Sexual Minority Women and Depressive Symptoms Throughout Adulthood

Objectives. We examined the associations between depressive symptoms and sexual identity and behavior among women with or at risk for HIV.Methods. We analyzed longitudinal data from 1811 participants in the Women’s Interagency HIV Study (WIHS) from 1994 to 2013 in Brooklyn and the Bronx, New York; Chicago, Illinois; Washington, DC; and Los Angeles and San Francisco, California, by comparing depressive symptoms by baseline sexual identity and ongoing sexual behavior. We controlled for age, socioeconomic status, violence history, and substance use.Results. In separate analyses, bisexual women and women who reported having sex with both men and women during follow-up had higher unadjusted odds of depressive symptoms compared with heterosexuals and women who reported only having male sexual partners (adjusted odd ratio [AOR] = 1.36; 95% confidence interval [CI]  = 1.10, 1.69 and AOR = 1.21; 95% CI = 1.06, 1.37, respectively). Age was a significant effect modifier in multivariable analysis; sexual minority women had increased odds of depressive symptoms in early adulthood, but they did not have these odds at midlife. Odds of depressive symptoms were lower among some sexual minority women at older ages.Conclusions. Patterns of depressive symptoms over the life course of sexual minority women with or at risk for HIV might differ from heterosexual women and from patterns observed in the general aging population.Depression is a major health concern for women. According to the Centers for Disease Control and Prevention (CDC), 10% of US women reported any depression and 5% reported major depression in the previous 2 weeks.1 Depression has been reported in 19% to 62%2–4 of HIV-infected women and is associated with reduced cognitive function,5 decreased adherence to highly active antiretroviral therapy (HAART),6 higher rates of unprotected sex among substance users,7 and increased mortality.2,6Women with or at risk for HIV are often exposed to factors such as poverty,8 substance use, and violence,9–11 which can independently and jointly contribute to depression. A recent study found that any combination of intimate partner violence (IPV), substance use, and HIV infection increased the odds of depression.12 Lower socioeconomic status (SES) in women12 and HIV infection4,5 were also independently associated with depression. However, studies showed no association among HIV stage, HAART use,4,8 CD4 count,8,13 or viral load and depression.4,8,13There is a strong association between sexual minority status (i.e., women who identify as lesbian or bisexual or have female sex partners) and poor mental health. In a US survey, lifetime major depression was reported by 42% of lesbians, 52% of bisexuals, and 27% of heterosexual women (P < .01); in the same study, major depression was reported by 15% of women who have sex with women (WSW), 51% of women who have sex with men and women (WSMW), and 27% of women who have sex with men (WSM; P < .01).14 In this study, we examined 2 aspects of sexual orientation15–17: sexual identity and sexual behavior. Although sexual attraction is also considered part of an individual’s sexual orientation, data on attraction was not collected in the original study.Despite the strong association between sexual minority status and depression, it is unknown whether sexual minority status acts as an independent predictor or effect modifier of depressive symptoms among women affected by HIV, substance use, and violence. Our original hypothesis was that lesbian, bisexual, and WSMW (but not WSW) would have higher odds of depression, with race/ethnicity acting as a potential effect modifier.     

Gender and Sexual Orientation Differences in Cognition Across Adulthood: Age Is Kinder to Women than to Men Regardless of Sexual Orientation

Despite some evidence of greater age-related deterioration of the brain in males than in females, gender differences in rates of cognitive aging have proved inconsistent. The present study employed web-based methodology to collect data from people aged 20-65 years (109,612 men; 88,509 women). As expected, men outperformed women on tests of mental rotation and line angle judgment, whereas women outperformed men on tests of category fluency and object location memory. Performance on all tests declined with age but significantly more so for men than for women. Heterosexuals of each gender generally outperformed bisexuals and homosexuals on tests where that gender was superior; however, there were no clear interactions between age and sexual orientation for either gender. At least for these particular tests from young adulthood to retirement, age is kinder to women than to men, but treats heterosexuals, bisexuals, and homosexuals just the same.     

Body Composition Correlates of Weight Dissatisfaction and Dietary Restraint in Young Women

Previous research found that when Body Mass Index (BMI) was statistically controlled in a multiple regression model, the percentage of body fat accounted for no additional variance in dietary restraint scores among women although, on its own, it was a significant predictor of this variable. These results imply that anatomical factors, besides fatness, influence dieting behaviour. The present study was designed to compare the relative influence on dietary restraint and weight dissatisfaction, of three body composition measures, each of which contributes in a different way to subjective impressions of body size (viz. BMI, body fat content, and skeletal frame size). Measures of emotional reactivity ('neuroticism'), body dissatisfaction, and body focus were also included in the regression model. Results indicated that these psychological variables were strongly and positively related to restraint. Frame size was also a significant predictor of restraint and weight dissatisfaction. In fact, when frame size was controlled in the regression model, neither percentage of body fat nor BMI were able to explain any additional variance in restraint scores. These findings indicate that weight concerns and dieting behaviour are influenced, at least among young women, more by the size of their skeletal structure than their degree of adiposity. The irony of these findings is obvious and disheartening. An anatomical feature which is essentially resistant to change by dieting or exercise appears to be a primary influence in women's weight dissatisfaction and their tendency to diet. It is acknowledged, however, that this relationship may not obtain among very obese women.     

Associations Between Patterns of Sexual Initiation,Sexual Partnering,and Sexual Health Outcomes from Adolescence to Early Adulthood

The goal of this study was to examine, in a nationally representative sample, relationships between various sexual initiation patterns, subsequent sexual partnerships, and related health outcomes from adolescence through early adulthood. Data were from a subset of 6587 respondents from the National Longitudinal Study of Adolescent to Adult Health. Bivariate analyses and adjusted logistic and ordinary least squares regression models were used to determine associations between membership in three sexual initiation classes, lifetime sexual partner counts, and multiple health outcomes, including lifetime sexually transmitted infection or disease (STI/STD) diagnosis, lifetime unintended pregnancy, and romantic relationship quality. Broadly, having fewer lifetime sexual partners was associated with lower odds of STI/STD diagnosis and unintended pregnancy, and better relationship quality; however, findings also indicated both within and between sexual initiation class differences in the relationship between lifetime sexual partners and all three health outcomes. In particular, results showed little variation in health outcomes by sexual partnering among those who postponed sexual activity, but members of the class characterized by early and atypical sexual initiation patterns who had fewer lifetime partners exhibited better health outcomes than most other initiation groups. These results show that while both sexual initiation and partnering patterns add important information for understanding sexual health from adolescence to early adulthood, partnering may be more relevant to these sexual health outcomes. Findings indicate a need for more comprehensive sexuality education focused on sexual risk reduction and promotion of relationship skills among adolescents and adults.     

Body Image Dissatisfaction,Obesity and Their Associations with Breastfeeding in Mexican Women,a Cross-Sectional Study

Introduction In Mexico the breastfeeding rate is low and the obesity rate is high. Body image concerns, particularly prevalent in obese women, are associated with low breastfeeding rate; however, this association has never been examined in Mexican women. To fill this need, we examined the association between body image dissatisfaction (BID) and breastfeeding across levels of maternal weight status in Mexican women. Methods A cross-sectional study was used, utilizing data from the Mexican National Health and Nutrition Survey (ENSANUT) for 2012. The breastfeeding (Never or breastfed less than 30 days, Still breastfeeding, Ever breastfed) of the last child (age?≤?3 years), BID (Stunkard Figure Rating Scale), anthropometric (Body Mass Index, BMI), and associated characteristics were collected. Weighted-multinomial logistic regression models were utilized to examine the adjusted association between BID and breastfeeding and the effect modification of maternal weight status. Results Overall, 2422 women aged 20–49 years met the eligibility criteria. Of these, 247 (10.8%) had never breastfed or breastfed less than 30 days, 826 (32%) were still breastfeeding, and 1349 (57.2%) had breastfed. A total of 38.2% were overweight (25?≤?BMI?<?30 kg m²) and 26.2% were obese (BMI?≥?30 kg m²). In the adjusted model, while stratifying by maternal weight status levels, a greater BID was associated with a lower odds of sill breastfeeding (OR 0.58, 95% CI 0.45–0.75) and having breastfed (OR 0.65, 95% CI 0.50–0.83) only among women with BMI?≥?30 kg m². Discussion The results highlight the potential relationship between body image concerns and breastfeeding in Mexican women with obesity. However, the causality of such relationship needs further investigation, ideally using a longitudinal study design.     

Exploring Body Image,Contraceptive Use,and Sexual Health Outcomes Among an Ethnically Diverse Sample of Women

This cross-sectional study examined the links between body appreciation, contraceptive use, and sexual health outcomes. Body appreciation has been shown to influence contraceptive use in homogenous samples of women. However, a common problem in body image literature is a lack of racial and ethnic diversity with regard to sample; this study was able to take steps toward overcoming that limitation. A sample of 499 women aged 18–56 (M = 26.24; SD = 6.15) was recruited via Reddit.com—White (29.3%, n = 120), Asian (19%, n = 78), Black (17.3%, n = 73), multiracial (13.9%, n = 57), and Latina (13.9%, n = 57). Covariates included race/ethnicity, body size as measured by body mass index, relationship status, age, sexual orientation, and education level. Results indicated that higher levels of body appreciation were related to a higher likelihood of using non-barrier contraception. Regarding the covariates, race, relationship status, age, and education were related to non-barrier contraceptive use and age was related to dual contraceptive use. Further exploration is needed to determine how body appreciation may affect contraceptive use and sexual health outcomes and how these differ by race/ethnicity.     

The Relationships Between Sexual Function, Body Image, and Body Mass Index Among Women

The cross-sectional study was conducted to examine the relationship between sexual function, body mass index and body image among women. 193 women were included in the sampling. The data was collected using questionnaire form, the Female Sexual Function Index (FSFI), and Body Image Scale (BIS). The mean of the total FSFI score was 22.62 (SD 6.54, range 2.00–32.00). The mean of the BIS score was 145.29 (SD 17.73, range 93–200). The mean of the body mass index (BMI) was 24.50 (SD 3.75, range 16.05–35.56). Of the six sexual function parameters, pain (r = 0.044) did not correlate with BIS, while desire (r = 0.351), arousal (r = 0.335), lubrication (r = 0.242), orgasm (r = 0.335), satisfaction (r = 0.339) and FSFI total (r = 0.343), all p < 0.001 did. In according to BMI groups of women were observed significant difference in BIS scores (p = 0.007), but FSFI scores were not (p > 0.05). In conclusion, positive body image of women had a positive effect on their sexual function. Overweight and obese based on BMI among women had a negative effect on woman’s body image, but had no effected on woman’s sexual function.     

Negative Body Attitudes and Sexual Dissatisfaction in Men: The Mediating Role of Body Self-Consciousness During Physical Intimacy

Previous research indicated that negative attitudes about the body and appearance are common among men and demonstrated that negative body attitudes are associated with negative sexual experiences. The present study investigated the association between body attitudes and sexual dissatisfaction and the mediating role of body self-consciousness during physical intimacy. In a cross-sectional design, 201 Dutch men completed an online survey regarding body attitudes toward muscularity, body fat, height, and genitals, body self-consciousness during physical intimacy, and sexual dissatisfaction. Hypotheses were tested using correlation analyses and a mediation analysis with body attitudes as predictors, body self-consciousness as mediator, and sexual dissatisfaction as outcome. Correlation analyses showed that negative body attitudes and body self-consciousness during physical intimacy were significantly related to sexual dissatisfaction. The mediation analysis revealed that negative attitudes toward muscularity, body fat, and genitals had indirect effects on sexual dissatisfaction through body self-consciousness during physical intimacy. Negative attitudes toward genitals additionally had a direct effect on sexual dissatisfaction. These findings indicate that body image interventions focused on male body attitudes may be beneficial in improving men’s body image, which may ultimately increase sexual satisfaction.     

Sexual Abuse in Childhood and Physical and Mental Health in Adulthood: An Australian Population Study

Although childhood sexual abuse (CSA) is associated with a wide range of health problems later in life, there is also evidence of substantial individual differences. This study describes the mental and physical health of a population sample of Australians, randomly selected from the Commonwealth electoral roll, who have reported their CSA histories. Some 58% of those located from the electoral roll agreed to a telephone interview (n=1,784). Health status was measured using the Short Form 36 questionnaire. Men who had experienced non-penetrative and penetrative sexual abuse in childhood had 2.25 (95% CI=1.32-3.82) and 5.93 (95% CI=2.72-12.95) times respectively the rate of impaired mental health, but no higher rates of impaired physical health. Women who had experienced non-penetrative and penetrative sexual abuse in childhood had 1.87 (95% CI=1.19-2.95) and 3.15 (95% CI=1.87-5.33) times respectively the rate of impaired mental health and 1.87 (95% CI=1.19-2.92) and 2.31 (95% CI=1.34-3.97) times respectively the rate of impaired physical health. However, participants who had experienced CSA were no less likely than those who had not experienced CSA to be in optimum physical and mental health. None of the possible confounding or moderating variables tested appeared to mitigate the impact of CSA on health outcomes. Those with the highest levels of mental and physical health appear to be unaffected by the experience of CSA.     

Sexual Function,Body Image and Quality of Life of Women with Advanced Cancer

Sexuality and Disability - Few studies have focused exclusively on the sexuality and body image of women with advanced cancer and the physical and emotional impact of cancer treatment on sexual...     

Sexual Victimization in Adulthood and Associated Factors Among Men and Women: Cross-Sectional Evidence from Mainland China

Archives of Sexual Behavior - Limited empirical research addresses sexual victimization and related factors among the general adult population in China. To address this gap, we explored the...     

The Association Between Body Esteem and Sexual Desire Among College Women

Relationships between body image variables and sexuality have been found among several groups of women. However, research has largely focused on generalized experiences of sexuality. With the exception of two studies which focused on specific medical populations, to our knowledge there has been no investigation of the relationship between body image and acute measures of sexual response. In the current study, we investigated the relationships between body esteem, sexual response to erotica in a laboratory-setting, and self-reported sexual functioning in a non-clinical sample of 85 college women. Women participated in one study session, during which mental sexual arousal, perceptions of physical arousal, and sexual desire were assessed. Results showed that higher body esteem was significantly positively related to sexual desire in response to erotica in the laboratory setting. Similarly, higher body esteem was positively related to self-reported measures of sexual desire, as assessed by a validated measure of sexual function. The sexual attractiveness and weight concern subscales of the Body Esteem Scale, which relate to body characteristics that are most likely to be under public scrutiny, were particularly linked to sexual desire. This is the first study to show that body esteem is related to sexual responses to a standardized erotic stimulus in a laboratory setting.     

Exploring Knowledge,Belief and Experiences in Sexual and Reproductive Health in Immigrant Hispanic Women

This study examined the transformation of immigrant women’s knowledge, belief and experience with regard to sexual and reproductive health after living in the US. Four focus groups (N = 24) were held with Hispanic women ≥18 years old. We identified two main themes (Fertility/Knowledge and Gender power) with five subthemes (Sex education, Contraception and unintended pregnancy, Men versus women, Intimate partner violence, and Immigrating to the US). Most of these women were raised in a very restricted family context where talking about sex was viewed as sinful. In spite of their own experiences of sexual silence and the consequences to their lives, women valued the positive changes achieved by immigrating to the US; they felt empowered to make their own decisions regarding reproductive health.     

Sexual Identity,Body Image and Life Satisfaction Among Women With and Without Physical Disability

The current study examined the association between sexual identity, body image and life satisfaction among women with and without physical disability. Seventy women with physical disability (spinal cord injuries and injuries resulting from polio) and 64 women without disability completed the following questionnaires: Sexuality Scale, Body Image Scale and Quality of Life Questionnaire. The results demonstrated that women with physical disability had the same sexual needs and desires as women without disability, but their body image, sexual self-esteem, sexual satisfaction and life satisfaction were significantly lower. These differences were stronger among young adult women than among more mature women. It was also found that sexual satisfaction was a major factor in explaining the variance in life satisfaction in both groups, and the relationships between sexual satisfaction and life satisfaction were bidirectional. At the same time, different patterns of congruency and inconsistency between sexual satisfaction and life satisfaction were exposed in both groups. In addition, the research demonstrated a moderating effect of family status on links between sexual and life satisfaction.     

A Multidimensional Model of Sexual Health and Sexual and Prevention Behavior Among Adolescent Women

PurposeSexual health refers a state of lifespan well-being related to sexuality. Among young people, sexual health has multiple dimensions, including the positive developmental contributions of sexuality, as well as the acquisition of skills pertinent to avoiding adverse sexual outcomes such as unintended pregnancy and sexually transmitted infections (STIs). Existing efforts to understand sexual health, however, have yet to empirically operationalize a multi-dimensional model of sexual health and to evaluate its association to different sexual/prevention behaviors.MethodsSexual health dimensions and sexual/prevention behaviors were drawn from a larger longitudinal cohort study of sexual relationships among adolescent women (N = 387, 14–17 years). Second order latent variable modeling (AMOS/19.0) evaluated the relationship between sexual health and dimensions and analyzed the effect of sexual health to sexual/prevention outcomes.ResultsAll first order latent variables were significant indicators of sexual health (β: 0.192 – 0.874, all p < .001). Greater sexual health was significantly associated with sexual abstinence, as well as with more frequent non-coital and vaginal sex, condom use at last sex, a higher proportion of condom-protected events, use of hormonal or other methods of pregnancy control and absence of STI. All models showed good fit.ConclusionsSexual health is an empirically coherent structure, in which the totality of its dimensions is significantly linked to a wide range of outcomes, including sexual abstinence, condom use and absence of STI. This means that, regardless of a young person's experiences, sexual health is an important construct for promoting positive sexual development and for primary prevention.