stimulation.     

Spousal motivations of care for demented older adults: A cross-cultural comparison of Greek and American female caregivers

Purpose of the study: This study examines motivations for caregiving in American and Greek female spousal caregivers (FSCGs), and identifies cross-culturally equivalent and culturally specific types of motivations for care of a demented spouse. Design and Methods: Thirty American women and 44 Greek women who were caring for their demented husbands were surveyed about their motivations for caregiving. Results: Greek and American FSCGs were dissimilar in the extent to which they reported being motivated by a desire to maintain family harmony. Greek and American caregivers also differed in how often they cited financial reasons, wanting to please their spouse, being against institutionalization, and giving the best care as motivations for care. Implications: Culturally related differences in caregiving motivations may translate into differences in the extent to which motivations result in adaptive or maladaptive outcome for the caregiver and the care recipient.     

Prevalence of and Factors Associated with Oral Sex Among Rural and Urban Malawian Men

ABSTRACT

Objectives: Despite medical evidence that female-to-male oral sex (fellatio) carries a lower risk for HIV transmission than unprotected vaginal intercourse, little research exists on the practice of fellatio in Africa. The objective of this study was to document the prevalence of oral sex in Malawi, and to provide the first evidence on factors associated with the practice in sub-Saharan Africa. Methods: We used two samples of men from Malawi—one rural and one urban—to examine the prevalence of oral sex, as well as factors that were associated with the knowledge and practice of oral sex. Results: While 97% of the rural sample and 87% of the urban sample reported having had vaginal sex, just 2% and 12%, respectively, said they had ever received oral sex. Only half of the rural sample, and less than three quarters of the urban sample, reported having heard of oral sex. Education, exposure to newspapers and television, and condom use significantly predicted oral sex knowledge after controlling for other confounding factors, while exposure to radio did not. Conclusions: The large gap between sexual activity and oral sex prevalence suggests that fellatio should be taken into consideration as a potential component of an HIV prevention strategy, but further quantitative and qualitative research that includes women as well as men is needed to understand potential benefits and drawbacks.     

Student Nurse Education in a University Health Center

Abstract

Objective: This study assessed the association between ethnicity and family socioeconomic status (SES) as it relates to the prevalence of vaginal douching among female undergraduates in a university community. Participants and Methods: This was a cross-sectional survey conducted between September 2011 and February 2012 among 1,535 female undergraduates using a semistructured behavioral questionnaire adapted by the authors from previous research related to vaginal douching practice. Results: The overall prevalence of vaginal douching was 79.35% and the practice was significantly associated with the mother's age, ethnicity, low SES (educational level, occupation, and monthly income), and area of residence. The father's age and SES were statistically nonsignificant. Conclusion: Ethnicity and low SES of mothers were significantly associated with a higher prevalence of douching in daughters. These factors should be considered among others in any intervention to discourage vaginal douching among college women.     

Factors associated with the motivation to use psychoactive substances and the motivation to change in adolescents in an authoritarian context

The use of psychoactive substances (alcohol and drugs) by young people placed in rehabilitation centers in Quebec is well documented, but their motivation to use and to change substance use behavior remains unknown. There has been very little research on the details of the change process in adolescents, and even less in adolescents under supervision in rehabilitation centers.The present study aimed to identify the factors that youth associate with their motivation to use psychoactive substances and the factors that they associate with their motivation to change. Twenty-seven young males (age 14–18 years) were interviewed in the Centre jeunesse de Montreal. The majority of the participants were able to identify motivations to use and to change their substance use behavior. The motivations to use differed depending on the type of substance and the surrounding context in which drug use occurs. The motivations to change were associated with substance-related problems and with the perceived effect of external factors (e.g. constraints) on substance use. Finally, neither the motivations to use nor the motivations to change were strongly associated with the closely supervised setting in which the youth found themselves. Thus the controlled environment of the Centre jeunesse appears to have facilitated the change process for some participants and had no impact on others. The implications of these results for substance-abuse interventions involving troubled youth are discussed.     

Drinking Patterns,Problems, and Motivations Among Collegiate Bisexual Women

Objective and Participants: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). Methods: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. Results: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. Conclusions: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.     

Effects of Genital Response Measurement Device and Stimulus Characteristics on Sexual Concordance in Women

Investigations of sexual concordance suggest that, on average, women exhibit a low, positive correlation between their subjective sexual arousal and genital response. However, this relationship appears to be stronger, on average, when genital response is measured via the external tissues of the vulva than within the vagina walls. Given the methodological variations, such as stimulus content and duration, in studies of vulvar and vaginal concordance, direct comparisons between individual studies are limited. In the current study, sexual concordance was examined using concurrent measures of vulvar blood flow (using laser Doppler imaging) and vaginal vasocongestion (using vaginal photoplethysmography) to investigate potential differences in vulvar and vaginal concordance. Twenty-five women viewed two erotic films that differed in sexual activity content (foreplay and intercourse) while their subjective sexual arousal and genital response was measured. In support of previous meta-analytic findings, results suggest that subjective sexual arousal is more strongly correlated with vulvar blood flow than with vaginal vasocongestion. Likewise, perceived genital response and actual vulvar blood flow are more strongly related than are vaginal vasocongestion and self-reported genital sensations. Practical implications for the study of women’s sexual concordance as well as broader implications for the understanding of female sexuality are considered.     

Drinking patterns, problems, and motivations among collegiate bisexual women

OBJECTIVE AND PARTICIPANTS: The authors compared the drinking behaviors, motivations, and problems of collegiate bisexual women with those of heterosexual women (N = 2,788; n = 86 bisexual women). METHODS: Data came from the 2003 Student Life Survey, a random population-based survey at a large midwestern university. The authors explored the hypothesis that bisexual women would be more likely than heterosexual women to report drinking motivations related to stress and coping as a result of sexual identity stigma. RESULTS: They found that bisexual women drank significantly less than did heterosexual women. There were few differences between the 2 groups in drinking motivations and problems. Bisexual women reported a comparable number of problems related to their drinking but were significantly more likely to report contemplating suicide after drinking than were heterosexual women. CONCLUSIONS: More research is needed to understand the finding that despite lower levels of alcohol consumption, bisexual women reported a comparable number of drinking problems. College health educators and health care providers need to be aware of findings related to heightened suicidal risk among bisexual women.