Correlates of Increased Sexual Satisfaction

Comparisons of nationally representative survey data of the population ages 18–54 years in 1971 (N = 2252) and 1992 (N = 1718) from Finland show that sexual satisfaction has greatly increased particularly among women. Some predictors of sexual satisfaction of men and women are examined on the basis of the 1992 survey data on people ages 18–74 years (N = 2250). Correlations between social background factors, sexual ideas and assertiveness, optional relationships, sexual practices, orgasm, and satisfaction with sexual intercourse were calculated. To control the simultaneous effect of the variables explaining satisfaction, path analyses were conducted. Results show that young age, a sexually unreserved and a nonreligious childhood home, early start of sexual life, high education, sexual assertiveness, considering sexuality important in life, reciprocal feeling of love, use of sex materials, frequent intercourse, many-sided (versatile) sexual techniques, and frequent orgasm correlate with finding sexual intercourse pleasurable. There were some gender differences in the connections between the independent factors and satisfaction with coitus. The importance of sexuality in life, love, and the use of sexual materials were connected directly to physical sexual satisfaction among men but only indirectly among women. For women, but not for men, young age and early start of sexual life correlated with enjoyment of intercourse. The greater sexual dissatisfaction of women compared to men, which still prevails, may be due to their late start of sexual life, conservative sexual attitudes, unimportance of sexuality in life, lack of sexual assertiveness, and use of restricted sexual techniques. The emancipation of women may change these ideas and practices of women. This might lessen the gender gap in physical sexual satisfaction.     

Efficacy results and quality-of-life measures in men receiving sildenafil citrate for the treatment of erectile dysfunction

The aim of the present study was to evaluate the efficacy of sildenafil citrate and its effects on quality of life (QoL) in men with erectile dysfunction (ED) using data from three multicenter, double-blind, placebo-controlled clinical trials. Efficacy was evaluated using a global efficacy question (improvement of erections) and questions from the International Index of Erectile Function (IIEF) addressing the ability to achieve and maintain erections. QoL directly related to ED was evaluated using questions 13 and 14 of the IIEF, several psychometric instruments, and a questionnaire addressing men's concerns about their erection problems. Ninety-seven percent of patients receiving sildenafil reported improved erections compared with 23% of patients receiving placebo (p < 0.0001); also reported were improvements in the ability to achieve and maintain erections with sildenafil but not with placebo (p < 0.0001). Improvements were also seen for other aspects of sexual function (overall satisfaction with sex life, sexual relationships with partners, concerns about erectile problems; p < 0.0001) and general mental health (well-being, self-control, satisfaction with relationship, health relative to 1 year ago, mental health; p ≤ 0.05) following treatment with sildenafil. Thus, treatment of ED with sildenafil can significantly improve key QoL parameters related to sexual dysfunction and general mental health. This revised version was published online in June 2006 with corrections to the Cover Date.     

Circumcision in Australia: further evidence on its effects on sexual health and wellbeing

Objective: To report on the prevalence and demographic variation in circumcision in Australia and examine sexual health outcomes in comparison with earlier research. Methods: A representative household sample of 4,290 Australian men aged 16–64 years completed a computer‐assisted telephone interview including questions on circumcision status, demographic variables, reported lifetime experience of selected sexually transmissible infections (STIs), experience of sexual difficulties in the previous 12 months, masturbation, and sexual practices at last heterosexual encounter. Results: More than half the men (58%) were circumcised. Circumcision was less common (33%) among men under 30 and more common (66%) among those born in Australia. After adjustment for age and number of partners, circumcision was unrelated to STI history except for non‐specific urethritis (higher among circumcised men, OR=2.11, p<0.001) and penile candidiasis (lower among circumcised men, OR=0.49, p<0.001). Circumcision was unrelated to any of the sexual difficulties we asked about (after adjusting for age) except that circumcised men were somewhat less likely to have worried during sex about whether their bodies looked unattractive (OR=0.77, p=0.04). No association between lack of circumcision and erection difficulties was detected. After correction for age, circumcised men were somewhat more likely to have masturbated alone in the previous 12 months (OR=1.20, p=0.02). Conclusions: Circumcision appears to have minimal protective effects on sexual health in Australia.     

Sexual Knowledge,Sexual Attitude,and Life Satisfaction Among Korean Older Adults: Implications for Educational Programs

The aim of this study was to: identify the sexual knowledge, sexual attitude, and life satisfaction in Korean older adults; and explore significant factors among demographic characteristics, sexual activity, sexual knowledge, and sexual attitude, that influence life satisfaction among Korean older adults. Participants were recruited in community centers and public parks (N = 571). Data were collected on sexual knowledge, sexual attitudes, and life satisfaction using three valid and reliable instruments. Data were analyzed using t test, ANOVA, Pearson’s correlation, and hierarchical multiple regression. Educational level, gender, and living arrangement significantly affected sexual knowledge and attitudes (p < .001) among older adults. There was a positive relationship between sexual knowledge and attitudes (r = .490, p < .001), life satisfaction and sexual knowledge (r = .144, p = .001), and life satisfaction and sexual attitudes (r = .121, p = .004). Age (β = .16, t = 3.45, p < .01), gender (β = .52, t = 2.07, p < .05), presence of spouse (β = ?.12, t = ?2.42, p < .05), and sexual knowledge (β = .10, t = 2.17, p < .05) were factors with a significant influence on life satisfaction for older adults. When designing and implementing sexual counseling and education programs for older adults, individual background, sexual knowledge, and sexual attitudes must be assessed and considered. Also, those without spouses who live alone may need more attention because they tend to have low knowledge levels and negative attitudes toward sexual activity.     

Physical activity of patients with schizophrenia in Nigeria: Distribution and correlates

BackgroundExcess morbidity among patients with schizophrenia has been linked to physical inactivity. Unfortunately, very few patients with schizophrenia engage in a health-enhancing level of physical activity (PA). There are geographic and cultural variations in levels of PA. The aim of this study was to examine PA levels in Nigerian patients with schizophrenia and to identify the clinical as well as sociodemographic correlates of PA in such patients.MethodsThe patients were recruited from the Department of Psychiatry, University College Hospital, Ibadan, and the Psychiatry Unit of the State Hospital, Adeoyo, Ibadan, Nigeria. We assessed their physical activity (PA) with the International Physical Activity Questionnaire (IPAQ) Short Form. The symptom severity of patients with schizophrenia was assessed with the Positive and Negative Syndrome Scale (PANSS). Anthropometric measures such as waist circumference, weight and height were also taken. We then explored the factors that were independently associated with PA using binary logistic regression models.ResultsTwo hundred and fifteen patients with schizophrenia were included in the study. The majority of the participants 143 (67.1%) had a low level of PA. Physical activity was associated with the remission status of the participants (P = 0.03). The level of education (r = −0.18 p = 0.01), waist circumference (r = −0.17p = 0.02) and the severity of depression (r = −0.15 p = 0.03), were inversely correlated with the level of physical activity. Social and occupational functioning were positively correlated with the level of physical activity (r = 0.24 p < 0.01). Psychopathology, namely excitement (P4) on the PANSS scale was positively correlated with PA (r = 0.18 p = 0.01), while a lack of judgment and lack of insight were negatively correlated with PA (r = −0.14 p = 0.04). The level of education, waist circumference, social and occupational functioning were independently associated with PA (all p < 0.05).ConclusionThe level of physical activity in the majority of patients with schizophrenia from Nigeria is low. Such physical activity is associated with certain sociodemographic and clinical correlates. These can be foci of targeted intervention to improve PA.     

Sexual behaviours in the context of the Ebola virus disease (EVD) in Ghana

Evidence suggests that Ebola virus disease can be transmitted through unprotected sexual intercourse, in particular through contact with the semen of an infected person. Yet few studies examine sexual behaviours in the context of Ebola. Using data collected from 460 women and 340 men within 40 selected communities in the Greater Accra Region of Ghana, this study employed hierarchical linear modelling to examine individual and community-level factors that influence willingness to engage in behaviours that protect against the sexual transmission of Ebola. Results indicate that both individual and community-level factors are significant predictors of respondents’ willingness to engage in preventive behaviours. Compared with those with no risks, female respondents with low and medium risk perceptions were significantly more likely to indicate they would use condoms to prevent the sexual transmission of Ebola (AOR = 2.23; p < 0.01). Compared with men who were very concerned, those who were not very concerned (AOR = 0.356; p < 0.01) and not at all concerned (AOR = 0.356; p < 0.05) about Ebola were significantly less likely to protect against the sexual transmission of Ebola. Female respondents in communities with high knowledge about Ebola were significantly more likely to engage in behaviours preventing the sexual transmission of Ebola virus disease (AOR = 1.93; p < 0.05).     

Sexual Functioning and Selected Clinical and Psychosocial Factors Among Individuals with Chronic Non-specific Low Back Pain in Ibadan,Nigeria

Chronic non-specific low back pain (CNLBP) has significant impact on psychosocial life, functional status, and sexual functioning. Prevalence of sexual dysfunction, and influence of selected clinical and psychosocial factors on sexual functioning were investigated in patients with CNLP in Ibadan, Nigeria. Sexual function, pain intensity, pain disability, quality of life were assessed using a modified questionnaire on sexual dysfunction in CNLBP, visual analogue scale, Oswestry low back pain disability questionnaire and quality of life questionnaires respectively. General attitude to sexuality, fear of increased pain at the low back, unwillingness to have sex, expression of sexual feelings, fear of losing the ability to perform sexual activities were assessed with the modified questionnaire. Participants (50 males; 46 females) were aged 46.7 ± 11.8 years. Orgasmic sexual dysfunction (50.0%) was the most prevalent while dysfunction with sexual satisfaction (14.6%) was the least prevalent. Participants with or without sexual dysfunction did not differ significantly in age (p = 0.07), pain duration (p = 0.64), pain disability (p = 0.76) and quality of life (p = 0.64). However, they differed significantly in pain intensity (p = 0.00). Significant associations exist between gender (p = 0.000) and sexual functioning. Participants’ sexual functioning were significantly influenced by psychosocial factors willingness to have sex (p = 0.013), expression of sexual feelings (p = 0.000). Participants’ pain intensity also significantly influenced (p = 0.00) their sexual functioning. Sexual dysfunction is prevalent among individuals with chronic non-specific low back pain and was influenced by clinical factors of pain intensity, pain disability, quality of life and psychosocial factors of general attitude towards sexuality, expression of sexual feelings, and willingness to have sex.     

Effects of An Occupational Therapy Memory Strategy Education Group Intervention on Irish Older Adults’ Self-Management of Everyday Memory Difficulties

An occupational therapy memory strategy education group (MSEG) was developed to assist clients with varying levels of memory impairment to adopt strategies to manage memory impairment in their daily lives. Participants were healthy older adults presenting with subjective memory complaints (SMC, n?=?14), mild cognitive impairment (MCI, n?=?33), or early stages of dementia (n?=?13). Clients and their caregivers attended a one-hour session each week for six weeks. Outcome measures were taken at baseline, two weeks post completion of the group, and at a 3-month follow-up for 47 participants. Statistically significant improvements post-program were scored on the Rivermead Behavioural Memory Test (p?=?0.001) and a dementia quality of life measure (p?=?0.02), with increased use of external memory aids (p?<?0.001) and significant improvements in participants’ self-ratings of performance (p?<?0.001) and satisfaction with their performance (p?<?0.001) using the Canadian Occupational Performance Measure. Findings suggest positive outcomes that were maintained at 3-month follow-up and thus, support the role of occupational therapy in delivering occupation-focused memory strategy programs.     

Ethnic differentials in under-five mortality in Nigeria

Objective. There are huge regional disparities in under-five mortality in Nigeria. While a region within the country has as high as 222 under-five deaths per 1000 live births, the rate is as low as 89 per 1000 live births in another region. Nigeria is culturally diverse as there are more than 250 identifiable ethnic groups in the country; and various ethnic groups have different sociocultural values and practices which could influence child health outcome. Thus, the main objective of this study was to examine the ethnic differentials in under-five mortality in Nigeria.

Design. The study utilized 2008 Nigeria Demographic and Health Survey (NDHS) data. We analyzed data from a nationally representative sample drawn from 33,385 women aged 15–49 that had a total of 104,808 live births within 1993–2008. In order to examine ethnic differentials in under-five mortality over a sufficiently long period of time, our analysis considered live births within 15 years preceding the 2008 NDHS. The risks of death in children below age five were estimated using Cox proportional regression analysis. Results were presented as hazard ratios (HR) with 95% confidence intervals (CI).

Results. The study found substantial differentials in under-five mortality by ethnic affiliations. For instance, risks of death were significantly lower for children of the Yoruba tribes (HR: 0.39, CI: 0.37–0.42, p < 0.001), children of Igbo tribes (HR: 0.58, CI: 0.55–0.61, p < 0.001) and children of the minority ethnic groups (HR: 0.66, CI: 0.64–0.68, p < 0.001), compared to children of the Hausa/Fulani/Kanuri tribes. Besides, practices such as plural marriage, having higher-order births and too close births showed statistical significance for increased risks of under-five mortality (p < 0.05).

Conclusion. The findings of this study stress the need to address the ethnic norms and practices that negatively impact on child health and survival among some ethnic groups in Nigeria.     

Can a woman refuse sex if her husband has a sexually transmitted infection? Attitudes toward safer-sex negotiation among married women in Bangladesh

In developing countries, HIV, sexually transmitted infections (STIs) and unintended pregnancy take an enormous toll on women's reproductive health, yet preventive programmes are lacking as married women's risks are frequently underestimated. We examined predictors of married Bangladeshi women's attitudes towards safer-sex negotiation using data on 15,178 currently married women aged 15–49 from the 2011 Bangladesh Demographic Health Survey. Approximately 92% of women believed that a wife's refusal to have sex with her husband is justified if he has an STI. Multilevel logistic regression analysis revealed that the likelihood of a woman holding this belief increased with her autonomy, as measured by the ability to go to a health centre/hospital without another adult, participation in household decision making and rejection of wife beating (p < 0.001). Other significant predictors were knowledge/awareness of STIs (p < 0.05), living in Dhaka division (p < 0.001) and younger age (p < 0.01). Our findings suggest that sexual health education programmes may be more effective if they include strategies to address social norms and cultural practices that limit women's autonomy in society.     

Why Communication Is Crucial: Meta-Analysis of the Relationship Between Safer Sexual Communication and Condom Use

The purpose of this study was to quantitatively synthesize the growing literature on the relationship between safer sexual communication (SSC) among sexual partners and condom use, and to systematically examine a number of conceptual and methodological moderators of this relationship. Data from 53 articles published in 27 journals met criteria for the study. Fifty-five independent effect sizes coded from samples totaling N = 18,529 were meta-analyzed. Results indicate that the mean sample-size weighted effect size of the SSC-condom use relation was r = .22, and a number of conceptual variables were found to moderate this relationship. Specifically, communication about condom use (r = .25) and sexual history (r = .23) had significantly (p < .05) larger effect sizes than communication about safer sex (r = .18). In addition, SSC measures operationalized differently had significantly (p < .05) different effect sizes. From largest to smallest, these were behavioral format (r = .29), intentional format (r = .18), and self-efficacy format (r = .13). Measures that tried to assess persuasion attempts as compared with informational exchanges were not found to have significantly different effect sizes (p > .05). Further, methodological moderators tended to be unrelated to effect size. Implications for the future study of safer sexual communication as well as the importance of emphasizing communication skills in HIV preventive interventions are discussed.     

The effect of counseling based on Bandura’s self-efficacy theory on sexual self-efficacy and quality of sexual life

ABSTRACT

This study aimed to determine the effect of counseling, based on Bandura’s self-efficacy theory, on sexual self-efficacy and quality of sexual life. This randomized controlled trial was conducted on 96 newlywed women in Zanjan, Iran during 2015–2016. The participants were assigned to the control and intervention groups through block randomization. Six 90-minute counseling sessions were held weekly for participants in the intervention group. Questionnaires of sexual self-efficacy and quality of sexual life were completed before and 8 weeks after the end of intervention. No significant difference was observed between groups in sexual self-efficacy and quality of sexual life at baseline (p > .05). Using ANCOVA, the mean score for sexual self-efficacy in the intervention group was significantly higher than the control group 8 weeks after the intervention ended (mean difference in scores = 9.4; 95% confidence interval [CI] 2.6 to 16.2; p = .007). However, no significant difference was observed in the quality of sexual life between the two groups (mean difference in mean score = 2.1; 95% CI ?2.5 to 6.7; p = .365). Thus, counseling had a positive impact on sexual self-efficacy. However, the intervention had no significant impact on the quality of sexual life, which may be attributed to the short duration of follow-up.     

Economic Dependence and Unprotected Sex: The Role of Sexual Assertiveness among Young Urban Mothers

In the USA, sexual intercourse is the leading route of human immunodeficiency virus transmission among women, primarily through their main partner. Because male condom use is not directly under a woman's control, gender inequalities may help shape this sexual risk behavior. To examine this association, data came from follow-up interviews of young, primarily minority, pregnant women enrolled in a prospective, randomized controlled trial. Specifically, we aimed to determine the relationship between economic dependence on a male partner and condom use, and to establish whether this relationship was mediated by sexual assertiveness. Overall, 28% of women reported being economically dependent on a male partner. Young women dependent on a male partner were 1.6 times more likely to report not using a condom at last sex than women not dependent on their partner (95% confidence interval = 1.11–2.32; p = 0.01). Sexual assertiveness mediated the relationship between economic dependence and condom use (Sobel = 2.05, p = 0.04). Coupled with past research, this study supports the premise that sexual behaviors may be rooted in a complex web of social determinants. Addressing gender inequalities in contextual factors may promote healthier decisions within sexual relationships.     

Solid waste management in informal urban neighbourhoods. Occupational safety and health practices among tricycle operators in Kumasi,Ghana

ABSTRACT

The study examines the nature of activities and assess knowledge on occupational safety and health (OS&H) risks and practices among solid waste collectors in two low-income informal neighbourhoods in Kumasi (Aboabo and Asawase). Using observations and semi-structured interviews with 83 participants and relevant institutions, the findings indicate that informal tricycle waste collectors provided spot-to-spot waste collection using improvised sirens to signal their arrival. Workers generally had low knowledge, expressed less about occupational health risks, and thus adopted less safe work practices. The study however showed significant differences between knowledge of health risks (p < 0.000, R = 0.83) and years of working experience (p < 0.01, R = 0.74) and adoption of safe practices. Workers who had knowledge the associated health risks of the activity and also have been in the activity for more than 2 years were more likely to use at least one PPE/PPC. The study recommends that targeted interventions to mitigate risks and improve the health and safety of workers require effective risk communication. The study concludes that insight into OS&H is important to offer opportunities for better waste management strategies in the informal urban areas.     

Test–Retest Reliability of Self-Reported Sexual Behavior, Sexual Orientation, and Psychosexual Milestones Among Gay, Lesbian, and Bisexual Youths

Despite the importance of reliable self-reported sexual information for research on sexuality and sexual health, research has not examined reliability of information provided by gay, lesbian, and bisexual (GLB) youths. Test–retest reliability of self-reported sexual behaviors, sexual orientation, sexual identity, and psychosexual developmental milestones was examined among an ethnically diverse sample of 64 self-identified GLB youths. Two face-to-face interviews were conducted approximately 2 weeks apart using the Sexual Risk Behavior Assessment Schedule for Homosexual Youths (SERBAS-Y-HM). Overall, the mean of the test–retest reliability coefficients was substantial for 6 of the 7 domains: lifetime sexual behaviors (M=.89), sexual behavior in the past 3 months (M=.96), unprotected sexual behavior in the past 3 months (M=.93), sexual identity (κ=.89), sexual orientation (M=.82), and ages of various psychosexual developmental milestones (M=.77). Inconsistent reliability was found for reports of sexual behaviors while using substances. A small number of gender differences emerged, with lower reliability among female youths in the lifetime number of same-sex partners. The overall findings suggest that a wide range of self-reported sexual information can be reliably assessed among GLB youths by means of interviewer-administered questionnaires, such as the SERBAS-Y-HM.

HIV-Related Stigma in Midlife and Older Women

HIV-related stigma has been identified as a barrier to HIV testing and prevention efforts internationally and nationally. Although the prevalence of HIV/AIDS is rapidly increasing in women aged 50 and older, little is known about the HIV-stigmatizing behaviors in this underserved population. In this exploratory analysis we investigated the influence of self esteem, sensation seeking, self silencing, and sexual assertiveness on the HIV-stigmatizing behaviors in 572 women aged 50 to 93. The variables considered in this analysis included subscales for the variables self silencing (Externalized Self Perception, Care as Self Sacrifice, Silencing the Self, Divided Self) and sexual assertiveness (Information Communication, Initiation, Refusal). Contributing predictive variables in the final model included: Self esteem (β = ?.190, t = ?4.487, p = .000), Care as Self-Sacrifice (β = .125, t = 2.714, p = .007), and Silencing the Self (β = .164, t = 3.290, p = .001). Initiation (β = .108, t = ?2.619, p = .009) and Refusal (β = ?.091, t = ?2.154, p = .032). Implications for social work and health perception regarding HIV prevention in midlife and older women are considered. Development of age- and gender-appropriate strategies assisting women in addressing HIV-stigma and related influences are addressed.     

The effects of a community-based intervention on women’s knowledge and attitudes about safe abortion in intervention and comparison towns in Oromia,Ethiopia

The aim of this post-intervention assessment was to measure the effects of community intervention on the knowledge and attitudes of women regarding safe abortion in Ethiopia. In 2014, following implementation of an educational intervention on sexual and reproductive health from December 2012 to December 2013, 800 women were interviewed about their knowledge, attitudes, and practices regarding abortion. Multivariate regression analyses of respondents’ demographics, sources of abortion information, knowledge, and attitudes about safe abortion were conducted. More women in the intervention community knew safe abortion was available in the community (76 percent vs. 57 percent; p < 0.001). Women in the intervention community had greater odds of feeling that women should have access to safe abortion services (adjusted odds ratio [aOR]: 1.55, 95 percent confidence interval [CI]: 1.06, 2.28) after adjusting for socio-demographic characteristics. They had significantly greater odds of feeling comfortable and confident talking to a healthcare provider (aOR: 2.44, 95 percent CI: 1.55, 3.84) and/or her partner (aOR: 2.47, 95 percent CI: 1.58, 3.85) about abortion. Increased mobilization of community networks in disseminating sexual health and abortion information was followed by increased knowledge of abortion services in the intervention community and improved reproductive choices for women.