Sexual orientation, sexual behaviors, and pregnancy among American Indian adolescents

PURPOSE: A recent study found a disproportionate number of pregnancies among Euro-American lesbian and bisexual adolescents compared to heterosexual peers. American Indian adolescents have reported higher prevalence of gay/lesbian/bisexual orientations than Euro-Americans; do they also report higher prevalence of pregnancy? METHODS: The study assessed prevalence of teen pregnancy and related factors by sexual orientation among sexually experienced, reservation-based American Indian adolescent males (n = 2056) and females (n = 1693) who participated in a national school-based survey in 1991. Self-reported orientation was classified as heterosexual, gay/lesbian/bisexual, and "unsure" of orientation. RESULTS: Gay/bisexual males were more likely than other males to report early heterosexual intercourse (<14 years), more consistent contraception, and a higher prevalence of abuse and running away (p < 0.05 to p < 0.0001). Likewise, lesbian/bisexual females were more likely to report early onset of heterosexual intercourse, more frequent intercourse, and running away. Sexual or physical abuse did not vary by orientation for females. Prevalence of pregnancy also did not vary by orientation (males, 18.6% gay/bisexual vs. 10.4% "unsure" vs. 11.8% heterosexual; females, 25.0% lesbian/bisexual vs. 22.1% "unsure" vs. 21.9% heterosexual). For lesbian/bisexual females, no variables were significantly associated with pregnancy history; for "unsure" females, pregnancy was associated with contraceptive frequency and early onset of heterosexual activity. For heterosexual females, age, intercourse frequency, and physical abuse were associated. For gay/bisexual males, intercourse frequency, ineffective contraception, and physical abuse were associated with involvement in a pregnancy; for "unsure" and heterosexual males, most items except ineffective contraception were related to pregnancy involvement history. CONCLUSIONS: Although prevalence of pregnancy is similar, findings show group differences in associated risk factors by sexual orientation. Interventions to reduce pregnancy among American Indian adolescents should include assessment of sexual orientation and behavioral risk factors.     

Premature ejaculation: Investigation of factors in ejaculatory latency.

Data from 10 premature ejaculators (mean age 34.4 yrs) and 14 normal males (mean age 31.8 yrs) were gathered utilizing psychophysiological and self-report measures. Sexual arousal was induced through a tape-recorded erotic story, erotic slides, and sexual fantasy. At no point did premature ejaculators and normal Ss differ in penile responding or in subjective report or arousal. Groups were not significantly different in their rates of sexual arousal, the absolute amount of sexual arousal shown, nor in the number of sexual situations to which they responded. Premature ejaculators, however appeared to ejaculate at a lower level of sexual arousal. Results support the hypotheses that premature ejaculators have longer periods of abstinence from intercourse and ejaculation and that there is an inverse relationship between period of abstinence from intercourse/ejaculation and ejaculation latency. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nocturnal penile tumescence and rigidity monitoring in young potent volunteers: reproducibility, evaluation criteria and the effect of sexual intercourse

PURPOSE: We studied the reproducibility of nocturnal penile tumescence, rigidity evaluation criteria and the possible effects of sexual intercourse in young, healthy, potent male volunteers. MATERIALS AND METHODS: We recruited 12 male medical students 21 to 24 years old into the study. A disorder-free medical history, availability of a sexual partner and normal erectile function were the inclusion criteria. All subjects completed 3 sessions of 3 nights of recording using the RigiScan* device with at least a 3-day interval between recordings. During the last 3-night recording subjects were asked to have sexual intercourse at least once. Analysis of the recordings was focused on the best erectile event as well as on rigidity and tumescence activity units normalized per hour. RESULTS: The subjects completed 36, 3-night recordings. Of the total of 108 sessions 18 occurred after sexual intercourse. We analyzed 562 erectile episodes. All 3-night recordings included at least 1 episode of rigidity at the penile tip greater than 60% and more than 10 minutes in duration. Sexual intercourse did not significantly affect nocturnal penile tumescence and rigidity. When rigidity and tumescence activity unit values were normalized by the hour and expressed as mean values of the 3-night sessions, documented values became reproducible. CONCLUSIONS: At least 2 consecutive nights of recording are necessary to evaluate nocturnal penile tumescence and rigidity recordings. Nocturnal penile tumescence and rigidity with at least 1 erectile episode of tip penile rigidity greater than 60% and 10 minutes in duration may be associated with potency. Mean rigidity and tumescence activity unit values per hour of a recording may be used as objective parameters to measure overall erectile activity. In addition, sexual intercourse seems to decrease nocturnal penile tumescence and rigidity measurements, although not statistically significant. We anticipate that application of these criteria for nocturnal penile tumescence and rigidity evaluation will improve the diagnostic validity of the test. Future research will determine whether these criteria are too strict for the evaluation of aging men.     

Life after breast cancer: understanding women's health-related quality of life and sexual functioning

PURPOSE: To describe the health-related quality of life (HRQL), partner relationships, sexual functioning, and body image concerns of breast cancer survivors (BCS) in relation to age, menopausal status, and type of cancer treatment. PATIENTS AND METHODS: A cross-sectional sample of BCS in two large metropolitan areas was invited to participate in a survey study that included the following standardized measures: the RAND 36-Item Health Survey; the Centers for Epidemiologic Studies-Depression Scale (CES-D); the Dyadic Adjustment Scale (DAS); the Breast Cancer Prevention Trial (BCPT) Symptom Checklist; the Watts Sexual Functioning Questionnaire (WSFQ); and subscales from the Cancer Rehabilitation Evaluation System (CARES). RESULTS: Eight hundred sixty-four BCS completed the survey. RAND Health Survey scores were as good or better than those of healthy, age-matched women, and the frequency of depression was similar to general population samples. Marital/partner adjustment was similar to normal healthy samples, and sexual functioning mirrored that of healthy, age-matched postmenopausal women. However, these BCS reported higher rates of physical symptoms (eg, joint pains, headaches, and hot flashes) than healthy women. Sexual dysfunction occurred more frequently in women who had received chemotherapy (all ages), and in younger women who were no longer menstruating. In women > or = 50 years, tamoxifen therapy was unrelated to sexual functioning. CONCLUSION: BCS report more frequent physical and menopausal symptoms than healthy women, yet report HRQL and sexual functioning comparable to that of healthy, age-matched women. Nevertheless, some survivors still experience poorer functioning, and clinicians should inquire about common symptoms to provide symptomatic management or counseling for these women.     

High-risk sexual behavior at a midwestern university: a confirmatory survey

According to a 1991 study of sexual behavior based on a random sample of heterosexual undergraduates at a Midwestern university, 80% of the males and 73% of the females had experienced vaginal or anal intercourse. The average age at first vaginal intercourse was 17.2 years for both sexes. Seventeen percent of the sexually experienced males and 18% of the sexually experienced females had engaged in heterosexual anal intercourse; among these respondents, the average age at first anal intercourse was 20.3 for males and 19.1 for females. Although less than four years, on average, had elapsed since the respondents had first had vaginal intercourse, males reported an average of 8.0 lifetime vaginal-sex partners and females reported an average of 6.1. Overall, the findings from this random sample of students are similar to those from a 1988 convenience sample of the same college population.     

Psychologists' attitudes and practices regarding erotic and nonerotic physical contact with patients.

Conducted a nationwide survey to investigate psychotherapists' beliefs and practices regarding physical contact with their patients. 1,000 PhD licensed psychologists, selected from the respondents to the 1974 American Psychological Association Manpower Survey, were mailed questionnaires; the response rate was 70%, and data from 347 male and 310 female Ss was used in the analysis. Results show that 5.5% of the male and .6% of the female Ss reported having had sexual intercourse with patients; an additional 2.6% of the males and .3% of the females reported having had sexual intercourse with these patients within 3 mo after the termination of therapy. Of those Ss who had had intercourse with patients, 80% repeated it. More males than females reported erotic contact with patients (10.9% vs 1.9%), but there were almost no differences on this variable among therapists of 5 therapy orientations. On nonerotic contact there were no sex differences, but there were therapy-orientation differences. The results are compared with previously reported results for physicians, and implications regarding the exploitation of patients are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

SSRI-induced sexual dysfunction: fluoxetine, paroxetine, sertraline, and fluvoxamine in a prospective, multicenter, and descriptive clinical study of 344 patients

The authors analyzed the incidence of sexual dysfunction (SD) with different selective serotonin reuptake inhibitors (SSRIs; fluoxetine, fluvoxamine, paroxetine, and sertraline) and hence the qualitative and quantitative changes in SD throughout time in a prospective and multicenter study. Outpatients (192 women and 152 men; age = 39.6 +/- 11.4 years) under treatment with SSRIs were interviewed with an SD questionnaire designed for this purpose by the authors and that included questions about the following: decreased libido, delayed orgasm or anorgasmia, delayed ejaculation, inability to ejaculate, impotence, and general sexual satisfaction. Patients with the following criteria were included: normal sexual function before SSRI intake, exclusive treatment with SSRIs or treatment associated with benzodiazepines, previous heterosexual or self-erotic current sexual practices. Excluded were patients with previous sexual dysfunction, association of SSRIs with neuroleptics, recent hormone intake, and significant medical illnesses. There was a significant increase in the incidence of SD when physicians asked the patients direct questions (58%) versus when SD was spontaneously reported (14%). There were some significant differences among different SSRIs: paroxetine provoked more delay of orgasm or ejaculation and more impotence than fluvoxamine, fluoxetine and sertraline (chi 2, p < .05). Only 24.5% of the patients had a good tolerance of their sexual dysfunction. Twelve male patients who suffered from premature ejaculation before the treatment preferred to maintain delayed ejaculation, and their sexual satisfaction, and that of their partners, clearly improved. Sexual dysfunction was positively correlated with dose. Patients experienced substantial improvement in sexual function when the dose was diminished or the drug was withdrawn. Men showed more incidence of sexual dysfunction than women, but women's sexual dysfunction was more intense than men's. In only 5.8% of patients, the dysfunction disappeared completely within 6 months, but 81.4% showed no improvement at all by the end of this period. Twelve of 15 patients experienced total improvement when the treatment was changed to moclobemide (450-600 mg/day), and 3 of 5 patients improved when treatment was changed to amineptine (200 mg/day).     

Sexual function after major resections of the sacrum with bilateral or unilateral sacrifice of sacral nerves

The sexual function of nine patients with severance of sacral nerves bilaterally (five patients) or unilaterally (four patients), performed during operations for radical extirpation of tumors of the sacrum or its vicinity, was studied. Sexual histories were obtained and sensibility tests were performed. In four of the five male patients an attempt was made to collect electromyographic recordings from the external urethral and anal sphincters during ejaculation. Bilateral loss of S3 to S5 nerves in two women seemed not to affect their sexual function. Bilateral loss of S2 to S5 nerves in one man was compatible with gratifying sexual intercourse, the stimulation for erection being purely psychogenic, and "ejaculation" of a dripping nature. Unilateral loss of all sacral nerves did not impair previously normal sexual function, although the penises and vulvae of these patients were anesthetic on one side. The sensibility of the penis seemed to be subserved by the second sacral nerve. The myoelectric activity of the striated urethral and anal sphincters during ejaculation recorded in one patient with unilateral total loss of sacral nerves was normal bilaterally considering the duration of, and intervals between, the clonic contractions.     

The role of sexual factors in the aetiology of cervical dysplasia

The effect of sexual behavior on the risk for cervical dysplasia was evaluated in a case-control study. Cases (n = 257) had a histologically confirmed diagnosis of cervical dysplasia. Controls (n = 705) were sampled from the general population. A postal questionnaire was used to obtain information about, among other things, age at first sexual intercourse, number of sexual partners, current frequency of intercourse and contraceptive use. Information was also collected about other risk factors for cervical dysplasia, in order to adjust for possible confounding. We observed higher risks for cervical dysplasia (mild, moderate and severe) with increasing number of sexual partners. This effect appeared to be dependent on smoking behaviour. For women who reported more than six sexual partners, the adjusted odds ratio (aOR) was 9.1 (95% CI: 3.5-23.7) for non-smokers, and 26.4 (95% CI: 11.8-58.8) for women who smoked > or = 20 cigarettes per day. The effects of age at first sexual intercourse and current frequency of intercourse disappeared after adjustment for other risk factors. Use of oral contraceptives for > 10 years increased the risk (aOR = 2.3; 95% CI: 1.2-4.6). Thus, the number of sexual partners, especially in combination with smoking behaviour, appeared to be the most important risk factor for cervical dysplasia.     

Health-related behaviors in secondary-school students: sexual relations and tobacco, alcohol and cannabis consumption

BACKGROUND AND OBJECTIVES: The main premature mortality causes among youngsters are related to risk behaviors, usually initiated in adolescence. The study objective is to describe substance use and sexual behaviours among 10th-grade Barcelona students in 1996 (last year of compulsory education), as well as the interrelations between these variables and several sociodemographic variables. METHODS: Cross sectional study. Random sample including 35 10th grade classrooms (958 students whose mean age is 15.8 years old) stratified by academic or vocational studies, public or private school, school neighbourhood socioeconomical level and school size. Measurement instrument is a previously validated questionnaire. Tobacco, alcohol, and cannabis consumption, sexual intercourse as well as gender, age, weekly available money, parental instruction and type of studies are studied. Bivariate chi 2 analysis and multivariate gender specific log-linear model are performed. RESULTS: 27% of the students smoke daily and 31% drink alcohol weekly. 15% have had sexual intercourse, and among those 79% use always or almost always condoms. Among girls tobacco consumption is related to alcohol (OR = 4.2), to cannabis (OR = 5.9) and sexual intercourse (OR = 3.9), and, less strongly, with age, available money and vocational studies. Alcohol is associated with tobacco and cannabis use (OR = 4.2). Having had sexual intercourse is related to tobacco use, age (OR = 3.4), vocational studies (OR = 2.4) and cannabis experience (OR = 2.8). Among boys tobacco consumption is related to alcohol, (OR = 2.7), to cannabis (OR = 7.6) and sexual intercourse (OR = 4.4), and, less strongly, to available money and type of studies. Alcohol consumption is associated with tobacco and cannabis use (OR = 5.5). Sexual intercourse is related to tobacco use and age (OR = 2.5). DISCUSSION: Risk behaviors among final year secondary school students are strongly and significantly interrelated, both among boys and among girls, and are more frequent among older students, those with more money available and those in vocational curricula.     

Awareness of language in children who have reading difficulties: historical comparisons in a longitudinal study

The purpose of this study was to assess factors associated with the use of family planning at first sexual intercourse among young adults aged 15 to 24 in urban Ecuador. The study population consisted of 1443 young adults (494 females and 949 males) in the cities of Quito and Guayaquil, interviewed by the 1988 Ecuador Young Adult Reproductive Health Survey, who reported having experienced consensual sexual intercourse. Approximately 11% of females and 15% of males reported using contraception at first intercourse. Binary logistic regression was performed to assess jointly the effect of multiple factors on contraceptive use at first intercourse. The regression model was first run on the entire study population and then separately for males and females. In the overall population, the following variables were significantly related to using family planning at first sex: being male; being from Guayaquil; older age; father's completion of secondary school. Having lost one's virginity to a prostitute was significantly associated with non-use of family planning. Males were 3.6 times more likely than females to use family planning during their first sexual intercourse. For each year older a young adult was at first sex, his or her odds of using family planning was multiplied by a factor of 1.3. Twenty-eight per cent of males in this study experienced their first sexual intercourse with a prostitute, and these young men were highly unlikely to use family planning. A male who experienced first intercourse with his girlfriend was more than five times as likely to use contraception than a male who lost his virginity to a prostitute.     

The relationship between age and gender in workers' attitudes toward sexual harassment

The relationship between gender, age, and workers' attitudes toward sexual harassment as measured by the Sexual Harassment Attitudes Scale was examined. Participants were full-time workers employed at a local hardware-manufacturing company or a local utility company in New England. Results indicated that the women younger than 40 years old were significantly less tolerant of sexual harassment than older women were. In contrast, male workers' tolerance of sexual harassment decreased with age up until the age of 50 years, after which their tolerance level of sexual harassment increased significantly.     

The Healthy for Life project: sexual risk behavior outcomes

Sexual risk behavior outcome data from the Healthy for Life (HFL) project is presented. Using a social influences model, the intervention was designed to positively affect the health behaviors of middle school students in five related areas: alcohol use, tobacco use, marijuana use, nutrition, and sexuality. The in-school program was supplemented by parent, community and peer components. The research used self-report data on an initial sample of 2,483 middle school students followed from Grade 6 to Grade 10. Twenty-one schools were assigned to three conditions--age appropriate (program taught in Grades 6, 7, and 8), intensive (program taught in Grade 7) and control--using blocked randomization. Attrition was 20% (by Year 4) and 33% (by Year 5). By ninth grade the lifetime intercourse rate among both groups of HFL subjects was significantly higher than for controls (controlling for baseline substance use risk and involvement with the opposite sex), but reported past month intercourse rates and condom use did not differ. At the tenth grade follow-up, the age appropriate subjects reported higher adjusted rates of lifetime and past month intercourse than did the controls. Intensive subjects perceived significantly lower normative rates of intercourse than controls at ninth grade follow-up, but age appropriate subjects perceived significantly higher norms at tenth grade. Our expectation that this approach would be effective in reducing adolescent sexual risk behavior has not been supported. The influence of social and community norms and contextual factors has a far greater influence on the behavior of students (even 6 years later) than this school-based social influences program targeting only one grade cohort.     

Suicidal thoughts and behaviours in former sexual abuse victims.

Examined the relationship between childhood sexual abuse and subsequent suicidality in 195 women (mean age 27.4 yrs) presenting to the crisis intervention program of a community health center. As predicted, former sexual abuse victims were considerably more likely to have made at least 1 suicide attempt in the past (55% of the 133 Ss) than were nonabused clients (23% of the 62 Ss) and were more likely to report suicidal ideation upon intake. Sexual abuse was associated with suicide attempts that occurred in childhood or adolescence. Among former sexual abuse victims, greater suicidality was correlated with multiple perpetrators, concurrent physical abuse, and sexual intercourse. Childhood sexual abuse is hypothesized to result in lowered self-esteem, guilt and self-blame, perceived powerlessness, and interpersonal dysfunction—all of which may lead to increased self-destructiveness. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Heart failure and echocardiographic changes during long-term follow-up of patients with sick sinus syndrome randomized to single-chamber atrial or ventricular pacing

OBJECTIVE: In the present study, physical and sexual abuse among incarcerated youth were examined with respect to sexual activity, contraceptive use, and pregnancy. METHOD: The self-report survey data were collected from 62 females and 334 males who were incarcerated in Nevada youth correctional facilities in the summer of 1994. Of the males, 46.8% (n = 156) reported a history of physical abuse and 9.9% (n = 33) reported sexual abuse. A surprisingly high 73% (n = 46) of the females reported a history of physical abuse and 68.3% (n = 43) reported sexual abuse. RESULTS: The analyses indicated that females who reported a history of sexual abuse had an earlier mean age of first intercourse than those who reported no sexual abuse. In addition, male and female respondents with a history of physical and/or sexual abuse reported using no method of contraception as compared to youth with no history of abuse. CONCLUSIONS: Implications of these results for detention-based counseling and prevention programming are discussed.     

Sexual behaviour in young people

A review of the literature from the United Kingdom reveals a progressive reduction in recent decades in the age at first intercourse, an increase in the prevalence of premarital sex to the point of near universality, and a convergence of the sexual behavior of males and females. Over the past 30 years, the median age at first intercourse in the UK has dropped from 16 to 14 years for females and from 15 to 13 years for males. Fewer than 1% of women 16-24 years of age had their first sexual experience within marriage compared with 40% of women 45-59 years old. These trends reflect biologic factors, including earlier age at menarche, and social factors such as liberalization of norms governing sex behavior and peer pressure. Age at first intercourse increases with educational level and social class status. Curiosity is the factor most commonly cited by males as motivating first intercourse, while females identify romantic reasons. Nearly half of young women and over half of young men who have intercourse before the age of 16 years have unprotected sex. Contraceptive use is more likely with casual than steady sex partners. The condom is the most widely used contraceptive method in the early stages of sexual experience, and its use is increasing as a result of awareness of acquired immunodeficiency syndrome. More than two-thirds of young people consider themselves inadequately prepared at first intercourse in terms of information on sexual matters. Although the majority gain their information about sexuality from friends, schools are cited as a preferred source. The importance of sex education is confirmed by the positive association of predominantly school-based information and contraceptive use at first intercourse. There is no evidence that sex education hastens the onset of sexual activity.     

Chronic renal failure and sexual functioning: clinical status versus objectively assessed sexual response

BACKGROUND: Sexual dysfunctions are common among patients with chronic renal failure. The prevalence was assessed in a population of 281 patients (20-60 years), and it was attempted to determine whether their mode of treatment (haemodialysis, peritoneal dialysis, or kidney transplantation), or biochemical and endocrine variables and neuropathy affect sexual functioning. Patients with rheumatoid arthritis served as a comparison group. METHODS: Assessment included clinical history, physical and laboratory examinations, questionnaires measuring erotosexual dysfunctions, and a psychophysiological test procedure. The latter is a laboratory method which measures, in a waking state, subjective and physiological sexual arousal. RESULTS: Men on haemodialysis or peritoneal dialysis suffered significantly more often from 'Hypoactive Sexual Desire Disorder', 'Sexual Aversion Disorder' and 'Inhibited Male Orgasm' than men with kidney transplantation or rheumatoid arthritis. Interestingly, the prevalence of 'Male Erectile Disorder' did not differ significantly between the four groups and ranged between 17 and 43%. Of the women, transplanted patients suffered significantly less from 'Hypoactive Sexual Desire Disorder' than the other three groups; the prevalence of other sexual dysfunctions did not differ between the groups. Although 'Male Erectile Disorder' and 'Female Sexual Arousal Disorder' had a relatively high prevalence there were no differences in the four groups of patients in genital responses during psychophysiological testing. Genital responses during psychophysiological assessment had no relationship to the duration of renal replacement treatment, biochemical/endocrine variables, or the presence/ absence of neuropathy. CONCLUSION: The prevalence of sexual dysfunction was high. Sexual dysfunction in men on haemodialysis or peritoneal dialysis was not so much due to erectile failure but largely to loss of sexual interest, subjectively ascribed to fatigue. The latter was also found in women on haemodialysis or peritoneal dialysis.     

Decreasing postpartum sexual abstinence time

Postpartum sexual abstinence time can be safely shortened for most patients when episiotomy repair is done meticulously with fine PGA suture on small needles. The time preferred by patients for resumption of intercourse seems to be between the second and third postpartum week. We have seen no ill effects from this, and we feel that sexual intercourse at these early dates does not influence the healing of the episiotomy in any way.     

Sexual behaviour in untreated and treated coeliac patients

BACKGROUND: Sexual behaviour is often altered in chronic illness. AIM: To evaluate sexual behaviour in coeliac patients before and after treatment with a gluten-free diet. PATIENTS: Fifty-five adults with coeliac disease and 51 age- and sex-matched healthy controls. METHODS: Routine clinical and laboratory work-up was used for diagnosis of coeliac disease. Age of first sexual intercourse, prevalence of individuals who were sexually active, frequency of intercourse, reduction in sexual desire, difficulty in attaining orgasm, pain during intercourse, and prevalence of individuals defining themselves as satisfied with their sexual life were investigated by an anonymous, self-administered questionnaire administered before and after one year's treatment with a gluten-free diet in coeliac patients, and only once in controls. Analyses included clinical conditions, demographic and socio-economic data. RESULTS: Compared with controls, untreated coeliac patients had a significantly lower frequency of intercourse and a lower prevalence of individuals satisfied with their sexual life. Patients with overt and subclinical coeliac disease did not show significant differences for any indices of sexual behaviour. Compared with untreated conditions, coeliac patients after one year of treatment had improved values for all indices of sexual behaviour: differences were significant for frequency of intercourse and prevalence of individuals satisfied with their sexual life. CONCLUSION: Untreated coeliac disease, even in its subclinical presentation, is associated with disorders in sexual behaviour which are improved by the dietary treatment.