Alcohol Use and Sexual Risk Behaviors in a Migrant Worker Community

There are not many studies exploring the association between alcohol use and risky sexual behaviors among migrant workers. This study analyzed how changes in alcohol use was associated with changes in risky sexual behavior and psychosocial variables. Data for this study was drawn from an HIV risk reduction project. Repeated measures ANOVA and Linear mixed model statistical method was conducted to find changes and association between alcohol use, sexual risk and psychosocial variables over time. The sample (n = 203) was composed of African Americans (33.0 %) and Hispanics (77.0 %) men. Both groups, over time, showed reduction in sexual risk in accordance with reduction in alcohol use. Changes in alcohol use and psychosocial variables showed significant association with sexual risk changes over time. Psychological strategies like building social support should be considered for HIV risk reduction intervention directed towards high alcohol consuming migrant workers.     

Childhood Sexual Abuse and HIV-Related Risks Among Men Who Have Sex with Men in Washington,DC

Childhood sexual abuse (CSA) has been reported to be disproportionately higher among men who have sex with men (MSM) than among heterosexual men; it has also been found to be significantly positively associated with HIV status and HIV risk factors, including unprotected anal intercourse. The purpose of this study was to assess the correlates of CSA in a sample of community-recruited MSM, investigate race as a potential effect modifier, and describe the independent association between CSA and HIV infection in Washington, DC. A total of 500 MSM were recruited by venue-based sampling in 2008 as part of the National HIV Behavioral Surveillance. More than one-half of MSM identified as White, while one-third identified as Black. CSA was reported by 17.5 % of the 451 MSM, with the first instance of abuse occurring at a median age of 8.3 (interquartile range = 5.0, 11.0). In multivariable analysis, HIV-positive men were significantly more likely to report a history of CSA compared to HIV-negative men after adjusting for intimate partner violence in the last 12 months, having been arrested in the last 12 months, and depressive symptoms. HIV-positive MSM had more than four times the odds of reporting CSA after controlling for other correlates (aOR = 4.19; 95 % CI 2.26, 7.75). Despite hypothesizing that race modified the effect of CSA on HIV infection we found this was not the case in this sample. More research is needed to investigate the potential pathway between a history of CSA and HIV infection, and how this contributes to driving the HIV epidemic among MSM in Washington, DC.     

Use of the Internet to Meet Sexual Partners,Sexual Risk Behavior,and Mental Health in Transgender Adults

The purpose of this study was to examine the use of the internet to meet sexual partners among transgender individuals and examine correlates of this use, including sexual risk behavior, discrimination experiences, and mental health. A sample of 166 transgender adults (112 male-to-female transgender women and 54 female-to-male transgender men) were recruited in community venues and anonymously completed measures assessing these variables. Most participants (64.5 %) were HIV-negative, 25.2 % were HIV-positive, and 10.3 % did not know their HIV status. Overall, 33.7 % of participants reported having met a sexual partner over the internet, which did not differ significantly between transgender women and men. Among these individuals, transgender women reported significantly more lifetime internet sexual partners (median = 3) than transgender men (median = 1). Use of the internet to meet sexual partners was associated with lower self-esteem but not with depression, anxiety, somatic distress or discrimination experiences. Among transgender women, use of the internet to meet sexual partners was associated with each of the 11 sexual risk behaviors examined, including having multiple partners, sex under the influence of drugs, number of unprotected anal or vaginal sex acts, and history of commercial sex work. The use of the internet to meet partners was not associated with sexual risk behavior among transgender men (0/11 variables assessed). Although the internet is a common mode of meeting sexual partners among some transgender adults, it may also be a potential venue for prevention interventions targeting transgender individuals at particularly high risk for HIV acquisition.     

Sexual Risks and Policing among Male Migrant and Non-migrant Market Vendors in Central Asia

The following study examined associations between sexual risk behaviors and policing among external migrant, internal migrant, and non-migrant male market workers in Almaty, Kazakhstan. Negative binomial regression and logistic regressions examined associations between sexual risk behaviors and policing (questioning by market officials and migration police, and arrest) for 1342 external, internal, and non-migrant workers recruited using respondent-driven sampling (RDS). Incidence rate ratios (IRR) and adjusted odds ratios (OR) were stratified by migration status. External migrants were more likely than non-migrants to experience questioning by market officials (IRR = 2.07, p<0.01), migration police (IRR = 3.60, p<0.001), and arrest (OR = 5.32, p<0.001). When stratified by migration status, being under the influence of drugs or alcohol (IRR = 3.04, p<0.01) and sex with men (IRR = 2.71, p<0.05) were associated with being questioned or harassed by market police among external migrants. External migrant who reported having more than one sex partner while traveling were also more likely to report being arrested than external migrants (OR = 3.92, p<0.05). Meeting HIV prevention needs of labor migrants demands acknowledging the role of policing and allocating sufficient resources to support the implementation of HIV prevention programs in these settings.     

Sexual Victimization,Alcohol Intoxication,Sexual-Emotional Responding,and Sexual Risk in Heavy Episodic Drinking Women

This study used an experimental paradigm to investigate the roles of sexual victimization history and alcohol intoxication in young women’s sexual-emotional responding and sexual risk taking. A nonclinical community sample of 436 young women, with both an instance of heavy episodic drinking and some HIV/STI risk exposure in the past year, completed childhood sexual abuse (CSA) and adolescent/adult sexual assault (ASA) measures. A majority of them reported CSA and/or ASA, including rape and attempted rape. After random assignment to a high alcohol dose (.10 %) or control condition, participants read and projected themselves into an eroticized scenario of a sexual encounter involving a new partner. As the story protagonist, each participant rated her positive mood and her sexual arousal, sensation, and desire, and then indicated her likelihood of engaging in unprotected sex. Structural equation modeling analyses revealed that ASA and alcohol were directly associated with heightened risk taking, and alcohol’s effects were partially mediated by positive mood and sexual desire. ASA was associated with attenuated sexual-emotional responding and resulted in diminished risk taking via this suppression. These are the first findings indicating that, compared to non-victimized counterparts, sexually victimized women respond differently in alcohol-involved sexual encounters in terms of sexual-emotional responding and risk-taking intentions. Implications include assessing victimization history and drinking among women seeking treatment for either concern, particularly women at risk for HIV, and alerting them to ways their histories and behavior may combine to exacerbate their sexual risks.     

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.     

Depression and Sexual Orientation During Young Adulthood: Diversity Among Sexual Minority Subgroups and the Role of Gender Nonconformity

Sexual minority individuals are at an elevated risk for depression compared to their heterosexual counterparts, yet less is known about how depression status varies across sexual minority subgroups (i.e., mostly heterosexuals, bisexuals, and lesbians and gay men). Moreover, studies on the role of young adult gender nonconformity in the relation between sexual orientation and depression are scarce and have yielded mixed findings. The current study examined the disparities between sexual minorities and heterosexuals during young adulthood in concurrent depression near the beginning of young adulthood and prospective depression 6 years later, paying attention to the diversity within sexual minority subgroups and the role of gender nonconformity. Drawn from the National Longitudinal Study of Adolescent Health (N = 9421), we found that after accounting for demographics, sampling weight, and sampling design, self-identified mostly heterosexual and bisexual young adults, but not lesbians and gay men, reported significantly higher concurrent depression compared to heterosexuals; moreover, only mostly heterosexual young adults were more depressed than heterosexuals 6 years later. Furthermore, while young adult gender nonconforming behavior was associated with more concurrent depression regardless of sexual orientation, its negative impact on mental health decreased over time. Surprisingly, previous gender nonconformity predicted decreased prospective depression among lesbians and gay men whereas, among heterosexual individuals, increased gender nonconformity was not associated with prospective depression. Together, the results suggested the importance of investigating diversity and the influence of young adult gender nonconformity in future research on the mental health of sexual minorities.     

HIV Testing Characteristics Among Hispanic Adolescents

Hispanic adolescents are disproportionally impacted by HIV/AIDS. Among Hispanic people living with HIV, delayed testing and late entry into HIV care have been documented. The current study examined Hispanic adolescents’ HIV testing characteristics and factors related to testing. Adolescents aged 13–16 (N = 223) completed a survey on HIV testing motivation, perceptions, and experience, sexual behavior, and substance use. Results indicate few adolescents (9 %) had taken an HIV test. Among those who have not been tested, 32.5 % expressed interest in testing. HIV testing was favorably perceived with 82.4 % reported testing should be done with all youth or those are sexually active. Adolescents who had engaged in high risk behaviors (history of sexual intercourse, substance use) were more likely to have been tested or to express interest in testing. Given that HIV testing is positively perceived by Hispanic adolescents, prevention efforts should focus on minimizing barriers and enhancing accessibility to HIV screening.     

Emotional Intimacy Among Coupled Heterosexual and Gay/Bisexual Croatian Men: Assessing the Role of Minority Stress

Emotional intimacy cuts across contexts as diverse as sexual motivation and satisfaction, psychological and physical health, and relational well-being. Although the experience of intimacy and its effects on sex life may be gender and sexual orientation-specific, the role of intimacy in personal and sexual relationships has been studied mostly among heterosexual individuals and couples. Using the minority stress framework (Meyer, 2003) to address this gap in knowledge, the present study comparatively explored levels and predictors/correlates of emotional intimacy, and its association with sexual satisfaction among coupled heterosexual and gay/bisexual men sampled online in a predominantly homonegative country (Croatia). Heterosexual participants (n = 860; M_age = 36.4, SD = 9.09) were recruited in 2011 and gay/bisexual participants (n = 250; M_age = 29.4, SD = 7.13) in 2013. Controlling for age and relationship duration, gay/bisexual men reported higher levels of emotional intimacy than heterosexual men. Suggesting that the role of emotional intimacy in sexual satisfaction is not sexual orientation-specific, the strength of the association between these two constructs was similar in both samples. However, internalized homonegativity, which was negatively associated with emotional intimacy in this study, remains a challenge to creating and maintaining intimacy in male same-sex relationships.     

Dissociation During Sex and Sexual Arousal in Women With and Without a History of Childhood Sexual Abuse

Women with a history of childhood sexual abuse (CSA) experience dissociative symptoms and sexual difficulties with greater frequency than women without a history of CSA. Current models of sexual dysfunction for sexual abuse survivors suggest that dissociation may mediate the relationship between CSA and sexual arousal difficulties. Dissociation, however, is often conceptualized as a single construct in studies of CSA and not as separate domains as in the dissociation literature. In the present study, women with (CSA, N = 37) and without (NSA, N = 22) a history of CSA recruited from the community were asked to indicate the frequency and intensity of their experience in two dissociation subgroups, derealization and depersonalization, during sex with a partner and in their daily life. Findings showed that, in the NSA group, more depersonalization during sex with a partner was associated with lower sexual arousal functioning. However, for both the NSA and CSA groups, more derealization during sex was associated with higher sexual arousal functioning. No measure of dissociation was significantly associated with sexual responses in the laboratory. These findings highlight the importance of distinguishing between different forms of dissociation (i.e., derealization and depersonalization) in the study of sexual arousal functioning. In addition, the findings challenge the notion that dissociation is a main predictor of sexual arousal problems in survivors of CSA and suggest that a more nuanced relationship may exist.     

Dating violence,quality of life and mental health in sexual minority populations: a path analysis

Purpose

Theories explaining the impact of intimate partner violence (IPV) on mental health have focused on heterosexual relationships. It is unclear whether mental health disparities between heterosexual and sexual minority people are due to IPV or factors related to sexual orientation. The present study aimed to investigate pathways of how sexual orientation influenced quality of life and mental health.

Methods

The present cross-sectional study was conducted in 1076 young adults in a university population (934 heterosexual and 142 sexual minority groups). Structural equation modelling was used to examine the pathways of sexual orientation, dating violence, sexual orientation concealment, quality of life and mental health (perceived stress, anxiety and depression).

Results

After adjusting for sociodemographic factors, quality of life in sexual minority people was poorer [estimate ?2.82, 95 % confidence interval (CI) ?4.77 to ?0.86, p = 0.005], and stress (estimate 2.77, 95 % CI 1.64–3.92, p < 0.0001), anxiety (estimate 1.84, 95 % CI 1.13–2.56, p < 0.0001) and depression levels (estimate 0.62, 95 % CI 0.05–1.2, p < 0.0001) were higher than in heterosexual people. Dating violence and sexual orientation concealment were mediators, with the models showing a good fit.

Conclusion

Our study has progressed investigation of the link between sexual orientation and quality of life and mental health in the Chinese context. It has helped identify health disparities between heterosexual and sexual minority people and determined specific factors affecting their quality of life and mental health.

     

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.     

Sexual Self-Schemas,Sexual Dysfunction,and the Sexual Responses of Women with a History of Childhood Sexual Abuse

Accumulating evidence points to the mediating effects of sexual self-schemas on the sexual difficulties of women with a history of childhood sexual abuse (CSA). The following study adds to the extant literature by investigating (1) sexual function and (2) sexual satisfaction utilizing validated measures, and reporting on the relationship between sexual self-schemas and physiological (vaginal photoplethysmography), subjective, and affective responses during laboratory exposure to sexual stimuli. In a community sample of women with (N = 48) and without (N = 48) a history of CSA, we tested (1) the mediation of negative affect on the relation between sexual self-schemas and sexual function/satisfaction, (2) the mediation of negative affect in the relation between CSA and sexual function/satisfaction, and (3) the mediation of sexual self-schemas in the relation between a history of CSA and negative affect prior to sexual stimuli. We found that more Embarrassed/Conservative and less Romantic/Passionate sexual self-schemas predicted negative affect prior to exposure to sexual stimuli which, in turn, predicted levels of sexual satisfaction. The lower sexual satisfaction of CSA survivors was partially mediated by higher reports of negative affect prior to sexual stimuli. However, negative affect prior to sexual stimuli was not mediated by the sexual self-schemas of CSA survivors. Thus, although sexual self-schemas predicted sexual satisfaction, they did not predict variance in negative affect prior to sexual videos experienced by women with a history of CSA.     

The Association Between Men’s Concern About Demonstrating Masculine Characteristics and Their Sexual Risk Behaviors: Findings from the Dominican Republic

Quantitative analyses exploring the relationship between masculinities and men’s sexual risk behaviors have most commonly used one dimension of masculinities: men’s gender ideology. Examining other dimensions may enhance our understanding of and ability to intervene upon this relationship. In this article, we examined the association between gender role conflict/stress (GRC/S)—men’s concern about demonstrating masculine characteristics—and three different sexual risk behaviors (having two or more sex partners in the last 30 days; never/inconsistent condom use with non-steady partners; and drinking alcohol at last sex) among a sample of heterosexual men in the Dominican Republic who were participating in an HIV prevention intervention (n = 293). The GRC/S Scale we used was adapted for this specific cultural context and has 17 items (α = 0.75). We used logistic regression to assess the relationship between GRC/S and each sexual behavior, controlling for sociodemographic characteristics. In adjusted models, a higher GRC/S score was significantly associated with increased odds of having two or more sex partners in the past 30 days (AOR 1.33, 95 % CI 1.01–1.74), never/inconsistent condom use with non-steady partners (AOR 1.45, 95 % CI 1.04–2.01), and drinking alcohol at last sex (AOR 1.56, 95 % CI 1.13–2.17). These results highlight the importance of expanding beyond gender ideology to understanding the influence of GRC/S on men’s sexual risk behaviors. Interventions should address men’s concern about demonstrating masculine characteristics to reduce the social and internalized pressure men feel to engage in sexual risk behaviors.     

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.     

Psychosocial Predictors of Sexual HIV Transmission Risk Behavior among HIV-Positive Adults with a Sexual Abuse History in Childhood

Childhood sexual abuse (CSA) is associated with HIV sexual risk behavior. Although many psychosocial correlates of sexual risk among HIV-positive persons have been identified, studies predicting continued risk among HIV-positive adults with histories of CSA are limited. This cross-sectional study identified variables predictive of sexual transmission risk behavior among an ethnically diverse sample of 256 HIV-positive adults (women and men who have sex with men; MSM) with CSA histories. Participants were assessed for trauma symptoms, shame related to HIV and sexual trauma, substance use, coping style, and sexual risk behavior. Logistic regression analyses were conducted to identify variables predictive of unprotected sexual behavior in the past 4 months. Unprotected sex was significantly associated with substance use and trauma-related behavioral difficulties among women and men, and less spiritual coping among men. Unprotected sex with HIV negative or serostatus unknown partners was significantly associated with greater trauma-related behavioral difficulties, more HIV-related shame, and fewer active coping strategies. Thus, trauma symptoms, shame, coping style, and substance use were significantly associated with sexual risk behavior among HIV-positive adults with histories of CSA, with models of prediction differing by gender and partner serostatus. HIV prevention intervention for persons with HIV and CSA histories should address trauma-related behavioral difficulties and enhance coping skills to reduce sexual transmission risk behavior.     

The Effects of Mindfulness on Sexual Outcomes: The Role of Emotion Regulation

Individuals higher in dispositional mindfulness, a quality of non-judgmental attention to the present moment, fare better than their less mindful counterparts on a wide range of psychological and interpersonal outcomes. However, remarkably little is known about the potential influence of dispositional mindfulness on sexual outcomes. Here we investigated whether dispositional mindfulness was associated with a range of sexual outcomes, including sexual satisfaction, sexual hyperactivation (heightened sexual desire and worry), sexual deactivation (suppression of sexual desire and behavior), and problematic pornography use. We also tested whether capacity for emotion regulation was the mechanism underlying the mindfulness–sexual outcome association. These hypotheses were tested in two samples: a sample of adults in a committed romantic relationship (N = 407) and a group of adults who were long-term single (N = 400). Across both samples, dispositional mindfulness predicted more adaptive sexual outcomes, and emotion regulation generally mediated these associations. Of particular importance, the positive effects of dispositional mindfulness on sexual outcomes appear to generalize across relationship statuses, with both partnered and long-term single individuals displaying a similar pattern of results. These findings highlight that high dispositional mindfulness may predict a range of positive sexual outcomes in both partnered and single individuals.