PMCC PMCC

Search tips
Search criteria

Advanced
Results 1-25 (948819)

Clipboard (0)
None

Related Articles

1.  Secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds: cross sectional survey of four populations, 1971-2001 
Objective To study secular trends in self reported sexual behaviour among 70 year olds.
Design Cross sectional survey.
Settings Four samples representative of the general population in Gothenburg, Sweden.
Participants 1506 adults (946 women, 560 men) examined in 1971-2, 1976-7, 1992-3, and 2000-1.
Main outcome measures Sexual intercourse, attitudes to sexuality in later life, sexual dysfunctions, and marital satisfaction.
Results From 1971 to 2000 the proportion of 70 year olds reporting sexual intercourse increased among all groups: married men from 52% to 68% (P=0.002), married women from 38% to 56% (P=0.001), unmarried men from 30% to 54% (P=0.016), and unmarried women from 0.8% to 12% (P<0.001). Men and women from later birth cohorts reported higher satisfaction with sexuality, fewer sexual dysfunctions, and more positive attitudes to sexuality in later life than those from earlier birth cohorts. A larger proportion of men (57% v 40%, P<0.001) and women (52% v 35%, P<0.001) reported very happy relationships in 2000-1 compared with those in 1971-2. Sexual debut before age 20 increased in both sexes: in men from 52% to 77% (P<0.001) and in women from 19% to 64% (P<0.001).
Conclusion Self reported quantity and quality of sexual experiences among Swedish 70 year olds has improved over a 30 year period.
doi:10.1136/bmj.a279
PMCID: PMC2483873  PMID: 18614505
2.  Virginity Lost, Satisfaction Gained? 
Journal of sex research  2010;47(4):384-394.
Despite the literature's focus on (hetero)sexual initiation, we know little about the degree to which young people are satisfied by their first vaginal intercourse experience, let alone the factors that predict satisfaction. We analyzed data from a cross-sectional survey of 1986 non-Hispanic White and Black 18-25 year old respondents from four university campuses. Respondents were asked to rate the degree to which their first vaginal intercourse was physiologically and psychologically satisfying. Both Black and White women were significantly less likely than Black and White men to experience considerable or extreme satisfaction at first vaginal intercourse, particularly physiological satisfaction. Among all four gender-race groups, being in a committed relationship with one's sexual partner greatly increased psychological satisfaction, particularly among women. Experiencing less guilt at first sexual intercourse was also strongly associated with psychological satisfaction for women. Developing sexual relationships with partners they care for and trust will foster satisfaction among young people at first vaginal intercourse. Our findings highlight strong gender asymmetry in affective sexual experience.
doi:10.1080/00224491003774792
PMCID: PMC3572537  PMID: 20401787
sexual debut; sexual initiation; first heterosexual intercourse; sexual satisfaction (physical, psychological); gender differences
3.  A comparison of sexual behaviour and attitudes of healthy adolescents in a Danish high school in 1982, 1996, and 2001 
Aim
To assess changes in sexual behaviour among students at a high school in Denmark from 1982 to 2001.
Methods
An anonymous self-administered questionnaire was used to compare data from three identical cross-sectional surveys performed in 1982, 1996, and 2001.
Results
Girls: More girls reported their first sexual intercourse before their 16th birthday in 2001 (42%) than in 1996 (29%) In 1982 it was also 42% (Chi-square for trend: p = 0.003). Fewer girls with no regular partner used condoms for their personal protection in 2001 (2%) than in 1996 (9%) and 1982 (0%) (Chi-square for trend p = 0.016). The proportion of girls with no regular partner who considered protection from sexually transmitted disease important for their choice of contraception was 39% in 2001 compared with 71% in 1996 and only 10% in 1982 (Chi-square for trend: p < 0.0001).
Boys: More boys reported sexual debut before their 16th birthday in 2001 (40%) than in 1996 (37%) and 1982 (24%) (Chi-square for trend: p = 0.023). For boys with no regular partner, condom was preferred for personal protection by 85% in 2001, 91% in 1996 and 61% in 1982 (Chi-square for trend p = 0.007). Protection against sexually transmitted infection declined, especially among boys with no regular partner, from 51% in 2001 to 72% in 1996 and 21% in 1982 Chi-square for trend: p < 0.0001).
The tendency towards earlier sexual debut and less use of safe sex practices to protect against sexually transmitted infections (STI) was accompanied by a rise in the number of detected STIs during this period.
Conclusions
The period from 1982 to 1996 during which sexual attitudes were directed toward safer sex seems to have given way to a reverse trend in the period from 1996 to 2001. These findings may have significant implications for health care authorities organising preventive strategies for healthy adolescents.
doi:10.1186/1478-7954-2-5
PMCID: PMC394347  PMID: 15038827
4.  Young adult sexual health: current and prior sexual behaviors among non-Hispanic white U.S. college students 
Sexual health  2010;7(1):10.1071/SH09028.
Objective
Less is known about the sexual health of young adults compared to adolescents, despite 20-24 year olds' greater risk of unintended pregnancy and sexually transmitted infections. This paper provides information on college students' prior and current sexual practices, including oral sex, vaginal intercourse, anal intercourse, and masturbation.
Methods
We analyzed data from a cross-sectional sexuality survey of students from two university campuses in the USA, one Midwestern and one Southwestern (N=1504). The sample consisted of non-Hispanic white, never-married students who identified as heterosexual.
Results
Of 16 possible combinations of four sexual activities (solitary masturbation, oral sex, vaginal intercourse, and anal intercourse), only four contained more than 5% of respondents: masturbation, oral sex, and vaginal intercourse (37%); oral sex and vaginal intercourse only (20%); all four (14%); and none (8%). Twenty percent had ever engaged in anal intercourse. Women were significantly less likely than men to have ever masturbated (48% versus 92%). Analyses exhibited several sexual health challenges, including lack of verbal sexual consent, alcohol use proximal to sex, and lack of contraceptive use.
Conclusions
Although few young adults are substituting it for vaginal intercourse, anal intercourse is increasingly common, and safer sex efforts should encourage condom use during both sexual activities. Masturbation should be encouraged as an alternative to higher risk sexual practices and an essential aspect of sexual well-being. Finally, practitioners should continue to address specific threats to college students' sexual health, including alcohol use and nonverbal consent.
doi:10.1071/SH09028
PMCID: PMC3816118  PMID: 20152094
Sexual health; sexual practices; young adults; college students; masturbation; anal intercourse; oral sex
5.  Age at first sex: understanding recent trends in African demographic surveys 
Sexually Transmitted Infections  2004;80(Suppl 2):ii28-ii35.
Objectives: To describe recent trends in age at first sex in African countries, identifying and making due allowances for a variety of common reporting errors.
Methods: Demographic and Health Surveys (DHS) data from six African countries conducting three or more surveys since 1985 were analysed using survival analysis techniques, combining information on virginity status and retrospective reporting of age at first sex. Hazard analysis was used to separate the effects of reporting error and compositional change and to estimate true changes in sexual debut over time. A multistate life table analysis incorporating transition to first marriage allowed cohorts to be classified according to person years spent as virgins, as sexually active unmarried, and married.
Results: Intersurvey comparisons generally suggested a slow secular rise in age at first sex. However, tracing birth cohorts between surveys revealed inconsistencies—median ages reported by female members of a birth cohort in their teens were generally higher than those reported when they reached their twenties, even when allowing for residence and education changes—probably a result of young, sexually active women denying they had ever had sex. Male birth cohorts tend to display the opposite kind of bias.
Conclusions: Uganda, Kenya, and Ghana have experienced a more pronounced and unambiguous decline in premarital sexual activity than Tanzania, Zambia, and Zimbabwe, with statistically significant increases in age at first sex. In addition, Uganda has maintained a very short interval between onset of sexual activity and marriage for both sexes.
doi:10.1136/sti.2004.012674
PMCID: PMC1765851  PMID: 15572637
6.  The Role of Religion in Shaping Sexual Frequency and Satisfaction: Evidence from Married and Unmarried Older Adults 
Journal of sex research  2011;48(2-3):297-308.
This study assesses the role of religion in influencing sexual frequency and satisfaction among older married adults and sexual activity among older unmarried adults. We propose and test several hypotheses about the relationship between religion and sex among these two groups of older Americans, using nationally representative data from the National Social Life, Health, and Aging Project (NSHAP). Results suggest that among married older adults, religion is largely unrelated with sexual frequency and satisfaction, although religious integration in daily life shares a weak but positive association with pleasure from sex. For unmarried adults, such religious integration exhibits a negative association with having had sex in the last year among women but not men.
doi:10.1080/00224491003739993
PMCID: PMC3119480  PMID: 20349390
7.  Sexual Risk and Bridging Behaviors Among Young People in Hai Phong, Vietnam 
AIDS and Behavior  2007;12(4):643-651.
The risk of the HIV epidemic spreading from high-risk groups to the general population in Vietnam depends on sexual risk and bridging behaviors between high- and low-risk individuals. A cross-sectional study was used to describe sexual activities of youth aged 18–29 years. Nearly half (41.4%) were sexually active. Premarital sex was reported by 43.3% of them; 78.3% of sexually active males and 13.5% of sexually active females. Multiple sex partners were reported by 31.0%; 56.7% of males and 9.2% of females. Almost 27% of males and 5% of females engaged in sexual bridging behaviors. Being unmarried was significantly associated with having sex with non-regular partners. Being unmarried and early age at first intercourse were associated with having sex with a sex worker. Consistent condom use was high with commercial sex workers but low with regular partners. Education to delay early sexual debut, increased employment, and strategies to inform young sexually active people to adopt safer behaviors are urgently needed.
doi:10.1007/s10461-007-9265-0
PMCID: PMC2938170  PMID: 17636375
Sexual risk; Bridging behaviors; Young people; Hai Phong; Vietnam
8.  Sexual Health 
BMC Women's Health  2004;4(Suppl 1):S24.
Health Issue
Much attention is devoted to women's reproductive health, but the formative and mature stages of women's sexual lives are often overlooked. We have analyzed cross-sectional data from the Sexual Behaviour module of the 2000/2001 Canadian Community Health Survey (CCHS), and reviewed the literature and available indicators of the sexual health of Canadian women.
Key Findings
Contemporary Canadian adolescents are becoming sexually active at younger ages than in previous generations. The gender gap between young males and females in age at first intercourse has virtually disappeared. The mean age at first intercourse for CCHS respondents aged 15–24 years was between 16 and 17. Canadian-born respondents are significantly younger at first intercourse than those who were born outside of Canada. Few adolescents recognize important risks to their sexual health. Older Canadians are sexually active, and continue to find emotional and physical satisfaction in their sexual relationships.
Data Gaps and Recommendations
Both health surveys and targeted research must employ a broader understanding of sexuality to measure changes in and determinants of the sexual health of Canadians. There is reluctance to direct questions about sexual issues to younger Canadians, even though increased knowledge of sexual health topics is associated with delayed onset of sexual intercourse. Among adults, sex-positive resources are needed to address aspects of aging, rather than medicalizing age-related sexual dysfunction. Age and gender-appropriate sexual health care, education, and knowledge are important not only for women of reproductive age, but for Canadians at all stages of life.
doi:10.1186/1472-6874-4-S1-S24
PMCID: PMC2096696  PMID: 15345087
9.  Female Sexual Dysfunction: Prevalence and Risk Factors 
Background and Aim: Sexual dysfunction adversely affects quality of life, self esteem and interpersonal relationships and it may often be responsible for psychopathological disturbances. The purpose of this study was to explore the prevalence and associated risk factors for Female Sexual Dysfunction (FSD) in women with Kurdish culture from western Iran .
Material and Methods: This was a cross-sectional descriptive survey which included 400 women aged 18–50 years old, married, from Ilam-IR, who were interviewed as per the Iranian version of Female Sexual Function Index (FSFI). The subjects were randomly selected from 4 primary health centres.
Results: According to the findings, 185 (46.2%) women reported FSD. Prevalence of FSD increased with age, from 22% in women aged <20 years to 75.7% in women aged 40-50 years. FSD was detected as a desire problem in 45.3% of women, an arousal problem in 37.5%, a lubrication problem in 41.2%, an orgasm problem in 42.0%, a satisfaction problem in 44.5% and a pain problem in 42.5%. The educational level was inversely correlated with the risk of FSD (OR: 1.54 ,95% CI: 1.09-2.13). Patients with FSD were significantly more likely to be older than 40 years (OR: 2.23, 95% CI: 1.12-2.68), who had sexual intercourse fewer than 3 times a week (OR:1.85, 95% CI: 1.23-1.99), who had been married for 10 years or more (OR:1.76, 95% CI: 1.04-1.97), who had 3 children or more (OR: 1.48, 95% CI: 0.97-1.24), who had husbands aged 40 years or more (OR: 2.11, 95% CI: 1.35-2.37) and who were unemployed (OR: 1.34, 95% CI: 1.06-1.63). No significant differences were detected in smoking history, residences and contraception methods used (p>0.05).
Conclusion: FSD needs to be recognized as a significant public health problem in Kurd women. Further research, particularly studies on awareness and competency of physicians in the management of FSD, is required.
doi:10.7860/JCDR/2013/6813.3822
PMCID: PMC3919309  PMID: 24551663
Sexuality; Women; Risk factors; Iranian
10.  Sexual behaviour of lesbians and bisexual women 
Sexually Transmitted Infections  2003;79(2):147-150.
Objectives: To provide data about the sexual histories of a large sample of lesbians and bisexual women, to inform those who provide health care or carry out research with women who may be sexually active with other women.
Design: Cross sectional survey.
Setting/subjects: 803 lesbians and bisexual women attending, as new patients, lesbian sexual health clinics, and 415 lesbians and bisexual women from a community sample.
Main outcome measures: Self reported sexual history and sexual practice with both male and female partners.
Results: 98% of the whole sample gave a history of sexual activity with women, 83% within the past year, with a median of one female partner in that year. 85% of the sample reported sexual activity with men; for most (70%) this was 4 or more years ago. First sexual experience tended to be with a man (median 18 years old), with first sexual experience with a woman a few years later (median 21 years). Oral sex, vaginal penetration with fingers, and mutual masturbation were the most commonly reported sexual practices between women. Vaginal penetration with penis or fingers and mutual masturbation were the most commonly reported sexual activities with men.
Conclusions: These data from the largest UK survey of sexual behaviour between women to date demonstrate that lesbians and bisexual women may have varied sexual histories with both male and female partners. A non-judgmental manner and careful sexual history taking without making assumptions should help clinicians to avoid misunderstandings, and to offer appropriate sexual health advice to lesbians and bisexual women.
doi:10.1136/sti.79.2.147
PMCID: PMC1744617  PMID: 12690139
11.  Sexual function among married menopausal women in Amol (Iran) 
Journal of Mid-Life Health  2011;2(2):77-80.
Background:
Sexual activity is an important part of the human being's life but this instinct could be influenced by some factors such as diseases, drug using, aging, and menopause. But information about that is limited.
Aim:
The aim of this study is to determine the status of sexual activity among married menopausal women in Amol, Iran.
Materials and Methods:
This descriptive analytical study was conducted to describe the sexual activity and sexual dysfunction of women after menopause. Data were collected from health centers in Amol from 280 married women using a questionnaire (self-completed or by interview).
Finding:
Mean age of subjects were 55.9 ± 6.02 years. 23.4% of subjects reported that their sexual intercourse had been low. 70% of subjects reported a decrease in their sexual activities after menopause. Sexual dysfunctions includes sexual desire disorder 80% arousal dysfunction 80%, orgasmic dysfunction 25%, dyspareunia 55.6%, and lack of sexual satisfaction 43.2%.
Conclusion:
Findings revealed high percentage of sexual desire disorder and sexual arousal disorder in menopausal women. Therefore, we should have emphasis on counseling and education about sexual activities during the menopause period.
doi:10.4103/0976-7800.92534
PMCID: PMC3296390  PMID: 22408336
Menopause; sexual function; women
12.  Breast and Cervical Cancer Screening Practices among Disabled Women Aged 40–75: Does Quality of the Experience Matter? 
Journal of Women's Health  2008;17(8):1321-1329.
Abstract
Background
Women with disabilities (WWD) face significant barriers accessing healthcare, which may affect rates of routine preventive services. We examined the relationship between disability status and routine breast and cervical cancer screening among middle-aged and older unmarried women and the differences in reported quality of the screening experience.
Methods
Data were from a 2003–2005 cross-sectional survey of 630 unmarried women in Rhode Island, 40–75 years of age, stratified by marital status (previously vs. never married) and partner gender (women who partner with men exclusively [WPM] vs. women who partner with women exclusively or with both women and men [WPW]).
Results
WWD were more likely than those without a disability to be older, have a high school education or less, have household incomes <$30,000, be unemployed, and identify as nonwhite. In addition, WWD were less likely to report having the mammogram or Pap test procedure explained and more likely to report that the procedures were difficult to perform. After adjustment for important demographic characteristics, we found no differences in cancer screening behaviors by disability status. However, the quality of the cancer screening experience was consistently and significantly associated with likelihood of routine cancer screening.
Conclusions
Higher quality of cancer screening experience was significantly associated with likelihood of having routine breast and cervical cancer screening. Further studies should explore factors that affect quality of the screening experience, including facility characteristics and interactions with medical staff.
doi:10.1089/jwh.2007.0591
PMCID: PMC2944439  PMID: 18788985
13.  Frequency of Discrimination, Harassment, and Violence in Lesbian, Gay Men, and Bisexual in Italy 
PLoS ONE  2013;8(8):e74446.
Background
This cross-sectional study assessed the frequency of discrimination, harassment, and violence and the associated factors among a random sample of 1000 lesbian, gay men, and bisexual women and men recruited from randomly selected public venues in Italy.
Methods
A face-to-face interview sought information about: socio-demographics, frequency of discrimination, verbal harassment, and physical and sexual violence because of their sexual orientation, and their fear of suffering each types of victimization.
Results
In the whole sample, 28.3% and 11.9% self-reported at least one episode of victimization because of the sexual orientation in their lifetime and in the last year. Those unmarried, compared to the others, and with a college degree or higher, compared to less educated respondents, were more likely to have experienced an episode of victimization in their lifetime. Lesbians, compared to bisexual, had almost twice the odds of experiencing an episode of victimization. The most commonly reported experiences across the lifetime were verbal harassment, discrimination, and physical or sexual violence. Among those who had experienced one episode of victimization in their lifetime, 42.1% self-reported one episode in the last year. Perceived fear of suffering violence because of their sexual orientation, measured on a 10-point Likert scale with a higher score indicative of greater fear, ranges from 5.7 for verbal harassment to 6.4 for discrimination. Participants were more likely to have fear of suffering victimization because of their sexual orientation if they were female (compared to male), lesbian and gay men (compared to bisexual women and men), unmarried (compared to the others), and if they have already suffered an episode of victimization (compared to those who have not suffered an episode).
Conclusions
The study provides important insights into the violence experiences of lesbian, gay men, and bisexual women and men and the results may serve for improving policy initiatives to reduce such episodes.
doi:10.1371/journal.pone.0074446
PMCID: PMC3749994  PMID: 23991220
14.  Increasing risk behaviour and high levels of undiagnosed HIV infection in a community sample of homosexual men 
Sexually Transmitted Infections  2004;80(3):236-240.
Objectives: To estimate changes in sexual behaviour over time. To examine the proportion of undiagnosed HIV infection in a community sample of homosexual men. To explore the relation between HIV status, diagnosis, and sexual behaviour.
Methods: Five cross sectional surveys of men attending selected gay community venues in London between 1996 and 2000 (n = 8052). Men were recruited in 45 to 58 social venues (including bars, clubs, and saunas) across London. Participants self completed an anonymous behavioural questionnaire. In 2000, participants in community venues provided anonymous saliva samples for testing for anti-HIV antibody.
Results: The proportion of men having unprotected anal intercourse (UAI) increased significantly each year from 30% in 1996 to 42% in 2000 (p<<0.001). In 2000, 132 of 1206 (10.9%) saliva samples were HIV antibody positive. Of the HIV saliva antibody positive samples, 43/132 (32.5%) were undiagnosed. Around half of both diagnosed and undiagnosed HIV saliva positive men reported UAI in the past year. Of the 83% of men who reported their current perceived HIV status, 4.1% reported an incorrect status. HIV antibody positivity was associated with increasing numbers of UAI partners, and having a sexually transmitted infection (STI) in the past year (OR 2.15).
Conclusions: Homosexual men continue to report increasing levels of UAI. HIV prevalence is high in this group, with many infections remaining undiagnosed. The high level of risky behaviour in HIV positive men, regardless of whether they are diagnosed, is of public health concern, in an era when HIV prevalence, antiretroviral resistance, and STI incidence are increasing.
doi:10.1136/sti.2003.007286
PMCID: PMC1744829  PMID: 15170012
15.  Diabetes Mellitus and Sexual Function in Middle-Aged and Older Women 
Obstetrics and Gynecology  2012;120(2 Pt 1):331-340.
Objective
Diabetes mellitus is an established risk factor for sexual dysfunction in men, but its effect on female sexual function is poorly understood. We examined the relationship of diabetes to sexual function in middle-aged and older women.
Methods
Sexual function was examined in a cross-sectional cohort of ethnically-diverse women aged 40 to 80 years using self-administered questionnaires. Multivariable regression models compared self-reported sexual desire, frequency of sexual activity, overall sexual satisfaction, and specific sexual problems (difficulty with lubrication, arousal, orgasm, or pain) among insulin-treated diabetic, noninsulin-treated diabetic, and nondiabetic women. Additional models assessed relationships between diabetic end-organ complications (heart disease, stroke, renal dysfunction, and peripheral neuropathy) and sexual function.
Results
Among the 2,270 participants, mean±SD age was 55±9.2 years, 1,006 (44.4%) were non-Latina white, 486 (21.4%) had diabetes, and 139 (6.1%) were taking insulin. Compared to 19.3% of non-diabetic women, 34.9% of insulin-treated diabetic women (adjusted OR[95%CI]=2.04[1.32–3.15] and 26.0% of non-insulin-treated diabetic women (adjusted OR[95%CI]=1.42[1.03–1.94]) reported low overall sexual satisfaction. Among sexually active women, insulin-treated diabetic women were more likely to report problems with lubrication (OR[95%CI]=2.37[1.35–4.16]) and orgasm (OR[95%CI]=1.80[1.01–3.20]) than nondiabetic women. Among all diabetic women, end-organ complications such as heart disease, stroke, renal dysfunction, and peripheral neuropathy were associated with decreased sexual function in at least one domain.
Conclusions
Compared to nondiabetic women, diabetic women are more likely to report low overall sexual satisfaction. Insulin-treated diabetic women also appear at higher risk for problems such as difficulty with lubrication and orgasm. Prevention of end-organ complications may be important in preserving sexual activity and function in diabetic women.
doi:10.1097/AOG.0b013e31825ec5fa
PMCID: PMC3404429  PMID: 22825093
16.  Heterosexual anal intercourse and HIV infection risks in the context of alcohol serving venues, Cape Town, South Africa 
BMC Public Health  2011;11:807.
Background
The most efficient sexual behavior for HIV transmission is unprotected receptive anal intercourse. However, it is unclear what role heterosexual unprotected anal sex is playing in the world's worst HIV epidemics of southern Africa. The objective is to examine the prevalence of heterosexual unprotected anal intercourse among men and women who drink at informal alcohol serving establishments (shebeens) in South Africa.
Methods
Cross-sectional surveys were collected from a convenience sample of 5037 patrons of 10 shebeens in a peri-urban township of Cape Town, South Africa. Analyses concentrated on establishing the rates of unprotected anal intercourse practiced by men and women as well as the factors associated with practicing anal intercourse.
Results
We found that 15% of men and 11% of women reported anal intercourse in the previous month, with 8% of men and 7% of women practicing any unprotected anal intercourse. Multiple logistic regression showed that younger age, having primary and casual sex partners, and meeting sex partners at shebeens were independently associated with engaging in anal intercourse. Mathematical modeling showed that individual risks are significantly impacted by anal intercourse but probably not to the degree needed to drive a generalized HIV epidemic.
Conclusions
Anal intercourse likely plays a significant role in HIV infections among a small minority of South Africans who patronize alcohol serving establishments. Heterosexual anal intercourse, the most risky sexual behavior for HIV transmission, should not be ignored in HIV prevention for South African heterosexuals. However, this relatively infrequent behavior should not become the focus of prevention efforts.
doi:10.1186/1471-2458-11-807
PMCID: PMC3207968  PMID: 21999574
17.  Intoxication before last sexual intercourse and HIV risk behavior among men and women in Uganda: Evidence from a nationwide survey 
Aims
To establish the prevalence of intoxication before sex and its association with risky sexual behavior.
Design
The data were from the 2006 Uganda Demographic and Health Survey which had been designed for a cross-sectional descriptive study.
Setting
The study covered the whole country-Uganda.
Participants
The respondents were 6,253 women and 1,804 men who had ever had sex.
Measurements
The key independent variable was intoxication before last sexual intercourse while the major outcome variables were condom use and sex with non-regular partners. Weighted prevalence of intoxication was computed and multivariable logistic regression was applied to assess the independent association of intoxication with risky sexual behavior.
Findings
Twelve percent of men and 16% of women reported having been intoxicated before last sexual intercourse. Of the women who reported intoxication before last sexual intercourse, 78% said it was their partners who were intoxicated. Of the men who reported intoxication, 83% said it was they themselves who were intoxicated. Intoxication of the men was associated with having sex with non-regular partners (OR=1.78, 95%CI: 1.04-3.03) and having unprotected sex (OR=1.71, 95%CI: 1.07-2.73). Women who were intoxicated were less likely to have been with non-regular partners (OR=0.55, 95%CI: 0.32-0.95). The women whose partners were intoxicated before last sexual intercourse were more likely to report having had unprotected sex (OR=1.55, 95%CI: 1.12-2.15).
Conclusion
HIV prevention mechanisms should address intoxication before sex. More effort is needed to find ways of helping women avoid unprotected sex with intoxicated partners.
PMCID: PMC3470462  PMID: 23071484
HIV; risky sexual behavior; intoxication; alcohol use; sexual partners
18.  Who reports sexual function problems? Empirical evidence from Britain's 2000 National Survey of Sexual Attitudes and Lifestyles 
Sexually Transmitted Infections  2005;81(5):394-399.
Objective: To identify sociodemographic, sexual, and health behavioural and attitudinal factors associated with reporting sexual function problems.
Methods: A probability sample survey of 11 161 men and women aged 16–44 years resident in Britain in 2000. Data collected by a combination of computer assisted face to face and self interviewing. Outcomes were self report of a range of sexual function problems, considered as "any problems" (1+ lasting 1+ months in the past year) and "persistent problems" (1+ lasting 6+ months in the past year), and associations with sociodemographic, behavioural, and attitudinal variables.
Results: Both "any" and "persistent" sexual function problems were more commonly reported by women than men. A variety of sociodemographic factors were associated with both measures but differed by gender. For example, the adjusted odds ratio (AOR) for reporting any problems for married v single respondents was 0.70 (95% confidence interval (CI) 0.57 to 0.87) v 1.31 (95% CI 1.10 to 1.56) for men and women, respectively. Sexual behaviours significantly associated with reporting sexual function problems included competence at first sex, paying for sex in the past 5 years, number of occasions of sex and masturbation, both in the past 4 weeks. For men (only), reporting STI diagnosis(es) was significantly associated with reporting "any" problems (AOR 2.1, 95% CI 1.4 to 3.2) and "persistent" problems (AOR 2.1, 95% CI 1.1 to 3.9). Both measures were significantly more likely among men and women who reported communication difficulties with their partners, with AORs in excess of 1.9.
Conclusions: Sexual fulfilment is an important part of sexual health. Understanding factors associated with reporting sexual problems, and recognising that such factors maybe partnership specific, is an important step towards improving our understanding of sexual function and thus improving the provision of care and support available.
doi:10.1136/sti.2005.015149
PMCID: PMC1745042  PMID: 16199738
19.  Sexual violence against adult women primary care attenders in east London. 
BACKGROUND: Sexual violence against women is common. The prevalence appears to be higher in north America than Europe. However, not all surveys have differentiated the experience of forced sex by a current or former partner. Few women are thought to report these experiences to their general practitioner (GP). AIM: To measure the prevalence of rape, sexual assault, and forced sexual intercourse by a partner among women attending general practices, to test the association between these experiences of sexual violence and demographic factors, and to assess the acceptability to women of screening for sexual violence by GPs. DESIGN OF STUDY: Cross-sectional survey. METHOD: A self-administered questionnaire survey of 1207 women aged over 15 years was carried out in 13 general practices in Hackney, east London. RESULTS: Eight per cent (95% confidence interval [CI] = 6.2 to 9.6) of women have experienced rape, 9% (95% CI = 7.0 to 10.6) another type of sexual assault, and 16% (95% CI = 13.6 to 18.1) forced sex by a partner in adulthood: 24% (95% CI = 21.2 to 26.5) have experienced one or more of these types of sexual violence. Experiences of sexual violence demonstrated high levels of lifetime co-occurrence. Women forced to have sex by partners experienced the most severe forms of domestic violence. One in five women would object to routine questioning about being raped and/or sexually assaulted, and one in nine about being forced to have sex by a partner. CONCLUSION: Experiences of sexual violence are common in the lives of adult women in east London, and they represent a significant public health problem. Those women who have one experience appear to be at risk of being victims again. A substantial minority object to routine questions about sexual violence.
PMCID: PMC1314728  PMID: 14702905
20.  Violence against wives, sexual risk and sexually transmitted infection among Bangladeshi men 
Sexually Transmitted Infections  2007;83(3):211-215.
Objective
To assess the relationship between men's reported violence against wives and their sexual risk behaviours and sexual health.
Design, setting and participants
Cross‐sectional analyses of a survey of a nationally representative household‐based sample of married men in Bangladesh (n = 3096).
Main outcome measure(s)
Physical and sexual violence against wives during the previous 12 months was assessed and examined for relations to men's extramarital sexual behaviours and sexually transmitted infection (STI) symptoms or diagnosis during this same period, as well as to men's disclosure of such infection to wives and condom use while infected.
Results
More than 1 in 3 (36.84%) married Bangladeshi men reported physically and/or sexually abusing their wives in the past year. Men perpetrating such violence were more likely to report both premarital and extramarital sex partners (ORadjs 1.80–3.45; 95% CI 1.20 to 8.23); those reporting physical violence were more likely to report STI symptoms or diagnosis in the past year (ORadjs 1.68–2.52; 95% CI 1.24 to 3.73). Men perpetrating physical violence and contracting an STI were somewhat more likely to fail to disclose infection status to wives (ORadj 1.58; 95% CI 0.93 to 2.70) than infected men not reporting such abuse.
Conclusions
Violence against wives is common among Bangladeshi men. Men who perpetrate such abuse represent increased risk regarding their wives' sexual health because they are more likely to both participate in extramarital sexual behaviour and contract an STI compared with non‐abusive husbands. Given the growing epidemic of HIV infection among monogamous South Asian women based on intercourse with infected non‐monogamous husbands, research and intervention regarding men's violence in marriage and implications of such behaviour for women's sexual health should be prioritised.
doi:10.1136/sti.2006.023366
PMCID: PMC2659096  PMID: 17301104
21.  Behaviours and expectations in relation to sexual intercourse among 18-20 year old Asians and non-Asians 
Sexually Transmitted Infections  1999;75(3):162-167.
OBJECTIVES: To begin to map the reported behaviours and attitudes of young Britons of south Asian origin that may have implications for sexual health. "South Asian" refers to people able to trace their ancestry from the Indian subcontinent (that is, India, Pakistan, and Bangladesh), henceforth referred to as "Asian". DESIGN: A cross sectional study of sexual behaviour using self report measures in a self complete section of a social survey administered by trained interviewers in 1996. SETTING: Greater Glasgow, Scotland. SUBJECTS: Sample (n = 824) originally recruited aged 14-15 in 1992 in secondary schools in Greater Glasgow and subsequently traced through general practitioner registration for 1996 survey. 492 Asians and non-Asians aged 18-20 years old eventually interviewed in their own homes. MAIN OUTCOME MEASURES: Self reported experience of sexual intercourse, age at first intercourse, and contraceptive practice over year before interview. METHODS: Measures of sexual behaviour and attitudes were elicited through a self complete questionnaire filled out in the presence of, and returned to, a trained social interviewer. RESULTS: Asians, and particularly Asian women, were far less likely to report having had heterosexual intercourse. Those Asian women who had had intercourse were likely to do so for the first time at an older age, and with an older partner, than the non-Asian women. Asian women were less likely to report using the pill than non-Asian women, irrespective of their marital status, and Asian men were less likely than non-Asian men to report using condoms. Asian sexual abstinence was reported to be for religious reasons, which were not important for non-Asians. In contrast with non-Asians, Asians saw themselves as likely to be married with children within the next 5 years. Asian men considered the ideal age to marry for men and women to be younger than the non-Asian men's average estimate. Asian and non-Asian women suggested a similar ideal age for men to marry, but Asian women considered a younger age appropriate for women than did non-Asian women. CONCLUSIONS: The higher level of sexual abstinence among Asians, and particularly women, has implications for the delivery of sexual health services to the minority who are sexually active before marriage. The underreporting of condom use by Asian men compared with their non-Asian counterparts, suggests a failure of the existing sexual health education and health services to reach minority ethnic young men which may be remedied by collaborative work with institutions currently used by the Asian community. 



PMCID: PMC1758202  PMID: 10448393
22.  Sex and relationships for HIV positive women since HAART: a quantitative study 
Sexually Transmitted Infections  2005;81(4):333-337.
Objective: To investigate current levels of sexual activity, enjoyment, condom use, and other factors affecting sexual behaviour in a sample of women living with HIV.
Method: Participants were self selected. A cross sectional design using semi-structured questionnaires was employed. 82 HIV positive women completed questionnaires asking about demographics, relationships, sexual behaviour, and safer sex practices. The Hospital Anxiety and Depression Scale (HADS) and Golombok-Rust Inventory of Sexual Satisfaction (GRISS) were administered.
Results: 28% of women had had no sexual partners since diagnosis. Mean time diagnosed was 69 months, range 4–191 months. Time since diagnosis was not associated with having had a sexual partner. 59% of women had a current sexual partner, half reporting intercourse in the past month. Infrequent sex (84%), avoidance (84%), non-communication (69%), and dysfunction (60%) were among the most prevalent sexual difficulties. Endorsement of HIV impaired sexual enjoyment was associated with reduced sexual frequency (p = 0.006) and sexual dysfunction (p = 0.042). Sexual dissatisfaction was associated with infrequency of sex (p = 0.037), avoidance (p = 0.02), and non-communication (p = 0.032). Clinically significant levels of anxiety and depression were reported in 60% and 38% of cases, respectively. Depression was associated with avoidance of sex and higher total GRISS scores (p = 0.006 and p = 0.042). 60% of respondents stated that they "always" used condoms; a trend was observed between reduced condom use and higher levels of depression and anxiety (p = 0.09 and p = 0.06, respectively).
Conclusion: Sexual difficulties, including abstinence, were prevalent in this sample indicating the potential for interventions addressing the psychosexual needs of HIV positive women and their partners.
doi:10.1136/sti.2004.013516
PMCID: PMC1745005  PMID: 16061542
23.  Individual characteristics are less important than event characteristics in predicting protected and unprotected anal intercourse among homosexual and bisexual men in Melbourne, Australia 
Sexually Transmitted Infections  2006;82(6):474-477.
Objective
To describe individual, social network and encounter specific factors associated with protected anal intercourse (PAI) and unprotected anal intercourse (UAI).
Methods
This was a cross sectional survey conducted between April and November 2002. A total of 733 sexual encounters were reported by 202 men recruited from the gay community in Melbourne, Australia. Predictors of self reported PAI and UAI were examined.
Results
Of the 733 sexual events most (56.3%) did not involve anal intercourse, and more involved PAI than UAI (30.6% versus 13.1%). PAI was more likely than no anal intercourse (NAI) if the participant's social network was mostly homosexual, the partner was an occasional or casual partner, or was HIV positive. PAI was less likely if sex took place at a “beat” but more likely if it took place at a sauna. PAI was more likely if the partner was affected by drugs or alcohol. UAI was more likely than NAI if the participant had injected drugs in the year before interview. It was less likely if the partner was occasional or casual or was HIV positive but more likely if the partner's HIV status was unknown. UAI was much more likely than NAI if the encounter took place at a “sex on premises” venue.
Conclusions
In this analysis it is the characteristics of the sexual encounter that predict whether PAI or UAI rather than NAI takes place.
doi:10.1136/sti.2006.020917
PMCID: PMC2563880  PMID: 17151033
sexual behaviour; HIV; homosexual men
24.  Sexual Dysfunction Improved in Heroin-Dependent Men after Methadone Maintenance Treatment in Tianjin, China 
PLoS ONE  2014;9(2):e88289.
Objective
To investigate whether methadone maintenance treatment (MMT) is correlated with sexual dysfunction in heroin-dependent men and to determine the prevalence and risk factors of sexual dysfunction among men on MMT.
Methods
The study included a retrospective survey and a cross-sectional survey which contained interviews of 293 men who are currently engaged in MMT. The results of the two surveys were compared. For a subset of 43 participants, radioimmunoassay was additionally conducted using retrospective and prospective blood samples to test the levels of plasma testosterone and luteinizing hormone. Other study evaluations were the International Index of Erectile Function (IIEF-15), and Self-rating Depression Scale.
Results
Sexual dysfunction in all five IIEF-15 domains (erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) was strongly associated with long-term use of heroin. A decrease in the severity of sexual dysfunction was associated with MMT initiation. Erectile dysfunction, lack of sexual desire, inability to orgasm, and lack of intercourse satisfaction were significantly correlated with increasing age of the participants. Methadone dose and duration of methadone treatment were not found to be associated with sexual dysfunction. The level of plasma testosterone significantly declined during methadone treatment, but results from multivariate analysis indicated low levels of testosterone were not the main cause of sexual dysfunction. No correlation between reported depression status and sexual function was found.
Conclusions
While high levels of sexual dysfunction were reported by heroin-dependent men in our study before and after MMT initiation, MMT appears to be correlated with improved sexual function in the population of the study.
doi:10.1371/journal.pone.0088289
PMCID: PMC3919724  PMID: 24520361
25.  Selective adherence to antihypertensive medications as a patient-driven means to preserving sexual potency 
Objective
To describe hypertensive patients’ experiences with sexual side effects and their consequences for antihypertensive medication adherence.
Methods
Data were from a study conducted to identify facilitators of and barriers to adherence to blood pressure-lowering regimens. Participants were 38 married and unmarried veterans with a diagnosis of hypertension and 13 female spouses. Eight patient and four spouse focus groups were conducted. A directed approach to content analysis was used to determine the facilitators of and barriers to adherence. For this report, all discussion concerning the topic of sexual relations was extracted.
Results
Male patients viewed sexual intercourse as a high priority and felt that a lack of sexual intercourse was unnatural. They pursued strategies to preserve their potency, including discontinuing or selectively adhering to their medications and obtaining treatments for impotence. In contrast, spouses felt that sexual intercourse was a low priority and that a lack of sexual intercourse was natural. They discouraged their husbands from seeking treatments for impotence.
Conclusion
Although the primary study was not designed to explore issues of sexual function, the issue emerged spontaneously in the majority of discussions, indicating that sexuality is important in this context for both male patients and their spouses. Physicians should address sexual side effects of antihypertensive medications with patients, ideally involving spouses.
PMCID: PMC2770379  PMID: 19920964
hypertension; sexual side effects; antihypertensive medication; adherence; blood pressure

Results 1-25 (948819)