Correlates of Increased Sexual Satisfaction

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

Understanding of Sexuality and Reproductive Health Among Women With and Without Physical Disabilities

This study compares differences in how women with disabilities and women without disabilities learned about their sexuality and reproductive functioning. A written questionnaire was sent to a national sample of women with disabilities and their non-disabled woman friends recruited through independent living centers and announcements in the media. Responses were received from 504 women with disabilities and 442 women without disabilities. Participants were asked how old they were when they first learned about the physical aspects of sexual intercourse. Women with disabilities learned about the physical aspects of sexual intercourse at about the same age (M = 13.16) as women without disabilities (M = 12.93). The most commonly reported sources for learning about sexuality and sexual functioning for both groups were books and other printed material, having sex, partners, friends, and teachers in primary school. More women with disabilities received information from a woman with a disability and a rehabilitation counselor. Women in both groups indicated that sex was never or seldom the subject of general family conversation. On average the women with physical disabilities had their first date at age 16.6, which is later than women without physical disabilities (M = 14.91). Women with physical disabilities who reported having acquired sexuality information at a later age reported having sexual intercourse at an older age (M = 20.37) than women without physical disabilities (M = 17.75). Age at acquiring sexuality information was neither associated with frequency of intimate touch nor frequency of sexual intercourse. The results of this study can be used to generate recommendations for health care professionals concerning ways to respond more effectively to the special needs for sexuality information of physically disabled women.     

Sexuality After Injury: Interviews with Women After Traumatic Spinal Cord Injury

The aim of this study is to illuminate sexual experiences in women after traumatic spinal cord injury (SCI), including psychological, physical and social barriers that will have to be overcome to resume a sexually active life with a partner. Interviews with eight women were performed. The women were 20–43 years old, previously healthy, with experience of stable heterosexual relationships both before and after SCI. The interviews covered three main areas: 1. The first sexual contact after injury: expectations, concerns, outcome; 2. Communication with partner on sexual matters, before and after injury; and 3. Sexual activity after injury: limitations, compensatory strategies. In addition, advice from the women to newly injured and rehabilitation staff/counselors was requested. Results suggest a strong influence of pre-injury sexual behaviour on post-injury sexual adaptation. A positive attitude towards sexuality and good communicative skills seem to be of particular importance for a favourable outcome of sexual rehabilitation. Even under such circumstances, however, SCI as a rule leads to significant loss of sexual ability. A realistic approach is therefore recommended in counseling, taking the mourning of loss of function into consideration, and allowing the patients to express their grief. Thus, sexual rehabilitation programs need to address a dynamic process of mourning and coping, rather than merely teaching skills for having sexual intercourse after SCI.     

Beyond sexual desire and curiosity: sexuality among senior high school students in Papua and West Papua Provinces (Indonesia) and implications for HIV prevention

When it comes to sexuality and norms, young Indonesians are becoming more open. Concern about this is related to the rapid increase in HIV prevalence in Indonesia, especially in Papua and West Papua Provinces. While much research has been conducted among youth who have left school, little is known about senior high school students' sexuality and sexual practices in these provinces. Using qualitative and quantitative data, we explore perspectives on and experiences of sexuality, contraceptive use, unintended pregnancy and unsafe abortion among 1082 Year 11 students from 16 senior high schools in both provinces. Findings suggest that around 38.3% of students reported having had sexual intercourse and 36.5% of these having had their first sexual encounter before they were 15 years old. Furthermore, contraceptive use among sexually active students was very low. Around 32% of female students who reported having had sexual intercourse also reported having an unintended pregnancy and the majority of them had had unsafe abortions. The paper points to the implications of students' high-risk sexual behaviours for HIV prevention.     

A profile of sexually active male adolescent high school students in Lima, Peru

To document knowledge and attitudes regarding sexuality and sexual practices of male adolescent high school students in Lima, Peru, a self-administered, anonymous survey was completed by 991 male adolescents aged 12-19 as part of a School-Based Sex Education Intervention model. Questions concerned sociodemographic information; family characteristics; personal activities; knowledge and attitudes regarding sexuality; sexual experience; and contraceptive use. Knowledge related to sexuality was limited. Males tended to mainly discuss sexuality with their male peers (49.8%). Attitudes towards sexual activity and condom use were largely positive, although some males expressed ambivalent feelings towards the latter. Of the sample, 43% had ever had sex; age at first sexual intercourse was 13 years. While 88% of the sample would use condoms, 74% also gave reasons for not using them. Sexual activity was related to age, ever having repeated a grade, living with only one parent or in a mixed family, activities such as going to parties, use of alcohol, tobacco, and drugs, and viewing pornographic videos or magazines. Many male adolescents were at risk of causing an unintended pregnancy or acquiring an STD.     

Two steps forward and one step back? Australian secondary students’ sexual health knowledge and behaviors 1992–2002

PurposeTo report on changes in the sexual health knowledge and sexual and risk behaviors of year 10 and 12 Australian school students between 1992 and 2002.MethodsSurveys were administered at five yearly intervals to a total of 6781 students in 263 government secondary schools in all Australian states and territories.ResultsAnalysis of data from the three survey administrations shows high levels of knowledge concerning human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS), but a small but consistent decline since 1992. Knowledge about sexually transmitted infections and hepatitis remains poor. In 2002, there was an increase in the number of students reporting ever having had sexual intercourse, and this was most pronounced for year 10 students. The number of young men in year 10 who reported having three or more partners had doubled since 1997 to 33%. More year 10 young women also reported having intercourse with three or more partners. Consistency of condom use has improved over time; however, 39% still report condom use only sometimes.ConclusionSchool-based sexual health education provides a critical basis for ensuring that young people begin to experience sex safely and with an appropriate knowledge base.     

“May I?” About Sexuality and Love in the New Generation with Intellectual Disabilities

The aim of the article is to identify, describe and understand the opportunities and hindrances for young people with intellectual disabilities (ID) in forming relationships and expressing sexuality and love. The methods are participant observations at dances geared towards youths with ID and qualitative interviews with youngsters, staff members and parents. The results show a big variation of sexual conduct, where intercourse seems to be quite unusual. The study also shows that staff and parents feel responsibility for the youngsters sexuality and often act disciplinary as new institutional walls, while the youngsters develop different social strategies to cope with the surroundings. It seems clear that staffs need more guidance and education about sexuality and disability in their social interaction with a new generation of people with ID.     

Sexual health and socioeconomic-related factors in Spain

PurposeThe aim of the present study was to describe sexual health in Spain according to three important indicators of the World Health Organization definition and explore the influence of socioeconomic factors.MethodsWe performed a population-based cross-sectional study of sexually active people aged 16-44 years residing in Spain in 2009 (2365 women and 2532 men). Three main aspects of sexual health were explored: sexual satisfaction, safe sex, and sexual abuse. The independent variables explored were age, age at first intercourse, reason for first intercourse, type of partner, level of education, country of origin, religiousness, parity, and social class. Bivariate and multivariate logistic regression models were fitted.ResultsBoth men and women were quite satisfied with their sexual life, their first sexual intercourse, and their sexual relationships during the previous year. Most participants had practiced safe sex both at first intercourse and during the previous year. Levels of sexual abuse were similar to those in other developed countries. People of disadvantaged socioeconomic position have less satisfying, more unsafe, and more abusive sexual relationships. Women experienced more sexual abuse and had less satisfaction at their first intercourse.ConclusionsThe state of sexual health in Spain is relatively good. However, we observed inequalities according to gender and socioeconomic position.     

Correlates of Sexual Activity and Satisfaction in Midlife and Older Women

PURPOSESexual activity is an important component of quality of life for women across their lifespan. Prior studies show a decline in sexual activity with age, but these studies often fail to consider the role of sexual satisfaction. The aim of this study is to give updated prevalence estimates of sexual activity among women and to elucidate factors associated with sexual activity and sexual satisfaction.METHODSWe report a cross-sectional analysis of the second wave of a nationally representative sample of US adults aged 28 to 84 years, the Survey of Midlife Development in the United States. The survey used self-administered questionnaires to assess demographic data, self-rated physical and mental health, medical problems and medication use, relationship factors, and sexual activity and satisfaction.RESULTSOf 2,116 women who answered the questions regarding sexuality, 1,345 (61.8%) women were sexually active in the previous 6 months. The proportion of women who were sexually active decreased with advancing age. Women who were married or cohabitating had approximately 8 times higher odds of being sexually active (odds ratio = 7.91, 95% CI, 4.16–15.04; P <.001). Among women aged 60 years and older who were married or cohabitating, most (59.0%) were sexually active. Among women who were sexually active, higher relationship satisfaction (P <.001), better communication (P = .011), and higher importance of sex P = .040) were related to higher sexual satisfaction, but age was not (P = .79).CONCLUSIONSA considerable proportion of midlife and older women remain sexually active if they have a partner available. Psychosocial factors (relationship satisfaction, communication with romantic partner, and importance of sex) matter more to sexual satisfaction than aging among midlife and older women.     

Sexual behaviors and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus infection: Experience of an urban tertiary center

PurposeTo assess sexual knowledge, behaviors, and procreational intentions of adolescents and young adults with perinatally acquired human immunodeficiency virus (PNA HIV) infection. Increasingly, children with PNA HIV infection survive to adolescence and become sexually active. Understanding their procreational intentions could aid in designing reproductive health and secondary prevention programs.MethodsA cross-sectional survey of adolescents and young adults with PNA HIV infection at an urban tertiary center was conducted. From June 2003 through September 2004, participants completed a questionnaire that inquired about their sexual knowledge and behaviors. Participants aware of their diagnoses also completed items regarding procreational intentions.ResultsSeventy-four percent (57/77) of eligible participants completed the survey. Thirty-three percent (19/57) of participants reported having had penile–vaginal intercourse, 89.4% of them after learning of their HIV status. Fifty percent (5/10) of sexually active female participants had been pregnant. Among the 50 participants who were aware of their diagnosis, 70% (n = 35) expressed intent to have children. A majority of those aware of the risk of maternal-to-child transmission (MTCT) (71.1%) expressed intent to procreate. Participants who perceived MTCT as low were more likely to express intent to procreate than those who perceived the risk of MTCT as high.ConclusionsAdolescents with PNA HIV infection are becoming sexually active and express intent to have children. This has important implications for secondary prevention of HIV infection. These adolescents need innovative intervention programs offering reproductive health education including procreational choices and considerations.     

Sexual behaviour among truck drivers in Pakistan

This study examines the level of risk of acquiring sexually transmitted infections among truck drivers and their helpers in Pakistan. Quantitative, self-reported, sexual behaviour data were collected from 300 randomly selected long-distance truck drivers and their helpers. Qualitative information was gathered through conversations with drivers. The findings show that multiple sexual partnerships with men and women are common among truckers. Awareness of AIDS and knowledge of sexual transmission of HIV is high. However, most truckers do not believe that AIDS exists in Pakistan. Nor are they aware that condoms are an effective way of preventing HIV transmission. Knowledge of the risks associated with unprotected sex is low among truckers, who consider themselves invulnerable to sexually transmitted infections because of their self-perception of being moral persons. Campaigns to increase risk awareness should emphasize the importance of condom use as an STI/HIV prevention method. Interpersonal communication is likely to be important in convincing truckers that sexually transmitted infections can be prevented.     

Knowing the Consequences of Unprotected Sex with Seroconcordant Partner Is Associated with Increased Safer Sex Intentions among HIV-positive Men in Kathmandu, Nepal

Unprotected sexual intercourse among HIV-positive people can adversely affect their own health by increasing their exposure to multiple strains of HIV-1 or other sexually transmitted infections (STIs). The study explored the relationship between knowledge of Nepalese HIV-positive men about the consequences of having unprotected sex with seroconcordant partners and their intention to practise safer sex with such partners. In total, 166 participants recruited conveniently in the Kathmandu Valley, Nepal, were interviewed. Each participant reported intention to practise safer sex with seroconcordant partners, know-ledge about the consequences of having unprotected sex with seroconcordant partners, perceived partner-related barriers to condom-use, belief that condoms interfere with sex, and condom-use self-efficacy. Of the 166 participants, 50.6% intended to practise safer sex every time they have sex with seroconcordant partners. Results of multiple logistic regression analysis showed that the participants who were aware of the possibility of HIV superinfection [adjusted odds ratio (AOR)=2.93, 95% confidence interval (CI) 1.16-7.34, p=0.022)] or that the presence of STIs in HIV-positive persons increases progression of HIV disease (AOR=2.80, 95% CI 1.08-7.26, p=0.033) were more likely to intend to practise safer sex with seroconcordant partners. Similarly, the participants who were employed or who had lower levels of belief that condoms interfere with sex were more likely to intend to practise safer sex. The findings suggest that improving the knowledge of HIV-positive persons about the consequences of having unprotected sex with seroconcordant partners might improve their intention to practise safer sex with such partners.Key words: HIV infections, Intention, Knowledge, Knowledge, attitudes, practices, Perceptions, Safe sex, Sexual behaviour, Nepal     

Oral contraceptives and sexuality in university women

The relationship between use of oral contraceptives and sexuality in university women who completed the McCoy Female Sexuality Questionnaire was examined. Pill users reported sexual intercourse earlier, were less likely to be virgins, more likely to have a sex partner, more apt to be engaging in petting and intercourse than nonusers, and reported more frequent intercourse than sexually active nonusers. Nonusers reported a greater frequency and enjoyment of anal intercourse than pill users. The prediction that pill users would have less vaginal lubrication than nonusers was supported. Contrary to prediction, pill users reported a higher frequency of sexual thoughts and fantasies, and level of sexual interest than active nonusers. Triphasic Orthonovum 7/7/7 (OR7/7/7) users reported more sexual thoughts and fantasies and had higher Sexual Interest (Factor 1) scores than monophasic Orthonovum 1/35 (OR1/35) users. Triphasic users as a group enjoyed sexual activity more, were more aroused during sexual activity, and had higher Sexual Interest factor scores than monophasic users. Triphasic users reported more sexual thoughts and fantasies, sexual interest and had higher Sexual Interest factor scores than nonusers, while monophasic users did not. Monophasic users reported less vaginal lubrication than nonusers, whereas triphasic users did not. Comparisons of OR7/7/7 and OR1/35 users with nonusers revealed the same findings. Results suggest that women using triphasic pills experience greater sexual interest and response than those using monophasics. Possible reasons for these differences are discussed. Preparation of this paper was supported, in part, by the Pacific Center for Sex and Society (PCSS), John A. Burns School of Medicine, University of Hawaii, Manoa, Milton Diamond, Director.     

The role of assertiveness in female sexuality: a comparative study between sexually assertive and sexually nonassertive women.

To examine the role of assertiveness in female sexuality, a nonclinical population of married women (ages 18-31 years) were stratified as above or below the median score (73) on sexual assertiveness, as measured by the Hurlbert Index of Sexual Assertiveness (HISA), and matched accordingly for demographics, resulting in two samples: sexually assertive and sexually nonassertive, each group consisting of 50 women. Comparative assessments were made between the two matched samples on frequency of sexual activity, number of orgasms, subjective sexual desire, and both marital and sexual satisfaction. The t-test was used to test the equality of means between samples. Pearson's r was used for correlational data. ANOVA methods were employed to examine race, religion, and employment status. Using t-test, significant differences between the two groups appeared on all five measures. Sexually assertive women reported higher frequencies of sexual activity and orgasms, rated themselves as having greater subjective sexual desire, and reported greater marital and sexual satisfaction.     

A Momentary Sampling Study of the Affective Experience Following Coital Events in Adolescents

PurposeTo describe the affective experience following sexual intercourse among sexually active adolescents. We hypothesized that these youth would experience more positive and less negative affects following sexual intercourse than at other times in their daily lives.MethodsApproximately every 3 waking hours, sexually active adolescents aged 15–21 years used a handheld computer to report current affect and recent sexual intercourse in response to random signals. Participants also completed a report after sexual intercourse. Affect was determined by eight states, as well as composite variables for positive and negative affect. Generalized estimating equations compared affect on reports that did and did not include sexual intercourse. Each model included average affect, affect variability (standard deviation), and significant interactions with the occurrence of sexual intercourse. Based on their distribution, outcome variables were modeled as presence/absence of affect.ResultsSixty-seven youth completed 1385 random and 392 event reports. There were 266 unique coital reports (median 2.6/participant/week); 94% were with a main partner and 49% involved condom use. Youth were more likely to report positive affect and less likely to report negative affect when they were also reporting recent sexual intercourse, as compared to noncoital reports. In multivariate analyses, participants had greater odds of reporting well being and alertness and lower odds of reporting stress and anger following sexual intercourse compared to other times.ConclusionsAdolescents report improvement in specific positive and negative affective states following sexual intercourse. Determining how feeling more positive and less negative after sexual intercourse may motivate or reinforce sexual intercourse will be important in understanding adolescent sexual behavior.     

Beyond stereotypes of Brazilian male sexuality: Qualitative and quantitative findings from São Paulo,Brazil

This study examined aspects of male sexuality in São Paulo using both qualitative and quantitative methods. It commences with an outline of some key tenets of emerging perspectives on male sexuality in Brazil and contemporary issues such as sexual orientation, first intercourse, perception of male sexual nature, sexual philosophies (with particular reference to gender and the double standard) and number of sexual partners. The findings show evidence for some aspects of traditional stereotypes, but also evidence of more gender-liberal and sexually monogamous traits among many men in São Paulo. Care needs to be taken against over-generalization regarding male sexuality in Brazil.     

Coital Positions and Sexual Functioning in Patients with Chronic Pain

The objectives of this study were to describe (1) coital positions adopted by chronic back pain patients, (2) and to describe sexual function as assessed by Derogatis Inventory of Sexual Functioning (DISF). In addition, patients were asked questions regarding effects of sexual intercourse on severity of pain, influence of pain over sexual functioning, and perceived factors causing sexual problems. This is a subset (45 patients) of a larger study (70 patients) describing sexual functioning. These 45 patients responded to additional questions as described above. Mean age of the patients was 55.7 years (range 36–74 years). There were 40 male patients. Twenty-five patients (56%) were married. Mean duration of pain was 145.2 months. Thirty-two patients (27 male and 5 female) were sexually active. Eighty-one percent of male and 100% of female patients, who were sexually active, preferred male superior position. Of those sexually active, 41% performed sexual intercourse while sitting on a chair. A majority of patients were experiencing problems in all domains of sexual functioning except for fantasy. Thirty-nine patients (87%) reported that pain extremely interfered in performing sexual intercourse. Twenty-nine patients (64%) reported worsening of pain due to sexual intercourse. Majority (n = 34) of the patients (76%) had fear of failure to perform and 25 patients (56%) reported fear of aggravating pain due to sexual activity. There is need for further research in this area.     

Sexting Among Young Men Who Have Sex With Men: Results From a National Survey

PurposeWe know little about the prevalence of sexting behavior among young men who have sex with men (YMSM) or its association with their sexual behaviors.MethodsTo address these gaps, we used data from an online study examining the partner-seeking behaviors of single YMSM (N = 1,502; ages 18–24 years) in the United States. Most participants (87.5%) reported sexting, with 75.7% of the sample reporting having sent and received a sext.ResultsSexting was more frequent among sexually active YMSM, with YMSM who had sent and received a sext being more likely to report insertive anal intercourse, with and without condoms, than those who had not sexted. We found no association between sexting and receptive anal intercourse.ConclusionsOur findings suggest that sexting may vary by YMSM's sexual roles. We discuss our findings with attention to their implications for sexual health promotion.     

Supporting Sexuality in Adults with Intellectual Disability—A Short Review

Sexuality in persons with intellectual disability (ID) is one of the frequently discussed topics of many scientific disciplines. Sexuality in persons with ID is determined by the specific features of ID, but also by the attitudes of the society and possibilities of persons with ID to establish intimate relationships, have sexual experience, and be able to express their own sexuality as an autonomous human need. The objective of the review was to present an analysis of published knowledge about supporting (and expression) of adults with ID in the area of sexuality (i.e. support provided to persons with ID as well as carers, professionals and family members providing support to persons with ID in the area of sexuality). Relevant studies (N?=?47) identify the following as the most significant areas of supporting sexuality in adults with ID: sexual relationships, contraception, pregnancy and parenthood, sexually transmitted diseases, gay or lesbian relations/relationship, unacceptable and criminal sexual conduct, taking responsibility for sexual behavior, defining sexuality, values, body image, etc. Another important aspect is cooperation with close persons, carers and parents of individuals with ID. There is a possibility to use specific instruments for elementary assessment (SSKAT, SexKen-ID, ASK), the technique of social stories, and the content of educational program aimed at sexuality in persons with ID. Another option is sexual assistance and self-advocacy. Existing research focuses mainly on prevention of sexual abuse of persons with ID, but attention should also be paid to other aspects of their sexuality. Available evidence suggests that providing support to persons with ID in relation to their own sexuality is a difficult task. There is a need for further training and education of professionals, close persons and carers in order to provide qualified support to these clients.