Unprotected Anal Intercourse in HIV-Positive and HIV-Negative Gay Men: The Relevance of Sexual Arousability,Mood, Sensation Seeking,and Erectile Problems

Reduction of unprotected anal intercourse (UAI) in gay men infected with HIV is important in preventing further spread of this infection. In previous studies, personality trait measures relevant to sexual arousability and the effects of anxiety have been shown to relate to UAI in both gay and heterosexual men. Are HIV+ gay men similar in these respects or are there other personality-related factors that influence their sexual risk taking? This question was addressed using a convenience sample of 156 HIV+ gay men and 155 HIV? gay men, matched for age and UAI risk. There were no significant differences between these two groups on measures of sexual arousability, inhibition of sexual arousal in risky situations, sensation seeking, depression and anxiety proneness, or tendency to increased sexual interest in negative mood states. HIV+ men were, however, more likely to report erectile problems and higher scores on an associated trait measure, inhibition of arousal due to threat of performance failure. As this association was not anticipated, questions about whether erectile problems preceded the seroconversion were not asked. Such problems could be associated with reluctance to use condoms, thus increasing the likelihood of seroconversion and/or disease transmission. Alternatively, erectile problems could be a consequence of HIV infection. In each case, this has implications for prevention. The associations among HIV status, erectile problems, and UAI need to be specifically addressed in future research.     

Adaptive servo-ventilation and deadspace: effects on central sleep apnoea

Central Sleep Apnoea (CSA) occurs commonly in heart failure. Adaptive servo-ventilation (ASV) and deadspace (DS) have been shown in research settings to reverse CSA. The likely mechanism for this is the increase of PaCO(2) above the apnoeic threshold. However the role of increasing FiCO(2) on arousability remains unclear. To compare the effects of ASV and DS on sleep and breathing, in particular effects on Arousal Index (ArI), ten male patients with heart failure and CSA were studied during three nights with polysomnography plus measurements of PetCO(2). The order of the interventions control (C), ASV and DS was randomized. ASV and DS caused similar reductions in apnoea-hypopnoea index [(C) 30.0 +/- 6.6, (ASV) 14.0 +/- 3.8, (DS) 15.9 +/- 4.7 e h(-1); both P < 0.05]. However, DS was associated with decreased total sleep time compared with C (P < 0.02) and increased spontaneous ArI compared to C and ASV (both P < 0.01). Only DS was associated with increased DeltaPetCO(2) from resting wakefulness to eupnic sleep [(C) 2.1 +/- 0.9, (ASV) 1.3 +/- 1.0, (DS) 5.6 +/- 0.5 mmHg; P = 0.01]. ASV and DS both stabilized ventilation however DS application also increased sleep fragmentation with negative impacts on sleep architecture. We speculate that this effect is likely to be mediated by increased PetCO(2) and respiratory effort associated with DS application.     

Sexual desire,general arousability,and sexual dysfunction

To determine the interrelationships among neuroticism, general arousability, sexual desire, and sexual dysfunction in women, two studies were conducted. The first found a significant positive correlation between general arousability and neuroticism. The second found a curvilinear relationship between general arousability and sexual dysfunction, and a negative correlation between levels of sexual desire and sexual dysfunction. Implications for therapy with sexually dysfunctional women are discussed.     

Sexual Risk-Taking in Gay Men: The Relevance of Sexual Arousability, Mood, and Sensation Seeking

This paper examined the relationship of three aspects of personality to sexual risk-taking in gay men: (1) sexual arousability, as propensity for sexual excitation, and propensity for inhibition of sexual arousal in the face of threat (measured by the Sexual Excitation, SES, and Sexual Inhibition, SIS1, SIS2, scales); (2) the relation between negative mood and sexuality; and (3) sensation seeking. Risk-taking was assessed for the past 6 months in relation to unprotected anal intercourse (UAI), oral sex, number of casual partners, and patterns of cruising behavior. A combination of number of partners and use of condoms was used to derive a longer-term risk grouping. Two patterns of association were identified. UAI and high risk oral sex were more likely in those with low inhibition of sexual response due to threat of performance consequences" (i.e., low SIS2) and low trait anxiety (low STAI). High numbers of casual partners and frequent cruising were associated with increased sexual interest in states of depression and high propensity for sexual excitation (SES). Higher long-term risk was also associated with low SIS2. Unexpectedly, high SIS1, which is strongly related to vulnerability to erectile failure, was also predictive of higher long-term risk. Possible reasons for this are discussed. Disinhibition from the Sensation Seeking Scales was a positive predictor of all types of sexual risk assessed. All three aspects of personality are of potential relevance to designing better interventions to reduce high risk sexual behavior and in evaluating their effectiveness.     

An inventory for the measurement of female sexual arousability: The SAI

This report describes the development of a self-report Sexual Arousability Inventory (SAI) for women. Sexual arousability was defined as the sum of a respondent's ratings of 28 erotic experiences along a 7-point Likert arousal dimension. Multiple-regression and factor analyses were used to select valid items from a 131-item pool and build in factorial purity. The SAI has concurrent validity with respect to sexual experience, activity, and satisfaction, and discriminates between clinical and normal populations. In addition, the SAI is easy to administer and score, may be used with single, married, or lesbian women, is available with norms and in alternate forms, and possesses exceptional internal consistency. Although the SAI was designed primarily for clinical use, the construct it measures may have theoretical significance in future research.This research was supported by the Dalhousie University Computer and Psychological Services Centres.     

Attention and Emotional Responses to Sexual Stimuli and Their Relationship to Sexual Desire

Little is known about why individuals vary in their levels of sexual desire. Information processing models, like Barlow’s (Journal of Consulting and Clinical Psychology 54:140–148, 1986) model of sexual functioning, suggest that individuals with higher sexual desire attend more and respond with more pleasant emotions to sexual cues than individuals with lower levels of sexual desire. In this study, 69 participants (36 women, 33 men) completed a dot detection task measuring attention capture by sexual stimuli and a startle eyeblink modulation task indexing the valence of emotional response to affective stimuli. Participants with high levels of sexual desire were slower to detect targets in the dot detection task that replaced sexual images but did not differ in startle eyeblink responses to sexual stimuli. The results suggest that the amount of attention captured by sexual stimuli is a stronger predictor of a person’s sexual desire level than the valence of the emotional responses elicited by such stimuli.

Effect of infant sleeping position on sleep spindles

Sleep spindles play an active role in inducing and maintaining sleep and may affect arousal by blocking the transmission of external stimuli through the thalamus to the cortex. Previously we have demonstrated that sleeping in the prone position impairs arousal in infants at 2-3 months of age, but not at 5-6 months. We aimed to examine if sleeping position and postnatal age affected duration and/or density of sleep spindles. Twenty-one healthy term infants were studied using daytime polysomnography at 2-3 months and 16 were again studied at 5-6 months. Infants slept both prone and supine at each study. The mean duration of non-rapid eye movement (NREM) sleep was not different between the two studies in either position. At 2-3 months both spindle density (P < 0.001) and proportion of NREM sleep (P < 0.025) with spindles were significantly greater in the supine than in the prone position. At 5-6 months spindle duration was longer in the supine than in the prone position (P < 0.03). Spindle density in the supine position was not different between the two studies, however, when infants slept prone, it was significantly increased at 5-6 months compared with 2-3 months (P < 0.001). Arousal threshold was not correlated with either spindle density or percentage of NREM sleep with spindles in either position at either study. In this study spindle density and the percentage time spent with spindles were not well correlated with infant arousability, and hence may not be able to be used as markers of depressed arousal responses in infants.     

Asexuality: Classification and Characterization

The term "asexual" has been defined in many different ways and asexuality has received very little research attention. In a small qualitative study (N = 4), individuals who self-identified as asexual were interviewed to help formulate hypotheses for a larger study. The second larger study was an online survey drawn from a convenience sample designed to better characterize asexuality and to test predictors of asexual identity. A convenience sample of 1,146 individuals (N = 41 self-identified asexual) completed online questionnaires assessing sexual history, sexual inhibition and excitation, sexual desire, and an open-response questionnaire concerning asexual identity. Asexuals reported significantly less desire for sex with a partner, lower sexual arousability, and lower sexual excitation but did not differ consistently from non-asexuals in their sexual inhibition scores or their desire to masturbate. Content analyses supported the idea that low sexual desire is the primary feature predicting asexual identity.     

Styles of sexual expression in women: Clinical implications of multivariate analyses

Two different multivariate techniques were applied to self-reported trait and behavioral data concerning sexual behavior from a sample of North American women. Canonical correlation delineated three styles in which certain demographic attributes and cognitive indices of sexual arousal were related to forms of sexual expression. The first style was characterized by respondents who experienced high rates of intercourse and orgasm in a cohabitation arrangement but who did not necessarily report satisfaction with their sexual responsivity. A second style was characterized by older women currently without partners who expressed a liking for erotic literature and media, direct genital stimulation, and frequent masturbation but who were dissatisfied with their sexual responsivity. The third style, which included respondents most satisfied with their sexual responsivity, was characterized by women who were more aware of physiological changes during sexual arousal and who enjoyed gently seductive erotic activities, breast stimulation, and genital stimulation. A discriminant analysis showed that those women who were most highly satisfied with their sexual responsivity experienced frequent intercourse and orgasm consistency, enjoyed gently seductive erotic activities and breast stimulation, but were unresponsive to erotic literature and media. A second discriminant analysis showed that women who achieved orgasm most consistently were older, were more aware of physiological changes during sexual arousal, reported higher frequencies of masturbation and intercourse, and were less likely to be aroused by erotic preliminaries. These results are discussed within the context of the literature on the treatment and prevention of sexual dysfunction.Research supported by the Dalhousie University Computer and the Psychological Services Centres.