Risk assessment of adolescents with same-sex relationships.

PURPOSE: To compare the risk status on health and behavior for those with same-sex partners and those without. METHODS: Add Health data provide a sample of 20,745 adolescents in grades 7 through 12 interviewed at home. The risk statuses of respondents with no partners, same-sex-only partners, and partners of both sexes were compared to respondents with opposite-sex partners only. Respondents were evaluated on selected personal and social attributes (verbal IQ, family structure, masculinity, popularity), and risk status (substance use, depression, suicidal thoughts, anal sex, general delinquency, being physically attacked, perceived risk of being killed or getting AIDS). Data were analyzed by logistic and linear regression using STATA to adjust for clustering and sampling weights. RESULTS: Compared to boys with opposite-sex-only partners, boys with same-sex-only partners were at high risk for emotional problems, but not delinquency or substance use. Boys with partners of both sexes were at high risk for delinquency and substance use, but not for emotional problems. Neither group of boys with same-sex partners is at high risk of being attacked compared to those with opposite-sex partners only. Girls with only same-sex partners are never a high-risk group, while girls with partners of both sexes are the high-risk category in every case. CONCLUSIONS: Adolescents with same-sex-only partners do not resemble those with partners of both sexes in risk status. Combining the two categories obscures the unique risk profile of those with both-sex partners, and obscures the low risk on most variables but the high emotional risk of boys with only same-sex partners.     

Differences in Sexual Risk Behaviors Between College Students with Same-Sex and Opposite-Sex Experience: Results from a National Survey

The goal of this study was to identify differences in the sexual health behaviors (condom use and number of sexual partners) between college students with same-sex sexual experiences and those with only opposite-sex partners. Data from a random sample of American university students were gathered as part of the 1997 College Alcohol Study. Odds ratios were estimated for consistent condom use and multiple sex partners for students with same-sex or both-sex sexual partners compared to those with exclusively heterosexual contacts. Five percent of respondents reported ever having a same-sex partner. Significant differences in safer-sex practices were found between groups. Females with both-sex experience and males with both-sex or only same-sex experiences were more likely to report multiple recent sexual partners than their peers with only opposite-sex partners. Odds ratios of consistent condom use were lower for men with only same-sex experience than among those with only opposite-sex partners. Findings have implications for sexual health education on the college campus. Consistent condom use remains low among college students. Education programs should emphasize the importance of limiting the number of lifetime sex partners, especially among students with same-sex experiences.     

Relationship Between Mental Disorders/Suicidality and Three Sexual Behaviors: Results from the National Comorbidity Survey Replication

The present study examined the relationship between sexual behaviors and mental disorders and suicidality in the National Comorbidity Survey Replication, a representative sample of adults ages 18 years and older (N = 5,692). The World Health Organization Composite International Diagnostic Interview was used to make DSM-IV based disorder diagnoses. Participants were also asked about suicidality and sexual behaviors. Multiple logistic regression analyses adjusted for sociodemographic variables were used to examine the relationships of three sexual behaviors (age of first intercourse, number of past year partners, and past year condom use) with 15 mental disorders (clustered into any mood, anxiety, substance use, and disruptive behavior groups) and suicidality (ideation and attempts). Compared to ages 15–17, those with age of first intercourse between 12 and 14 had increased rates of lifetime disruptive behavior, substance use, and any mental disorder, and suicidal ideation and attempts (adjusted odds ratio (AOR) range, 1.46–2.01). Those with age of first intercourse between ages 18–25 and 26–35 were at decreased likelihood of several lifetime disorder groups (AOR range, 0.19–0.81). Individuals who had two or more sexual partners in the past year had increased rates of all past year disorder groups examined (AOR range, 1.44–5.01). Never married participants who rarely/never used condoms were more likely than those who always used condoms to experience any mood, substance use, and any mental disorder, and suicide attempts (AOR range, 1.77–8.13). Future research should longitudinally examine these associations and account better for possible familial and personality confounders.     

Sex in Australia: sexual identity, sexual attraction and sexual experience among a representative sample of adults

OBJECTIVE: To describe the prevalence of same-sex and opposite-sex attraction and experience in Australia and the prevalence of different sexual identities. METHOD: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years from all States and Territories of Australia. The overall response rate was 73.1% (men, 69.4%; women, 77.6%). Men and women were asked about their experience of same-sex and opposite-sex attraction and experience along with their sexual identity. The agreement and disagreement between sexual attraction and sexual experience were explored. RESULTS: Among men, 97.4% identified as heterosexual, 1.6% as gay or homosexual and 0.9% as bisexual. Among women, 97.7% identified as heterosexual, 0.8% as lesbian or homosexual and 1.4% as bisexual. Among men, 91.4% reported only opposite-sex attraction and experience, as did 84.9% of women. Thus, some same-sex attraction or experience was reported by 8.60% of men and 15.1% of women. Of men, 4.2% reported sexual attraction and sexual experience that was inconsistent, as did 8.2% of women. Factors associated with this agreement or disagreement included age group, non-English-speaking background, education and socio-economic status. CONCLUSION: Relatively few Australians reported a sexual identity other than heterosexual. However, both same-sex attraction and homosexual experience are more common than homosexual or bisexual identity would suggest. Reporting same-sex attraction or experience was associated with poorer mental health and is likely to reflect responses to homophobia in Australian society.     

Sex in Australia: heterosexual experience and recent heterosexual encounters among a representative sample of adults

OBJECTIVE: To describe numbers of opposite-sex partners, experiences of different heterosexual behaviours, and recent heterosexual experiences among a representative sample of Australian adults. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years from all States and Territories. The response rate was 73.1% (69.4% among men and 77.6% among women). RESULTS: Men reported more sexual partners than women over their lifetime, in the past five years and in the past year. 15.1% of men and 8.5% of women reported multiple sexual partners in the past year. Reporting multiple opposite-sex partners was significantly associated with being younger, identifying as bisexual, living in major cities, having a lower income, having a blue-collar occupation, and not being married. All but a handful of respondents' most recent heterosexual encounters involved vaginal intercourse and condoms were used in one-fifth of these sexual encounters. Anal intercourse was very uncommon during respondents' most recent heterosexual encounters. CONCLUSION: Patterns of heterosexual experience in Australia are similar to those found in studies of representative samples in other countries. IMPLICATIONS: There may be a need for interventions targeted at people with multiple sexual partners to promote safer sexual behaviour and to reduce the likelihood of transmission of HIV and other sexually transmitted infections.     

Sex with Men Before Coming-Out: Relation to Sexual Activity and Sexual Risk-Taking Behavior

This study examined the difference in sequence of coming-out and first same-sex experience in relation to risk-taking behavior in a sample of Dutch gay and bisexual men. A questionnaire assessed age of disclosure (coming-out) and age of first same-sex experience, and information on sexual history, sexual relationships, and sexual behavior. It was found that 68% of respondents engaged in their first same-sex experience before coming-out. This proportion increased with age. Men who had sex with men before coming-out reported more lifetime sex partners and more casual sex partners in the past 6 months than men in which this sequence was reversed. In addition, among this group a higher proportion of men reported STDs, engaging in anal intercourse with casual partners in the previous 6 months, and unprotected anal sex with casual sex partners in the recent past, compared to men who came out before having their first same-sex experience. The extent to which external factors (such as tolerance toward homosexuals) or internal factors (such as personality factors) can account for the difference in sexual behaviors in general and sexual risk-taking behavior in particular could be subject of further study.     

Lifetime prevalence of suicide symptoms and affective disorders among men reporting same-sex sexual partners: results from NHANES III

OBJECTIVES: This study examined lifetime prevalence of suicide symptoms and affective disorders among men reporting a history of same-sex sexual partners. METHODS: In the third National Health and Nutrition Examination Survey, men aged 17 to 39 years were assessed for lifetime history of affective disorders and sexual behavior patterns. The study classified this subset of men into 3 groups: those reporting same-sex sexual partners, those reporting only female sexual partners, and those reporting no sexual partners. Groups were compared for histories of suicide symptoms and affective disorders. RESULTS: A total of 2.2% (95% confidence interval [CI] = 1.3%, 3.1%) of men reported same-sex sexual partners. These men evidenced greater lifetime prevalence rates of suicide symptoms than men reporting only female partners. However, homosexually/bisexually experienced men were no more likely than exclusively heterosexual men to meet criteria for lifetime diagnosis of other affective disorders. CONCLUSIONS: These data provide further evidence of an increased risk for suicide symptoms among homosexually experienced men. Results also hint at a small, increased risk of recurrent depression among gay men, with symptom onset occurring, on average, during early adolescence.     

Child sexual abuse and subsequent psychopathology: results from the National Comorbidity Survey

OBJECTIVES: This study examined the relationship between child sexual abuse (CSA) and subsequent onset of psychiatric disorders, accounting for other childhood adversities, CSA type, and chronicity of the abuse. METHODS: Retrospective reports of CSA, other adversities, and psychiatric disorders were obtained by the National Comorbidity Survey, a nationally representative survey of the United States (n = 5877). Reports were analyzed by multivariate methods. RESULTS: CSA was reported by 13.5% of women and 2.5% of men. When other childhood adversities were controlled for, significant associations were found between CSA and subsequent onset of 14 mood, anxiety, and substance use disorders among women and 5 among men. In a subsample of respondents reporting no other adversities, odds of depression and substance problems associated with CSA were higher. Among women, rape (vs molestation), knowing the perpetrator (vs strangers), and chronicity of CSA (vs isolated incidents) were associated with higher odds of some disorders. CONCLUSIONS: CSA usually occurs as part of a larger syndrome of childhood adversities. Nonetheless, CSA, whether alone or in a larger adversity cluster, is associated with substantial increased risk of subsequent psychopathology.     

Minority Stress in Lesbian,Gay, and Bisexual Young Adults in Australia: Associations with Psychological Distress,Suicidality, and Substance Use

Lesbian, gay, bisexual, and other same-sex attracted young people have been shown to be at a higher risk of mental health problems, including depression, anxiety, suicidality, and substance abuse, compared to their heterosexual peers. Homophobic prejudice and stigma are often thought to underlie these disparities. In this study, the relationship between such experiences of social derogation and mental health and substance use in same-sex attracted young people was examined using Meyer’s minority stress theory. An online survey recruited 254 young women and 318 young men who identified as same-sex attracted, were aged 18–25 years, and lived in Sydney, Australia. Multivariate logistic regression analyses showed that internalized homophobia, perceived stigma, and experienced homophobic physical abuse were associated with higher levels of psychological distress and self-reported suicidal thoughts in the previous month. Furthermore, perceived stigma and homophobic physical abuse were associated with reporting a lifetime suicide attempt. The association between minority stress and substance use was inconsistent. While, as expected, higher levels of perceived stigma were associated with club drug dependence, there was an inverse association between internalized homophobia and club drug use, and between perceived stigma and hazardous alcohol use. The findings of this study provide support for the minority stress theory proposition that chronic social stress due to sexual orientation is associated with poorer mental health. The high rates of mental health and substance use problems in the current study suggest that same-sex attracted young people should continue to be a priority population for mental health and substance use intervention and prevention.     

Disability Associated with Comorbid Anxiety Disorders in Women with Chronic Physical Illness in Ontario,Canada

ABSTRACT

Anxiety disorders are more prevalent in individuals with chronic physical illness compared to individuals with no such illness, and about twice as prevalent in women as in men. This study used data collected in the 2005 Canadian Community Health Survey (21,198 women and 20,478 men) to examine factors associated with comorbid anxiety disorders and to assess the relation of these disorders on short-term disability and suicidal ideation. Comorbid anxiety disorders were more prevalent among women who were young, single, poor, and Canadian-born, and among women with chronic fatigue syndrome; fibromyalgia, bowel disorder or stomach or intestinal ulcers, or bronchitis had the highest rates of anxiety disorders. The presence of comorbid anxiety disorders was significantly associated with short-term disability, requiring help with instrumental daily activities, and suicidal ideation. Our findings underscore the importance of early detection and treatment of anxiety disorders in the physically ill, especially those who also suffer from mood disorders.     

Disability associated with comorbid anxiety disorders in women with chronic physical illness in Ontario, Canada

Anxiety disorders are more prevalent in individuals with chronic physical illness compared to individuals with no such illness, and about twice as prevalent in women as in men. This study used data collected in the 2005 Canadian Community Health Survey (21,198 women and 20,478 men) to examine factors associated with comorbid anxiety disorders and to assess the relation of these disorders on short-term disability and suicidal ideation. Comorbid anxiety disorders were more prevalent among women who were young, single, poor, and Canadian-born, and among women with chronic fatigue syndrome; fibromyalgia, bowel disorder or stomach or intestinal ulcers, or bronchitis had the highest rates of anxiety disorders. The presence of comorbid anxiety disorders was significantly associated with short-term disability, requiring help with instrumental daily activities, and suicidal ideation. Our findings underscore the importance of early detection and treatment of anxiety disorders in the physically ill, especially those who also suffer from mood disorders.     

A Multidimensional Measure of Sexual Orientation,Use of Psychoactive Substances,and Depression: Results of a National Survey on Sexual Behavior in France

Using data from a large national representative survey on sexual behavior in France (Contexte de la Sexualité en France), this study analyzed the relationship between a multidimensional measure of sexual orientation and psychoactive substance use and depression. The survey was conducted in 2006 by telephone with a random sample of the continental French speaking population between the ages of 18 and 69 years. The sample used for this analysis consisted of the 4,400 men and 5,472 women who were sexually active. A sexual orientation measure was constructed by combining information on three dimensions of sexual orientation: attraction, sexual behavior, and self-definition. Five mutually exclusive groups were defined for men and women: those with only heterosexual behavior were divided in two groups whether or not they declared any same-sex attraction; those with any same-sex partners were divided into three categories derived from their self-definition (heterosexual, bisexual or homosexual). The consumption of alcohol and cannabis, which was higher in the non-exclusively heterosexual groups, was more closely associated with homosexual self-identification for women than for men. Self-defined bisexuals (both male and female) followed by gay men and lesbians had the highest risk of chronic or recent depression. Self-defined heterosexuals who had same-sex partners or attraction had levels of risk between exclusive heterosexuals and self-identified homosexuals and bisexuals. The use of a multidimensional measure of sexual orientation demonstrated variation in substance use and mental health between non-heterosexual subgroups defined in terms of behavior, attraction, and identity.     

National and State-Specific Health Insurance Disparities for Adults in Same-Sex Relationships

Objectives. We examined national and state-specific disparities in health insurance coverage, specifically employer-sponsored insurance (ESI) coverage, for adults in same-sex relationships.Methods. We used data from the American Community Survey to identify adults (aged 25–64 years) in same-sex relationships (n = 31 947), married opposite-sex relationships (n = 3 060 711), and unmarried opposite-sex relationships (n = 259 147). We estimated multinomial logistic regression models and state-specific relative differences in ESI coverage with predictive margins.Results. Men and women in same-sex relationships were less likely to have ESI than were their married counterparts in opposite-sex relationships. We found ESI disparities among adults in same-sex relationships in every region, but we found the largest ESI gaps for men in the South and for women in the Midwest. ESI disparities were narrower in states that had extended legal same-sex marriage, civil unions, and broad domestic partnerships.Conclusions. Men and women in same-sex relationships experience disparities in health insurance coverage across the country, but residing in a state that recognizes legal same-sex marriage, civil unions, or broad domestic partnerships may improve access to ESI for same-sex spouses and domestic partners.There are approximately 646 000 same-sex couples in the United States according to the 2010 decennial census.1 Same-sex couples reside in every state, but each state has its own laws and regulations regarding the legal status of same-sex marriage. At the time of this writing, 16 states and the District of Columbia had recognized legal marriages for same-sex couples; an additional 3 states had extended civil unions or comprehensive domestic partnerships to same-sex couples; and the remaining states had banned same-sex marriage altogether through legislative action or amendments to their state constitutions.2 Differences in same-sex marriage laws can affect access to health insurance for same-sex couples or members of the lesbian, gay, bisexual, and transgender (LGBT) population. When states adopt same-sex marriage or civil unions that extend spousal rights and protections to same-sex couples, fully insured private employers regulated by state insurance laws are often required to treat married same-sex couples as married opposite-sex couples.The Employee Retirement Income Security Act of 1974 limits the reach of state insurance regulation. Although states maintain jurisdiction over fully insured health plans, employers that self-insure—or assume the risk of health claims out of their own assets—are regulated under the federal Employee Retirement Income Security Act, as health benefits are treated not as insurance but as an employee benefit similar to employer-provided pension plans.3,4 In 2010, more than half of all workers (57.5%) with employer-sponsored insurance (ESI) were covered by self-insured plans.5 Because so many workers are covered by self-insured plans, state-level marriage policies can have a limited effect. Buchmueller and Carpenter, using data from the 2001–2007 California Health Interview Surveys, found that insurance mandates that extended health care benefits to same-sex spouses in California had no statistically significant effect on dependent coverage for gay and bisexual men and only a small positive effect on lesbian and bisexual women.6The federal Defense of Marriage Act, passed in 1996, created additional barriers for LGBT workers interested in adding their spouses to their ESI plan, even when states acknowledged the legality of same-sex marriage. Section 3 of the Defense of Marriage Act (ruled unconstitutional by the US Supreme Court in 2013) defined marriage as “a legal union between one man and one woman as husband and wife” for federal purposes.7 The federal government does not tax employer contributions to an opposite-sex spouse’s health benefits, but under the Defense of Marriage Act, a same-sex partner’s health benefits were taxed as if the employer contribution was taxable income. LGBT employees paid, on average, $1069 in additional federal income taxes when they added their same-sex spouses to employer health plans.8 These barriers to ESI may have led LGBT persons to enroll in public programs or forgo health insurance and access to affordable health care.Data on the LGBT population have historically been limited to convenience and nonprobability samples of gay men and lesbians through health care providers and researchers focusing their research on LGBT health.9 Although federal surveys do not ascertain sexual orientation, data have been edited to identify same-sex couples and households. Three previous studies have used intrahousehold information from federal population surveys to compare the health insurance coverage of individuals in same-sex relationships with that of those in opposite-sex relationships.Heck et al. used the National Health Interview Survey to compare health insurance coverage and access to medical care of adults in same-sex relationships with that of married adults in opposite-sex relationships.10 They used multivariate logistic regression models for men and women and found women in same-sex relationships significantly less likely to have health insurance, to have seen a medical provider in the previous 12 months, and to have a usual source of care. Health insurance coverage, unmet medical needs, and having a usual source of care were not statistically different between men in same-sex relationships and married men in opposite-sex relationships. The authors believed the HIV epidemic motivated gay men to maintain a regular provider. Compared with the other studies using federal surveys, the National Health Interview Survey accommodates the smallest sample size (316 men and 298 women in same-sex relationships)—even after pooling data across a wide time frame (1997–2003).Ash and Badgett took advantage of larger samples in the Current Population Survey.11 Designed to measure labor force participation and unemployment, the Annual Social and Economic Supplement to the Current Population Survey requires respondents to report health insurance coverage during the previous 16 months for each person in the household. Pooled data between 1996 and 2003 still produced relatively small sample sizes (486 men and 478 women in same-sex relationships), but their study found that both men and women in same-sex couples were 2 to 3 times more likely to be uninsured than were married individuals in opposite-sex relationships.Buchmueller and Carpenter used a national sample of adults aged between 25 and 64 years in the Behavioral Risk Factor Surveillance System to compare health insurance and utilization of health services of same-sex couples with those of opposite-sex couples (both married and unmarried).12 Again, both men and women in same-sex relationships were significantly less likely to be insured. Married people in opposite-sex relationships had the highest rates and odds of insurance coverage, followed by men and women in same-sex relationships, and then by unmarried men and women in opposite-sex relationships. Although it provides the largest sample to date (2384 men and 2881 women in same-sex relationships), their study pooled data across a wide period (2000–2007) of decline in health insurance coverage, especially for people with ESI.13These 3 studies were restricted to national-level estimates and surveys with limited sample sizes. Our research builds on the previous work but extends the analysis to all states. To our knowledge, only 1 other study has estimated health insurance disparities for same-sex couples in a single state using the California Health Interview Study.14 Because of the variation in state policies and attitudes toward same-sex couples,15,16 we expected geographic patterns in health insurance. We took advantage of relatively large samples in the American Community Survey (ACS) to compare state-specific health insurance disparities, particularly in ESI coverage. Following recent studies examining the potential for same-sex marriage to improve the health of the LGBT population,17–20 we sought to add early evidence on the relationship between legal same-sex marriage and health insurance coverage.     

Dimensions of Sexual Orientation and the Prevalence of Mood and Anxiety Disorders in the United States

Objectives. We used data from a nationally representative sample to examine the associations among 3 dimensions of sexual orientation (identity, attraction, and behavior), lifetime and past-year mood and anxiety disorders, and sex.Methods. We analyzed data from wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions.Results. Mental health outcomes differed by sex, dimension of sexual orientation, and sexual minority group. Whereas a lesbian, gay, or bisexual identity was associated with higher odds of any mood or anxiety disorder for both men and women, women reporting only same-sex sexual partners in their lifetime had the lowest rates of most disorders. Higher odds of any lifetime mood or anxiety disorder were more consistent and pronounced among sexual minority men than among sexual minority women. Finally, bisexual behavior conferred the highest odds of any mood or anxiety disorder for both males and females.Conclusions. Findings point to mental health disparities among some, but not all, sexual minority groups and emphasize the importance of including multiple measures of sexual orientation in population-based health studies.In the United States, mental health disorders affect a substantial proportion of the general population.^1,2 Data from the National Comorbidity Study show that approximately 29% of adults meet Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV)³ criteria for anxiety disorder and nearly 21% for a mood disorder over their lifetime.¹ Data from the 2001–2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) indicate that 11% of the US general population met criteria for a DSM-IV independent (nonsubstance-induced) anxiety disorder in the past year and 9.3% met criteria for a DSM-IV mood disorder in the past year.² Given the personal and societal costs associated with mental illness,⁴ it is necessary to understand which groups are at disproportionate risk for mental health disorders so that appropriate prevention and intervention programs can be designed.A growing body of evidence suggests that sexual minorities are at higher risk for mental health disorders than their heterosexual counterparts.^5–8 In a meta-analysis, Meyer⁸ concluded the odds of lifetime mood and anxiety disorders were twice as high for lesbian, gay, and bisexual women and men as for heterosexuals. However, as Meyer and others^9,10 have noted, research on the mental health of sexual minorities has been hampered by methodological limitations, such as nonrandom samples that constrain the generalizability of findings. In addition, many studies contain small samples, which preclude analyses by age, race/ethnicity, and other characteristics that vary with mental health disorders. Lesbian, gay, and bisexual women and men are often combined for analytic reasons, such as the need to increase the overall sample size and corresponding statistical power. This obscures potential differences between lesbians or gays and bisexuals as well as between men and women—and can lead to biased results.Although some researchers have considered how different operationalizations of sexual orientation may affect health outcomes,^11–13 national studies rarely assess sexual orientation and, to date, no national population-based study has compared mental health outcomes across all 3 major dimensions of sexual orientation—identity, behavior, and attraction.¹⁴ As others have noted,^10,15 health risks associated with one dimension of sexual orientation, such as behavior, may differ from those associated with another, such as sexual identity. Furthermore, virtually no population-based health studies of adults have explored associations between sexual attraction and health outcomes. Through the inclusion and measurement of these 3 dimensions in population-based health studies, we can begin to better understand the different dimensions of sexual orientation and their associations with health behaviors and health outcomes.^16–18To address the aforementioned limitations and to contribute to a greater understanding of the prevalence of mental health disorders among sexual minorities, we used data from the 2004–2005 NESARC to assess lifetime and past-year prevalence of DSM-IV mood and anxiety disorders among heterosexual and sexual minority women and men. Our purpose was to answer the following question: does the prevalence of mood and anxiety disorders differ across the 3 major dimensions of sexual orientation and does it differ for women and men?     

Sex in Australia: safer sex and condom use among a representative sample of adults

OBJECTIVE: To provide reliable estimates of the frequency of condom use and correlates of condom use among Australian adults. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The response rate was 73.1% (69.4% men, 77.6% women). RESULTS: Although the majority of respondents had used a condom at some time in their lives, fewer than half of the respondents who were sexually active in the year before being interviewed had used a condom in the past year. Condom use in the past year was associated with youth, greater education, residence in major cities, lower incomes, white-collar occupations, being a former smoker, and having more sexual partners in the past year. In the six months prior to interview, 7.1% of respondents always used condoms with regular cohabiting partners, 22.5% always used condoms with regular non-cohabiting partners, and 41.4% always used condoms with casual partners. Approximately 20% of respondents used a condom the last time they had vaginal intercourse, and one in eight of these condoms were put on after genital contact. Condom use during the most recent sexual encounter was associated with youth, living in a major city, having a lower income, having sex with a casual partner, and not using another form of contraception. CONCLUSION: As in other studies, condom use was strongly associated with partner type and use of other contraception. IMPLICATIONS: People with multiple sexual partners need to be aware that non-barrier methods of contraception (and condoms applied late) do not protect against sexually transmitted infections.     

Accurate Identification of a Preference for Insertive Versus Receptive Intercourse from Static Facial Cues of Gay Men

In intercourse between men, one of the partners typically assumes the role of an insertive partner (top) while the other assumes a receptive role (bottom). Although some research suggests that the perceptions of potential partners’ sexual roles in gay men’s relationships can affect whether a man will adopt the role of top or bottom during sexual intercourse, it remains unclear whether sexual roles could be perceived accurately by naïve observers. In Study 1, we found that naïve observers were able to discern men’s sexual roles from photos of their faces with accuracy that was significantly greater than chance guessing. Moreover, in Study 2, we determined that the relationship between men’s perceived and actual sexual roles was mediated by perceived masculinity. Together, these results suggest that people rely on perceptions of characteristics relevant to stereotypical male–female gender roles and heterosexual relationships to accurately infer sexual roles in same-sex relationships. Thus, same-sex relationships and sexual behavior may be perceptually framed, understood, and possibly structured in ways similar to stereotypes about opposite-sex relationships, suggesting that people may rely on these inferences to form accurate perceptions.     

Sex in Australia: selected characteristics of regular sexual relationships

OBJECTIVE: To describe selected characteristics of Australian adults' regular or ongoing sexual relationships. METHOD: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The overall response rate was 73.1% (69.4% men, 77.6% women). Respondents indicated how often they had sex in the past four weeks, contraceptive use, their own and their partners' expectations about having sex with other people during their relationship, whether they had discussed these expectations with their partners and whether they had an explicit agreement about sex with other people. RESULTS: 85.3% of men and 89.5% of women were in a regular heterosexual relationship, among whom 81.4% of men and 89.3% of women reported contraceptive use. Men and women who had a regular partner for the past 12 months had had sex with their partners an average of 1.84 times per week in the four weeks before interview; younger people had sex more often. Most respondents expected themselves and their partners to not have sex with other people, although men were less likely than women to have discussed these expectations with their partner. Bisexually identified men and women were significantly less likely than heterosexually identified men and women to support having sex only with their regular partner. Only 4.9% of men and 2.9% of women in regular heterosexual relationships had concurrent sexual partners in the past 12 months. CONCLUSION: Australians' attitudes to not having sex with people while in a regular relationship are highly consistent with their behaviour.