Body Image,Body Satisfaction,and Unsafe Anal Intercourse Among Men Who Have Sex With Men

Using survey results from the 1998 Twin Cities Lesbian, Gay, Bisexual, and Transgender (LGBT) Pride Festival (N = 535), we explored associations between body image and unsafe anal intercourse (UAI) among men who have sex with men (MSM), and evaluated whether body satisfaction mediated this association. MSM who reported underweight body image had lower odds than those who reported average weight of UAI (AOR = 0.33; 95% CI = 0.13, 0.85); body satisfaction was not found to mediate this association. 13.3% of men who reported overweight/obese body image had engaged in UAI compared with 21.6% of those who reported average weight and 8.2% of those who reported underweight (p < .05). Compared with MSM in exclusive relationships, MSM in non exclusive relationships had increased odds of UAI (AOR = 5.78; 95% CI = 2.96, 11.29) as did men who were not partnered (AOR = 3.20; 95% CI = 1.72, 5.93). These findings highlight the importance of including body image in sexual behavior models of MSM to better understand body image's role in influencing sexual risk and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) transmission.     

Brief Report: Sexual Wellbeing in Heterosexual,Mostly Heterosexual,and Bisexually Attracted Men and Women

Abstract

Objective: To assess differences in sexual wellbeing among men and women with exclusively heterosexual, mostly heterosexual, and bisexual attractions. Method: An anonymous online survey in a convenience sample of 597 young adults (394 women, 203 men; average age = 20.04) assessed patterns of sexual attraction, desire, sexual functioning, and sexual satisfaction using validated questionnaires. Results: Individuals with mostly heterosexual attractions reported significantly higher solitary sexual desire than exclusively heterosexual individuals (women: d?=?0.64; men: d?=?0.68). Partnered sexual desire did not differ between groups. Women with exclusively heterosexual attractions reported significantly higher sexual functioning and satisfaction than either mostly heterosexual or bisexually attracted women (functioning: d?=?0.29; satisfaction: d?=?0.47). Men with mostly heterosexual attractions reported significantly lower sexual functioning than either exclusively heterosexual or bisexually attracted men (d?=?0.40). Conclusions: There were significant differences between exclusively vs. mostly heterosexual individuals in several aspects of sexual wellbeing, supporting the assertion that mostly heterosexual may constitute a distinct orientation. Taken together with prior research showing higher rates of sexual dysfunction in bisexual women, these findings highlight sexual health disparities among nonmonosexual women. Efforts to support the sexual wellbeing of sexual minority individuals should include consideration of mostly heterosexual individuals, as this population may have unique sexual health needs.     

Heterosexual Anal Sex Among Men and Women in Substance Abuse Treatment: Secondary Analysis of Two Gender-Specific HIV-Prevention Trials

Receptive anal sex has high human immunodeficiency virus (HIV) transmission risk, and heterosexual substance-abusing individuals report higher anal sex rates compared to their counterparts in the general population. This secondary analysis evaluated the effectiveness of two gender-specific, evidence-based HIV-prevention interventions (Real Men Are Safe, or REMAS, for men; Safer Sex Skill Building, or SSSB, for women) against an HIV education (HIV-Ed) control condition on decreasing unprotected heterosexual anal sex (HAS) among substance abuse treatment-seeking men (n = 171) and women (n = 105). Two variables, engagement in any HAS and engagement in unprotected HAS, were assessed at baseline and three months postintervention. Compared to the control group, women in the gender-specific intervention did not differ on rates of any HAS at follow-up but significantly decreased their rates of unprotected HAS. Men in both the gender-specific and the control interventions reported less HAS and unprotected HAS at three-month follow-up compared to baseline, with no treatment condition effect. The mechanism of action for SSSB compared to REMAS in decreasing unprotected HAS is unclear. More attention to HAS in HIV-prevention interventions for heterosexual men and women in substance abuse treatment is warranted.     

Heterosexual Masculinities,Anti‐homophobias,and Shifts in Hegemonic Masculinity: The Identity Practices of Black and White Heterosexual Men

In this study, I use in‐depth interview data with black and white heterosexual men to explore shifts in the role of homophobia in the social construction of heterosexual masculinities. A continuum is introduced to map a range of interactional practices through which these men enact heterosexual masculinities. Heterosexual men who, on one end of the continuum, construct their heterosexual masculinities through homophobic practices establish strong boundaries of social distance from gays. The other end documents heterosexual men's anti‐homophobias, moving from men who establish weak boundaries to those who blur them. These heterosexual men's anti‐homophobic stances trade on the prestige of being tolerant of gays, with black men's anti‐homophobias drawing on their experiences with racism.     

Homelessness Among Out-of-Treatment Drug Users in Long Beach,CA*

Abstract

Two studies were conducted to determine the reliability of measures of homelessness (Study 1), and to use these measures to predict homelessness from data collected over a 1O-year period (Study 2). For Study 1, to determine test-retest reliability, the Risk Behavior Assessment (REA; National Institute on Drug Abuse, 1991) was administered twice within a 48-hour period. Cohen’s kappa was calculated at .86 for the two REA measures of homelessness. For Study 2, to predict homelessness from data collected over a 10-year period, a logistic regression model was built. Earlier homelessness and illegal income were identified as risk factors; number of times tested for HIV and Black ethnicity were identified as protective against homelessness. Predictive accuracy was assessed with a reduced bias method approximating jackknifing techniques. These findings point to the need to provide enhanced services-including HIV testing opportunities andjob training- to the homeless.     

Conceptualizations of Heterosexual Anal Sex and HIV Risk in Five East African Communities

Heterosexual anal sex is underresearched and little understood, particularly in the African context. Existing prevalence data indicate that heterosexual anal sex is a widespread practice, yet little is known about the way in which it is conceptualized and understood. Describing findings from qualitative research conducted in Kenya, Tanzania, and Uganda, we shed light on conceptualizations of heterosexual anal sex and its relation to human immunodeficiency virus (HIV). These findings suggest that penile-anal sex is practiced by men and women in Africa for a range of reasons, including virginity maintenance, contraception, fulfillment of male pleasure, relationship security, menstruation, in the presence of vaginal complications, financial gain, fidelity, and prestige. Despite anal sex being the most efficient way to transmit HIV sexually, there is widespread lack of knowledge about its risks. These findings describe the ways in which anal sex is conceptualized in five East African communities, highlighting how penile-anal intercourse is often not considered “sex” and how the omission of anal sex in safe-sex messaging is interpreted as meaning that anal sex is safe. In light of its frequency and risks, greater attention must be paid to heterosexual anal sex in Africa to ensure a comprehensive approach to HIV prevention.     

Social,Relational and Network Determinants of Unprotected Anal Sex and HIV Testing Among Men Who Have Sex with Men in Beirut,Lebanon

Objectives: We examined the social, relational and network determinants of condom use and HIV testing among men who have sex with men (MSM) in Beirut. Methods: Two-hundred thirteen men were recruited via respondent driven sampling and administered a survey. Results: Sixty-four percent reported unprotected anal intercourse (UAI), including 23% who had UAI with unknown HIV status partners (UAIU); 62% of participants had tested for HIV. In multivariate analysis, being in a relationship was associated with UAI and HIV testing; lower condom self-efficacy was associated with UAIU and HIV testing; gay discrimination was associated with UAIU; MSM disclosure was associated with UAI, UAIU and HIV testing; and network centralization was associated with HIV testing. Conclusions: Multi-level social factors influence sexual health in MSM.     

Anal Cancer Screening: Barriers and Facilitators Among Ethnically Diverse Gay,Bisexual, Transgender,and Other Men Who Have Sex With Men

ABSTRACT

Knowledge and beliefs about anal cancer screening among gay and other men who have sex with men remains unclear, despite data that suggests significant risk for intra-anal HPV-related cancers. Nevertheless, community-based screening activities may be most effective when stakeholder perspectives are addressed. We conducted four focus groups among 16 male and 3 female health care advocates experienced in working with diverse gay and other men who have sex with men in Los Angeles. Barriers to anal cancer screening included lack of awareness, stigma, psychological and physical discomfort, the anus as hidden/private, primary concern with HIV, and men's lack of healthcare seeking. Facilitators were community screening sites, novel strategies such as home testing, health care system changes and targeted educational campaigns, which may increase anal cancer awareness and screening among ethnically diverse men who have sex with men.     

Anal Cancer Screening: Barriers and Facilitators Among Ethnically Diverse Gay, Bisexual, Transgender, and Other Men Who Have Sex With Men

Knowledge and beliefs about anal cancer screening among gay and other men who have sex with men remains unclear, despite data that suggests significant risk for intra-anal HPV-related cancers. Nevertheless, community-based screening activities may be most effective when stake-holder perspectives are addressed. We conducted four focus groups among 16 male and 3 female health care advocates experienced in working with diverse gay and other men who have sex with men in Los Angeles. Barriers to anal cancer screening included lack of awareness, stigma, psychological and physical discomfort, the anus as hidden/private, primary concern with HIV, and men's lack of healthcare seeking. Facilitators were community screening sites, novel strategies such as home testing, health care system changes and targeted educational campaigns, which may increase anal cancer awareness and screening among ethnically diverse men who have sex with men.     

Comparison of Daily and Retrospective Reports of Vaginal Sex in Heterosexual Men and Women

This study examined the agreement between daily and retrospective reports of vaginal sex over a two-month period in a sample of 376 heterosexually active men and women. We also examined whether gender, age, or method of daily data collection (self-administered vs. interviewer administered) were related to agreement between daily and retrospective reports. Both counts and categorical measures of frequency of the behaviors were examined. There were no gender, age, or data collection method effects. When measured as a count, participants reported more instances of vaginal intercourse in the retrospective reports than on the daily reports. In contrast, comparison of retrospective categorical measures of frequency to daily reports showed considerable variability. Possible reasons for the over-reporting of counts of vaginal sex in retrospective reports are explored.     

Generation,Displacement, and Deservedness among Karen Refugees in California

In this article, we draw on ethnographic interviews with sixteen Karen refugees living in San Diego, California to explore how experiences of exile, displacement, and resettlement differ along generational lines and complicate straightforward dichotomies between “involuntary refugees” and “economic migrants”. While older‐generation Karen experienced political violence and displacement first‐hand, younger‐generation Karen were born in refugee camps in Thailand and usually experienced violence and displacement through its impacts on extended families. Across both generations, Karen exerted agency in exile, displacement, and diaspora. The older generation used stays in refugee camps strategically as a means of economically supporting family members in Burma, while the younger generation view resettlement in the US as a way of achieving educational aspirations. This research points to the importance of generation as a dimension of refugee experience and to the problem of reinforcing victimhood within refugee communities rather than acknowledging refugee agency and resilience.     

Differences in Visual Attention Patterns to Sexually Mature and Immature Stimuli Between Heterosexual Sexual Offenders,Nonsexual Offenders,and Nonoffending Men

Men, whether gynephilic or androphilic, show both early and late attention toward adults and not toward children. We examined early and late visual attention to sexually mature versus immature stimuli in four groups of heterosexual men: sexual offenders against children (SOAC = 18), sexual offenders against adults (SOAA = 16), nonsexual offenders (NSO = 18), and nonoffending men (NOM = 19). We simultaneously presented adult and child stimuli and measured time to first fixation, number of first fixations, total duration of fixation, and fixation count to four areas of interest: entire body, then face, chest, and pelvis. We found a significant interaction where only SOAC tended to fixate more first times to child than to adult stimuli. Conversely, we found longer total duration of fixations for the bodies of adults compared to the bodies of children in all groups; however, in both the total duration of fixations and the fixation count for the whole body, but especially in the chest, SOAC tended to fixate longer and more often on child stimuli than the other two groups of offenders, but not longer or more often than NOM. This study adds to the limited research using eye-tracking techniques in samples of SOAC.     

Psychological Flexibility and Self-Compassion in Gay and Heterosexual Men: How They Relate to Childhood Memories,Shame, and Depressive Symptoms

This study explores differences between men who are gay (n = 53) and men who are heterosexual (n = 52) regarding memories of shame events and of warmth and safeness experiences with parents during childhood and adolescence, self-compassion, psychological flexibility, internal shame, and depression. Also, it aims to explore whether psychological flexibility and self-compassion play a role in the association between these memories and internal shame and depressive symptoms. Results confirmed the mediating role of psychological flexibility and self-compassion. These findings suggest the appropriateness of promoting acceptance and self-compassion towards difficult memories in a therapeutic setting with men who are gay experiencing shame and depressive symptoms.     

Distressing Sexual Difficulties in Heterosexual and Non-Heterosexual Croatian Men: Assessing the Role of Minority Stress

Although research has shown a connection between minority stressors and internalizing mental health problems, the role of minority stress has mainly been neglected in the assessment of sexual problems among non-heterosexual men. Using online samples of heterosexual (n = 933) and non-heterosexual participants (n = 561) aged 18 to 50 years, this study aimed to comparatively assess sexual difficulties and problems and explore the role of minority stress in non-heterosexual men's sexual problems. Although the age-adjusted odds of reporting rapid ejaculation, delayed ejaculation, and sex-related anxiousness significantly differed between the two groups, the overall prevalence of sexual difficulties and the associated levels of distress did not significantly differ between the samples. In multivariate assessment, anxiety and depression significantly increased the odds of reporting distressing sexual difficulties among both heterosexual and non-heterosexual participants. In the non-heterosexual sample, positive body image significantly decreased the odds of experiencing sexual problems. Pointing to a role of minority stress, highest levels of victimization related to sexual orientation increased the risk of sexual problems. This association was partially mediated by negative emotions. Our findings offer some support for a recent call to include sexual orientation among the social determinants of health recognized by the World Health Organization.     

Longitudinal Consistency in Self-Reported Age of First Vaginal Intercourse among Young Adults

We examined consistency in self-reports of age at first vaginal sex among 9,399 male and female respondents who participated in Waves III and IV (separated by approximately seven years) of the National Longitudinal Study of Adolescent Health (Add Health). Respondents were coded as consistent if they reported an age at first vaginal intercourse at Wave IV that was within one year of the age they reported at Wave III. Sociodemographic, behavioral, and cognitive predictors of consistency were examined using bivariate and multivariate logistic regression. Overall, 85.43% of respondents were able to provide consistent reports. Among both males and females, consistency was associated with age, years since first vaginal intercourse, race/ethnicity, and lifetime number of other-sex partners in final multivariate models. Respondents who were older and had more recently had their first sexual experience were more likely to be consistent. For females only, those who reported a history of nonparental, physically forced sex were less likely to be consistent. Most young adults consistently report age at first vaginal intercourse, supporting the credibility of retrospective self-reports about salient sexual events such as timing of first vaginal intercourse.     

Momentary Desire for Sexual Intercourse and Momentary Emotional Intimacy Associated With Perceived Relationship Quality and Physical Intimacy in Heterosexual Emerging Adult Couples

Sexual desire and emotional intimacy are central to relationships, yet little is known about how these feelings vary within and between partners or relate to dyad functioning. We explored magnitude and stability of momentary sexual desire and emotional intimacy in relation to quality and functioning of heterosexual relationships. After reporting perceived relationship quality and physical intimacy enjoyment, members of 18 emerging adult heterosexual couples reported momentary partner-specific sexual desire and emotional intimacy several times a day for two weeks (2,224 reports). Mean and mean squared successive difference (MSSD) characterized magnitude and stability, respectively, of the momentary states. Regression models of relationship outcomes examined influence of the male versus female partner having greater or more stable desire and intimacy. Sexual desire and emotional intimacy magnitude and stability were associated with relationship quality and physical intimacy enjoyment differently for men versus women. Gender-specific differences between partners also predicted relationship outcomes. Men particularly perceived higher relationship quality and enjoyed physical intimacy more when they had higher and more stable sexual desire and their female partners had more stable emotional intimacy. Partner differences in momentary sexual desire and emotional intimacy may contribute to understanding quality and functioning of heterosexual relationships.     

Physical Abuse in Early Childhood and Transition to First Sexual Intercourse among Youth in Cape Town,South Africa

This study examined the relationship of physical abuse in early childhood and timing of first sexual intercourse among young South Africans aged 14 to 22 in Cape Town. Using the Cape Area Panel Survey and applying log-normal models, time ratios were estimated to show how rapidly or slowly youth experience first sexual intercourse. Results indicated that boys who experienced physical abuse in early childhood had faster timing to first sex. Boys and girls with violent school environments had faster timing to first sex. Race moderated the effects of physical abuse. Compared to Blacks, Coloreds who experienced higher levels of physical abuse in early childhood had faster timing to first sex. Youth with greater knowledge about HIV/AIDS and those with greater risk perception of contracting HIV/AIDS delayed first sex. On the basis of these findings, policy makers are encouraged to consider the early childhood experiences of youth when designing policies toward HIV/AIDS prevention in South Africa.     

Doing Fake Masculinity,Being Real Men: Present and Future Constructions of Self among Black College Men

Through a qualitative analysis of twenty‐nine black college men at a large research university, this project explores how black masculinity is physically, behaviorally, and materially constructed from idealized images resulting in a contextually adaptive sense of self. The findings suggest that black masculinity, specifically the thug image, is symbolically affirmed or denied through a particular type of raced, gendered, classed, and sexualized discourse within black public social spaces. Moreover, these data show that maintaining this construction of black masculinity promotes bodily self‐doubt or insecurity and inauthentic intra‐ and interracial interactions. In contrast, black manhood is thought to involve more genuine interactions, regardless of the social location. Unlike doing masculinity, the idealized notion of being men allows young black men to project a future construction of self that seemingly resolves their feelings of inauthenticity or bodily insecurity.     

Demographic and Psychological Factors Related to Sexual Desire among Heterosexual Women in a Relationship

This study examined demographic, psychological, and relationship factors that are associated with the experience of sexual desire in women. The contribution of other aspects of sexual function on sexual desire was also investigated. The participants were 741 partnered heterosexual women (mean age = 45.7 years), who completed the Female Sexual Desire Questionnaire online, which evaluated their levels of sexual desire, as well as a range of individual and dyadic variables. For each of the six aspects of sexual desire assessed, the number and frequency of problems in other aspects of women's sexual functioning were the most common predictors. The results demonstrated that sexual desire was lower among older, postmenopausal women and those who had been in their current relationship for a longer period of time. Women who reported that their partner experienced a sexual dysfunction also obtained lower sexual desire scores. These findings demonstrate the strong interrelationship between the different phases of the sexual response cycle for women. Further, they suggest that sexual dysfunction in one partner is likely to be associated with sexual dysfunction in the other partner. The clinical implications of these findings in terms of the treatment for sexual dysfunction among women (and their partners) are discussed.