Risky sexual behavior in low‐income African American women: The impact of sexual health variables

In a sample of 163 low‐income African American women, we used logistic regression analyses to test for associations between (a) 5 operationalized constructs theorized in the Sexual Health Model to impact one's overall sexual health (barriers to healthy sexuality, sexual anatomy and functioning, positive sexuality, sexual health care, and cultural identity) and (b) several measures of risky sexual behavior (consistent condom use, multiple concurrent partnerships, and overall sexual risk). No significant relationship was found between acculturation and risky sexual behaviors. Having sexual difficulties was positively associated with overall sexual risk and multiple concurrent partnerships. Favorable attitudes toward condoms were positively associated with consistent condom use. Desiring or intending pregnancy was positively associated with inconsistent condom use and overall sexual risk behavior. This is only the second study linking sexual difficulties and risky sexual behavior. The exact nature of this correlational relationship needs to be studied and replicated in different and more heterogeneous populations.     

Sexual Violence and the MDGs

ABSTRACT

Sexual violence is multi-faceted. Three (overlapping) categories can be distinguished: violence that is sexual in nature, gender-based violence, and sexuality-based violence. The latter refers to violence against persons because of their sexuality and/or their (presumed) sexual behavior. Being female, young, poor, and living in a sexually conservative culture and/or in conflict areas appear to be important risk factors for sexual violence. Sexual violence is widespread (one in five girls worldwide are sexually abused in childhood and up to three-quarters of women in some countries have been victimized by a partner), but prevalence figures around the globe are hard to compare. Both the individual and society suffer from sexual violence. The eradication of sexual violence is directly relevant to achieving the Millennium Development Goals (MDGs) related to infant and maternal health and mortality, and combating HIV/AIDS. And certainly no less important, it is very closely linked to the MDGs related to gender equality and the empowerment of women, poverty, and primary education for all. Campaigning against sexual violence against women has been presented as one of the ‘quick wins’ in progress towards achieving the MDGs by the UN Millennium Project. Many good practices have been employed in political-legal, awareness raising, prevention, and health care domains, but important setbacks are noteworthy as well. Priority number one for the World Association for Sexual Health now seems to be to adequately and strategically contribute to the continuous efforts to integrate sexual health into the Millennium Development framework.     

Psychosexual Correlates of Sexual Double Standard Endorsement in Adolescent Sexuality

Endorsement and enactment of the (hetero)sexual double standard (SDS), prescribing sexual modesty for girls and sexual prowess for boys, has been shown to be negatively related to sexual and mental health. To be able to challenge the SDS, more insight is needed into the conditions that shape gendered sexual attitudes. A survey was conducted among 465 heterosexual adolescents (aged 16–20 years), examining the relationship between a number of relevant demographic and psychosexual variables and SDS endorsement. SDS endorsement was assessed using a newly developed instrument, the Scale for the Assessment of Sexual Standards Among Youth (SASSY). Gender (being male) and religiousness were significantly associated with increased SDS endorsement. For both boys and girls, increased feelings of entitlement to self-induced sexual pleasure (e.g., masturbation) were significantly associated with reduced SDS endorsement, whereas higher gender investment was significantly associated with increased SDS endorsement. Furthermore, increased feelings of entitlement to partner-induced sexual pleasure and more frequent talking about sexuality with peers were associated with increased SDS endorsement among boys but not among girls. We conclude that future research should explore peer influence processes through peer communication about sex, gender investment, and feelings of entitlement to both self and partner-induced sexual pleasure.     

Relationship functioning and sexuality among people with multiple sclerosis

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three‐hundred eighty‐one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health‐related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients' lives.     

Using Masturbation in Sex Therapy

Abstract

Masturbation may be useful in treating hypoactive sexual desire disorder. To examine this possibility, the current study examined the relationships between masturbation, sexual desire, sexual fantasy, and dyadic sexual activity. The relationships between masturbation and other constructs were also examined: overall sexual dysfunction, relationship satisfaction, life stress, and sexual attitudes. Mediational analyses suggest several causal pathways between masturbatory desire, masturbatory frequency, sexual fantasy, sexual desire, and sexual activity. Developing a model of masturbation may help illustrate its role in sexual functioning and highlight its potential role in sex therapy.     

Adapting a Family-Based HIV Prevention Program for HIV-Infected Preadolescents and Their Families

Summary

This article describes a family-based HIV prevention and mental health promotion program specifically designed to meet the needs of perinatally-infected preadolescents and their families. This project represents one of the first attempts to involve perinatally HIV-infected youth in HIV prevention efforts while simultaneously addressing their mental health and health care needs. The program, entitled CHAMP+ (Collaborative HIV Prevention and Adolescent Mental Health Project-Plus), focuses on: (1) the impact of HIV on the family; (2) loss and stigma associated with HIV disease; (3) HIV knowledge and understanding of health and medication protocols; (4) family communication about puberty, sexuality and HIV; (5) social support and decision making related to disclosure; and (6) parental supervision and monitoring related to sexual possibility situations, sexual risk taking behavior and management of youth health and medication. Findings from a preliminary evaluation of CHAMP+ with six families are presented along with a discussion of challenges related to feasibility and implementation within a primary health care setting for perinatally infected youth.     

Putting the “S” Back into Sexual and Reproductive Health

ABSTRACT

Sexuality is the most fundamental aspect of our lives and yet it has long been the silent partner in sexual and reproductive health (SRH). Growing awareness of the rights-based approach to health, the commitment of governments and international bodies to promote sexual health and well-being, and the failure of many of the interventions to combat the HIV/AIDS epidemic are helping the reproductive health community put the “S” back into SRH even as the Millennium Development Goals fail to address SRH directly. The disconnect is due to the fragmented, non-holistic approach to reproductive health, short-sightedness in neglecting violations like gender-based violence, a lack of training for students and health care professionals in sexuality, a dearth of indicators and sexuality research and discrimination against vulnerable groups like youth and sexually diverse populations. Recommendations include reaching consensus about the nexus between sexuality and reproductive health and strengthening the commitment to gender equity, empowerment, sexuality and sexual rights among policymakers. Ensuring that explicit and positive references to sexuality are universal, especially in comprehensive sexuality education, youth-focused programs and the integration of HIV and other SRH programs, and strengthening the ability of program managers and service providers to work on sexual health issues are key to successful integration and program sustainability. Strengthening understanding, acceptance and competence in serving sexually diverse populations and improving the research and evaluation specific to sexuality are longer processes, but equally important in the paradigm shift to non-stigmatizing, gender-equitable, rights-based, pleasurable sexual health services.     

Sexual Health for the Millennium: An Introduction

ABSTRACT

This special issue of the International Journal of Sexual Health is devoted to the issues of the United Nations Millennium Development Goals and the effort by the World Association for Sexual Health to argue that the promotion of sexual health is an essential strategy for attaining those goals. Recently, the World Association for Sexual Health has published Sexual Health for the Millennium: A Declaration and Technical Document (2008). This special issue of the IJSH contains the background papers which served as a foundation for the development of the declaration and technical document. These articles argue that sexuality is a fundamental aspect of being human, that human development must be premised on the promotion of sexual health and is a basic human right for all citizens. Public policies designed to promote human development must make the promotion of sexual health an essential strategy. This special issue is designed to stimulate more interest in the Sexual Health for the Millennium: A Declaration and Technical Document, encourage further analysis and research which will support the statements in the declaration, provoke more advocacy for sexual health, and, most importantly, to stimulate sound and effective public policies to create a sexually healthier world.     

Gender differences in sexual attitudes and behaviors: a review of meta-analytic results and large datasets

Gender differences in sexual attitudes and behaviors are typically believed to be large, yet recent evidence suggests that some gender differences in sexuality are much smaller than common knowledge would suggest. This article reviews gender differences in sexual attitudes and behaviors as reported by major meta-analyses and large datasets. In particular, this article reviews gender differences in heterosexual intercourse, masturbation, pornography use, attitudes toward premarital sex, and gender differences in same-gender sexuality. Evolutionary psychology, social cognitive learning theory, and social structural theory are explored as possible explanations for gender differences in sexuality.     

Sexual Education,Gender Ideology,and Youth Sexual Empowerment

Sexual education plays an essential role in preventing unplanned pregnancy and the transmission of sexually transmitted infections (STIs). School-based sexual education programs, in particular, may be well positioned to address social factors that are empirically linked to negative sexual health outcomes, such as traditional social norms surrounding gender and sexuality. However, youth are seldom granted access to sexual education programs that explicitly address these issues. This study presents findings from a pretest–posttest survey of a sexual education program that did. It was designed for eighth graders (N=95) in the context of a school–community collaboration. The study assessed the links between several components of sexual empowerment, including gender ideology, sexual knowledge, and contraceptive beliefs. Findings link participation in the sexual education program to more progressive attitudes toward girls and women, less agreement with hegemonic masculinity ideology, and increases in sexual health and resource knowledge. Structural equation models suggest that traditional attitudes toward women were significantly related to hegemonic masculinity ideology among both boys and girls, which was in turn negatively related to safer contraceptive beliefs.     

A longitudinal study of the effects of a university human sexuality course on sexual attitudes

This study tested the hypotheses that students taking a university human sexuality course will have different attitudes over a 2‐year period than students not taking such a course, and more accepting attitudes toward the sexual behaviors of others, over a 2‐year period, than toward their own sexual behavior. Sexual attitudes of 127 human sexuality class students and 114 control class students at the University of Northern Iowa were measured at the beginning of class (pretest), the end of class (posttest), and 2 years after the end of class (follow‐up). There were no pretest differences between the treatment and control groups in university classification, marital status, political affiliation, religious affiliation, sex, age, grade point average, or sexual attitudes. Both hypotheses were supported. Human sexuality students developed more accepting attitudes and became more accepting of behaviors for others compared to behaviors for self. Control group students developed less accepting attitudes and became less accepting of behaviors for others compared to behaviors for self. The sex of the students and the session they attended class were also found to influence sexual attitudes.     

The relation between early abuse and adult sexuality

One thousand and thirty‐two (566 non‐Asian; 466 Asian) undergraduates were assessed in a confidential laboratory setting regarding levels of physical abuse, emotional abuse, sexual abuse, neglect, and a wide range of sexuality variables. The purpose was to examine relationships between specific forms of early abuse and later adult sexuality, and to assess potential gender and ethnic differences in these associations. Independent of other forms of abuse, sexual abuse in females was significantly positively related to sexual drive and experience, range of sexual fantasies, liberal sexual attitudes, frequency of intercourse and masturbation, and likelihood of engaging in unrestricted sexual behaviors and fantasies, and was negatively related to virginity status. Among males, emotional abuse was significantly associated with poor body image and sexual dissatisfaction, independent of the other forms of abuse. There were no significant differences in associations between early abuse and sexuality between persons of Southeast Asian and European ancestry.     

Religiosity, sexual behaviors, and sexual attitudes during emerging adulthood

The current study examined associations between religiosity and sexual behaviors and attitudes during emerging adulthood. Two hundred and five emerging adults completed surveys about five aspects of their religiosity (group affiliation, attendance at religious services, attitudes, perceptions of negative sanctions, and adherence to sanctions) and their sexual behaviors (abstinence, age of onset, lifetime partners, condom use) and attitudes (conservative attitudes, perceived vulnerability to HIV, and condom-related beliefs). Associations were found between the measures of religiosity and sexuality, although the patterns differed by measures used. Religious behavior was the strongest predictor of sexual behavior. Many aspects of religiosity were associated with general sexual attitudes, which was not the case for perceived vulnerability to HIV and condom-related beliefs. The findings support reference group theory and highlight the importance of considering the specific constructs of religiosity and sexuality assessed in studies of these topics.     

A psychoanalytic study of contraception

The purpose of this study was to evaluate three sets of predictors of attitudes toward homosexuality: (a) anti‐black and orthodox religious attitudes, (b) sexual permissiveness, and (c) the effect of an introductory human sexuality course. Significantly more positive attitudes were expected for those holding more positive attitudes toward blacks and those who were more sexually permissive. A negative relationship was expected for those holding orthodox religious attitudes. Furthermore, information from a college course in human sexuality was expected to produce positive attitude change toward homosexuality. A survey instrument consisting of several scales and indexes measuring the aforementioned variables, as well as several indexes of sexual behavior, was administered to 194 students in a human sexuality course and 120 students in an introductory psychology course. Results showed significant regression coefficients for anti‐black attitudes and religious orthodoxy, confirming the predictions. Sexual permissiveness did not significantly add to the prediction of attitudes toward homosexuality, although the Pearson correlation was significant, r = .19 (p < .05). The experimental group showed significantly greater change in attitude toward homosexuality than the control group, F(1, 291) = 23.70, p < .001. A fourth objective was to assess sex differences on a series of sexual behavioral indexes. Results show a number of significant differences suggesting that sexual behavior still reflects a double standard in U.S. society.     

Relationship functioning and sexuality among people with multiple sclerosis

This study was concerned with how the sexuality and relationships of people with Multiple Sclerosis (MS) are different from those of people from the general population. Three-hundred eighty-one respondents (144 males, 237 females) with MS and 291 respondents (101 males, 190 females) from the general population participated in the study. Sexual satisfaction, sexual dysfunction, relationship satisfaction, and coping style were assessed among all respondents. Information was also obtained from people with MS regarding age of onset and diagnosis of symptoms, as well as severity of symptoms. Overall, males with MS experienced a higher frequency of sexual dysfunction than males from the general population, while females with MS only differed from females from the general population in their levels of masturbation and numbness of the genital area. Coping strategies and levels of cognitive functioning were important predictors of sexual satisfaction, sexual dysfunction, and relationship satisfaction for women with MS, but there were fewer coping or health-related factors that predicted these variables among men with MS. The results of this study are discussed in terms of factors related to sexual satisfaction and positive interpersonal relationships. There is a need to conduct further research in this area so that professionals working with people with MS are informed on strategies to improve the sexuality and relationships of their clients lives.     

Religiosity,sexual behaviors,and sexual attitudes during emerging adulthood

The current study examined associations between religiosity and sexual behaviors and attitudes during emerging adulthood. Two hundred and five emerging adults completed surveys about five aspects of their religiosity (group affiliation, attendance at religious services, attitudes, perceptions of negative sanctions, and adherence to sanctions) and their sexual behaviors (abstinence, age of onset, lifetime partners, condom use) and attitudes (conservative attitudes, perceived vulnerability to HIV, and condom‐related beliefs). Associations were found between the measures of religiosity and sexuality, although the patterns differed by measures used. Religious behavior was the strongest predictor of sexual behavior. Many aspects of religiosity were associated with general sexual attitudes, which was not the case for perceived vulnerability to HIV and condom‐related beliefs. The findings support reference group theory and highlight the importance of considering the specific constructs of religiosity and sexuality assessed in studies of these topics.     

Psychometrics of the students´ attitudes towards addressing sexual health scale for students in social work

Previous research regarding social work related to sexual health and sexuality shows the importance of competence in this field for social workers and therefore is a need to explore students´ attitudes, knowledge and view on working with sexual health in their future profession. This project aims to psychometrically test the questionnaire Students’ Attitudes towards Addressing Sexual Health (SA-SH) for students in social work. The results show good content validity, construct validity, internal consistency and intra-rater reliability for the SA-SH for students in social work (response rate of 91%, 242 students).

The SA-SH can therefore be recommended to be used to measure attitudes, believed competence, and knowledge regarding sexual health among social work students, and to follow up educational interventions.