Annual Review of Sex Research

The international, psychological and sociological research literature on prostitution from 1990 through 2000 is reviewed. The stage is set by scanning topics and perspectives in earlier writings. Then the research is discussed under the following headings: (a) HIV related research (HIV prevalence studies, factors in condom use, and prevention program evaluation); (b) workers' background and motivational issues (early victimization and connected factors, economic motives and connected factors); (c) work related issues (working routines, risks and stresses, and managing risk, work and identity); (d) research on clients, and (e) issues related to social and legal status. The literature is still much more about sex than it is about work. In addition, although an increasing number of authors have criticized the dominance of a deviance perspective over work perspectives on prostitution, the literature still reveals many features of stigmatization. For instance, the wrongs associated with sex work are all too often attributed to the nature of sex work itself instead of to the stigma attached to it or to specific negative circumstances. Likewise, the association between prostitution and negative features (in particular HIV and early victimization) is overwhelming, despite evidence that, for large groups of sex workers, these issues are of limited relevance. Generally, writers fail to adequately differentiate among types of sex workers. In particular, in relation to issues of health and well-being, differentiation among sex workers on the basis of specific features of their working situation (e.g., contexts, routines, relations, conditions) has hardly been studied and is recommended for the future.

This article tracks the conjunction between the social, cultural, political, and economic changes taking place on a global level and the shift in sexuality research from primarily biomedical and behavioral concerns to those of rights and social justice. Particular attention is paid to how transnational public health and human rights discourses, and social movements concerned with gender inequality and the oppression of sexual minorities, have influenced the field of sexuality research. This influence is especially clear in the emergence of the concepts of sexual health and sexual rights, which have enabled researchers to draw clear connections between highly localized phenomena and transnational systems. The importance of rights-based approaches, in particular, has supported an explicit politicization of research and the engagement of researchers in social justice causes. To illustrate the interests and approach of contemporary sexuality research, the article includes a review of recent literature on sex trafficking and same-sex marriage. These cases are used to outline the negative and positive use of rights-the former a means to control harm and the latter a means to advance freedoms. Addressing the tension between these two strategies is a core challenge for the field of sexuality research.

Researchers have frequently linked childhood sexual abuse (CSA) with some form of adult sexual disturbance. Unfortunately, research on how to treat sexual dysfunctions in women with a history of childhood sexual abuse has lagged behind. In this article, we review the literature concerning childhood sexual abuse and sexual dysfunction. In addition, we look at two theories that help explain the relationship between CSA and sexual dysfunction. Both of these theories highlight the importance of emotional experience. The contextual behavioral model described by Polusny and Follette (1995) is derived from the work of Hayes and colleagues (Hayes, Strosahl, & Wilson, 1999) and focuses on the role of experiential avoidance in understanding the problems experienced by CSA survivors. Greenberg and colleagues' emotion theory (Greenberg & Pavio, 1998; Greenberg, Rice, & Elliott, 1993; Greenberg & Savin, 1987) is useful in highlighting the way in which early abuse experiences can impair emotional development and result in maladaptive emotional schemes contributing to sexual problems. Treatments for CSA survivors' sexual problems based on the two above theories are outlined. The question concerning the applicability of traditional sex therapy for CSA survivors versus a modified treatment is discussed and recent developments in the field of sexual functioning as well as future directions for the field are also highlighted.

As we move into the 21st century, information about sex is widespread and more accessible to the general public than ever before. This interest in sex also increases the focus on symptoms and patterns associated with sexual problems. However, the etiology of sexual dysfunction is multifaceted and poorly understood. One factor that has received growing attention is the role that early sexual abuse plays in sexual development and later sexual functioning, and how these associations differ between males and females. Despite high prevalence rates of child sexual abuse (CSA), which occurs to approximately 1 in 3 females and 1 in 10 males under the age of 18, we do not completely understand the complexities of how and to what extent CSA affects sexual functioning. Nonetheless, the research highlights the need to recognize the potentially powerful influence that abusive childhood experiences contribute to sexual health, performance, and satisfaction. We review research on the relationship between CSA and adolescent and adult sexual functioning. We use a developmental framework to guide our understanding of the effects of CSA, as well as gender and ethnic differences, on the sexual functioning of male and female survivors.

This paper has two aims: first, to review work addressing the functional significance of variation in sexuality across the women's menstrual cycle and its implications for an understanding of human sexual nature; second, to illustrate the more general use of adaptationism in sex research. Adaptationism provides a method for recognizing adaptations, traits that evolved because they bestowed reproductive advantages upon their owners. The telltale sign of adaptation is its special design for a particular function. In recent years, evolutionary psychologists have explored changes in women's sexuality and standards of male attractiveness across the menstrual cycle. Evidence provisionally supports the idea that these changes constitute special design for the function of obtaining genetic benefits through mating with men other than primary partners.

Alcohol has been implicated as having a causal role in a variety of sexual processes and outcomes. We review nonexperimental research illustrating the nature of alcohol's association with sexuality. Methodological considerations limiting causal assertions permissible with nonexperimental data are discussed. We also review findings from experiments, mostly analogue paradigms, examining the effects of alcohol on genital arousal, sexual risk taking, and sexual assault. In each case, it is observed that alcohol can exert a causal effect on one or more of the constituent responses undergirding these phenomena. We conclude that alcohol does appear to have a causal impact on many sexuality indices studied in laboratory conditions. Both alcohol expectancy and alcohol myopia models have been applied to explain these causal linkages. Expectancy models seem to account well for postdrinking sexual reactions and perceptions. Overall, myopia analyses seem to offer the most persuasive explanations of postdrinking expressions of sexual risk taking and sexual assault.

The meaning of homosexual identity as shaped by the adult life course is poorly described in the lives of gay men. In particular, the transition from young adulthood to middle age raises questions of how homosexual identity is redefined as gay men alter their participation in gay sexual culture, experience change in sexual desire and activity, and revise broader psychosocial identity as influenced by psychological and socialization processes related to aging. In addition, the HIV epidemic and historical change in social tolerance of homosexuality have shaped the experience of sexual identity among the generation of currently middle-aged gay men in the United States. A perspective that integrates sociocultural, historical, and psychosocial factors is thus needed to understand thesubjective meaning of homosexual identity as it is experienced in midlife. In this paper I have described exploratory research on the meaning of homosexual identity in the life trajectories of middle-aged men. Such meanings reflect available social and cultural pathways for change in midlife homosexual identity, as well as individual psychological attributes and idiosyncrasies of life history. These findings have heuristic value in further refinement of models of homosexual identity maintenance and support a more inclusive view of the life course that considers the effects of sexual orientation on adult identity.

This article is a review of academic research on the content and effects of sexual information in advertising (i.e., sex in advertising). In addition to covering common types of sexual content analyzed in research, inquiry on processing and emotional response effects is reviewed. Several areas for continued research are identified, especially with regard to advertisers' use of sexual outcomes as reasons for using brands and the ability of sexual information to influence brand perceptions. This review has applicability to advertising and marketing research and practice, as well as to any area that employs sexual information for persuasive purposes (e.g., safer-sex social marketing campaigns). In addition, it is hoped that sex researchers will recognize and elaborate on the role of sexual response identified in this research to further inform advertising theory and effects research.

We briefly outline the importance of statistical input into clinical trial research in the pharmaceutical industry and in interactions with regulatory agencies, with particular concentration on the role of the statistician in projects on sexual health during Phases 2 and 3 of clinical trials required in bringing new drugs to the market.

In response to some recent critiques, we (a) analyze the arguments and data presented in those commentaries, (b) integrate the findings of several metaanalytic summaries of experimental and naturalistic research, and (c) conduct statistical analyses on a large representative sample. All three steps support the existence of reliable associations between frequent pornography use and sexually aggressive behaviors, particularly for violent pornography and/or for men at high risk for sexual aggression. We suggest that the way relatively aggressive men interpret and react to the same pornography may differ from that of nonaggressive men, a perspective that helps integrate the current analyses with studies comparing rapists and nonrapists as well as with cross-cultural research.

As a result of the current STI epidemic, women are at particularly high risk. Sexual relations with men are the greatest source of risk for women in contracting HIV or other STIs. Because the male condom is still the most effective means of protection against these diseases, prevention efforts for women need to concentrate on the ability to effectively negotiate condom use. To date, research has primarily addressed the role of knowledge, attitudes, and beliefs about condoms in predicting their use rather than the situation within which individuals make sexual decisions. Our first goal is to present a theoretical model focusing on the situational influences and cognitive processes occurring at the time of a woman's sexual interaction with a man. The underlying premise for this model is that sexual decision making is mediated by a series of primary and secondary appraisals during the sexual encounter. Our second goal is to discuss specific contextual influences on women's cognitions during the process leading to sexual decision making. We review the literature on the effects of alcohol consumption, relationship status, and sexual arousal on the cognitive appraisal process, as well as on sexual decision making. Finally, although our main interest is the specific situation and context, we also review the influence of background factors and experiences that are especially relevant to the cognitive appraisal process, including alcohol expectancies, sexual victimization, sexuality-related characteristics, relationship-related characteristics, and other personality traits. Examining women's cognitive processes at the time of a sexual encounter can yield information that will enhance women's power to protect themselves against HIV and other STIs.

In view of the recent phase of political opposition to sex research and intense public interest in Alfred C. Kinsey, this paper considers the impact that Kinsey's research has had on the political process in the past 50 years. Initial reactions to Kinsey's research that remain relevant today include "normal" people don't participate in sex surveys, sex surveys are intended to promote homosexuality, and asking people about their sex lives in a nonjudgmental fashion promotes immorality. Episodes of political opposition are documented, and the long-running anti-Kinsey campaign and its impact on the political process are described and discussed. Reasons why people might still oppose sex research are considered, and conclusions are reached about how sex researchers might deal with this problem.

As the study of human sexual response becomes increasingly complex to meet the demands of this interdisciplinary field, the need for appropriate analytical tools has grown as well. In this review, we attempt to familiarize sexologists with the wide range of applications of regression analysis to the study of human sexual response. To this end, a typical experiment in human sexual response is described, and the basic regression model for the experiment is provided. Then, depending on the specific question under investigation, the nature of the study variables, and the design of the study, a number of different regression models are suggested, with each describing a specific variation from the basic regression model. Sample outputs are included to enable comparisons across several different models. With this information, researchers may develop a better understanding of the use and flexibility of the regression model in handling the kinds of problems often encountered in the experimental study of human sexual response.

Ejaculation is the final stage of coitus in the mammalian male and results in the expulsion of sperm out of the urethral meatus. Two successive phases, emission and expulsion, can be distinguished during ejaculatory response. Normal anterograde ejaculation requires close coordination of sympathetic, parasympathetic, and somatic components commanding the different peripheral anatomical structures (accessory sexual glands, ducti, and striated muscles) involved in ejaculation. The efferent pathways innervating these anatomical structures drive motor outputs originating from spinal thoracolumbar and lumbosacral nuclei. These spinal ejaculatory centers, the synchronized activation of which is likely carried out by a group of spinal cells, are under the control of both peripheral sensory afferents coming from genital areas and supraspinal information arising from specific brain regions.

Sexual selection has had profound effects at the copulatory and postcopulatory levels, upon the evolution of reproductive anatomy, physiology, and patterns of mating behavior. This review deals with the effects of sexual selection upon the evolution of relative testes sizes, sperm morphology, seminal vesicular function, penile morphology, and copulatory behavior in the Order Primates. The concept of cryptic female choice is also discussed, and its potential value in understanding how co-evolution of genital morphologies may have occurred in primates and inother animals.

In all species, sexual behavior is directed by a complex interplay between steroid hormone actions in the brain that give rise to sexual arousability and experience with sexual reward that gives rise to expectations of competent sexual activity, including sexual arousal, desire, and performance. Sexual experience allows animals to form instrumental and Pavlovian associations that predict sexual outcome and thereby directs the strength of sexual responding. Although the study of animal sexual behavior by neuroendocrinologists has traditionally been concerned with mechanisms of copulatory responding, more recent use of conditioning and preference paradigms, and a focus on environmental circumstances and experience, has revealed behaviors and processes that resemble human sexual responses. In this paper, we review behavioral paradigms used with rodents and other species that are analogous or homologous to human sexual arousal, desire, reward, and inhibition. The extent to which these behavioral paradigms offer predictive validity and practicality as preclinical tools and models is discussed. Identification of common neurochemical and neuroanatomical substrates of sexual responding between animals and humans suggests that the evolution of sexual behavior has been highly conserved and indicates that animal models of human sexual response can be used successfully as preclinical tools.

Proximate and ultimate biological theories for understanding sexual behavior predict that sexual dimorphism in sexual partner preference should be ubiquitous in the animal kingdom. A review of the literature found evidence for same-sex sexual partner preference in a small number of species (female pukekos, cows, domestic rams, female Uganda kobs, female Japanese macaques). Thus, theoretical predictions concerning the development and evolution of sexual partner preference appear to hold true except for a handful of exceptional species. Why individuals in some animal species exhibit same-sex sexual partner preference remains the object of debate. At a proximate level, domestic rams that exhibit same-sex sexual partner preference have been shown to differ in certain aspects of their neurobiology and physiology from rams that do not exhibit such a preference. It remains unclear, however, as to whether these differences are produced by sex-atypical perinatal exposure to androgens and their estrogenic metabolites. At an ultimate level, numerous functional hypotheses for same-sex sexual partner preference have been tested in female Japanese macaques but have failed to receive support. Understanding why same-sex sexual partner preference evolves in some species may involve abandoning a strictly functional perspective and, instead, approaching the issue from the perspective of each species' unique evolutionary history.

Striking secondary sexual traits, such as brightly colored "sexual skin," capes of hair, beards, and other facial adornments occur in adult males of many anthropoid primate species. This review focuses upon the role of sexual selection in the evolution of these traits. A quantitative approach is used to measure sexually dimorphic characters and to compare their development in the monogamous, polygynous, and multimale-multifemale mating systems of monkeys, apes, and human beings.