A Twin Study of Sexual Behavior in Men

The role of genetic and environmental influences on age of initiation of first sexual relations and engaging in sexual activity with multiple partners (10 or more partners in 1 year) was investigated in male twins (N = 6,744) from the Vietnam Era Twin Registry. Individual differences in both types of sexual behaviors were heritable, but only age of onset of sexual relations was significantly influenced by the environment shared by the twins. There was a moderate negative correlation between age of initiation of sexual relations and the multiple partners variable; initiating sexual relations earlier was associated with a higher probability of having multiple partners. The additive genetic influence on age of initiation also influenced the multiple partners variable. The substantial unique environmental influences on each variable were uncorrelated with each other. The data suggest that the observed association between age of initiation of sexual relations and having multiple partners is due to genetic influences common to both behaviors.     

The Relationship Between Alcohol and Individual Differences Variables on Attitudes and Behavioral Skills Relevant to Sexual Health Among Heterosexual Young Adult Men

The purpose of this experiment was to investigate the effects of alcohol, alcohol sex expectancies, and sexual sensation seeking on determinants of sexual health behavior according to the Information-Motivation-Behavioral Skills (IMB) model. The participants were 48 heterosexual young adult males who attended 2 laboratory sessions. During Session 1, participants completed a set of screening and individual differences measures, and during Session 2 they were randomly assigned to 1 of 3 beverage conditions: control, alcohol (0.65 g alcohol/kg body weight), or placebo. Following the experimental manipulation, all participants completed measures regarding attitudes toward condom use, intention to engage in risky sex, and condom use negotiation skills. The results showed that participants who consumed alcohol had poorer negotiation skills and greater intention to engage in risky sex compared to participants who did not drink alcohol. Although alcohol did not affect any dimension of attitude regarding condom use, attitude about condoms' effects on sex, as well as sexual sensation seeking, were correlated with both intention ratings and skills. Multiple regression models, including both attitudes and sensation seeking, showed that attitudes accounted for 20-25% of variance independent of beverage condition in predicting intention ratings and skills. The findings were consistent with past research showing that alcohol consumption can have detrimental effects on determinants of sexual health behavior and that individual differences factors can enhance the power of models like the IMB to predict such behavior.     

成都市男男性行为人群性伴数量影响因素分析

目的 了解成都市男男性行为(Men Who Have Sex With Men,MSM)人群的性行为情况,探索成都市MSM人群性伴数量的影响因素.方法 采用立意抽样和“滚雪球”抽样的方法对成都市291名MSM进行一对一问卷调查,采用非条件Logistic回归对该人群性伴数量的影响因素进行分析.结果 调查对象中,48.5％在近6个月性伴数量在1人以上;90.2％有肛交行为;51.6％在性行为中不能坚持使用安全套.Logistic回归显示,“安全套使用情况”和“在成都你找7个同性性伴就可能会遇到一个艾滋病感染者”等4个条目是MSM人群性伴数量的影响因素.结论 成都市MSM人群的普遍存在高危行为,可以尝试从减少性伴数量角度进行有针对性干预,以降低其艾滋病感染风险.     

Gene-Environment Contributions to Young Adult Sexual Partnering

To date, there has been relatively little work on gene-environment contributions to human sexuality, especially molecular analyses examining the potential contributions of specific polymorphisms in conjunction with life experiences. Using Wave III data from 717 heterozygous young adult sibling pairs included in the National Longitudinal Study of Adolescent Health, this article examined the combined contributions of attendance at religious services and three genetic polymorphisms (in the dopamine D4 receptor [DRD4]), dopamine D2 receptor [DRD2]), and the serotonin transporter promoter [5HTT]) to sensation seeking, a personality construct related to sexual behavior, and the number of vaginal sex partners participants had in the year before interview. Data analyses used an Allison mixed model approach to account for population stratification and correlated observations. DRD4 was unrelated to sensation seeking and to the number of sex partners in tests of both main effects and in interaction with religious attendance. Contrary to hypothesis, presence of the A1 DRD2 allele was associated with having had fewer sex partners in the past year. Associations between the 5HTT allele and sex partners varied by religious attendance, but again the patterns of associations were contrary to hypothesized relationships and were small in magnitude. These findings underscore the necessity of using more comprehensive multiple gene-multiple life experience approaches to investigations of complex behaviors such as sexual patterns.     

Attitudes Toward Male and Female Sexuality Among Men and Women With Intellectual Disabilities

Studies comparing the sexual attitudes of men and women with intellectual disabilities (ID) have been limited. A mixed-methods approach was employed to explore attitudes toward sexuality among men and women with ID in Taiwan and to ascertain the disparities between attitudes among men and women with ID. First, fifty-six men and forty-four women with mild and moderate ID completed a face-to-face interview survey. After this, focus groups were conducted for men and women with ID. Results indicated that women with ID were more likely to have negative attitudes toward parenting and non-reproductive sexual behavior than their male counterparts. Qualitative data indicated that men and women with ID had different sexual attitudes and experiences and were subject to different expectations from people around them. Both men and women with ID had very limited opportunities to develop romantic relationships and a healthy sexual identity. Sexual rights awareness and practice should be matters of concern for this group of adults and women with ID in particular.     

Sexual activity and risk-taking in later life

The primary study objective was to identify the prevalence of sexual activity and sexual risk-taking behaviour among a sample of older community-based adults. Secondary objectives included gathering data about past experiences of consultations regarding sexual health issues with general practitioners (GPs) and at genitourinary medicine (GUM) clinics, and exploring participants' STI and HIV/AIDS-related information needs. Individuals over the age of 50 were identified from four electoral wards within Sheffield, UK by means of a postal screen based on the electoral register. Respondents self completed a short postal questionnaire. Three hundred and nineteen individuals aged over 50 years selected at random from the general population responded. Approximately 80% of respondents were currently sexually active and 7% engaged in behaviours that may place them at risk of contracting a sexually transmitted infection (STI). Risk takers were typically male, aged between 50 and 60 years and married. Being male was also related to reporting current or past sexual health concerns. In total, of 75 respondents reporting such concerns, two thirds had discussed these concerns with their GP or attended a GUM clinic. Levels of satisfaction with such consultations were generally high, but declined with increasing age. Overall, most participants felt they had not received very much information about STIs and HIV, and about one quarter reported that they would like to receive more information on these topics. These data have implications for all health and social care professionals who work with older people and indicate a potential need for education to help professionals meet the sexual health needs of their older patients/clients. Further implications for sexual health promotion and the need for additional research in this field are also discussed.     

Serostatus Disclosure to Sexual Partners by HIV-Infected Women Before and After the Advent of HAART

ABSTRACT

HIV-positive individuals have been encouraged by public health officials to disclose their HIV status to sexual partners. In deciding what to do, however, they must weigh what they see as the potential costs and benefits of disclosing or not disclosing. In the present report we examine the reasons women offer for disclosing or not disclosing their serostatus and the reactions to that disclosure among two matched samples of HIV-infected women. The first sample was interviewed in 1994–1996, before the widespread availability of HAART; while the second sample was interviewed from 2000–2003 after these medications were widely in use. The findings reveal striking similarities between the two time periods in women's reasons for sharing or not sharing their status with partners, and the reactions to disclosure they experienced. The reconceptualization of AIDS as a chronic illness, rather than an acute fatal one, did not appear to have diminished women's felt responsibility to share their diagnosis with potential sexual partners nor their fear that disclosure would be met with rejection. The data revealed that disclosure remains a highly stressful event for HIV-infected women and that they experience considerable emotional suffering as a result of the diminished sense of self-worth and physical attractiveness brought about by their diagnosis. These findings suggest that intervention efforts toward reducing the stigmatization of HIV/AIDS and for assisting women to manage the stress of disclosure and non-disclosure and address women's feelings of self-worth continue to be needed despite the advent of HAART.     

Predictors of Multiple Sexual Partners among Men in Ethiopia: A Multilevel Analysis

BackgroundMultiple sexual partnerships were one of the public health issues in the spread of high rates of sexually transmitted infections in sub-Saharan regions. An increase in the number of non-marital sexual partners can lead to a loss of satisfaction as well as other mental health repercussions such as greater rates of anxiety, depression, etc. This study examined the predictors of multiple sexual partners among men in Ethiopia.MethodsThis study used 2016 nationally representative data which was conducted using a multistage stratified cluster sampling method. Multilevel binary logistic regression models were employed to estimate the predictors of multiple sexual partners among men in Ethiopia with the assistance of the STATA software.ResultsIn this study 6778 participants were considered with an overall prevalence rate of multiple sexual partners of 6.5% during the 12 months preceding the survey. The findings showed that older-age, urban-resident, inconsistent use of a condom, exposure to any media, abuse of alcohol, early-time first-sex, and religion were predictors of multiple sexual partners among men in Ethiopia.ConclusionsThe findings revealed that the prevalence rate of men''s multiple sexual partners in Ethiopia was very high. Therefore, the country needs to re-examine the behavioral change strategies periodically to adapt to the contextual realities and engage relevant stakeholders. Specifically, health sectors and religious organizations should develop strategies to create awareness in society on the risk of having multiple sexual partnerships. In addition, we highly recommend stakeholders prepare risk reduction interventions that take the significant predictors of multiple sexual partners.     

Safer Sex Communication and Unsafe Sexual Behavior Among Young Men Who Have Sex with Men in California

Our objective was to investigate sexualcommunication and risk-taking behaviors among young menwho have sex with men (MSM). MSM aged 17 to 25 yearswere recruited from four areas throughout California. The construct Safer Sex Communication, assessedthrough principal-components analysis, was defined asperceived efficacy or experience in minimizing the riskof sexual HIV infection through communication with partners. In the 6 months prior to thesurvey, 35.6% of the MSM had participated in unprotectedanal intercourse (UAI). Adjusted logistic regressionanalyses found low Safer Sex Communication to be predictive of UAI. In addition, negativeattitudes toward safe sex, high perceived risk of HIVinfection, 10 or more male sex partners during theprevious 6 months, and use of cocaine in the past 6months were also independently related to UAI. SaferSex Communication skills should be an outcome ofinterventions designed to prevent HIV transmission amongyoung MSM.     

A Prospective Study of Intraindividual and Peer Influences on Adolescents' Heterosexual Romantic and Sexual Behavior

Theories and empirical studies of adolescent sexual behavior have identified the contributions of personal attributes and social experiences; however, it is rare that models have clarified developmental pathways to adolescent sexual behavior that include (1) factors assessed prior to and early in adolescence and (2) dyadic experiences in adolescence that provide the opportunity for sexual behavior (i.e., dating). Using data from a prospective study, structural equation modeling was used to test a model predicting adolescent sexual behavior at age 19, denoted by the number of lifetime sexual partners. Predictors examined were sociability and impulsivity assessed at 30 months of age, physical characteristics and experiences with peers measured at age 12-13, the age of first romantic relationship, and frequency of alcohol use at age 16. The pathway to greater sexual involvement was marked by some desired personal attributes (e.g., sociability) and peer experiences (e.g., higher quality friendships). These associations were mediated, however, by earlier initiation of romantic relationships and more frequent use of alcohol in middle adolescence. Earlier initiation of romantic relationships and more frequent alcohol use were predicted by greater sociability and less impulsivity in childhood, higher quality friendships and greater peer acceptance in early adolescence, and a more mature appearance and physical attractiveness (among females) at age 13. The findings imply a complex pathway that leads to a greater accumulation of sexual partners by age 19. This pathway begins in childhood and includes individual qualities, peer acceptance, romantic relationships, and alcohol use.     

Attitudes of Physicians in New Mexico Toward Gay Men and Lesbians

Previous studies suggest that negative attitudes held by many physicians toward gay men and lesbians may adversely affect this population's health care. This study examined the attitudes of physicians toward homosexuality through a questionnaire mailed to 1949 physicians in New Mexico. The questionnaire included a validated attitudinal scale. Each respondent was categorized as homophilic, neutral, or homophobic based on their responses. We had a 53.6% response rate. Over 8% of male respondents had homophobic scores versus 1.6% of female respondents. Of those practicing in cities with populations between 25,000 and 50,000, 20.6% had homophobic scores versus 4.5% of those practicing in larger cities and 6.4% of those in more rural areas. Multivariate analysis showed that gender, specialty, community size, and personal experiences help determine whether a physician is likely to hold negative attitudes toward gay men and lesbians. Our study found less homophobia among physicians than reported previously; however, we found that negative attitudes toward homosexuality persist in medicine. This study is the first to measure homophobia among physicians working in smaller cities; this may affect the quality of care available to lesbians and gay men who reside in these areas.     

Sexual Network Patterns and Their Association With Genital and Anal Human Papillomavirus Infection in Adolescent and Young Men

PurposeThis study aimed to determine individual- and partner-level factors associated with human papillomavirus (HPV) infection in vaccinated and unvaccinated men.MethodsA total of 747 men, aged 13–26 years, completed a survey of sexual behaviors and were tested for genital and perianal/anal HPV (36 types). Sexual network variables included recent and lifetime concurrency (being in more than one sexual relationship at the same time) and recent sex partner discordance (by race, ethnicity, age, and number of sexual partners). We determined individual-level and sexual network variables associated with ≥1 HPV type and HPV16/18, stratified by vaccination status, using separate multivariable logistic regression models.ResultsParticipants' mean age was 21.2 years; 64% were positive for ≥1 HPV type and 21% for HPV16/18. Factors associated with ≥1 HPV type in unvaccinated men included recruitment site and lifetime concurrency. Factors associated with ≥1 HPV type among vaccinated men included recruitment site, Chlamydia history, main male partner, number of lifetime female partners, and no condom use with female partner. Factors associated with HPV16/18 in unvaccinated men included race and partner concurrency. Factors associated with HPV16/18 in vaccinated men included ethnicity, main male partner, and recent concurrency.ConclusionsSexual network variables associated with HPV infection were different based on vaccination status and HPV type, suggesting risk factors for HPV infection may change as the proportion of vaccinated men increases. In addition, participant report of concurrency and not knowing whether one had practiced concurrency were consistent risk factors; clinicians should consider including concurrency in the sexual history to determine the risk of HPV.     

The Characteristics and Risk Factors of Web-Based Sexual Behaviors Among Men Who Have Sex With Men in Eastern China: Cross-sectional Study

BackgroundFinding casual sex partners on the internet has been considered a huge challenge for HIV transmission among men who have sex with men (MSM) in China.ObjectiveThis study aimed to identify the characteristics and risk factors of finding causal sex partners on the internet among MSM in Zhejiang Province, China.MethodsThis was a cross-sectional study. Participants were enrolled by 4 community-based organizations (CBOs) and 10 Voluntary Counselling and Testing (VCT) clinics through advertisements in bathrooms, bars, and gay hook-up apps from June to December 2018. A CBO- or physician-assisted survey was conducted to collected information on finding casual sex partners, perceived HIV infection, and HIV risk behaviors.ResultsAmong 767 participants, 310 (40.4%) reported finding causal sex partners on the internet. Factors associated with finding casual sex partners on the internet included watching pornographic videos on the internet more than once a week (adjusted odds ratio [aOR]=1.881, 95% CI 1.201-2.948), discussing “hooking-up online” with friends (aOR=4.018, 95% CI 2.910-5.548), and perceiving that the likelihood of HIV infection among casual sex partners sought on the internet was “medium” (aOR=2.034, 95% CI 1.441-2.873) or “low” (aOR=2.548, 95% CI 1.524-4.259). Among the participants who reported finding casual sex partners on the internet, 30.2% (91/310) reported having unprotected sex with casual sex partners encountered on the internet in the past 6 months. On multivariate logistic regression analyses, knowing the HIV infection status of casual sex partners sought on the internet was significantly associated with performing inserted intercourse (aOR=1.907, 95% CI 1.100-3.306) and a decreased risk of inconsistent condom use (aOR=0.327, 95% CI 0.167-0.642).ConclusionsWeb-based casual sexual behavior is becoming more prevalent, and the rate of unprotected sex among MSM in Zhejiang Province is high. Future HIV prevention approaches should emphasize the importance for MSM to proactively determine the HIV infection status of potential casual sex partners sought on the internet.     

Attitudes of UK doctors to intimate examinations

Medical culture has portrayed intimate examinations as important in maintaining the sexual and reproductive health of patients. Intimate examinations have also been at the centre of high-profile scandals. Existing literature suggests there is considerable heterogeneity in the use of intimate examinations, as influenced by underlying attitudes. This study sought to ask how doctors make decisions to perform intimate examinations and negotiate the emotional aspects. In-depth interviews were conducted with 38 doctors of different grades and from different areas of clinical practice in the South East of England. Data were analysed thematically using NVivo 9, adopting a constructivist approach. Findings indicate that doctors' emotional constructions of intimate examinations coalesce around feelings of embarrassment, fear and anxiety, and vulnerability. Understandings of gender, sex and power also influence emotional constructions. Doctors utilise varying methods to negotiate emotions, some of which may be detrimental to patient care. These emotional constructions lead doctors to attribute values to intimate examinations and to chaperones that extend beyond responding to indications or following guidelines for examination. Doctors who resolve their own feelings of embarrassment, anxiety and vulnerability may be more likely to perform intimate examinations when indicated, to use chaperones appropriately and to offer the best standards of patient care.     

医学生性观念、生殖健康及相关问题的调查

目的 了解医学生人群中性观念、生殖健康知识的认知和需求情况,以便开展有针对性的生殖健康教育.方法 采用自行设计的调查表,对我校两系大一大二2 156名学生进行问卷调查.结果 医学生人群中性观念相对开放,大多数学生能从期望的途径获取生殖健康知识,生殖、节育、人工流产有关知识相对缺乏,虽然对人工流产的后果有一定认识,但性安全意识和知识缺乏.结论 医学生人群中性观念、生殖健康知识的认知情况令人堪忧,只有为学生提供有效的生殖健康教育服务,才能提高生殖健康水平.     

Associations Between Online Pornography Consumption and Sexual Dysfunction in Young Men: Multivariate Analysis Based on an International Web-Based Survey

BackgroundExpanding access to the internet has resulted in more and earlier consumption of online pornography. At the same time, a higher prevalence of erectile dysfunction (ED) among young men is seen. Increased pornography consumption has been suggested as a possible explanation for this rise.ObjectiveThe aim of this study was to better understand associations between problematic pornography consumption (PPC) and ED.MethodsA 118-item survey was published online, and data collection took place between April 2019 and May 2020. Of the 5770 men who responded, the responses from 3419 men between 18 years old and 35 years old were analyzed. The survey used validated questionnaires such as the Cyber Pornography Addiction Test (CYPAT), International Index of Erectile Function (IIEF-5), and Alcohol Use Disorders Identification Test-Concise (AUDIT-C). The estimated amount of porn watching was calculated. Univariable and multivariable analyses were performed. For the multivariable analysis, a logistic regression model using a directed acyclic graph was used.ResultsAccording to their IIEF-5 scores, 21.48% (444/2067) of our sexually active participants (ie, those who attempted penetrative sex in the previous 4 weeks) had some degree of ED. Higher CYPAT scores indicating problematic online pornography consumption resulted in a higher probability of ED, while controlling for covariates. Masturbation frequency seemed not to be a significant factor when assessing ED.ConclusionsThis prevalence of ED in young men is alarmingly high, and the results of this study suggest a significant association with PPC.Trial RegistrationResearch Registry researchregistry5111; https://tinyurl.com/m45mcaa2     

Condom Refusal and Young Black Men: the Influence of Pleasure,Sexual Partners,and Friends

The study investigated pleasure-related, partner-related, and social normative correlates of recent condom refusal in young Black men (YBM). A cross-sectional study of YBM (N = 561) attending clinics treating sexually transmitted diseases in three cities was conducted. Mean age was 19.6 years (SD = 1.87). Nearly one of every two young men (46.8 %) indicated recent refusal to use a condom after a request from their partner. Significant findings included the following: partner-related beliefs “I feel closer to my partner without a condom” (OR = 2.52, 95 % confidence interval (CI) = 1.65–3.83) and “condoms make sex hurt for the female partner” (OR = 1.69, 95 % CI = 1.14–2.52), a scale measure of pleasure-related beliefs (OR = 2.58, 95 % CI = 1.73–3.84), and a scale measure of negative social beliefs associated with condom usage (OR = 1.05, 95 % CI = 1.00 – 1.10). Interventions addressing pleasure-related, partner-related, and social normative beliefs as barriers to condom use are warranted for YBM.     

Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey

Numerous studies on the mental health effects of terrorist attacks have been published, with some reporting increases in smoking and drug and alcohol use. None have reported on changes in sexual behavior. To investigate the impact of the September 11 attacks on sexual and drug- and alcohol-using behaviors of men who have sex with men (MSM), an anonymous Internet survey was conducted to obtain information retrospectively on behavior during three month periods before and after the attacks. A total of 2,915 MSM from all 50 U.S. states completed the survey. Men who were exposed to the attacks were not differentially targeted for the survey since the online banner ad used to recruit did not mention September 11. Exposure to the attacks varied: 11.4% lost a friend or relative; 5% witnessed the attacks in person; and nearly all saw the attacks on television within one hour of their occurrence. Nearly equal proportions of men reported increases and decreases in the number of sex partners following September 11. Small, statistically significant increases in unprotected anal intercourse and alcohol use, but not illicit drug use, were found when behavior after September 11 was compared to that before the attacks. Men who lost a friend or relative in the attacks were significantly more likely to report unprotected anal intercourse, an increased number of sex partners, and increased alcohol use after September 11 than those who did not. Counseling about substance abuse and risky sexual behavior should be incorporated into trauma-related programs for adolescents and adults.