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Positive sexuality and its impact on overall well-being
Abstract
Historically, the issue of sexual health has been largely considered with respect to the associated negative health outcomes. The dangers of sexual activity such as sexually transmitted infections (STIs), HIV/AIDS, unintended pregnancy, sexual coercion, and sexual violence have dominated the attention of those working in the field. Over the last 20 years, and particularly in the last decade, an increasing number of people from a variety disciplines that address issues of sexual health have developed a new discourse concerning the positive aspects of sexuality. This review of the literature explores this emerging discourse. The results indicate that sexual health, physical health, mental health, and overall well-being are all positively associated with sexual satisfaction, sexual self-esteem, and sexual pleasure. The beneficial effects of sexual satisfaction should be integrated into programs that seek to improve these diverse health outcomes through service delivery, prevention, and sexuality education.
... 4 Given its impact on both physical and mental health, as well as overall wellbeing, it is crucial to identify the factors contributing to lower sexual satisfaction, and thus greater sexual dissatisfaction. [5][6][7] Several factors have been associated with sexual dissatisfaction, including low quality of partnership and communication, [8][9][10][11] low sexual desire, 5,[12][13][14] and low self-esteem. 5,14,15 Among these factors, the frequency of sexual activity is frequently identified as a key determinant of sexual satisfaction. ...
... 4 Given its impact on both physical and mental health, as well as overall wellbeing, it is crucial to identify the factors contributing to lower sexual satisfaction, and thus greater sexual dissatisfaction. [5][6][7] Several factors have been associated with sexual dissatisfaction, including low quality of partnership and communication, [8][9][10][11] low sexual desire, 5,[12][13][14] and low self-esteem. 5,14,15 Among these factors, the frequency of sexual activity is frequently identified as a key determinant of sexual satisfaction. ...
... [5][6][7] Several factors have been associated with sexual dissatisfaction, including low quality of partnership and communication, [8][9][10][11] low sexual desire, 5,[12][13][14] and low self-esteem. 5,14,15 Among these factors, the frequency of sexual activity is frequently identified as a key determinant of sexual satisfaction. Most studies suggest that a lower frequency of sexual activity is associated with greater sexual dissatisfaction. ...
... Rannsóknir hafa lengi sýnt fram á gagnsemi kennslu um kynheilbrigði þá sérstaklega varðandi áhaettukynhegðun, til daemis í ábyrgari ákvörðunum sem sjá má í seinkun á fyrstu samförum, aukinni notkun getnaðarvarna og faerri tilfellum kynsjúkdóma (Jaramillo o.fl., 2017;Mueller o.fl., 2008;Reis o.fl., 2011). Síðustu áratugi hafa baeði rannsóknir á því sviði og námsefni verið að miklu leyti um áhaettukynhegðun og frjósemisheilbrigði, þar sem kynhegðun unglinga er oft talin neikvaeð eða vandraeðahegðun sem geti haft neikvaeðar afleiðingar (Anderson, 2013;Kågesten og Reeuwijk, 2021). Kynheilbrigði unglinga snýst þó ekki einungis um að koma í veg fyrir áhaettukynhegðun og hefur umraeðan á seinni árum orðið jákvaeðari. ...
... Vaxandi áhersla hefur verið lögð á kynferðislega vellíðan, ánaegjulegt kynlíf og tilfinningalega og félagslega faerni sem viðkemur kynheilbrigði (Kågesten og Reeuwijk, 2021;Mitchell o.fl., 2021). Þar með eru jákvaeðar og ánaegjulegar hliðar kynheilbrigðis að fá meiri hljómgrunn og aukin áhersla er til daemis lögð á mikilvaegi sjálfstrausts og kynferðislegrar sjálfsvirðingar (Anderson, 2013). Kynferðisleg sjálfsvirðing (e. sexual self-esteem) vísar til þess sjálfstrausts og vellíðanar einstaklingsins sem kynveru og haefni hans til samskipta um kynheilbrigðismál (Anderson, 2013). ...
... Þar með eru jákvaeðar og ánaegjulegar hliðar kynheilbrigðis að fá meiri hljómgrunn og aukin áhersla er til daemis lögð á mikilvaegi sjálfstrausts og kynferðislegrar sjálfsvirðingar (Anderson, 2013). Kynferðisleg sjálfsvirðing (e. sexual self-esteem) vísar til þess sjálfstrausts og vellíðanar einstaklingsins sem kynveru og haefni hans til samskipta um kynheilbrigðismál (Anderson, 2013). Rannsóknir hafa bent á mikilvaegi kynferðislegrar sjálfsvirðingar, til daemis í tengslum við kynferðislega ánaegju (Anderson, 2013;Ménard og Offman, 2009;Peixoto o.fl., 2018). ...
Tilgangur Á Íslandi eru fáar rannsóknir um hvernig kennslu um kynheilbrigði er háttað í skólum og hvaða skoðanir unglingar hafa á henni. Tilgangur rannsóknarinnar var að skoða mat framhaldsskólanema á gæðum kennslu um kynheilbrigði út frá kennsluháttum, fræðsluþörfum og kynferðislegri sjálfsvirðingu. Aðferð Rannsóknin var þversniðsrannsókn. Valdir voru ellefu framhaldsskólar víðs vegar á landinu með tilgangsúrtaksaðferð. Í úrtakinu voru 2.488 nemendur, 18 ára og eldri. Könnunin var lögð fyrir í janúar 2022. Gagnagreining byggðist á lýsandi tölfræði og tilgátuprófunum með Pearson kí-kvaðrat prófi. Marktektarmörk miðuðust við p<0,05. Niðurstöður Alls svöruðu 648 nemendur (26%) könnuninni og voru konur fleiri en karlar. Tvær af þremur tilgátum um viðhorf unglinga til kennsluhátta og fræðsluþarfa stóðust en sú þriðja stóðst að takmörkuðu leyti. Marktækur munur var á viðhorfum nemenda sem töldu sig hafa fengið góða kennslu samanborið við þá sem töldu hana síðri varðandi fjölbreytni kennsluaðferða (p<0,001), hæfni kennsluaðila (p<0,001), uppfyllingu fræðsluþarfa (p<0,001), gæði svara (p<0,001) auk upplýsinga um getnaðarvarnir (p<0,001) og kynsjúkdóma (p<0,001). Mat á gæðamun kennslunnar út frá kynferðislegri sjálfsvirðingu sýndi aðeins marktækan mun á tveimur af fimm atriðum sem voru: „Ég á auðvelt með að standa með sjálfri/u/um mér þegar setja þarf mörk í kynlífi“ (p<0,05) og „Ég er óhrædd/tt/ur að standa á mínu ef kynlífsfélagi þrýstir á mig“ (p<0,05). Ályktanir Um þriðjungur þátttakenda lýsti ánægju sinni með kennslu um kynheilbrigði. Góð kennsla um kynheilbrigði að þeirra mati felst í kennsluháttum og hversu vel hún mætir fræðsluþörfum þeirra. Leggja þarf meiri áherslu á jákvæðar hliðar kynverundar í kennslu líkt og kynferðislega sjálfsvirðingu.
... 5 Previous researches reported a positive association between positive sexual health and mental health. 8 Likewise, in a study, Hensel et al. 9 Objectives This research aims to investigate the relationship of sexual anxiety and sexual cognition with mental health. Also, the study sought to identify the potential predictor of mental health in terms of sexual cognition and sexual anxiety. ...
... Sexual anxiety and worry are found among people of all ages. 11 These anxieties can be related to self-adequacy, 8 performance as well as to the sustainability of better sexual relationship with the partner. Research suggests a strong and positive association between anxiety and functional impairment, 12 this is also found true in case of sexual anxiety and sexual functioning. ...
Background
Negative sexual cognition and sexual anxiety create a substantial amount of distress and guilt in an individual, which in turn can lead to reduced well-being. However, the impact of sexual cognition and sexual anxiety on mental health are less researched topics, especially in the Indian context.
Aim
To investigate the effect of sexual cognition and sexual anxiety on mental health.
Method
124 participants of age range 18–35 years were recruited using purposive sampling method. Sexual Cognition Checklist, Sexual Anxiety Inventory, and Mental Health Inventory were used to assess sexual cognition, sexual anxiety, and mental health respectively.
Results
Mental health was significantly negatively associated with sexual anxiety and negative sexual cognition. Also, a significant positive correlation was found between positive sexual cognition and mental health. Negative sexual cognition and sexual anxiety emerged as significant predictors, accounting for approximately 20% and 6% of the variance in mental health, respectively. Finally, an independent sample t-test suggests that males and females significantly differ in their level of sexual cognition, mental health, and sexual anxiety.
Conclusions
Negative sexual cognition and sexual anxiety are associated with poor mental health while positive sexual cognition is associated with better mental health. Unmarried Indian women tend to experience more negative sexual cognition and sexual anxiety than married women.
... One such mechanism is sexual agency 2 ; namely, the capability to express sexual desires and preferences and communicate sexual expectations and boundaries (Anderson, 2013;Kiefer & Sanchez, 2007). In the current research, we define and operationalize sexual agency as 'the ability to act according to one's own wishes and have control of one's own sexual life' (Fahs & McClelland, 2016, p. 396). ...
... Theoretically, such understanding can shed light on whether gender differences in sexuality are driven by nature or nurture (see . Practically, it represents an essential stride in the advancement of interventions aimed at enhancing women's sexual functioning, which is a fundamental aspect of their overall health and well-being (Anderson, 2013). ...
Objectification theory predicts that women's self‐objectification should lead to sexual dysfunction, yet previous studies failed to provide consistent support for this prediction. The present research—which used two sufficiently powered samples and a self‐objectification measurement (SOBBS) with improved psychometric qualities and content validity than previous measurements—found support for the expected association between self‐objectification and sexual dysfunction among heterosexual women in Israel and the United States (N = 404 and 366, M age = 30.59 and 36.93, respectively). We also examined two novel potential mediators of this association, entitlement for pleasure and sexual agency (i.e., the capability to express sexual desires and boundaries), and found that the latter mediated the link between self‐objectification and sexual dysfunction. The mediators originally proposed by objectification theory (i.e. appearance anxiety, body shame, awareness of internal body states and flow) failed to mediate this link. Theoretical and methodological implications are discussed.
... We used Williams et al.'s (2015Williams et al.'s ( , 2020 Framework of Positive Sexuality (FPS) to guide the research process. Positive sexuality adopts a strengths-based approach to sexuality and sexuality research and focuses on how people use their individual strengths and resources to overcome challenges and be fulfilled in their unique sexualities (Anderson, 2013). This theoretical framework emphasizes choice, empowerment, and diversity (Williams et al., 2015) and recognizes "individual sexual expressions as valid, consensual, healthy and meaningful" (Nimbi et al., 2022, p. 895). ...
... While existing research has focused on the negative impacts of sex work stigma on romantic relationship quality, our research adopted a strengths-based positive sexuality perspective (Anderson, 2013;Williams et al., 2015) to examine how sex workers and their romantic partners might resist this stigma to maintain the quality of their relationship. Research with other types of romantic relationships has shown that developing coping strategies is a key way that partners deal with interpersonal stressors (Finkel et al., 2017;Randall & Bodenmann, 2009). ...
Romantic relationships are an important part of our social identities and well-being. In this paper, we report on qualitative findings with thirty Canadian couples, interviewed together, where it was known that one or both partners sell sexual services for a living. We asked a series of open-ended questions related to the background of the couple's relationship, their day-to-day interactions and work-related stressors. Participants talked about the ongoing negotiations they engage in as a couple, the benefits of being open to each other about working in the sex industry, and how they manage its emotional toll on their partnership. We conclude that there are various ways that sex workers are able to maintain intimacy in their romantic relationships after sex work has been disclosed. Widespread social stigma attached to sex work, complicated by criminalization in countries such as Canada, nevertheless threatens relationship quality in the long run.
... 'Erotic vitality' could describe a sense of energetic, passionate engagement with one's erotic or sensual experiences that plays a role in clinical engagement and personal development [12]. In fact, research has consistently shown that experiencing sexual satisfaction and pleasure, as well as positive sexual self-esteem, benefits sexual and mental health, as well as physical health, quality of life, and overall satisfaction with life [13,14]. ...
The term BDSM is used to describe a wide range of sexual practices, with previously negotiated and mutually consented rules, which take place through a carefully dramatized exercise of roles and powers in the context of erotic and/or sexual interaction. This qualitative study explores the paths and discourses of 14 Portuguese men who practice BDSM and self-identify as submissive. In-depth online interviews were conducted to contextualize the emergence, development, and self-assessment of their practices. The thematic analysis of the results identified three themes: (1) between the awakening and consolidation of interest in the BDSM universe, (2) contacts, encounters, and (dis)continuities, and (3) erotic and sexual experiences (un)blindfolded. The reading of the results is based on a non-pathologizing perspective and highlights a positive evaluation of the sexual experiences reported, motivated by an intentional and collaborative search for pleasure and eroticism that violates traditional gender boundaries. It is recommended that future empirical studies are carried out using non-pathological models associated with BDSM, which could expand knowledge and legitimize different ways of experiencing sexuality.
... Sexology literature informs how a positive sexuality development is key for individuals' (future) well-being. Hence, scholars and stakeholders have advocated for research that identifies positive sexual socialization processes (Anderson, 2013;Maes, Trekels et al., 2022). ...
Este tráiler desarrolla la noción de alfabetización en intimidad digital, un concepto ausente en el debate sobre cómo empoderar la sexualidad de los jóvenes en la sociedad digital actual. Se plantea que existe una literatura abundante sobre diversas subáreas relacionadas con la intimidad digital y el desarrollo de la sexualidad en los usuarios, que podrían integrarse para lograr una comprensión más completa delfenómeno en jóvenes. Esta integración podría enriquecerse, además, con la inclusión de aportes desde la literatura comunicacional, por ejemplo, respecto de la necesidad de interacciones mediáticas adecuadas a la edad o sobre los costos ocultos de la eficiencia tecnológica. El avance en el conocimiento sobre la intimidad digital será clave para conceptualizar la alfabetización en intimidad digital como una herramientafundamental para empoderar la sexualidad de los jóvenes usuarios de medios. La alfabetización en intimidad digital se conceptualiza como un constructo único que trasciende la alfabetización mediática tradicional al incluir en su núcleo experiencias interactivas, respuestas emocionales y la sexualidad misma. Finalmente, es necesario profundizar la investigación en este campo para construir una comprensión integral de la intimidad digital juvenil que permita a las nuevas generaciones desarrollar plenamente su sexualidad.
... Sexual satisfaction is important for wellbeing (Anderson, 2013;Lewis et al., 2024;Mitchell et al., 2021) and contributes significantly to the quality of life (Blanchflower & Oswald, 2004;Cheng & Smyth, 2015;Kashdan et al., 2018;Stephenson et al., 2024). Consequently, lack of a satisfactory sex life contributes to illbeing and reduced quality of life (Flynn et al., 2016). ...
There has been an extensive search for efficient pharmacological treatment of female sexual interest/arousal disorder and other sexual dysfunctions. However, available treatments have met limited success, except for the drugs used for treating erectile deficiency. A possible reason for this may be that both the preclinical and clinical evaluation of treatment effects have been inadequate. The present literature review shows that the intensity of sexual approach behaviors in non-human animals appears to be predictive of clinical effect whereas the traditional studies of copulatory behaviors and associated motor patterns have questionable predictive power regarding effects on human sexual desire. In clinical studies, it is essential to include the unconscious components of sexual motivation in any approach to its quantification. This basic fact is incompatible with the use of self-reports for evaluating treatment effects on motivation. Genital responses to sexual incentives are automatic and therefore outside of volitional control and can, therefore, provide unbiased estimates of the intensity of sexual motivation. These responses may be objectively quantified. Tests for implicit sexual motivation must also be used for capturing unconscious mental components. Including the unconscious components of sexual motivation as well as of objective measures of genital responses in clinical studies may improve evaluations of the effectiveness of drug treatment of low sexual interest/arousal disorder. In preclinical studies, predictive validity can be improved by quantifying sexual approach behaviors rather than copulatory behavior. The paradigm shift suggested here may finally allow for the discovery of efficient treatments for some sexual dysfunctions.
... The fact that we found limited evidence for a causal relation between pleasure-inclusive sex education and sexual agency or sexual well-being, does not mean that it is absent or that a sex-positive approach does not have any positive impact. There is compelling evidence that sexual pleasure improves sexual health, mental health, and physical health (e.g., Anderson, 2013;Klein et al., 2022; for a review, see also Laan et al., 2021). Additionally, a focus on pleasure may also lead to more gender equality. ...
It is known that incorporating pleasure into sex education can promote condom use (e.g., Zaneva et al., 2022), but it remains unclear whether this approach also contributes to sexual agency and sexual well-being more broadly. Pleasure-inclusive sex education is designed to enhance sexual agency, which, in turn, may facilitate sexual well-being. In this study, we review the literature on two key topics: (1) the associations between pleasure-inclusive sex education and sexual agency, and (2) the links between sexual agency and sexual well-being. We conducted a search across five scientific databases using a broad range of variables related to pleasure-inclusive sex education, sexual agency, and various aspects of sexual well-being, focusing on research from the last two decades. A total of 33 articles were selected for inclusion. In Part 1 of the review, we found that all studies reported positive associations between pleasure-based sex education and sexual agency or sexual well-being. However, the literature was marked by limitations, preventing definitive conclusions about the added benefits of the pleasure component. In Part 2, we found positive associations between sexual agency (and related variables) and sexual well-being. While sexual agency appears to be linked to increased sexual well-being, it remains unclear whether pleasure-inclusive sex education plays a significant role in this relationship. Given these findings, there is a strong need for high-quality research using innovative evaluation designs that consider other important sources of sex education and contextual factors.
... The cis-heteronormative 1 and sex-negative character, then, is evident. First, public sexual health is focused on the prevention and treatment of "the negative sides of sexuality," for example, sexually transmitted infections (STIs), unwanted pregnancies, or sexual coercion and gender-based violence (Ford et al., 2019;Anderson, 2013). Approaches to sexuality, therefore, initially tend to be medicalized, with a dominant focus on dysfunction and a pathological perspective on sexuality as a result (Coleman, 2010). ...
Objective: This qualitative study aims to explore the meaning of a sexual well-being framework among LGBTQþ people in the Netherlands. Methods: A recently introduced framework of sexual well-being serves as the basis for this study. Interviews were conducted with twenty self-identified LGBTQþ participants, aged 25 to 35, to collect perceptions and personal experiences regarding sexual well-being. Results: Participants define sexual well-being as a state in which someone enjoys the aspects of one's sexuality that one considers important. Without compromising the diversity of the unique stories and experiences or their sub-jectivity, the common denominator when explaining sexual well-being lies within "feeling comfortable and safe with sexuality and accompanying sexual behavior." Other aspects that were considered vital, corresponding with the used framework, were identified: sexual desires and boundaries, sexual freedom and exploration and communication. Moreover, participants repeatedly expressed how sexual pleasure is an important facet of sexual well-being as a whole. Central to the narratives is the influence of cis-heteronormativity on how sexual well-being is shaped and experienced. Conclusion: What counts as sexual well-being may mean different things to different people; it is individually shaped and individually interpreted. Sexual well-being as a concept is concerned with someone's appraisal and quality of aspects of one's sexuality that one considers important. It must be understood as a reciprocated concept, between the individual and partner(s), where individual autonomy triumphs. We suggest the addition of sexual agency into the framework of sexual well-being, based on the observed influence of cis-heteronormativity on LGBTQþ sexual well-being. We argue that sexual well-being could be an important principle to consider when developing interventions in the domain of public health in relation to sexuality, as it represents reality by embracing individuality. ARTICLE HISTORY
... In general, the connection between engaging in sexual activities and mental health remains ambiguous and bidirectional (Pennanen-Iire et al., 2021). Participating in sexual acts can offer psychological and emotional advantages, but mental health, in turn, influences sexual desire and the frequency of sexual activities (Anderson, 2013;Blanchflower & Oswald, 2004;Pennanen-Iire et al., 2021;Shrier et al., 2012;Vasilenko & Lefkowitz, 2018). In line with this, increased levels of stress during the COVID-19 pandemic may have reduced sexual desire and engagement in sexual acts, but social distancing and stressful circumstances could also have increased the need for emotional bonding (Balzarini et al., 2022;Pennanen-Iire et al., 2021). ...
This study mapped self-reported sexual acts among students during the COVID-19 pandemic, as well as how they changed compared to the year preceding the pandemic, within the context of Flanders, Belgium. Given the growing literature that has identified students as a risk group for mental health problems, particularly during the COVID-19 pandemic, and the importance of sexual development during emerging adulthood, the current study additionally examined whether these (changes in) sexual acts were related to students’ mental health. A representative sample of higher education students from a major Belgian university was used (N = 1580, 41.60% male and 58.40% female). This study showed fewer students engaged in sexual acts with physical contact and more in sexual acts without physical contact, which was shown to be associated with higher and lower sexual satisfaction, respectively. In addition, changes in sexual acts were associated with sexual satisfaction: Students who engaged in sexual acts with physical contact prior to the pandemic, but did not engage in sexual acts during the pandemic, were more likely to experience reduced sexual satisfaction. Students who did not engage in sexual acts before the pandemic, but did engage in sexual acts without physical contact during that time, were more likely to be sexually satisfied. Sexual satisfaction, in turn, indirectly affected depressive feelings. These results contribute to the understanding of how students’ mental health was affected during the COVID-19 pandemic by examining their sexual activity. The results of the study should, however, be interpreted in light of several limitations, such as the use of self-reported and cross-sectional data.
... While relationships are a major driver of well-being, romantic relationships can be especially impactful given the extent of their intimacy and how they help people weather life's difficulties [8]. Research links such relationships with improved health (e.g., cognitive function, lower morbidity), self-worth and belonging, and life satisfaction [8][9][10][11]. Women labeled with ID also deeply value intimacy, reporting how sexual and partnered relationships are vital sources of joy, companionship, and sustenance [12][13][14]. However, many ID-labeled women are barred from the possibility of such intimacy [15], which they speak out against [16] and label as discriminatory [17]. ...
Sexual relationships are central to many people’s satisfaction and well-being in life. However, Capacity to Sexual Consent (CTSC) policies can abridge the right to intimate relationships among people labeled with intellectual disability (ID). Assuming the inalienability of human rights and with particular focus on ID-labeled women, this conceptual analysis offers a three-part critique of CTSC policy and associated standards of practice. First, CTSC requirements are unattainable for many due to systemic deficiencies. Inequities in both assessment practices and the broader conditions of ID-labeled women’s lives pose numerous impediments to meeting CTSC stipulations. Second, policies of sexual prohibition are often ineffectual in forestalling sexual violation and can paradoxically exacerbate women’s sexual vulnerability. Third, the requirements of CTSC are unjust because they pose a discriminatory double-standard for ID-labeled women. Moreover, the standards compound the injustices women already experience by responding to sexist and ableist conditions with rights abridgment. To uphold sexual rights, I propose a replacement CTSC policy guided by tenets of Nussbaum’s (2011) Capability Approach. I argue that such a policy can counteract the substantial sexual vulnerability women experience while simultaneously upholding their right to direct their sexual lives.
... The fact that we found limited evidence for a causal relation between pleasure-inclusive sex education and sexual agency or sexual well-being, does not mean that it is absent or that a sex-positive approach does not have any positive impact. There is compelling evidence that sexual pleasure improves sexual health, mental health, and physical health (e.g., Anderson, 2013;Klein et al., 2022; for a review, see also Laan et al., 2021). Additionally, a focus on pleasure may also lead to more gender equality. ...
Background
A recent review study showed that pleasure-inclusive sex education can contribute to reducing sexual health risks such as unwanted pregnancy and STIs (Zaneva et al., 2022). Pleasure-inclusive sex education could also contribute to other measures of sexual wellbeing. In this study, we review the literature on associations between pleasure-incorporating sex education and sexual agency (including related concepts such as autonomy) and sexual wellbeing (part 1), and between sexual agency and sexual wellbeing (part 2).
Methods
We searched in 5 scientific databases using a wide scope of variables related to pleasure inclusive sex education, sexual agency, and various outcomes of sexual wellbeing, focusing on the last 2 decades. Forty-six articles were selected.
Results
In part 1 of the review we found that all studies reported associations between pleasure-based sex education and sexual agency or sexual wellbeing, but the literature is characterized by limitations and did not permit conclusions about the role of an added benefit of the pleasure component. In part 2 of the review study, we found positive associations between sexual agency (and related variables) and sexual wellbeing (including decreased levels of (re-)victimization).
Conclusions
Sexual agency may be related to increased sexual wellbeing, but it is still largely unclear whether pleasure-inclusive sex education can significantly contribute to this. There is a great need for high quality research, using innovative evaluation designs, taking into account the role of other important sources of sex education and other contextual factors.
Key messages
• A lot of work has been done, but the evidence that pleasure in sex ed ‘works’ for sexual wellbeing, is limited and indirect.
• Great need for high quality research using novel and more realistic evaluation approaches.
... Additionally, we only used two variables to measure adolescent sexual well-being, both at the individual level. In other research that focusses on sexual well-being of adolescents, additional variables at individual and interpersonal level are used or suggested such as communication between sexual partners, focusing on sexual satisfaction of oneself and the partner and freedom from pain (Anderson, 2013;De Meyer et al., 2014;Harden, 2014;Michielsen et al., 2016). Testing our models with these factors, could provide additional information for ASRH programs. ...
This study aims to understand how gender diversity and gender attitudes are linked to the sexual well-being of young adolescents. Data was collected among 561 adolescents in secondary schools in Flanders and binary logistic regressions were performed. Gender diversity was conceptualized as gender identity, gender expression, sex assigned at birth, sexual orientation and personal gender attitudes. Whereas “like to become a wo/man” and body image were used as measures for sexual well-being. Age and migration were added as covariates.The data illustrates that gender diversity is present among young adolescents and that it can be linked to young adolescent’s body image and liking to become a wo/man. In addition, it shows how diverse sets of gender attitudes are differently associated with sexual well-being outcomes. The findings also suggest the internalization of patriarchal and heterosexual societal norms by the respondents. The results indicate an association between on the one hand gender diversity and gender attitudes and on the other hand adolescent sexual well-being. Furthermore, it suggests that gender transformative research and programs that aim to improve adolescent sexual health and well-being should carefully choose their gender focus and invest in improving gender equity beyond the individual level. Additional research is needed to investigate the association between gender diversity and adolescent sexual wellbeing among diverse sexual well-being conceptualizations and specific groups (gender, ethnic, and others) of young adolescents.
... The development of positive sexuality must include physical, emotional, and intellectual knowledge. Sexuality educational programs that include sexual communication, physiological understanding, and sexual self-confidence enhance positive sexuality (Anderson, 2013). ...
Purpose
Sexuality education is essential for children and adolescents to make better choices regarding their sexual well‐being. Parents, teachers, and healthcare providers are not always comfortable talking to school‐age children about sex, making sexuality education a concept of interest to be explored. The purpose of this paper is to explain the concept of sexuality education in school‐aged children and adolescents.
Design and Methods
This paper uses Walker and Avant's concept analysis to help clarify its meaning. The sexuality education concept is explored in this article in the views of educating school systems K‐12 with three types of sexuality education (abstinence‐only, abstinence‐plus, and comprehensive sexuality education). Literature from 1990 to 2023 was retrieved using PubMed, Google Scholar, and CINAHL.
Results
A model case is used to demonstrate the importance of sexuality education. A borderline case and a related case are proposed to explain other uses of the concept. Defining attributes, antecedents, consequences, and empirical referents are explored. Antecedents of sexuality education are grouped into three categories: resources, political environment, and social beliefs.
Practice Implications
A conceptual understanding of sexuality education can foster nurses' confidence in talking to their patients about this topic and encourage nurses to advocate for comprehensive sexuality education nationwide.
... While the definition was created for healthy adults, sexuality is also essential for a good quality of life (QoL) among people living with chronic disorders [2]. Yet, this specific population is much more prone to sexual dysfunctions and dissatisfaction with sexual life [3]. A vast body of literature has been published on the harmful effects of numerous chronic diseases on sexual health, involving neurological, vascular, urologic, gynecologic, and hormonal disorders [2]. ...
Sexual health, a critical aspect of overall well-being, is often compromised in individuals with chronic disorders. Hidradenitis suppurativa (HS) is a chronic inflammatory skin condition that mainly affects intertriginous areas, potentially impacting sexual health as a result of its specific symptoms and psychosocial burden.
This cross-sectional study utilized data from the EpiCAi project, focusing on 199 patients with HS. Participants completed digital questionnaires assessing sexual health via sex-specific instruments: the Female Sexual Function Index (FSFI) for women and the International Index of Erectile Function (IIEF) for men, alongside different psychosocial scales. The disease severity was assessed using the Hurley stage and the Lesion Identification Scheme for Acne Inversa (LISAI).
The majority of the participants reported impaired sexual health, with significant clinical sexual dysfunctions noted in 71.8% of women (FSFI score < 26) and erectile dysfunction in 63.8% of men. Sexual dysfunction was associated with several factors, including age, and marital status. Psychosocial factors, notably depression and quality of life, showed strong correlations with sexual health outcomes. Notably, women over 40 and those treated with biologics reported more severe dysfunction, while among men, employment status significantly influenced sexual health.
HS profoundly affects the sexual health of both male and female patients, with significant impacts on their quality of life and psychological well-being. The findings underscore the necessity for healthcare providers to address sexual health proactively in the management of HS, considering both physical symptoms and psychosocial impacts. This holistic approach is essential for improving patient outcomes and overall quality of life.
German Register for Clinical Trials, identifier DRKS00025315.
... However, sexual satisfaction has been the most extensively studied positive indicator of sexuality to date (Syme et al., 2013;Sánchez-Fuentes et al., 2014), with the sex positive perspective gaining popularity only in recent years (Nimbi et al., 2021). Positive sexuality dimensions, including sexual satisfaction, have been linked to both personal and relational variables, including better physical and mental health and higher relationship satisfaction, respectively (Anderson, 2013;Sánchez-Fuentes et al., 2014;Sánchez-Fuentes and Sierra, 2015). Indeed, individuals with better physical health and healthier lifestyles report higher sexual satisfaction, sexual pleasure, and sexual desire (Flynn et al., 2016;Mollaioli et al., 2020;Gianotten et al., 2021). ...
Introduction
Positive sexuality, defined as the happiness and fulfillment individuals derive from their sexual experiences, expressions, and behaviors, has been linked to relationship satisfaction and health. However, the intricate associations between positive sexuality and relationship functioning and health indicators have rarely been explored from a network perspective. This approach, by analyzing the interconnections among these factors within a broader system, can offer insights into complex dynamics and identify key variables for targeted interventions.
Methods
The present study applied network analysis to uncover interconnections between positive sexuality, relationship satisfaction, and health indicators, highlight the most relevant variables and explore potential gender-based differences in a sample of 992 partnered individuals (51% women, aged 18–71 years). Networks were estimated via Gaussian Graphical Models, and network comparison test was used to compare men and women.
Results
Results indicated that variables related to positive sexuality were more highly interconnected than the rest of the network. There were small-to-negligible connections between positive sexuality and relationship satisfaction variables, both of which had negligible or no connections with health. The network was globally invariant across gender, though a few connections were gender-specific. The most important variables, regardless of gender, related to pleasurable feelings during sexual intercourse.
Discussion
The findings underscore the importance of enhancing positive sexual experiences within intimate relationships and have implications for research and clinical practice in positive sexuality.
... Consistent with previous research on SGM-specific sexual health clinics Salway et al., 2019), participants emphasized that sexual health clinics represent potentially appropriate, safe and competent settings to integrate services that also respond to SGM men's mental health-and substance use-related needs and preferences. Over the past two decades, in some settings, including Vancouver, SGM-specific sexual health clinics have developed and provided services and interventions that aim to promote sexual satisfaction and pleasure while concurrently offering harm reduction and prevention care, moving away from previous approaches that exclusively focused on risk elimination (Anderson, 2013;Banks et al., 2011;Hart et al., 2016). Nevertheless, despite identifying sexual health clinics as a potential site in which integrated models of care could be implemented, participants also expressed concerns that discussing mental health and substance use within sexual health care settings could remain a challenge for some SGM men. ...
Background: Despite well-established evidence showing that young sexual and gender minority (SGM) men experience disproportionate mental health and substance use inequities, few sexual health services provide mental health and substance use care. This qualitative study examined the experiences and perspectives about integrated care models within sexual health services among young SGM men experiencing mental health and substance use challenges.
Methods: Semi-structured interviews were conducted with 50 SGM men aged 18–30 years who reported using substances with sex in Vancouver, Canada. Interviews were analyzed using thematic analysis.
Results: Three themes were identified: 1) participants asserted that their sexual health, mental health and sub- stance use-related health needs were interrelated and that not addressing all three concurrently could result in even more negative health outcomes. These concurrent health needs were described as stemming from the oppressive social conditions in which SGM men live. 2) Although sexual health clinics were considered a safe place to discuss sexual health needs, participants reported not being invited by health providers to engage in discussions about their mental health and substance use health-related needs. Participants also perceived how stigmas associated with mental health and substance use limited their ability to express and receive support. 3) Participants identified key characteristics they preferred and wanted within integrated care, including training for health providers on mental health and SGM men’s health and connections (e.g., referral processes) between services. Participants also recommended integrating social support programs to help them address SGM-related social challenges.
Conclusion: Our findings highlight that SGM men’s sexual health, mental health and substance use-related health needs and preferences are interrelated and should be addressed together. Tailored training and resources as well as structural adaptations to improve communication channels and collaborative connections between health providers are required to facilitate the development of integrated care for young SGM men.
... Previous research has suggested that ADHD might also go along with peculiarities in sexual functioning and sexual wellbeing [12,13]. Thereby, a healthy sexuality is closely related to overall well-being and overall quality of life [14]. This is all the more important since sexuality is frequently neglected during clinical visits, despite patients regularly expressing a desire to talk about their sexuality with their healthcare providers [15,16]. ...
Previous research has found some peculiarities in sexual functioning of adults with attention deficit/hyperactivity disorder (ADHD). Using a set of questionnaires that had to be answered online, we assessed the prevalence of paraphilic fantasies and behaviors in a sample of 160 adults with ADHD in comparison to 75 adults without ADHD and evaluated the association between paraphilias and hypersexuality in the ADHD group. Both groups reported high rates of paraphilic fantasies and behaviors. ADHD individuals were more likely to report about very sexually arousing paraphilic fantasies (ADHD: 58.2% vs. non-ADHD: 40.5%; χ² = 6.323, p = 0.01) and behaviors (ADHD: 44.9% vs. non-ADHD: 28.4%; χ² = 5.774, p = 0.02). Furthermore, ADHD individuals reported on average about more very sexually arousing paraphilic behaviors compared to non-ADHD individuals (ADHD: M = 1.28, SD = 0.10 vs. non-ADHD: M = 0.81, SD = 0.09; T = 2.68, p < 0.01). Furthermore, in ADHD individuals both very sexually arousing paraphilic interests in masturbation fantasies (r(158) = 0.17, p = 0.03) and in sexual behaviors (r(158) =0.19, p = 0.02) showed a significant correlation with hypersexuality. In non-ADHD individuals no such significant correlation could be found. Altogether, it can be concluded that individuals with ADHD seem to be more prone to develop and act out paraphilic sexuality than those without ADHD, however, found differences were rather small. The results of the present study add to the current trend to depathologize paraphilic sexuality in the general as well as in clinical populations.
... Ocurre un discurso emergente en casi cualquier lugar de que resulta aceptable y virtualmente "normal" cualquier variación sexual, identidad de género y fluidez sexual (34-36), entendiendo esa fluidez como los cambios en las atracciones e identidad de la propia orientación sexual. Suele considerarse que la salud sexual, así como la física, mental y el bienestar general se asocian positivamente con la satisfacción, autoestima y correspondientes disfrutes (37). Ahora bien, es preciso reconocer que tanto en hombres como en mujeres pueden existir e influir al respecto y de manera anómala, episódica, recurrente o crónica diversos trastornos sexuales del comportamiento y de las condiciones relacionadas con la salud sexual, así como ciertos trastornos mentales, del comportamiento y del neurodesarrollo. ...
Doctor y Licenciado en Medicina y Cirugía; Médico Especialista en Psiquiatría; Licenciado en Psicología. jmbertolin@comv.es https://orcid.org/0000-0001-8934-8051 Resumen La presente aportación versa acerca del amor y el deseo sexual, así como de su es-casamente documentada neurofisiología; también, de sus relaciones con la salud sexual y la mental, que incluye esta últi-ma los trastornos mentales, del comporta-miento y del neurodesarrollo. Estas cues-tiones se abordarán sucintamente desde una perspectiva eminentemente científica. Se han escrutado varios repertorios biblio-gráficos electrónicos cualificados interna-cionales y nacionales, sin pretender una imposible exhaustividad. Se constata que la información de calidad al respecto es extremadamente limitada, heterogénea y a menudo subjetiva o con sesgos deficien-temente controlados. Según los hallazgos, resultan probables las diferencias psicofi-siológicas para el amor y el deseo según sea el sexo y género de las personas, lo que sucede igualmente cuando concurren psi-copatologías. El mecanismo regulador de la excitación sexual es complejo en sus corre-latos neuronales y todavía son inciertas las bases neurofisiológicas correspondientes. Los trastornos mentales con influencia po-tencialmente más distorsionadora sobre el amor y el deseo sexual son los del estado de ánimo y, obviamente, los parafílicos. Se necesita investigar más y con mayor rigor acerca de la psiconeurobiología subyacente a estas cuestiones usuales.
... Aunque el desarrollo de la sexualidad es un proceso normativo en los adolescentes, existen diversos factores que pueden implicar riesgos para su salud sexual. La maduración física y psicológica, el no recibir suficiente información de padres u otras fuentes formales, el consumo de alcohol y las dificultades para evaluar riesgos y consecuencias de la conducta sexual pueden llevar a comportamientos sexuales de riesgo (Abad-Villaverde, 2022;Anderson, 2013;Dixon-Mueller, 2011;Lindberg et al., 2016;UNAIDS, 2004;Vasilenko et al., 2014). Dentro de las principales problemáticas en esta población se encuentra el embarazo, las enfermedades de transmisión sexual, el abuso y violencia sexual, la discriminación de género, etc. ...
... Sexual satisfaction is a crucial aspect of sexual health and well-being (Anderson, 2013). Rather than the lack of sexual problems, definitions of sexual satisfaction include aspects of the dyadic connection such as mutuality, orgasm, romance, creativity, and pleasure (Pascoal et al., 2014). ...
This quantitative study explores the rich tapestry of early childhood interactions and their substantial impact on a number of adult well-being variables. Using a broad sample size, the study seeks to identify the intricate relationships between early experiences and adult sexual satisfaction, body image, self-esteem, and positive and negative affect. The study uses a quantitative methodology, gathering data from a sizable and varied cohort with the use of surveys and standardised instruments. Early childhood connections are seen as a complex construct that includes impacts from peers, families, and society at large. The study looks for patterns and links between these variables using statistical analyses and correlation models. The findings of this research could make a substantial contribution to the domains of sociology, psychology, and human development by illuminating the long-term effects of early connections.
... In both sex research and health care there has been a shift in focus from disease and dysfunction to experiential dimensions ─ i.e., sexual satisfaction, sexual self-efficacy, sexual self-esteem and sexual pleasure (also called sex-positive approach) (Doorduin & van Berlo, 2014;Ford et al., 2019;Klooster, Knutson, & Matsuno, 2023;Laan, Klein, Werner, van Lunsen, & Janssen, 2021). Researchers have found that positive sexual experiences not only have a beneficial impact on an individual's sexual health, but also contribute to improvements in mental and physical well-being (Anderson, 2013;Marinelli et al., 2023;Nikkelen & Kreukels, 2018). ...
... 9 A review summarized that SS is a relevant construct in terms of positive sexuality and that different positive aspects of sexuality could improve mental and physical health as well as overall well-being. 12 In addition, the link between SS and quality of life has been demonstrated cross-culturally, including Chinese women. 13 Regarding the association between SS and female sexual function, many validation studies have examined the correlation by using the Female Sexual Function Index (FSFI) as a criterion to assess validity, 14,15 while currently no similar assessment has been performed in the validation of the NSSS-Short Form (NSSS-S). ...
Background
Existing research on sexual satisfaction has been carried out primarily in Western samples, lacking insights from less sexually permissive cultures such as China, particularly in the case of heterosexual and sexual minority women.
Aim
This study aimed to culturally adapt and validate the New Sexual Satisfaction Scale–Short Form (NSSS-S) in a sample of Chinese women with diverse sexual identities.
Methods
The standard forward-backward translation procedure and cognitive debriefing were conducted to translate the NSSS-S into Mandarin Chinese (NSSS-SC). The psychometric properties of the NSSS-SC were assessed in this cross-sectional survey.
Outcomes
The primary outcome measure was the NSSS-S. The World Health Organization Quality of Life–Abbreviated Form, the Positive Sexuality Scale, the Female Sexual Function Index, and a single-item measure of sexual satisfaction were used to test the measure’s validity.
Results
A total of 336 Chinese women were recruited, with an average age of 26.82 years (SD, 6.03; range, 18-56). The 1-dimensional model had a good fit to the data and was invariant across 2 sexual identity groups (cisgender heterosexual and sexual minority women) and age. The NSSS-SC had good reliability; no significant floor and ceiling effects were observed. We found moderate to strong correlations between the NSSS-SC scores and the sexual satisfaction, sexual function, positive sexuality, and quality-of-life indicators. On average, cisgender heterosexual women were characterized by higher sexual satisfaction scores when compared with sexual minority women.
Clinical Translation
The NSSS-SC can be used as a reliable and culturally appropriate measure of sexual satisfaction in women of different ages and sexual identities, which could be used in future sex-related surveys.
Strengths and Limitations
This study is the first to translate the NSSS-S into Chinese and validate the NSSS-SC in a sample of Chinese women with varied sexual identities. However, this study recruited only female participants; future studies should also validate the NSSS-SC in Chinese men.
Conclusion
The NSSS-SC is linguistically equivalent to the original scale and has solid psychometric properties, which can be used to assess sexual satisfaction levels in diverse samples of Chinese women.
... Sexual health is a cornerstone of overall well-being for individuals, couples, and families, making it a vital component of social and economic development [1,2]. The multifaceted importance of sexual health is underscored by its diverse benefits. ...
Sexual function is a vital component of overall well-being and quality of life. Physical activity is known to have a profound influence on various aspects of health, but its impact on sexual function in the general population remains an under-explored area. This systematic review seeks to thoroughly examine existing evidence, aiming to establish the correlation between physical activity and sexual function in both male and female adults. We conducted a comprehensive search of electronic databases and relevant sources, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Eligible studies were those that investigated the effects of physical activity on sexual function using the International Index of Erectile Dysfunction (IIEF-5) questionnaire and the Female Sexual Function Index (FSFI). Quality assessment was performed on the included studies, and the findings were synthesized through qualitative analysis. The review identified 12 randomized controlled trials, primarily focusing on males, with interventions ranging from home-based walking to structured exercise training. Only two studies were conducted among females. The most recommended exercise was aerobic exercise. Consistent aerobic exercise proves to be a hopeful and efficient non-drug intervention for enhancing erectile function in men. However, when considering the effects of physical exercise programs on sexual function and the quality of sexual life of females, the results present challenges in drawing clear conclusions. Health policymakers play an important role in providing guidelines and recommendations to healthcare professionals, encouraging them to prescribe exercise as a preferable alternative to pharmacological treatments for enhancing sexual functions in both men and women.
... This can eliminate many societal issues like HIV/AIDS, unintended pregnancy, sexual coercion, sexually transmitted infections (STIs), and sexual violence. Sexual health education in school can develop people's mindset towards positive sexuality (Anderson, 2013;Benzaken et al., 2011;McManus & Dhar, 2008;Weaver et al., 2005). Sexual health education can improve physical, emotional and social wellbeing. ...
The study investigates students’ perspectives on incorporating sexual health education into the curriculum of secondary schools in rural Bangalore. Focused on assessing how such education impacts students’ physical and psychological well-being, confidence, and ability to make informed decisions, the research collected data from 981 students across 6th to 10th grades. A structured questionnaire, measured on a five-point Likert scale, explored students’ perceptions of sexual health education and its outcomes. After a meticulous data cleaning process, which included outlier removal, the study utilized a final sample of 900 students. IBM SPSS 25 and AMOS 25 facilitated the statistical analysis. The findings underscore the significant positive effect of sexual health education on students’ confidence levels. It highlights how this form of education aids in maintaining personal hygiene and fosters balanced decision-making skills among students. The study’s results advocate for the implementation of sexual health education in schools, emphasizing its role in enhancing student wellbeing and confidence. Additionally, it contributes to defining the scope and framework of a sexual health education curriculum from the students’ perspective in rural Bangalore schools, aligning educational objectives with the actual needs and perceptions of the student body.
... We argue here that greater academic weight should be expended on offering amelioration to tangible sexual exclusion whilst trying to carefully avoid 'reinforcing discriminatory and oppressive social regimes' [12, p. 483]. The sexual citizenship needs of disabled people are well-documented and their neglect is, in turn, correlated with a decrease in happiness, mental health, flourishing, and overall well-being [1][2][17][18][19][20][21][22], Therefore, and in short, we side with Edmund Burke: 'In a connection, the most inconsiderable man, by adding to the weight of the whole, has his value, and his use; out of it, the greatest talents are wholly unserviceable to the public' [23 p. 146]. ...
This article responds to Ezio Di Nucci’s recent publication on the demoralisation of sex and continues to defend the practical focus of the Sex Doula Programme and the sexual citizenship of disabled people against Di Nucci’s meta-ethical debate over the metaphysical status of sex rights. We emphasis that our programme, a work of praxis, is targeted specifically at resolving or ameliorating the practical sexual citizenship needs disabled people. In this rejoinder, we identify that Ezio Di Nucci’s meta ethical shift necessarily results in paralysis in which no further ameliorations can obtain until such time that sex is ‘demoralised’. This paralysis is prejudicious on society’s disadvantaged and is unacceptable. In response, we identify analogous rights that have had practical resolutions despite their moral ‘indeterminacy’ and argue that there is no reason to stop the development of a sex doula programme simply because it is complicated to enact. We maintain that disabled people deserve sexual citizenship and that a just society owes them equity in this regard. Finally, we acknowledge that developing such a programme is not without its challenges and that maintain get safety of other vulnerable groups is important, advocating that, instead of expending efforts to analyse how such a programme could not operate due to the ambiguous nature of sex rights, it would be better if they were spent contributing to the safe development of the programme itself.
... Les discours scientifiques sur la sexualité des jeunes ont évolué au fil du temps, passant d'un discours centré sur les risques sexuels, dont les infections transmissibles sexuellement et par le sang (ITSS) et les grossesses non désirées, à un discours plus positif misant sur le potentiel de la sexualité. Une telle approche ne vise pas à banaliser les risques possibles liés à la sexualité, mais plutôt à mettre de l'avant et à promouvoir l'importance et le potentiel des expériences sexuelles sur les jeunes (Anderson, 2013). Les expériences amoureuses et sexuelles sont considérées comme normatives pour le développement et saines pour la santé des jeunes (Diamond et Savin-Williams, 2011). ...
Le présent chapitre visait à documenter : 1) les expériences relationnelles et sexuelles des jeunes; 2) le fonctionnement sexuel des jeunes selon le genre et; 3) les stratégies que les jeunes déploient lorsqu’ils vivent des difficultés dans leur vie amoureuse et sexuelle et les démarches de recherche d’aide qu’ils entreprennent.
... Because of the highly rewarding properties of sexual acts, sex is now regarded as a source of happiness and well-being (Anderson, 2013;Flynn et al., 2016;Mitchell et al., 2021). However, contrary to popular belief, the association between sexual frequency and happiness is curvilinear rather than linear. ...
Sexual motivation is an abstract concept referring to the mechanisms determining the responsivity to sexually relevant stimuli. This responsivity determines the likelihood of producing a sexual response and the intensity of that response. Both responsivity to stimuli and the likelihood of making a response as well as the intensity of response are characteristics of an individual. Therefore, we need to assume that the concept of sexual motivation materializes in physiological mechanisms within the individual. The aim of the present communication is to analyze the requisites for the endeavor to materialize sexual motivation. The first requisite is to provide an operational definition, making the concept quantifiable. We show that parameters of copulatory behavior are inappropriate. We argue that the intensity of sexual approach behaviors provides the best estimate of sexual motivation in non-human animals, whereas the magnitude of genital responses is an exquisite indicator of human sexual motivation. Having assured how to quantify sexual motivation, we can then proceed to the search for physiological or neurobiological underpinnings. In fact, sexual motivation only manifests itself in animals exposed to appropriate amounts of gonadal hormones. In female rats, the estrogen receptor α in the ventrolateral part of the ventromedial nucleus of the hypothalamus is necessary for the expression of sexual approach behaviors. In male rats, androgen receptors within the medial preoptic area are crucial. Thus, in rats sexual motivation can be localized to specific brain structures, and even to specific cells within these structures. In humans, it is not even known if sexual motivation is materialized in the brain or in peripheral structures. Substantial efforts have been made to determine the relationship between the activity of neurotransmitters and the intensity of sexual motivation, particularly in rodents. The results of this effort have been meager. Likewise, efforts of finding drugs to stimulate sexual motivation, particularly in women complaining of low sexual desire, have produced dismal results. In sum, it appears that the abstract concept of sexual motivation can be reliably quantified, and the neurobiological bases can be described in non-human animals. In humans, objective quantification is feasible, but the neurobiological substrate remains enigmatic.
... 2020). Sürekli ve doyum verici bir cinsel işlev, fiziksel ve ruhsal sağlık ile ilişkilidir (Anderson 2013, Bach ve ark. 2013, Jackson ve ark. ...
Objective: Coronavirus Diseases-19 (COVID-19) pandemic that has caused the death of thousands of people affected negatively not only people’s physical wellbeing but also their mental health. The aim of this study was to evaluate the sexual function, depression, anxiety and stress, and fear of COVID-19 of individuals according to gender and sexual orientation during the COVID-19 pandemic.
Method: The questionnaire form included sociodemographic data form, the Arizona Sexual Experiences Scale (ASEX), the Depression, Anxiety and Stress Scale-Short Form (DASS-21), and the Fear of COVID-19 Scale (FCV-19S). The form was distributed on social media platforms.
Results: 1593 sexually active participants were included in the study. 47.5% of the participants were females and 52.5% were males. 86.9% of them were heterosexuals and 13.1% were lesbian, gay, and bisexual (LGB) individuals. ASEX, DASS-21 Depression, Anxiety, and Stress, and FCV-19S scores were significantly higher in females than males (p<0.001). When anxiety, depression, stress, and fear of COVID-19 were controlled, level of sexual dysfunction continued to be higher in women. We found that while the ASEX and FCV-19S scores were similar between the heterosexuals and LGBs (respectively p=0.66 and p=0.31), the DASS-21 Depression, Anxiety, and Stress scores were higher in LGBs (p<0.001).
Conclusion: Our results reveal the effect of the pandemic period on female sexual functions and the importance of addressing this topic in clinical practice and research.
Keywords: Sexual Dysfunction, Mental Health, Gender, Sexual Orientation, COVID-19
Sexuality and reproduction are central to people’s life experiences and their ability to thrive. Existing frameworks and measurements related to sexuality and reproduction are predominantly focused on the presence or absence of adverse outcomes, neglecting the critical question of whether people experience positive outcomes and have the sexual and reproductive lives they wish to have. The increased attention to well-being in economic, political, and health spheres presents an opportunity to define and measure the holistic construct of sexual and reproductive well-being.
To this end, we engaged in an 18-month collaborative process to develop a definition of sexual and reproductive well-being, with the ultimate goal of informing the development of a measure that would be self-reported and assessed at the population level.
The resulting draft definition and measure development approach will serve as the foundation for subsequent measure development. This values-driven process of defining sexual and reproductive well-being will contribute to developing a reproductive justice– and human rights–aligned measure that can illuminate the extent to which structures and systems enable optimal sexual and reproductive experiences. ( Am J Public Health. Published online ahead of print May 22, 2025:e1–e9. https://doi.org/10.2105/AJPH.2025.308119 )
Background Sexual health is a fundamental aspect of well-being, yet migrant and refugee women from low- and middle-income countries (LMICs) often face unique challenges in navigating intimacy and sexual function post-migration. Sociocultural norms, migration-related stressors, and healthcare access influence their experiences, yet these perspectives remain underexplored. Methods This qualitative study examines the transition of sexual function experiences among first-generation migrant and refugee women residing in South Australia. Semi-structured interviews were conducted with 20 reproductive-aged women from diverse cultural backgrounds. Thematic analysis was used to identify key influences on sexual health and intimacy. Results Participants reported that cultural norms, sociocultural expectations, and migration-related stressors shaped their sexual experiences. Many described difficulties in navigating cultural taboos, communication barriers, and limited access to culturally sensitive healthcare services. While migration provided opportunities for increased sexual autonomy, self-discovery, and improved partner communication, deeply ingrained cultural beliefs and emotional struggles continued to impact their sexual well-being. Conclusions The findings highlight the need for culturally sensitive, gender-appropriate sexual health services and the removal of financial, linguistic, and systemic barriers in healthcare access. Healthcare providers, policymakers, and community organizations play a crucial role in fostering inclusive environments that support migrant and refugee women's sexual health and well-being.
OBJECTIVE: This study aimed to identify the performance, study focus, thematic trends, and historical development of sexual health publications in nursing science. MATERIAL and METHODS: The study was conducted using a descriptive bibliometric study design. The data were obtained from the Web of Science Core Collection. The analysis includes performance analysis and science mapping techniques. The R software Bibliometrix package was used to perform data analysis and visualization. RESULTS: A total of 3,484 publications were produced by 9,794 authors in 98 countries. The most productive country and author were the United States with 1,516 publications and M. Hayter with 22. Themes with higher density and centrality were HIV, adolescents, sexual behavior, reproductive health, sexuality, nursing, sexual health, and women’s health. Some themes with lower density and centrality were nursing education, gender identity, and LGBTQ. Also central were such themes as quality of life, depression, breast cancer, and sexual dysfunction. CONCLUSION: Nursing’s focus on sexual health is partially adequate but requires further studies and innovative approaches. Unlike the biomedical model, research should address the social and emotional aspects of sexuality, emphasizing components that enhance sexual health and well-being. Efforts should aim to elevate nursing practices and education to meet contemporary needs by embracing the concept of sexual health for all. Keywords: bibliometrics, science mapping, sexual care, sexual health, sexual well-being, nurses, nursing
Sexual epidemiology is a branch of behavioral epidemiology that studies the distribution, patterns, and determinants of sexual behavior within populations to understand their causes and associations with health outcomes. This chapter explores the emerging field of sexual epidemiology and its significance in culture, health, and prevention science among Black sexual minority men (SMM). It highlights how sexual epidemiology can deepen studies of behavioral epidemiology and other factors influencing sexual health, particularly among Black SMM. The role of sexual positioning (e.g., insertive and receptive anal intercourse) on disease transmission and health is examined along with how demographic, psychosocial, and cultural dynamics affect sexual epidemiology. The chapter also emphasizes that sexual epidemiology moves beyond a sole focus on risk prevention to include health and quality of life promotion. Ultimately, this chapter advocates for expanding prevention science and behavioral epidemiology to include sexual epidemiology, arguing that this discipline will enable public health efforts to more effectively address the complex needs of diverse communities, including Black SMM.
Individuals housed in prisons or forensic hospitals experience significant restrictions on their sexual rights. There is a lack of data on how sexual behavior and sexual health of institutionalized persons are managed and to what extent they are based on shared guidelines or decisions of the individual staff. Using a standardized online questionnaire, the heads of 35 prisons and 32 forensic psychiatric hospitals across 14 German federal states were surveyed, reflecting the situation of 16,902 inmates and patients. The findings reveal an absence of shared guidelines as well as an institution‐specific approach to sexual behavior and sexual health. Exploratory multiple linear regression identified four variables that predict differences in the regulation of individual's sexual behavior and sexual health: type of institution (prison or forensic hospital), percentage of institutionalized sex offenders, number of housed individuals, and an item concerning the sexuality‐related attitudes of the respondent. Respondents, particularly in the field of forensic psychiatry, expressed a general desire for guidelines. Our study shows that possibilities for sexual expression and sexual health vary strongly, depending on the institution. Therefore, it appears useful and desirable to develop guidelines on how to regulate sexual behavior and sexual health of institutionalized individuals.
Introduction
Implementing sex education programs during adolescence is crucial for addressing the risks associated with sexuality. However, some of these interventions lack proper incorporation of a gender perspective and maintain a heteronormative and biologically-focused approach, potentially resulting in inequitable outcomes for adolescents. In response, comprehensive sex education is most effective due to its multidimensional view of sexuality. However, integrating a comprehensive perspective on sexuality and a gender lens that contributes to adolescent health equity presents challenges, especially in low and middle-income countries. This study aimed to develop a comprehensive and gender-transformative sex education program for adolescents in a middle-income country of Latin America, utilizing the Intervention Mapping Approach.
Methods
This exploratory sequential mixed-method study comprised two phases. In the first phase, a literature review, nine focus groups with high school students, and 14 interviews with school professionals were conducted to inform program design. Subsequently, the program underwent validation through expert judgment. In the second phase—as part of program development—a preliminary evaluation was conducted by implementing the program in two high schools with 30 students from public high schools, who were administered a pre-post ad hoc survey.
Results
A comprehensive and gender-transformative sex education program was designed based on literature review findings and input from students and school workers. The ad hoc survey revealed a statistically significant increase in protective skills in sexuality (W = 59, p = .01) among all participants.
Discussion
Designing a sex education intervention through Intervention Mapping allowed for the integration of evidence and the needs of the target population. The results of the preliminary evaluation suggest the potential of the developed program to enhance protective skills in sexuality and promote health equity through gender-equitable outcomes in adolescent sex education.
Die gegenwärtige Forschungsarbeit untersucht intrapsychische Prozesse der weiblichen* Sexualität
im Alter von 18 bis 35 Jahren auf der Grundlage von 459 Daten. Das Forschungsinteresse umfasste
die zentrale Frage: „Wie gestaltet sich der Einfluss sexueller Bildung auf weibliche* Sexualität
zwischen 18 und 35 Jahren auf einer intrapsychischen Ebene?“ Zur Datenerhebung wurde ein
Fragebogen erstellt, der Items zu den Themen “allgemeines sexuelles Wissen über den biologisch
weiblichen Körper”, “Aneignung von Wissen über Sexualität”, “positive Körperwahrnehmung” und
“Wissen über die eigenen sexuellen Bedürfnisse” sowie eine Skala zur sexuellen Zufriedenheit
(Sexual-Satisfaction-Scale for Women) enthält. Mit einbezogen wurden alle Individuen, die sich als
weiblich identifizieren, unabhängig von ihrem bei der Geburt zugewiesenen biologischen
Geschlecht. Es konnte nachgewiesen werden, dass die sexuelle Zufriedenheit einerseits in keinem
signifikanten Zusammenhang mit dem Wissen über die Form der Klitoris steht (rs= .05, p= .308),
andererseits jedoch in einem signifikant positiven Zusammenhang mit dem aktiven Bemühen,
eigene sexuelle Wünsche und Vorlieben kennenzulernen (rs= .19, p<.001). Ein Dittel (36.4 %) der
Befragten* gab an, dass sie sexuelle Literatur lesen, um mehr über Sexualität zu erfahren. Zwischen
Frauen*, die eher (populär-)wissenschaftliche Literatur zum Thema Sexualität lesen, und solchen,
die dies eher nicht tun, konnte kein signifikanter Unterschied hinsichtlich ihres Wissens darüber
festgestellt werden, was sie sexuell erregen kann (U= 22154, Z= -1.80, p= .072). Allerdings stand
die bewusste Masturbation zur besseren Kenntnis des eigenen Körpers in signifikantem
Zusammenhang mit dem Wissen darüber, was sexuell erregen kann (rs= .30, p<.001).
A Sexualidade é uma característica inerente de cada indivíduo, sendo moldada por influência da construção social e cultural. Sendo assim, toda complexidade da sexualidade é alterada com o passar dos anos de acordo com a moral estabelecida como errado e certo. Dado ao multiculturalismo presente na sociedade, é comum o aparecimento de preconceitos, tabus e, consequentemente, a falta de diálogo sobre a temática. A Universidade como instância social, responsável pela divulgação e acessibilidade do conhecimento, tem o papel de informar e discutir todas as variantes referentes aos conceitos sexuais, com a finalidade de multiplicar as informações e educar os jovens a vivenciarem a sexualidade como uma questão social, histórica e política e não apenas como uma necessidade instintiva e biológica. Este estudo é um relato de experiência de integrantes do Grupo de Pesquisa e Extensão, intitulado Sexualidade: Múltiplos Olhares cujo intuito é descrever a vivência como integrante de grupo durante as aulas acerca deste tema em turmas do ensino superior do curso de Biologia Licenciatura de uma Universidade Federal do Nordeste brasileiro. Foi observado que em cada turma a pluralidade e diversidade demonstrada pelos próprios alunos se fez presente e dificilmente será possível reduzir a sexualidade a um aspecto puramente biológico de forma que não considere, também, os aspectos históricos, sociais, culturais e comportamentais. Deste modo, foi importante discutir a temática sexualidade nas disciplinas de Biologia Licenciatura, pois prepara os futuros professores de Ciências e Biologia para prática docente que promova pensamento reflexivo, respeito a opiniões e estilos de vida adotados nas novas gerações de estudantes. Isso possibilita a criação de ambiente de ensino harmonioso, construtivo e educativo, estimulando os jovens a terem uma vivência saudável da sexualidade.
This study aims to assess the patterns of life satisfaction with life (SwL), sexual satisfaction, and adjustment to aging (AtA), of older adults in Mexico and Portugal. A sample of 658 older adults, aged 65 years-old and older, from Mexico and Portugal were recruited for this cross-cultural study. The following measures were applied: (a) Adjustment to Aging Scale (ATAS); (b) Satisfaction with Life Scale (SwLS); (c) New Sexual Satisfaction Scale (NSSS); (d) Mini-Mental State Exam; and (e) Sociodemographic, health and lifestyle questionnaire. Clusters were identified and characterized by using K-means cluster analysis, encompassing SwL, AtA, and sexual satisfaction. Sexual well-being differences among clusters were analyzed with One-way ANOVAs. Findings indicated three clusters, which explained 76.4% (R-sq = 0.764) of the total variance: Cluster #1: “Moderately adjusted older adults” (n = 355, 53.9%), Cluster #2: “Moderately fulfilled older adults” (n = 265, 40.3%), and Cluster 3: “Well adjusted and satisfied older adults” (n = 38, 5.8%). Participants in Cluster #1 were mostly Mexican, with moderate levels of AtA and reduced sexual satisfaction and SwL. Conversely, Cluster #2 predominantly consisted of Portuguese participants with moderate sexual satisfaction and SwL, and lower levels of AtA. Participants from Cluster #3 were mostly Portuguese with high levels of AtA, sexual satisfaction, and SwL. This innovative study explored the intricate relationship between sexual well-being, the ability to adjust to aging, and overall SwL, in two different cultural contexts. Findings contributed to the understanding of the relationship between these three variables and for developing tailored future interventions and service planning with older adults in different cultures.
Emerging research suggests that reproductive coercion and abuse (RCA), like intimate partner violence (IPV), is associated with poorer mental and sexual health outcomes, including greater symptoms of post-traumatic stress disorder (PTSD) and depression and poorer markers of physical and sexual health such as sexually transmitted infections, unplanned pregnancies and lowered sexual agency. Although victims/survivors of RCA report long-lasting impacts on future relationships, including fear and anxiety, little is known about impacts of RCA on anxiety and general wellbeing, nor emotional and mental components of sexual health that comprise a person’s sexual self-concept. With community samples of participants in Australia, we conducted two studies to explore the impact of RCA and IPV on psychological (study 1) and sexual (study 2) health outcomes. Study 1 ( n = 368) found that experiencing IPV and RCA both significantly and uniquely contributed to poorer mental health outcomes. After controlling for age and IPV, RCA significantly predicted symptoms of depression, anxiety, stress, PTSD, and reduced satisfaction with life. Study 2 ( n = 329) found that IPV and RCA differentially predicted various components of sexual health. IPV predicted decreased sexual satisfaction and increased sexual anxiety, depression, and fear of sexual encounters. After controlling for age and IPV, RCA significantly and uniquely predicted lower levels of sexual assertiveness and increased sexual depression and fear of sexual encounters, but not sexual satisfaction or anxiety. We conclude that RCA is associated with significant psychological distress and a negative sexual self-concept that may impact future relationships. Screening for both IPV and RCA across settings is warranted.
Background:
The United Nations has declared 2021-2030 the 'Decade of Healthy Ageing' and identified the need to strengthen the evidence base on interpretations and determinants of healthy ageing to inform policy.
Objectives:
This study sought to interrogate a 'policy blind spot' and examine interpretations and experiences of sexuality and sexual health within the context of ageing well among women aged 50+.
Design:
The qualitative study design was underpinned by an interpretivist epistemology. Research was guided by principles of feminist scholarship and located in an affirmative ageing framework.
Methods:
Semi-structured individual interviews were conducted between April-June 2019 with 21 English-speaking women aged 52-76. Women were recruited through community organizations in North West England. Transcripts were analysed using a framework approach to thematic analysis, applying an inductive approach to theme generation.
Results:
Narratives encompassed six broad themes: reflections on 'ageing well'; age alone does not define sexuality and sexual health; interpretations of sexual health and sexuality; vulnerability and resistance in later-life sexual health; narratives of (in)visibility; and reimagining services to promote sexual health in later life. There was a dominant belief that sexual health represents a component of ageing well, despite a broad spectrum of sexual expression and health challenges. Sexual expression was diversely shaped by conflicting societal expectations within an evolving digitized environment. In clinical settings, however, sexual health discussions were often muted or framed from a disease-focussed lens. Women expressed a preference for holistic, person-centred sexual health provision from an orientation of wellness to support varied sexual expression, sensitive to wider health, life and relationship realities.
Conclusion:
This work strengthens calls to disentangle sexual health from disease-centred narratives and legitimize sexual health as part of the healthy ageing agenda.
Sexuality is an essential component of human existence, playing a vital role in maintaining and enhancing the overall quality of life and well-being for a substantial portion of the population. Sexual health encompasses psychological, physical, and social well-being, extending beyond the absence of dysfunction or disease. It encompasses aspects of identity and relationships. Sexuality holds significant importance in personal connections and serves as a fundamental aspect of general mental and physical wellness for many individuals. A satisfying sex life not only contributes to psychological benefits like improved depressive symptoms, general well-being, and quality of life but also promotes longevity. This chapter examines the Eastern and Western approaches including cardio training, Pilates, and yoga, which may contribute to enhancing sexual satisfaction among individuals. By examining the benefits of these practices, this chapter highlights how by incorporating such practices into our daily life we can gain insights into the multifaceted ways in which physical fitness and the mindful movement of yoga positively influences our sexual well-being.
Background: A satisfying and proper sexual relationship that meets the needs of both spouses plays a crucial role in the stability and longevity of the family. Sexual self-concept is one of the factors affecting women's sexual behavior and performance and can be changed throughout life. Objectives: This study aimed to determine the status of sexual self-concept and its socio-demographic predictors of women on the verge of marriage. Methods: This cross-sectional study was conducted on 130 women referring to premarital counseling centers in Tabriz, Iran. The data collection tool was the questionnaire of personal and social characteristics and Snell's Multidimensional Sexual Self-Concept Questionnaire. Pearson's correlation test, one-way analysis of variance, and multivariate linear regression test were used in data analysis with SPSS software version 24. Results: The mean (standard deviation) of the positive sexual self-concept score was 117 (0.20) from the obtainable score of 0 - 176, and the mean (standard deviation) of the negative sexual self-concept score was 16 (0.7) from the obtainable score of 4 - 38. Additionally, the mean (standard deviation) of the sexual self-concept score was 44 (0.9) from the range of the obtainable score of 0 - 72. The results of multivariate analysis with multivariate linear regression test and control of confounding variables showed that the husband’s age, education, and mother's education were the predictors of positive sexual self-concept. Moreover, age, father's education, and duration of previous acquaintance were reported as predictors of negative sexual self-concept, and age was observed as a predictor of situational sexual self-concept. Conclusions: The study's findings indicated that age, education, parents' education, and the duration of acquaintance with the future spouse could predict sexual self-concept in women approaching marriage without sexual abuse. Given that sexual self-concept evolves well before any sexual activity, policymakers can enhance women's sexual self-concept through interventions, such as psychological counseling with a focus on sexual health. This, in turn, can improve their overall well-being, ultimately supporting stable family foundations and successful childbearing in the future.
Currently, generation Z is 27.94% of the Indonesian population and triggers fulfillment of sexual reproductive health information, including contraception, which should be given of 9-12 years old. This effort is necessary to reduce unwanted pregnancy incidence, free sex, and abortion. A factor potential to influence is peer communication. Determine the relationship between peer communication with contraception knowledge of early adolescents in the urban area of Indonesia. This quantitative study with a cross-sectional design uses the Global Early Adolscent Study’s (GEAS) secondary data. The research subjects were 2,225, which were 7th grade of State Junior High Schools in Bandar Lampung, Semarang, and Denpasar, Indonesia. The relationship between peer communication to contraceptive knowledge considers age, gender, sexual history, economic status, residence, and parental communication. Contraception knowledge is divided into good and poor. Data processing was done with univariable, chi-square, and logistic regression statistical tests and used 95% confidence interval (CI) with a 0.05 significance level. Peer communication significantly related to contraceptive knowledge (p-value <0.001). Other factors that influenced were gender, residence, sexual intercourse, and parental communication, which were statistically significant. Conclusion: About half of the early adolescents have good contraception knowledge, which is three times more likely in adolescent who communicates with peers.
This study investigated the relationships between sexual self-esteem, sexual assertiveness and sexual satisfaction. It was hypothesized that higher levels of sexual self-esteem would be associated with greater sexual satisfaction and that sexual assertiveness would act as a partial mediator. The participants were 25 men and 46 women, aged 19-56 years, recruited from the community. Participants completed questionnaires measuring sexual self-esteem, sexual assertiveness and sexual satisfaction. The results showed strong correlations between all three variables and confirmed sexual assertiveness as a partial mediator of the relationship between sexual self-esteem and sexual satisfaction. The implications of the findings for clinical practice are considered.
Hypotheses concerning possible correlates of sexual satisfaction in marriage were tested using the replies of 797 married women and men of diverse ages to a 70-item mailed questionnaire that contained seven Likert-type sub-scales measuring different sexual and non-sexual variables. Multiple regression analysis, using sexual satisfaction as the dependent variable, yielded a five-variable model that accounted for a significant portion of the variation in sexual satisfaction (Adjusted R Squared = .602). The variable 'overall satisfaction with marriage' had the highest correlation with sexual satisfaction (r = .622), followed by 'satisfaction with non-sexual aspects of the relationship' (r = .609), frequency of spouse/partner orgasm per sexual encounter (r = .529), frequency of sexual activity (r = .370), and 'sexual uninhibitedness' (r = .230). None of three measures of religiosity made a significant contribution to explaining the variation on self reported sexual satisfaction. Men and women did not differ in level of sexual satisfaction, and adding gender to the regression model did not increase the level of explained variation. The results indicate that sexual satisfaction in these married respondents could not be compartmentalized to their sexual interactions, but was strongly associated with non-sexual aspects of the overall marital relationship as well.
This study examined associations between the pleasurability of various sexual activities and behavioural experience with these activities. Participants were 145 female and 78 male undergraduates. Participants rated the pleasurability of various sexual activities (vaginal intercourse, anal intercourse, receiving oral sex, performing oral sex, masturbation by a partner, and self-masturbation) and answered questions about their experience with these sexual activities. Vaginal intercourse, receiving oral sex, and being masturbated by a partner received the highest,pleasure ratings. For behaviours other than vaginal intercourse and receiving oral sex, pleasure ratings were significantly higher among respondents who had engaged in the activity. Pleasure ratings for several different sexual behaviours were intercorrelated. Participants who scored high on a pleasure index were more sexually experienced, engaged in more frequent sexual activity, and reported having more sex partners. Results are interpreted within the context of an evolutionary theory which suggests that pleasure motivates sexual behaviour.
Pleasure may be the key to the successful working of the reproductive systems of humans. However, for all the enjoyment sexual relationships can provide, there are countervailing forces of guilt and disappointment at work on the individual psyche. Religious and social norms enforce limits on sexual expressiveness. These controls are defended as means to protect individuals and their partners from unhappiness due to infidelity. The contrasting balance of potential pleasure on the one hand and deeply felt self-controls on the other gives rise to many problems of sexual health. Couples with discordant expectations about sexual pleasures can find their relationships crumbling. Deeply planted understandings about inappropriate behavior can cause individuals to feel shame or fear when faced with choices about their sexuality and particularly their desires. People unable to achieve desired pleasures due to physical handicaps experience a loss of wellbeing that can be extremely distressing. Simultaneously society struggles to control the individual expression of harmful sexual behavior such as child molestation while protecting the rights of individuals to enjoy personal satisfaction. The recognition and promotion of sexual pleasure as an integral part of wellbeing is one of the most challenging elements on the sexual health agenda. Progress in this area will require extraordinary efforts by professional groups and political leaders to forge a forthright understanding of the meaning of pleasure in people's lives, and the priority of promoting healthy sexuality as a part of a global health agenda.
This study examined the validity of the Interpersonal Exchange Model of Sexual Satisfaction (IEMSS) in long-term, heterosexual sexual relationships. The IEMSS proposes that sexual satisfaction depends on one's levels of rewards and costs in the sexual relationship, one's comparison levels (CL) for rewards/costs, and one's perceptions of the dyadic equality (EQ) of these rewards/costs. Sexual satisfaction is expected to be greater to the extent that, over time, levels of rewards (REW) exceed levels of costs (CST), relative reward levels (CLREW) exceed relative cost levels (CLcst), and interpersonal equality of rewards (EQrew) and of costs (EQCST) is perceived to exist. Married/cohabiting community volunteers and university alumni/staff completed two questionnaires, 3 months apart. The results obtained from this well-educated, relationally satisfied sample (N= 143) provided excellent support for the IEMSS. Hierarchical regression analysis revealed that each component of the model (REW - CST, CLrew - CLcst, and EQrew, EQcst) added to the prediction of sexual satisfaction as expected, accounting for 75% of the variance. Repeated measurement of the IEMSS components offered a better prediction of sexual satisfaction than a one-time measure alone. Neither gender nor relationship satisfaction interacted with the IEMSS components. However, including relationship satisfaction (but not gender) in the model significantly improved the prediction of sexual satisfaction. It was concluded that the model should be revised to include relationship satisfaction. Both the exchange components of the IEMSS and sexual satisfaction uniquely predicted relationship satisfaction. The IEMSS offers a promising approach for understanding sexual satisfaction and its relationship to relationship satisfaction, as well as for reconciling inconsistent findings in the literature.
Despite the World Health Organization's definition of sexual health as a state of well-being, virtually no public health research has examined sexual well-being outcomes, including sexual satisfaction. Emerging evidence suggests that sexual well-being indicators are associated with more classic measures of healthy sexual behaviors. We surveyed 2168 university students in the United States and asked them to rate their physiological and psychological satisfaction with their current sexual lives. Many respondents reported that they were either satisfied (approximately half) or very satisfied (approximately one third). In multivariate analyses, significant (P < .05) correlates of both physiological and psychological satisfaction included sexual guilt, sexual self-comfort, self-esteem (especially among men), relationship status, and sexual frequency. To enhance sexual well-being, public health practitioners should work to improve sexual self-comfort, alleviate sexual guilt, and promote longer term relationships.
Using data from a U.S. clinical safety trial of tenofovir gel, a candidate microbicide, we explored the intersection of sexual pleasure and vaginal lubrication to understand whether and under what circumstances women would use a microbicide gel covertly with primary partners. This study question emerged from acceptability research in diverse settings showing that even though future microbicides are extolled as a disease prevention method that women could use without disclosing to their partners, many women assert they would inform their primary partner. Participants (N = 84), stratified by HIV-status and sexual activity (active vs. abstinent), applied the gel intra-vaginally for 14 days. At completion, quantitative acceptability data were obtained via questionnaire (N = 79) and qualitative data via small group discussions (N = 15 groups, 40 women). Quantitatively, 71% preferred a microbicide that could not be noticed by a sex partner and 86% experienced greater vaginal lubrication with daily use. Based on our analysis of the qualitative data, we suggest that women's perception that their primary partners would notice a microbicide gel is a more important reason for their caution regarding covert use than may previously have been recognized. Our findings also showed that women's assessment of the possibility of discreet, if not covert, use was strongly related to their perception of how a microbicide's added vaginal lubrication would influence their own and their partner's pleasure, as well as their partner's experience of his sexual performance. A microbicide that increases pleasure for both partners could potentially be used without engendering opposition from primary partners.
Individuals engage in behaviors or partake of specific substances because it pleases them. Indeed, without the sensations of pleasure and displeasure we would be unlikely to repeat or restrict behaviors. Since repetitive sexual activity over the millennia has ensured the continuance of the human race, it is perhaps surprising that pleasure has received little attention in the research literature on sexual function and behavior. By exploring sexual pleasure and motivation theories and studies relevant to the evaluation of sexual function and dysfunction, a goal response model is presented. This model proposes a route from sexual stimuli, via cognitive and emotional processing to behavior and subsequent feedback, which illustrates how eudemonic goals could influence treatment outcomes.
Background: Little is known about how condoms and other contraceptives influence women’s sexual enjoyment, which could shape use patterns. Methods: Data from an online study of women’s sexual health and functioning were used to examine how three categories of contraceptive use – hormonal method only, condoms primarily, and dual use – could help predict decreased sexual pleasure associated with contraceptive method and overall sexual satisfaction in the past 4 weeks. Results: In analyses controlling for age, relationship length, and other variables, male condoms were most strongly associated with decreased pleasure, whether used alone or in conjunction with hormonal methods. Women who used hormonal methods alone were least likely to report decreased pleasure, but they also had significantly lower overall scores of sexual satisfaction compared with the other two groups. Dual users, or women who used both condoms and a hormonal method, reported the highest sexual satisfaction scores. Conclusions: Because male condoms were viewed by many of these women as decreasing sexual pleasure, sexual risk practices are likely to be affected. Although hormonal only users were highly unlikely to report decreased pleasure, they reported lower sexual satisfaction compared with the other two groups. Dual users, who had the highest sexual satisfaction scores, may have been the most sexually satisfied because they felt more fully protected against unwanted pregnancy and sexually transmissible infections – consistent with previous qualitative documentation of ‘eroticising safety.’ This exploratory study suggests that different contraceptives affect sexuality in various ways, warranting further research into these sexual dimensions and how they influence contraceptive practices.
We know surprisingly little about how contraception affects sexual enjoyment and functioning (and vice versa), particularly for women. What do people seek from sex, and how do sexual experiences shape contraceptive use? We draw on qualitative data to make 3 points. First, pleasure varies. Both women and men reported multiple aspects of enjoyment, of which physical pleasure was only one.
Second, pleasure matters. Clear links exist between the forms of pleasure respondents seek and their contraceptive practices. Third, pleasure intersects with power and social inequality. Both gender and social class shape sexual preferences and contraceptive use patterns. These findings call for a reframing of behavioral models that explain why people use (or do not use) contraception.
This study examined the associations between sexual self-concept (sexual esteem and sexual anxiety) and sexual self-efficacy (situational and resistive) in a sample of 388 high school students (59% Caucasian, 28% African American). Males reported lower sexual esteem and lower sexual self-efficacy than females. Males and African Americans reported higher levels of sexual anxiety and lower levels of resistive self-efficacy than females and Caucasians. In regression models, higher sexual self-esteem uniquely predicted higher sexual self-efficacy scores, even after controlling for demographic variables, knowledge of sexual risk, and previous coital experience. In post hoc analyses, sexual self-esteem mediated the relation between knowledge of sexual risk and both types of sexual self-efficacy. Results suggest the need for interventions to promote male sexual self-efficacy and sexual esteem and the need for longitudinal research that explicates models of sexual health in adolescence.
Comparisons of nationally representative survey data of the population ages 18-54 years in 1971 (N = 2252) and 1992 (N = 1718) from Finland show that sexual satisfaction has greatly increased particularly among women. Some predictors of sexual satisfaction of men and women are examined on the basis of the 1992 survey data on people ages 18-74 years (N = 2250). Correlations between social background factors, sexual ideas and assertiveness, optional relationships, sexual practices, organism, and satisfaction with sexual intercourse were calculated. To control the simultaneous effect of the variables explaining satisfaction, path analyses were conducted. Results show that young age, a sexually unreserved and a nonreligious childhood home, early start of sexual life, high education, sexual assertiveness, considering sexuality important in life, reciprocal feeling of love, use of sex materials, frequent intercourse, many-sided (versatile) sexual techniques, and frequent orgasm correlate with finding sexual intercourse pleasurable. There were some gender differences in the connections between the independent factors and satisfaction with coitus. The importance of sexuality in life, love, and the use of sexual materials were connected directly to physical sexual satisfaction among men but only indirectly among women. For women, but not for men, young age and early start of sexual life correlated with enjoyment of intercourse. The greater sexual dissatisfaction of women compared to men, which still prevails, may be due to their late start of sexual life, conservative sexual attitudes, unimportance of sexuality in life, lack of sexual assertiveness, and use of restricted sexual techniques. The emancipation of women may change these ideas and practices of women. This might lessen the gender gap in physical sexual satisfaction.
Correlates of sexual satisfaction were identified in a sample of older married women. A 70-item questionnaire was mailed to an age-stratified sample of 5,000 married persons, including 1,000 married women over the age of 50. Usable questionnaires were received from 148 participants (14.8% return rate). Hierarchical multiple regression analysis, using sexual satisfaction as the dependent variable, yielded five predictor variables that accounted for a significant portion of the variation in sexual satisfaction (Cumulative R2 = .73). These results serve as a reminder that sexual interactions cannot be compartmentalized but must be considered within the context of the overall marriage relationship. Given the low return rate, interpretations should be limited until replication with an adequate sample has been completed.
There is a paucity of systematic analysis of the relation between sexual activity and mental health. To address this gap, we ask whether sexual activity associates with lower levels of depression among older adults. We hypothesize that sexual activity—especially if it typically incorporates other forms of physical affection—may be a socially meaningful activity and may create intimacy that provides social uplift. We test this hypothesis against alternative hypotheses that relationship characteristics or physical health could account for any association between sex and depression. In addition, we consider whether there are gender dynamics that affect the association between sexual activity and depression. We analyze data from the National Social Life, Health, and Aging Project (NSHAP), a nationally representative survey of adults aged 57 to 85. Given findings of significant gendered aspects of depression, sexual activity, social support, and aging, we estimate separate models for women and men. Although we find differences between models for men and women for many control variables that correspond to gendered differences in depression, sexual activity that typically incorporates other forms of physical intimacy has a robust association with lower depression for both women and men.
This article reviews published research studies that have examined the impact of psychosocial factors on condom use among adolescents, and offers recommendations regarding the examination of psychosocial variables in future research and HIV prevention program development for adolescents. The review includes a critical analysis of methodological issues, and significant psychosocial predictors are discussed within the context of health behavior change theories. Findings suggest that HIV prevention programs for adolescents should address sexual pleasure and eroticization of condom use within the context of dyadic sexual relationships. Future research on adolescent condom use should attempt to address methodological concerns of prior research by using prospective cohort designs, combining qualitative and quantitative methods, and improving the measurement of psychosocial factors.
Despite the central importance of sexuality to human well-being, the study of sexuality remains
marginalized within health psychology, which hampers the ability of clinicians and policy-makers
to promote comprehensive health and well-being. In this review we discuss the evidence that sexual
functioning makes critical contributions to human health, focusing specifically on findings
linking sexual activity to morbidity and mortality, to the health-promoting effects of intimate relationships,
and to processes of emotion regulation. We argue that researchers studying the psychology
of health and well-being should more substantively integrate sexuality into their research
agendas. Health psychologists’ specific expertise in investigating and interpreting complex, reciprocal
associations between subjective emotional states, health-relevant cognitions, and health-relevant
behavior can make a notable contribution to elucidating some of the most intruiging correlations
between sexuality and health that have emerged from medical and epidemiological studies. If we
want to foster optimum physical and mental health among youths and adults, we must rigorously
investigate the multiple mechanisms through which positive sexual functioning plays a unique and
fundamental role in human well-being across the life course.
Pleasure - and even sex itself - have been noticeab absent from much of the dialogue surrounding sexually transmitted infections and the spread of HIV/AIDS. Safer sex and good sex are not mutually exclusive, yet most established educational programmes give the impression that they are, by using only fear of risk and disease to motivate their audience to practise safer sex. Yet evidence suggest that positive incentives provide the most effective way to get people to want to have safer sex. The Pleasure Project works with these incentives - pleasure and desire - to build bridges between the pleasure/sex industry and the safer sex world. It avoids negativity, ensuring that erotic materials include examples of safer sex and that sexual health and training materials take account of pleasure. In this article, the authors give a brief account of some of the Pleasure Project's work and reflect on how a more sex-positive approach to safer sex can help promote greater sexual well-being.
Introduction. Although lubricant use is commonly recommended to women for solo and partnered sexual activities, little is known about women's use of lubricant or their relationship to sexual pleasure and satisfaction.
Aim. The aim of this study was to assess: (i) how adult women used lubricant during partnered and solo sexual activities; (ii) relations between women's reports of sexual pleasure and satisfaction and their use of a lubricant during a particular sexual event; and (iii) to what extent lubricant use was associated with subsequent genital symptoms.
Methods. A total of 2,453 women completed a 5-week internet-based, double-blind prospective daily diary study in which they were assigned to use one of six water- or silicone-based lubricants.
Main Outcome Measures. Baseline data included demographics, contraceptive use, and sexual behavior during the 4 weeks prior to study enrollment. Daily diary data included reports of penile–vaginal sex, penile–anal sex, solo sex, lubricant use, lubricant application, ratings of sexual pleasure and satisfaction, and genital symptoms.
Results. Water-based lubricants were associated with fewer genital symptoms compared with silicone-based lubricants. In addition, the use of a water-based or silicone-based lubricant was associated with higher ratings of sexual pleasure and satisfaction for solo sex and penile–vaginal sex. Water-based lubricant use was associated with higher ratings of sexual pleasure and satisfaction for penile–anal sex as compared with no lubricant use.
Conclusion. The water- and silicone-based lubricants used in this study were associated with significantly higher reports of sexual pleasure and satisfaction and rarely associated with genital symptoms. Herbenick D, Reece M, Hensel D, Sanders S, Jozkowski K, and Fortenberry JD. Association of lubricant use with women's sexual pleasure, sexual satisfaction, and genital symptoms: A prospective daily diary study. J Sex Med 2011;8:202–212.
This article provides an overview of the recent interdisciplinary research on the connection between sexual satisfaction and overall relationship happiness for couples. The authors discuss the literature on same- and opposite-sex couples and, cognizant of gender, race, and class differences, state a case for how specific aspects of sexuality, such as frequency of sex, emotion, and orgasm, affect individual and couple satisfaction. © 2009 by the National Sexuality Research Center. All rights reserved.
To examine the associations between three key developmental assets and an aspect of sexual health, sexual enjoyment, which has rarely been studied in young adults, although its importance is stressed in all recent sexual health policy statements.
Using data from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health, and multiple logistic and ordered logistic regression, we explored the associations between sexual pleasure and autonomy, self-esteem, and empathy among 3,237 respondents aged 18-26 years in heterosexual relationships of ≥ 3-month duration. We also examined the distribution of sexual pleasure across various socio-demographic groups.
Compared with young women, young men reported more regular orgasms and more enjoyment of two kinds of partnered sexual behavior. Sexual enjoyment was not associated with age, race/ethnicity, or socioeconomic status. Among women, autonomy, self-esteem, and empathy co-varied positively with all three sexual enjoyment measures. Among men, all associations were in the same direction, but not all were statistically significant.
A substantial gender difference in enjoyment of partnered sexual behavior exists among emerging adults in the United States. This study is the first to use a representative population sample to find a relationship between developmental assets and a positive aspect of sexual health - sexual pleasure.
In the contemporary U.S., men and women are living longer and healthier lives. As such, many people spend greater portions of their lives as sexually active individuals. Yet, little is known about the myriad of ways that older adults experience their sexual lives.
This study sought to assess the context and frequency of sexual behaviors, condom use, sexual pleasure, and sexual experience of men and women over age 50.
Information regarding the sexual experiences of a nationally representative sample of men and women over age 50 within the past year was examined.
Sexual behavior over the past year was assessed in relation to several situational and contextual characteristics (e.g., event location, type of partner, health status, condom use). Participants were also asked about their experience (i.e., pleasure, arousal, pain, lubrication/erectile difficulties, and orgasm) during their most recent partnered sexual event. Bivariate or ordinal logistic regression models were used to investigate the relationship of age, health and partner status to sexual frequency and experience.
Although sizable proportions (20-30%) of both men and women remained sexually active well into their 80s age was related to a lower likelihood of solo and most partnered sexual behaviors. When controlling for age, relationship status, and health remained significant predictors of select sexual behaviors. The participant's evaluation of their most recent sexual experience in terms of arousal, erectile difficulty, and orgasm all declined with age. Health status was related to men's evaluation of the experience. Relationship status was the most consistent predictor of women's evaluation of the experience. Condom use rates remained low for participants across age groups.
Many older adults continue be sexually active well into advanced age (80+). Thus, providers need to be attentive to the diverse sexual health needs of older adults.
Developing a sexual self-concept is an important developmental task of adolescence; however, little empirical evidence describes this development, nor how these changes are related to development in sexual behavior. Using longitudinal cohort data from adolescent women, we invoked latent growth curve analysis to: (1) examine reciprocal development in sexual self-concept (sexual openness, sexual esteem and sexual anxiety) over a four year time frame; (2) describe the relationship of these trajectories with changes in sexual behavior. We found significant transactional effects between these dimensions and behavior: sexual self-concept evolved during adolescence in a manner consistent with less reserve, less anxiety and greater personal comfort with sexuality and sexual behavior. Moreover, we found that sexual self-concept results from sexual behavior, as well as regulates future behavior.
The pursuit of pleasure is one of the primary reasons people have sex; and sex is the most common way people contract HIV worldwide. Yet information about how to have (or deliver) pleasurable sex and stay healthy are largely missing from health resources and HIV prevention campaigns. Wendy Knerr and Anne Philpott explore how ‘erotophobia’ in the health and development sectors is hindering effective safer sex promotion, and highlight best practices from The Global Mapping of Pleasure, 2nd Edition, a collection of case studies on pleasure and safer sex communication from countries and contexts around the world. Development (2009) 52, 95–100. doi:10.1057/dev.2008.79
Higgins, Trussell, Moore, and Davidson (2010) expand our understanding of sexual satisfaction by showing that first vaginal sex is more likely to be psychologically than physically satisfying and by revealing differences between women and men and similarities between African Americans and Whites. Their analyses highlight the need for further theory-building, explicating the dynamics of change over time, integrating qualitative and quantitative approaches, and articulating implications for public policy. These are crucial steps toward developing a social science of sexual satisfaction. More research that focuses on positive aspects of sexuality, such as satisfaction, should be encouraged.
Sexuality for women at all ages is a vital aspect of life satisfaction and is based upon continuing growth, development, and adaptation. The successful aging model includes physical, mental/emotional, and social well-being. There is no known published literature on the topic of sexual activities of older women and its implications on life and sexual satisfaction.
To investigate the sexual activities of older women in Israel, their levels of sexual satisfaction and life satisfaction, and to examine the relationship between the level of sexual activities, sexual satisfaction, and life satisfaction.
Components of the Derogatis Sexual Functioning Inventory, and the Life Satisfaction Index.
A descriptive, correlational study guided by the theory of "successful aging" by Havighurst (1961) was conducted using a convenience sample of 127 women who attended a menopause clinic for routine and follow up care.
The research findings described older women as being involved in varied, though limited, sexual activities. There was no significant relationship discovered between the number of sexual activities and age. The level of sexual satisfaction of the studied sample was found to be above the mean score. Most of the women reported good sexual/intimate communication with their partners. Women were not satisfied with the limited variety in their sex life. Women reported a high level of life satisfaction. Ultimately, a positive significant correlation was discovered between sexual satisfaction and level of current sexual activity, and between sexual satisfaction and life satisfaction.
Older women are interested in continuing their sexual activities. It is a component of life satisfaction. The desire for sexual variety suggested an important area for patient education. Couple communication was deemed a priority. Health providers should include sexual health issues in their discussions with clients of all ages.
Little is known about women's use of vibrators within sexual partnerships. Data were collected from a population-based, cross-sectional survey of 2056 women aged 18-60 years in the United States. Partnered vibrator use was common among heterosexual-, lesbian-, and bisexual-identified women. Most vibrator users indicated comfort using them with a partner and vibrator use was related to positive sexual function as measured by the Female Sexual Function Index (FSFI). In addition, partner knowledge and perceived liking of vibrator use was a significant predictor of sexual satisfaction for heterosexual women (p < .01). Clinical and research implications are discussed.
Limited published data address the impact of low sexual desire and interest on multiple domains of women's partnered relationships.
To investigate associations between sexual interest and attitudes toward and frequency of partner interactions in women with reduced sexual desire.
A cross-sectional study was conducted using market research databases to recruit women from the general community in the United States, Germany, and Italy. Telephone interviews screened women to obtain a sample aged 18-65 years, in a relationship, and upset/bothered by decreased sexual desire. A 60-minute face-to-face questionnaire was conducted in participants' homes.
Attitudes Toward Partner Interactions (ATPI) index measured sexual and nonsexual partner interactions. Higher scores indicated more positive attitudes and a higher frequency of partner interactions. Sexual interest was assessed on a 6-point scale.
One thousand four hundred two of the 8,000 women screened met the inclusion criteria and agreed to participate (USA N = 600, Germany N = 402, Italy N = 400). A high percentage of participants reported that their sexual interest was absent to very weak (45%) or somewhat weak (43%). Mean ATPI scores increased significantly across sexual interest categories, from absent to very weak (3.7, 95% confidence interval [CI] 3.4 to 4.0) to somewhat weak (5.3, 95% CI 5.0 to 5.6) to somewhat strong or greater sexual interest (7.8, 95% CI 7.3 to 8.4) (one-way analysis of variance, effect size = 0.129, P = 0.001). Higher reported sexual interest was significantly associated with comparatively positive ATPI scores (above the median) (Phi-Kraemer, K = 0.194 P < 0.001).
Clinicians need to be aware that women suffering from characteristics of hypoactive sexual desire disorder have more negative patterns of partner interactions.
Some sex therapists and educators assume that many sexual behaviors provide comparable sexual satisfaction. Evidence is required to determine whether sexual behaviors differ in their associations with both sexual satisfaction and satisfaction with other aspects of life.
To test the hypothesis that satisfaction with sex life, life in general, sexual partnership, and mental health correlates directly with frequency of penile-vaginal intercourse (PVI) and inversely with frequency of both masturbation and partnered sexual activity excluding PVI (noncoital sex).
A representative sample of 2,810 Swedes reported frequency of PVI, noncoital sex, and masturbation during the past 30 days, and degree of satisfaction with their sex life, life in general, partnership, and mental health.
Multivariate analyses (for the sexes separately and combined) considering the different satisfaction parameters as dependent variables, and the different types of sexual activities (and age) as putative predictors.
For both sexes, multivariate analyses revealed that PVI frequency was directly associated with all satisfaction measures (part correlation = 0.50 with sexual satisfaction), masturbation frequency was independently inversely associated with almost all satisfaction measures, and noncoital sex frequencies independently inversely associated with some satisfaction measures (and uncorrelated with the rest). Age did not confound the results.
The results are consistent with evidence that specifically PVI frequency, rather than other sexual activities, is associated with sexual satisfaction, health, and well-being. Inverse associations between satisfaction and masturbation are not due simply to insufficient PVI.
Although pregnancy ambivalence is consistently associated with poorer contraceptive use, little is known about the sexual, social and emotional dynamics at work in pregnancy ambivalence.
During in-depth sexual and reproductive history interviews conducted in 2003, 36 women and men were asked about the relational and emotional circumstances surrounding each pregnancy, as well as their thoughts about conceiving a baby with both current and previous partners. An ethnographic, inductive approach was used to analyze the data.
Half of respondents had experienced at least one unintended pregnancy. Respondents described three categories of pleasure related to pregnancy ambivalence: active eroticization of risk, in which pregnancy fantasies heightened the charge of the sexual encounter; passive romanticization of pregnancy, in which people neither actively sought nor prevented conception; and an escapist pleasure in imagining that a pregnancy would sweep one away from hardship. All three categories were associated with misuse or nonuse of coitus-dependent methods.
For some individuals, the perceived emotional and sexual benefits of conception may outweigh the goal of averting conception, even when a child is not wholly intended. Future behavioral studies should collect more nuanced data on pregnancy-related pleasure. Clinicians and patients would benefit from clearer guidelines for assessing ambivalence and for linking ambivalent clients with longer-acting methods that are not coitus-dependent.
Sexuality and power relations based on gender are relevant to researchers, policymakers, and service providers in the reproductive health field, because they underlie virtually all of the behaviors and conditions that their programs address. Yet, a review of conventional treatments in the demographic and family planning literature reveals that, when they consider these topics at all, researchers typically adopt narrow definitions of sexual behavior and focus almost exclusively on risks of pregnancy and disease. This article proposes an analytic framework as a guide to researchers and family planning providers. It relates four dimensions of sexuality to reproductive health outcomes and concludes that family planning policies and programs should address a broader spectrum of sexual behaviors and meanings, consider questions of sexual enjoyment as well as risk, and confront ideologies of male entitlement that threaten women's sexual and reproductive rights and health.
Despite the fact that choosing a contraceptive method is often a decision made by couples, little is known about how men and women differ in their perceptions of the characteristics of various method types, and in the importance that they attach to those characteristics when choosing a contraceptive method.
The data analyzed here are subsets from two companion surveys conducted in 1991--1,189 men aged 20-27 who were surveyed in the National Survey of Men and 740 women aged 20-27 who were surveyed in the National Survey of Women. Multivariate ordered logit analysis is used to examine how gender is related to both the importance that individuals assign to seven specific contraceptive characteristics when choosing a method, and to perceptions about the extent to which five common method types possess each of these characteristics.
Women rank pregnancy prevention as the single most important contraceptive characteristic when choosing a method, with 90% citing it as "very important." The health risks associated with particular methods and protection from sexually transmitted diseases (STDs) are rated as the second most important characteristics by women (each mentioned as "very important" by 77%). In contrast, men consider STD prevention for themselves and their partner to be just as important as pregnancy protection (each mentioned as "very important" by 84-86%), and they rank STD prevention as more important than other health risks (by 72%). Women, but not men, rank both ease of use and the need to plan ahead as being more important characteristics than a method's interference with sexual pleasure. Both men and women have an accurate understanding of the strengths and weaknesses of particular methods, but differ enough in their perceptions to alter the relative attractiveness of each method. In particular, women have more favorable perceptions than men about the pill, being somewhat more likely than men to believe that the pill is "very good" at preventing pregnancy (75% vs. 67%) and to say that it is very good at not interfering with sexual pleasure (82% vs. 76%). In contrast, women have generally less favorable perceptions than men about other reversible methods, including the condom: Women were less likely than men to consider the condom very good at pregnancy prevention (29% vs. 46%) or at having no need for advance planning (22% vs. 38%). Gender differences in perceptions about the specific characteristics of contraceptive methods often vary by marital status.
Men and women have somewhat different priorities when choosing a contraceptive method. Despite many similarities between women and men in their perceptions about the characteristics of each method type, numerous differences between them may have an important influence on how couples make their method choices.
Sexual health is a complex, multidimensional construct. In analyzing race and ethnicity in sexual health, this article examines 2 domains of discourse: (1) preventive sexual health, a public health oriented domain of discourse concerned with the prevention of disease, and (2) eudaemonic sexual health, a domain of discourse concerned with attainment of sexual pleasure within a moral context. Research on the sexual health of ethnic minority populations is typically focused on preventive sexual health. There is an underemphasis on eudaemonic discourses when applied to ethnic minority persons, particularly in the examination of ethnic variations in sexual dysfunction. Medicalization of sexual dysfunction, control of minority sexualities, and ethnically oriented cultural scenarios are cited as reasons for this underemphasis. Exploring racial/ethnic aspects of eudaemonic sexual health can deepen understanding of sexual health in multiple domains and strengthen the ability to promote sexual health for all.
Effective STD and pregnancy prevention efforts should benefit from knowledge of what motivates adolescents to have sex. Positive motivations, and how they differ by gender and sexual experience, are poorly understood.
A sample of 637 ninth graders were asked about their relationship goals, expectations of the degree to which sex would satisfy these goals and sexual experience. Three scales measured adolescents' goals for intimacy, sexual pleasure and social status within a romantic relationship. Another three scales measured expectations that sex would lead to these goals. Data were examined in analyses of variance and mixed models.
Participants valued intimacy the most, then social status and, finally, sexual pleasure. These relationship goals differed significantly by gender and sexual experience. Females valued intimacy significantly more and sexual pleasure less than males. Sexually experienced adolescents valued both intimacy and pleasure more than sexually inexperienced adolescents. Among females, but not males, sexually experienced adolescents valued the goal of social status less than those with no sexual experience did. Adolescents expected that sex would most likely lead to sexual pleasure, then intimacy and, finally, social status. Females and sexually inexperienced adolescents reported lower expectations that sex would meet goals than did males and sexually experienced participants.
Adolescents view intimacy, sexual pleasure and social status as important goals in a relationship. Many have strong positive expectations that sex would satisfy these goals. Prevention programs and providers should address the risks of sex in the context of expected benefits.
Most sexual health education programmes use fear and risk of disease to try to motivate people to practise safer sex. This gives the impression that safer sex and pleasurable sex are mutually exclusive. Yet there is growing evidence that promoting pleasure alongside safer sex messaging can increase the consistent use of condoms and other forms of safer sex. To this end, the Pleasure Project created The Global Mapping of Pleasure, a document that identifies projects and organisations worldwide that put pleasure first in HIV prevention and sexual health promotion, and sexually provocative media that include safer sex. This article summarises some of the findings of this mapping exercise and what we learned about incorporating pleasure from it. We found that there are a variety of organisations, including religious and youth groups, and HIV/AIDS organisations and NGOs, promoting pleasurable safer sex. The techniques they use include promoting sexual techniques and dialogue about sex, teaching married couples how to have better sex and putting images of desire in sexual education materials. This paper focuses on ways of eroticising female and male condoms as examples of effective ways of using pleasure in HIV prevention and sexual health promotion.
Unsafe sex is the second highest cause of the global burden of disease. 2 Therefore, an urgent need exists to amplify effective use of evidence-based measures to diminish this burden, including barrier methods that protect against both STI and pregnancy (male and female condoms). The limited effect, so far, of public-health campaigns to promote effective use of these barrier methods might be attributable, in part, to scare tactics that emphasise adverse consequences of sexual acts. Promotion of pleasure in use of male and female condoms—alongside safer sex messages—can facilitate consistent use of condoms and boost their effectiveness to protect against STI and pregnancy. 3-6 Therefore, the effect of public-health initiatives that emphasise positive outcomes of use of male and female condoms as barrier methods, and positive results of practising other forms of safer sex, need to be investigated. Such work includes the potential for safer sex to contribute to good health and hygiene in general (and a healthy sex life in particular), to reduce anxiety about risk of STI and pregnancy, and, quite simply, to make sex more pleasurable. In this Viewpoint, we discuss the potential for increasing condom uptake and safer sexual behaviours by promoting pleasurable aspects of condom use in public-health campaigns. We have chosen to focus on evidence that male and female condoms can be promoted by discussion of pleasure. However, we acknowledge that many other elements of safer sex are both pleasurable and safe, including all non-penetrative sex, new potential prevention technologies (such as microbicides, which could be marketed as sexual lubricants), and sex without any physical contact (such as internet and telephone sex).
Relationships between condoms, hormon-al methods, and sexual pleasure and satisfaction: an exploratory analysis from the women's well-being and sexuality study
- Higgins Ja S Hoffman
- Graham Ca Sanders
- Sa
Higgins JA, Hoffman S, Graham CA, Sanders SA (2008) Relationships between condoms, hormon-al methods, and sexual pleasure and satisfaction: an exploratory analysis from the women's well-being and sexuality study. Sex Health 5(4):321– 330
Psychosocial factors impacting condom use among adolescents: a review and theoretical integration
- Gw Harper
- Sg Hosek
- R Contreras
- M Doll
Contraceptive characteristics: the perceptions and priorities of men and women
- W R Grady
- D H Klepinger
- Grady
Covert use, vaginal lubrication and sexual pleasure: a qualitative study of urban U.S. women in a vaginal microbicide clinical trial
- S Hoffman
- K M Morrow
- J E Mantell
- Hoffman
Women’s vibrator use in sexual partnerships: results from a nationally representative survey
- D Herbenick
- M R Reece
- B Dodge
- Herbenick