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1.
PLoS One ; 19(6): e0303693, 2024.
Article in English | MEDLINE | ID: mdl-38829902

ABSTRACT

Perceiving that a partner is highly committed tends to benefit close relationships. However, there may be relational drawbacks to perceiving high commitment. In particular, given that high commitment may signal that a partner is unlikely to leave the relationship, perceiving that a partner is highly committed might lead people low in agreeableness to feel comfortable behaving more selfishly toward that partner. One correlational study consisting of a highly diverse sample of individuals (n = 307), one observational study of newlywed couples (n = 202), and one experiment with undergraduate couples (n = 252) examined whether the implications of perceived partner commitment for selfish behaviors depend on agreeableness. Results demonstrated that perceiving high commitment resulted in more selfish behavior among disagreeable participants (Studies 1-3), but less selfish behavior among agreeable participants (Studies 1 and 3). Together, these results suggest that signaling commitment to disagreeable partners may backfire in romantic relationships.


Subject(s)
Interpersonal Relations , Humans , Male , Female , Adult , Young Adult , Sexual Partners/psychology , Perception
2.
Womens Health (Lond) ; 20: 17455057241259173, 2024.
Article in English | MEDLINE | ID: mdl-38847324

ABSTRACT

BACKGROUND: There is an increasing emphasis on promoting women's autonomy in reproductive decision-making, particularly given global efforts to increase contraceptive access and uptake. Scales to quantify autonomy have inconsistently included the effect of external influences and focused primarily on influences of partners. OBJECTIVES: This study aimed to gain greater depth in understanding how influences including and beyond a woman's partner affect her contraceptive decision-making, as well as how external influences can overlap and further complicate contraceptive decision-making. DESIGN: A phenomenological, qualitative study in which in-depth interviews were conducted in three phases from May 2021 to February 2022 with women living in northwest Tanzania who had varying histories of contraceptive use or non-use. METHODS: One-on-one, in-depth interviews were conducted in Swahili, the national language of Tanzania, by trained female interviewers. Interviews were digitally recorded, transcribed, translated into English, and independently coded by three investigators. Analysis was conducted using NVivo. The codes developed from the transcripts were grouped into overarching themes with supporting illustrative quotes. RESULTS: A total of 72 women were interviewed. Partners were the most influential in women's family planning decision-making, followed by friends, relatives, community religious leaders, and healthcare providers. Out of the 52 women with a partner who had ever used family planning, 76.9% had discussed their desire to use family planning with their partner and nearly all reported strong pressures to use or not to use family planning from partners, family, and friends. Rarely, participants stated that they were devoid of any influence. CONCLUSION: In rural Tanzania, women's decision-making about family planning was highly impacted by external influences, including not only partners but also family, friends, and community. Indicators of women's reproductive autonomy and measurements of interventions to promote contraceptive use should incorporate measures of these external influences.


Subject(s)
Contraception Behavior , Decision Making , Family Planning Services , Personal Autonomy , Qualitative Research , Rural Population , Humans , Female , Tanzania , Adult , Contraception Behavior/psychology , Contraception Behavior/statistics & numerical data , Young Adult , Contraception/psychology , Contraception/methods , Interviews as Topic , Middle Aged , Sexual Partners/psychology , Adolescent
3.
PLoS One ; 19(6): e0305056, 2024.
Article in English | MEDLINE | ID: mdl-38848400

ABSTRACT

This protocol presents a multilevel cluster randomized study in 24 communities in Cape Town, South Africa. The study comprises four specific aims. Aim 1, conducted during the formative phase, was to modify the original Couples Health CoOp (CHC) intervention to include antiretroviral therapy/pre-exposure prophylaxis (ART/PrEP), called the Couples Health CoOp Plus (CHC+), with review from our Community Collaborative Board and a Peer Advisory Board. Aim 1 has been completed for staging the trial. Aim 2 is to evaluate the impact of a stigma awareness and education workshop on community members' attitudes and behaviors toward young women and men who use AODs and people in their community seeking HIV services (testing/ART/PrEP) and other health services in their local clinics. Aim 3 is to test the efficacy of the CHC+ to increase both partners' PrEP/ART initiation and adherence (at 3 and 6 months) and to reduce alcohol and other drug use, sexual risk and gender-based violence, and to enhance positive gender norms and communication relative to HIV testing services (n = 480 couples). Aim 4 seeks to examine through mixed methods the interaction of the stigma awareness workshop and the CHC+ on increased PrEP and ART initiation, retention, and adherence among young women and their primary partners. Ongoing collaborations with community peer leaders and local outreach staff from these communities are essential for reaching the project's aims. Additionally, a manualized field protocol with regular training, fidelity checks, and quality assurance are critical components of this multilevel community trial for successful ongoing data collection. Trial registration. Clinicaltrials.gov Registration Number: NCT05310773. Pan African Trials: pactr.samrc.ac.za/ Registration Number: PACTR202205640398485.


Subject(s)
HIV Infections , Humans , HIV Infections/prevention & control , South Africa , Female , Male , Adult , Pre-Exposure Prophylaxis/methods , Social Stigma , Young Adult , Adolescent , Sexual Partners/psychology , Anti-HIV Agents/therapeutic use
4.
BMC Public Health ; 24(1): 1533, 2024 Jun 07.
Article in English | MEDLINE | ID: mdl-38849818

ABSTRACT

BACKGROUND: Risky sexual behaviour (RSB), particularly multiple sexual partnerships (MSP) continues to be a major public health concern and has been linked to the increasing STIs, including HIV/AIDS in many parts of sub-Saharan Africa (SSA), suggesting that there is an association between contextual factors and multiple sexual partnering. However, in South Africa, this association is not well established in recent literature. Hence, this study examined the contextual factors contributing to multiple sexual partnerships among young people in South Africa. MATERIALS AND METHODS: Data was extracted from the 2016 South Africa Demographics and Health Survey (2016 SADHS). A cross-sectional study of 3889 never-married young people. Descriptive and inferential statistics as well as multilevel logistic regression were used to analyse the data on never-married young people aged 15 to 24 years. RESULTS: The results indicated that at the individual level, young males (61.7%) were significantly more likely than their female counterparts (56.1%) to engage in multiple sexual partners, although, the difference was not as significant as expected. At the community level clustering, the likelihood of exposure to multiple sexual partnerships significantly increased among females (OR = 1.47; 95% CI: 1.25-1.73) but decreased among their male counterparts (OR = 0.73; 95% CI: 0.58-0.92), in particular, family disruption, residential instability, and ethnic diversity led young people to engage in multiple sexual partnerships. CONCLUSIONS: There is a need to intensify programmes aimed at considering appropriate policy options to reduce the prevalence of multiple sexual partnerships. Adopting the implications of these findings is essential for a developmental strategy towards achieving the sustainable development goal of ending STIs among young people in South Africa.


Subject(s)
Multilevel Analysis , Sexual Behavior , Sexual Partners , Humans , South Africa/epidemiology , Male , Adolescent , Female , Young Adult , Cross-Sectional Studies , Sexual Partners/psychology , Sexual Behavior/statistics & numerical data , Risk-Taking , Health Surveys
5.
Psychiatr Pol ; 58(1): 183-199, 2024 Feb 28.
Article in English, Polish | MEDLINE | ID: mdl-38852188

ABSTRACT

OBJECTIVES: Some studies suggest that homosexual identity, compared to heterosexual, may be associated with a reduced risk of premature ejaculation (PE). The aim of this study was to test this relationship and to investigate possible underlaying mechanisms. METHODS: The present study drew on a database obtained from a cross-sectional online study of the sexuality of Polish heterosexual (HM; N = 1,121), gay (GM; N = 1,789) and bisexual (BM; N = 743) men. The dependent variable was the PE diagnosis based on the PEDT questionnaire. The explanatory variables were characteristics of sexual and partnership patterns, health and minority stress among GM and BM. Statistical one- and multifactor analyses were performed. RESULTS: Homosexual identity proved to be an independent negative predictor of PE diagnosis. The preference for insertive penetration activity (including vaginal), performance anxiety and financial difficulties increased the risk of PE, while the experience of insertive and receptive forms of oral and anal sex but not vaginal sex, a higher level of education, better general sexual functioning and regular physical activity reduced such risk. The predictive meaning of homosexual identity has not been present in multifactor models for group of men in relationships. CONCLUSIONS: Homosexual identity is associated with a lower risk of PE diagnosis. This may be due to the differences in sexualities of GM and HM, as well as other psychosocial factors.


Subject(s)
Premature Ejaculation , Humans , Male , Premature Ejaculation/psychology , Premature Ejaculation/epidemiology , Adult , Cross-Sectional Studies , Poland , Homosexuality, Male/psychology , Homosexuality, Male/statistics & numerical data , Sexual Behavior/psychology , Sexual Behavior/statistics & numerical data , Young Adult , Sexual Partners/psychology , Middle Aged , Surveys and Questionnaires , Risk Factors , Heterosexuality/psychology , Heterosexuality/statistics & numerical data , Bisexuality/psychology , Bisexuality/statistics & numerical data
6.
PLoS One ; 19(6): e0301436, 2024.
Article in English | MEDLINE | ID: mdl-38861516

ABSTRACT

BACKGROUND: Sexual behavior (SB) is a well-documented pathway to HIV acquisition in emerging adults and remains common amongst African emerging adults. Previous research in high-income countries indicates a correlation between disordered eating behavior (DEB) and engaging in sexual behaviors. We aimed to describe the relationship between DEB and SB amongst emerging adults attending a tertiary educational institution at the Kenyan Coast. METHODS: We applied a cross-sectional design nested in a young adults' cohort study. Eligibility included sexually active emerging adults aged 18-24 years. Three DEBs (emotional, restrained and external eating) were assessed using the Dutch Eating Behavior Questionnaire and analysed using exploratory factor analysis. Seven SB indicators were assessed: non-condom use, casual sex, multiple sex partners, transactional sex, group sex, age-disparate relationship and anal sex, and grouped into low vs. high SB using latent class analysis. Logistic regression was used to assess the association between DEB and SB. RESULTS: Of 273 eligible participants (female, n = 110 [40.3%]), the mean of emotional, restrained and external eating was 1.9 [0.6], 2.0 [0.6] and 3.0 [0.5] respectively. Overall, 57 (20.9%) were grouped into the latent high SB class. Emotional (Adjusted odds ratio, AOR [95% confidence interval, CI]: 1.0 [0.9-1.0], p = 0.398), restrained (AOR, 1.0 [CI: 0.9-1.1], p = 0.301) and External (AOR, 1.0 [CI: 0.8-1.2], p = 0.523) eating were not independently associated with latent high SB. CONCLUSION: There was no significant association between DEB and SB in this study sample. In low- and middle-income countries like Kenya, interventions targeted at DEB among emerging adults towards controlling SB are unnecessary.


Subject(s)
Feeding and Eating Disorders , Sexual Behavior , Humans , Female , Kenya/epidemiology , Male , Young Adult , Sexual Behavior/psychology , Adolescent , Feeding and Eating Disorders/epidemiology , Feeding and Eating Disorders/psychology , Cross-Sectional Studies , Adult , Surveys and Questionnaires , Sexual Partners/psychology , Feeding Behavior/psychology
7.
Evol Psychol ; 22(2): 14747049241262712, 2024.
Article in English | MEDLINE | ID: mdl-38881307

ABSTRACT

Many researchers have proposed that women perceive men with masculine face shapes to be less suitable as parents and long-term partners than men with feminine face shapes, causing women to find masculine men more attractive for short-term than long-term relationships. However, recent work shows that results obtained using the type of experimentally manipulated stimuli that were employed in studies presenting evidence for these claims are not necessarily observed when natural (i.e., unmanipulated) face stimuli were used to suggest that the evidence for these claims may need to be revaluated. Consequently, we tested for possible relationships between ratings of natural male faces for parenting- and relationship-related traits and shape masculinity (Study 1) and also tested whether women's preferences for shape masculinity were stronger when natural male faces were rated for short-term relationships than when natural male faces were rated for long-term relationships (Studies 2 and 3). We saw no evidence for either of these predictions, instead finding that men with more attractive faces were perceived to be better parents and better long-term partners. Thus, our findings do not support the widely held view that masculine men are more attractive for short-term relationships because they are perceived to be unlikely to invest time and effort in their romantic partners and offspring.


Subject(s)
Facial Recognition , Masculinity , Sexual Partners , Social Perception , Humans , Female , Male , Adult , Young Adult , Sexual Partners/psychology , Facial Recognition/physiology , Choice Behavior , Face , Interpersonal Relations , Adolescent
8.
BMC Health Serv Res ; 24(1): 570, 2024 May 02.
Article in English | MEDLINE | ID: mdl-38698401

ABSTRACT

BACKGROUND: HIV partner notification services can help people living with HIV (PLHIV) to identify, locate, and inform their sexual and injecting partners who are exposed to HIV and refer them for proper and timely counseling and testing. To what extent these services were used by PLHIV and what are the related barriers and facilitators in southeast Iran are not known. So, this study aimed to explore HIV notification and its barriers and facilitators among PLHIV in Iran. METHODS: In this qualitative study, the number of 23 participants were recruited from November 2022 to February 2023 including PLHIV (N = 12), sexual partners of PLHIV (N = 5), and staff members (N = 6) of a Voluntary Counseling and Testing (VCT) center in Kerman located in the southeast of Iran. Our data collection included purposive sampling to increase variation. The content analysis was conducted using the Graneheim and Lundman approach. The analysis yielded 221 (out of 322) related codes related to HIV notification, its barriers, and its facilitators. These codes were further categorized into one main category with three categories and nine sub-categories. RESULTS: The main category was HIV notification approaches, HIV notification barriers, and facilitators. HIV notification approaches were notification through clear, and direct conversation, notification through gradual preparation and reassurance, notification due to being with PLHIV, notification through suspicious talking of the physician, and notification due to the behavior of others. Also, the barriers were classified into individual, social, and environmental, and healthcare system barriers and the facilitators were at PLHIV, healthcare staff, and community levels. Stigma was a barrier mentioned by most participants. Also, the main facilitator of HIV notification was social support, especially from the family side. CONCLUSIONS: The findings highlighted the multidimensionality of HIV notification emphasizing the importance of tailored support and education to enhance the notification process for PLHIV and their networks. Also, our results show that despite all the efforts to reduce stigma and discrimination in recent years, stigma still exists as a main obstacle to disclosing HIV status and other barriers are the product of stigma. It seems that all programs should be directed towards destigmatization.


Subject(s)
Contact Tracing , HIV Infections , Qualitative Research , Humans , Iran/epidemiology , HIV Infections/epidemiology , HIV Infections/psychology , Male , Contact Tracing/methods , Female , Adult , Sexual Partners/psychology , Middle Aged , Social Stigma , Counseling
9.
Cien Saude Colet ; 29(5): e15552022, 2024 May.
Article in English | MEDLINE | ID: mdl-38747777

ABSTRACT

The conceptions, values, and experiences of students from public and private high schools in two Brazilian state capitals, Vitória-ES and Campo Grande-MS, were analyzed regarding digital control and monitoring between intimate partners and the unauthorized exposure of intimate material on the Internet. Data from eight focus groups with 77 adolescents were submitted to thematic analysis, complemented by a questionnaire answered by a sample of 530 students. Most students affirmed that they do not tolerate the control/monitoring and unauthorized exposure of intimate materials but recognized that such activity is routine. They point out jealousy, insecurity, and "curiosity" as their main reasons. They detail the various dynamics of unauthorized exposure of intimate material and see it as a severe invasion of privacy and a breach of trust between partners. Their accounts suggest that such practices are gender violence. They also reveal that each platform has its cultural appropriation and that platforms used by the family, such as Facebook, cause more significant damage to the victim's reputation.


Subject(s)
Focus Groups , Sexual Partners , Students , Humans , Brazil , Adolescent , Female , Male , Surveys and Questionnaires , Students/psychology , Sexual Partners/psychology , Internet , Intimate Partner Violence/statistics & numerical data , Privacy , Gender-Based Violence , Interpersonal Relations , Jealousy , Schools , Young Adult
10.
PLoS One ; 19(5): e0299034, 2024.
Article in English | MEDLINE | ID: mdl-38758930

ABSTRACT

BACKGROUND: The practice of female genital mutilation is associated with harmful social norms promoting violence against girls and women. Various studies have been conducted to examine the prevalence of female genital mutilation and its associated factors. However, there has been limited studies conducted to assess the association between female genital mutilation and markers of women's autonomy, such as their ability to negotiate for safer sex. In this study, we examined the association between female genital mutilation and women's ability to negotiate for safer sex in sub-Saharan Africa (SSA). METHODS: We pooled data from the most recent Demographic and Health Surveys (DHS) conducted from 2010 to 2020. Data from a sample of 50,337 currently married and cohabiting women from eleven sub-Saharan African countries were included in the study. A multilevel binary logistic regression analysis was used to examine the association between female genital mutilation and women's ability to refuse sex and ask their partners to use condom. Adjusted odds ratios (aORs) with a 95% confidence interval (CI) were used to present the findings of the logistic regression analysis. Statistical significance was set at p<0.05. RESULTS: Female genital mutilation was performed on 56.1% of women included in our study. The highest and lowest prevalence of female genital mutilation were found among women from Guinea (96.3%) and Togo (6.9%), respectively. We found that women who had undergone female genital mutilation were less likely to refuse sex from their partners (aOR = 0.91, 95% CI = 0.86, 0.96) and ask their partners to use condoms (aOR = 0.82, 95% CI = 0.78, 0.86) compared to those who had not undergone female genital mutilation. CONCLUSION: Female genital mutilation hinders women's ability to negotiate for safer sex. It is necessary to implement health education and promotion interventions (e.g., decision making skills) that assist women who have experienced female genital mutilation to negotiate for safer sex. These interventions are crucial to enhance sexual health outcomes for these women. Further, strict enforcement of policies and laws aimed at eradicating the practice of female genital mutilation are encouraged to help contribute to the improvement of women's reproductive health.


Subject(s)
Circumcision, Female , Safe Sex , Humans , Female , Circumcision, Female/psychology , Circumcision, Female/statistics & numerical data , Africa South of the Sahara/epidemiology , Adult , Safe Sex/statistics & numerical data , Young Adult , Adolescent , Middle Aged , Health Surveys , Negotiating , Sexual Partners/psychology , Condoms/statistics & numerical data
11.
Ann Behav Med ; 58(6): 422-431, 2024 May 23.
Article in English | MEDLINE | ID: mdl-38703112

ABSTRACT

BACKGROUND: The past 15 years have seen increasing attention to relationship factors among sexual minority male (SMM) couples at high risk for HIV infection. Research has largely focused on HIV prevention outcomes. Outcomes relevant to SMM living with HIV have received relatively less attention. PURPOSE: This study evaluated associations between relational covariates (relationship status, sexual agreements, and seroconcordance) and HIV care cascade outcomes (having a current antiretroviral therapy [ART] prescription, ART adherence, viral load (VL) testing, and VL detectability) above and beyond cannabis and stimulant drug use. METHODS: Adult SMM (n = 36,874) living with HIV in the USA were recruited between November 1, 2017 and March 15, 2020 through social networking applications. They completed a cross-sectional survey online. RESULTS: Nonmonogamous SMM with serodiscordant partners were most likely to have an ART prescription. Those with seroconcordant partners (regardless of sexual agreements) were least likely to be adherent. While relational covariates were not associated with VL testing, SMM in nonmonogamous relationships with serodiscordant partners were significantly more likely to have an undetectable VL. Those in monogamous relationships with seroconcordant partners were significantly less likely to have an undetectable VL. CONCLUSIONS: SMM with seroconcordant partners and monogamous sexual agreements may experience diminished interpersonal motivation for HIV care engagement. HIV care cascade retention messages that emphasize the prevention of onward transmission may have limited relevance for these SMM. Novel intervention strategies are needed to enhance HIV care outcomes in this population, ideally ones that incorporate attention to drug use.


The majority of people living with HIV in the USA are sexual minority men (SMM). Whereas substantial work has examined HIV prevention in male couples, relatively little has examined relationship factors associated with HIV care outcomes. This study examined whether relationship status, main partner serostatus (seroconcordant vs. serodiscordant), and sexual agreements (monogamous vs. nonmonogamous) were associated with HIV care cascade outcomes (having a current antiretroviral therapy [ART] prescription, ART adherence, viral load testing, and viral load detectability) above and beyond cannabis and stimulant drug use. We surveyed adult SMM (n = 36,874) living with HIV in the USA between November 2017 and March 2020. Across outcomes where significant between-group differences were observed, results generally indicated partnered SMM with serodiscordant partners­particularly those in nonmonogamous relationships­were more likely to be retained in the HIV care cascade; meanwhile, SMM with seroconcordant partners­particularly those in monogamous relationships­were most vulnerable to attrition in the HIV care cascade. Given this pattern of findings, it is conceivable that efforts to motivate linkage and retention along the HIV care cascade have emphasized the prevention of onward transmission while failing to capitalize on or acknowledge health enhancement as an additional (and coequal) source of motivation.


Subject(s)
HIV Infections , Medication Adherence , Sexual Partners , Sexual and Gender Minorities , Humans , Male , Adult , HIV Infections/drug therapy , HIV Infections/psychology , Sexual Partners/psychology , Sexual and Gender Minorities/psychology , United States , Cross-Sectional Studies , Middle Aged , Medication Adherence/psychology , Substance-Related Disorders/psychology , Sexual Behavior/psychology , Young Adult , Viral Load , Anti-Retroviral Agents/therapeutic use , Homosexuality, Male/psychology
12.
Sci Rep ; 14(1): 11732, 2024 05 22.
Article in English | MEDLINE | ID: mdl-38778131

ABSTRACT

Having people around, especially if they provide social support, often leads to positive outcomes both physically and mentally. Mere social presence is especially beneficial when it comes from a loved one or romantic partner. In these studies, we aim to expand the understanding of how the presence of one's romantic partner affects emotion regulation in parental situations. Specifically, we examined how partner presence influences the parent's emotional intensity, emotion regulation, and interpretation of their child's emotion regulation. We examined these questions in parents of both non-autistic children (Study 1) as well as autistic children (Study 2), which we hypothesize leads to more intense emotional interactions. The parents of autistic children were better able to regulate their emotions when their partners were present compared to when they were absent. Furthermore, in both studies, parents' ratings of their children's ability to regulate their emotions were higher when their parent's partner was present compared to when the partner was absent. However, in both studies, we found no significant difference in the parents' emotional intensity when their partners were present compared to when their partners were absent during the emotionally charged interaction with their child. Our findings help highlight the impact of partner presence on parent and child emotion regulation.


Subject(s)
Emotional Regulation , Parent-Child Relations , Parents , Humans , Male , Female , Child , Adult , Parents/psychology , Emotions , Autistic Disorder/psychology , Middle Aged , Social Support , Sexual Partners/psychology
13.
BMC Public Health ; 24(1): 1458, 2024 May 31.
Article in English | MEDLINE | ID: mdl-38822304

ABSTRACT

BACKGROUND/AIMS: The dapivirine vaginal ring is a self-administered, women-initiated, discreet, long-acting HIV-1 prevention option for women. It was found to be safe and effective in healthy HIV-negative women who adhered to product use instructions, and has been approved for use in women aged 18 and older in some African countries. A qualitative study was conducted to explore participants' and their male partners' discussions on accidental/purposeful vaginal ring removals during The Ring Study (IPM 027 clinical trial). METHODS: Data were collected via in-depth interviews and focus group discussions with female trial participants and their male partners, from seven research centres in South Africa and Uganda. Data were thematically analysed using NVivo. RESULTS: More participants reported purposeful ring removals than accidental expulsions. Various factors influenced purposeful ring removal - including individual (discomfort during use/sex and to clean it), partner (to show them, because of discomfort during sex, to test if partners could feel it, and concerns of harm), organisational (doctor's request), and socio-cultural (rumours about sickness and infertility). Some described their own ring use removal, others discussed why other participants removed their rings. CONCLUSIONS: Vaginal ring adherence is critical to improve and support product efficacy. Counselling on vaginal anatomy, vaginal ring insertion and importance of adherence is important to minimise vaginal ring removal. Couples counselling is also important to facilitate support and long-term vaginal ring adherence behaviour. Understanding factors influencing vaginal ring adherence is important for tailoring and targeting messages to support correct and consistent vaginal ring use as it is made available to the public.


Subject(s)
Contraceptive Devices, Female , HIV Infections , Pyrimidines , Qualitative Research , Sexual Partners , Humans , Female , Male , Adult , South Africa , Pyrimidines/administration & dosage , Uganda , HIV Infections/prevention & control , Sexual Partners/psychology , Young Adult , Self Report , Focus Groups , Device Removal , Middle Aged , Interviews as Topic , Adolescent , Anti-HIV Agents/administration & dosage , Anti-HIV Agents/therapeutic use
14.
Hum Reprod ; 39(6): 1323-1335, 2024 Jun 03.
Article in English | MEDLINE | ID: mdl-38689464

ABSTRACT

STUDY QUESTION: Does medically assisted reproduction (MAR) use among cisgender women differ among those with same-sex partners or lesbian/bisexual identities compared to peers with different-sex partners or heterosexual identities? SUMMARY ANSWER: Women with same-sex partners or lesbian/bisexual identities are more likely to utilize any MAR but are no more likely to use ART (i.e. IVF, reciprocal IVF, embryo transfer, unspecified ART, ICSI, and gamete or zygote intrafallopian transfer) compared to non-ART MAR (i.e. IUI, ovulation induction, and intravaginal or intracervical insemination) than their different-sex partnered and completely heterosexual peers. WHAT IS KNOWN ALREADY: Sexual minority women (SMW) form families in myriad ways, including through fostering, adoption, genetic, and/or biological routes. Emerging evidence suggests this population increasingly wants to form genetic and/or biological families, yet little is known about their family formation processes and conception needs. STUDY DESIGN, SIZE, DURATION: The Growing Up Today Study is a US-based prospective cohort (n = 27 805). Participants were 9-17 years of age at enrollment (1996 and 2004). Biennial follow-up is ongoing, with data collected through 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS: Cisgender women who met the following criteria were included in this sample: endorsed ever being pregnant; attempted a pregnancy in 2019 or 2021; and endorsed either a male- or female-sex partner OR responded to questions regarding their sexual identity during their conception window. The main outcome was any MAR use including ART (i.e. procedures involving micromanipulation of gametes) and non-ART MAR (i.e. nonmanipulation of gametes). Secondary outcomes included specific MAR procedures, time to conception, and trends across time. We assessed differences in any MAR use using weighted modified Poisson generalized estimating equations. MAIN RESULTS AND THE ROLE OF CHANCE: Among 3519 participants, there were 6935 pregnancies/pregnancy attempts and 19.4% involved MAR. A total of 47 pregnancies or pregnancy attempts were among the same-sex partnered participants, while 91 were among bisexual participants and 37 among lesbian participants. Participants with same-sex, compared to different-sex partners were almost five times as likely to use MAR (risk ratio [95% CI]: 4.78 [4.06, 5.61]). Compared to completely heterosexual participants, there was greater MAR use among lesbian (4.00 [3.10, 5.16]) and bisexual (2.22 [1.60, 3.07]) participants compared to no MAR use; mostly heterosexual participants were also more likely to use ART (1.42 [1.11, 1.82]) compared to non-ART MAR. Among first pregnancies conceived using MAR, conception pathways differed by partnership and sexual identity groups; differences were largest for IUI, intravaginal insemination, and timed intercourse with ovulation induction. From 2002 to 2021, MAR use increased proportionally to total pregnancies/pregnancy attempts; ART use was increasingly common in later years among same-sex partnered and lesbian participants. LIMITATIONS, REASONS FOR CAUTION: Our results are limited by the small number of SMW, the homogenous sample of mostly White, educated participants, the potential misclassification of MAR use when creating conception pathways unique to SMW, and the questionnaire's skip logic, which excluded certain participants from receiving MAR questions. WIDER IMPLICATIONS OF THE FINDINGS: Previous studies on SMW family formation have primarily focused on clinical outcomes from ART procedures and perinatal outcomes by conception method, and have been almost exclusively limited to European, clinical samples that relied on partnership data only. Despite the small sample of SMW within a nonrepresentative study, this is the first study to our knowledge to use a nonclinical sample of cisgender women from across the USA to elucidate family formation pathways by partnership as well as sexual identity, including pathways that may be unique to SMW. This was made possible by our innovative approach to MAR categorization within a large, prospective dataset that collected detailed sexual orientation data. Specifically, lesbian, bisexual, and same-sex partnered participants used both ART and non-ART MAR at similar frequencies compared to heterosexual and different-sex partnered participants. This may signal differential access to conception pathways owing to structural barriers, emerging conception trends as family formation among SMW has increased, and a need for conception support beyond specialized providers and fertility clinics. STUDY FUNDING/COMPETING INTEREST(S): The research reported in this publication was supported by the National Institute on Minority Health and Health Disparities of the National Institutes of Health (NIH), under award number R01MD015256. Additionally, KRSS is supported by NCI grant T32CA009001, AKH by the NCI T32CA057711, PC by the NHLBI T32HL098048, BM by the Stanford Maternal Child Health Research Institute Clinical Trainee Support Grant and the Diversity Fellowship from the American Society for Reproductive Medicine Research Institute, BGE by NICHD R01HD091405, and SM by the Thomas O. Pyle Fellowship through the Harvard Pilgrim Health Care Foundation and Harvard University, NHLBI T32HL098048, NIMH R01MH112384, and the William T. Grant Foundation grant number 187958. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The first author recently had a leadership role in the not-for-profit program, The Lesbian Health Fund, a research fund focused on improving the health and wellbeing of LGBTQ+ women and girls. The fund did not have any role in this study and the author's relationship with the fund did not bias the findings of this manuscript. TRIAL REGISTRATION NUMBER: N/A.


Subject(s)
Reproductive Techniques, Assisted , Sexual Partners , Sexual and Gender Minorities , Humans , Female , Prospective Studies , Sexual and Gender Minorities/statistics & numerical data , Sexual and Gender Minorities/psychology , Adult , Sexual Partners/psychology , Pregnancy , Male , Heterosexuality/statistics & numerical data , Heterosexuality/psychology
15.
J Adolesc Health ; 75(1): 69-75, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38739051

ABSTRACT

PURPOSE: Intimate partner violence (IPV) and substance use in adolescents and young adults (AYAs) are significant public health issues in the United States. Together, they can harm emotional regulation and romantic relationship functioning. This study examines the role of concordant and discordant substance use on IPV within AYA relationships. METHODS: A prospective cohort of community-recruited AYA women in a heterosexual dating relationship with past-month IPV completed four months of daily surveys via a cell phone. Each day, participants reported any IPV perpetration and/or victimization, their alcohol and drug use, and observed partner substance use. Concordant substance use was coded when the participant and partner used drugs or alcohol on the same day. Discordant use was coded when only the participant or partner used drugs or alcohol on a given day. Alcohol and drug use were modeled separately. Generalized estimating equations accounted for the correlation of repeated measures. RESULTS: Participants (N = 143) were 18.2 (1.1) years old, 93% African American race. Discordant alcohol and drug use was associated with same-day victimization, perpetration, and co-occurring violence compared to concordant nonuse. Similarly, concordant alcohol use, drug use, and alcohol/drug use were associated with increased odds of victimization, perpetration, and co-occurring violence compared to concordant nonuse. DISCUSSION: Daily data illustrated that dyadic patterns of substance use are associated with IPV. These findings may facilitate the development of effective and developmentally appropriate IPV intervention programs for AYA that also integrate strategies to reduce substance use.


Subject(s)
Intimate Partner Violence , Substance-Related Disorders , Humans , Female , Intimate Partner Violence/psychology , Intimate Partner Violence/statistics & numerical data , Adolescent , Substance-Related Disorders/psychology , Young Adult , Prospective Studies , Crime Victims/psychology , Crime Victims/statistics & numerical data , Male , United States , Sexual Partners/psychology , Risk Factors
16.
Soc Sci Med ; 351: 116941, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38749254

ABSTRACT

Sexual minority male (SMM) couples tend toward behavioral similarity around cannabis use, illicit drug use, and sex with casual partners. Similarity in these behaviors may contextualize associations with relationship quality. This study tested the hypotheses that perceptions of partner (cannabis and illicit) drug use and sexual behavior would predict personal drug use and sexual behavior as well as moderate the association between relationship quality and these health outcomes. Recruitment via social networking applications yielded a sample of 5511 cisgender SMM aged 18-85 (M = 38.21, SD = 12.16) who were in a relationship with an adult cisgender male main partner. Respondents completed an online survey assessing their own cannabis use, illicit drug use, and condomless anal sex (CAS) with casual partners during the past 30 days as well as their belief about their partner's engagement in these behaviors. Three subscales of the Perceived Relationship Quality Components (PRQC) scale assessed relationship quality. Across the observed range of PRQC scores participants who reported their partner used cannabis, used other illicit drugs, and had recent CAS with a casual partner were more likely to report engaging in these activities themselves. Among participants who indicated their partner did not engage in these activities, relationship quality was negatively associated with personal cannabis use (OR = 0.985, p < 0.001), illicit drug use (OR = 0.973, p < 0.001), and CAS with casual partners (OR = 0.979, p < 0.001); meanwhile, among those who reported their partner engaged in these behaviors - relationship quality was positively associated with the odds of these behaviors (OR = 1.018, p < 0.001; OR = 1.015, p < 0.001; OR = 1.019, p = 0.015 for cannabis, illicit drug use and CAS with casual partners respectively). These findings suggest that perceptions of a partner's behavior contextualize associations between relationship quality and personal behavioral risk. Results emphasize the importance of integrating components that support relationship quality into behavioral health interventions for SMM couples and SMM in relationships.


Subject(s)
Sexual Partners , Sexual and Gender Minorities , Substance-Related Disorders , Humans , Male , Adult , Sexual and Gender Minorities/psychology , Sexual and Gender Minorities/statistics & numerical data , Middle Aged , Aged , Adolescent , Sexual Partners/psychology , Substance-Related Disorders/psychology , Substance-Related Disorders/epidemiology , Unsafe Sex/psychology , Unsafe Sex/statistics & numerical data , Aged, 80 and over , Surveys and Questionnaires , Protective Factors , Young Adult , Risk Factors , Sexual Behavior/psychology
17.
Arch Sex Behav ; 53(6): 2173-2188, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38755505

ABSTRACT

Latin America comprises 20 countries and 14 dependent territories throughout the Western Hemisphere. It is a diverse and plural region in terms of its geography, cultures, languages, and historical experiences, with fifteenth-century colonialism as a common denominator. Two areas in which the lingering effects of coloniality seem clearly ever-present are the realms of gender and sexuality. The latter encompasses sexual fantasies, a subject of focus in this article. The examination of sexual fantasies remains a ripe area for future research, particularly throughout the Global South, where its linkages to coloniality should be explored in detail. To contribute to this larger and long-term goal, we implemented an online qualitative study designed to document the sexual fantasies of Spanish-speaking individuals living in the Latin American region. We developed a data-gathering form that included open-ended questions to document sexual fantasies. The form was available through the JotForm online platform that was linked to the study webpage entitled "A Calzón Quita'o." We conducted a thematic analysis to identify response patterns. Three main categories emerged from: (1) spatiotemporal references, (2) multiple partners, and (3) power, control, and rough sex. We relied on perspectives linked to ongoing discussions about coloniality to analyze the thematic content in the participants' responses regarding their sexual fantasies. The findings highlight the existing tensions between the reproduction of-and resistance to-the norms associated with gender roles and their embodiment within the framework of the gender binary inherited from coloniality.


Subject(s)
Colonialism , Sexual Behavior , Humans , Latin America , Male , Female , Sexual Behavior/psychology , Adult , Erotica/psychology , Fantasy , Middle Aged , Sexual Partners/psychology , Imagination , Young Adult , Qualitative Research
18.
Clin Psychol Rev ; 111: 102447, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38781717

ABSTRACT

Committed romantic relationships between two individuals with Substance Use Disorder (or dual-SUD couples) are prevalent. Dual-SUD couples have poor treatment engagement and outcomes. Research has established a reciprocal link between relationship dynamics (e.g., conflict, intimacy) and substance use. Thus, the couple's relationship presents a distinct social context for both partner's substance use. Dual-SUD couples face unique challenges due to substance use being a shared behavior that may serve as a rewarding source of compatibility, closeness, and short-term relationship satisfaction despite it being at the cost of other alternative sources of substance-free reinforcement. Yet, treatment options for these couples are scarce. Dual-maladaptive health behaviors (e.g., dual-substance use) are challenging to treat; however, theory and preliminary research suggests that transformation of couple's joint motivation toward adaptive health behavior change may result in a more satisfying relationship and improved treatment outcomes for both individuals. The current paper reviews the extant literature on dual-SUD couples from theoretical, empirical, and treatment research and proposes an expanded paradigm regarding how we understand dual-SUD couples with the aim of informing basic research and treatment development.


Subject(s)
Interpersonal Relations , Substance-Related Disorders , Humans , Substance-Related Disorders/psychology , Substance-Related Disorders/therapy , Models, Psychological , Diagnosis, Dual (Psychiatry) , Sexual Partners/psychology
19.
BMJ Glob Health ; 9(5)2024 May 24.
Article in English | MEDLINE | ID: mdl-38789276

ABSTRACT

INTRODUCTION: Although sexual health has been holistically defined to include sexual satisfaction, it has been largely absent in health services and sexual and reproductive health and rights programmes in many parts of the world. We propose sexual satisfaction as a useful indicator, as one of the proxy measures for sexual health and well-being and as a component of well-being in general. METHODS: The Sialon II project is a multicentre biological and behavioural cross-sectional community-based survey implemented across 13 European cities during 2013-2014 among men who have sex with men. Sexual satisfaction was explored using one single item: 'How satisfied are you with your sex life?' A multivariable multilevel logistic random-intercept model was estimated to identify factors associated with reporting positive sexual satisfaction versus negative sexual satisfaction. RESULTS: Age, the number of partners and self-reported HIV status were not significantly associated with sexual satisfaction in the multivariate model. Participants reporting an insertive role or reported both an insertive and receptive role during the last anal intercourse were more likely to be sexually satisfied, compared with a receptive role. Participants reporting anal intercourse with a condom were more likely to be satisfied than those declaring no anal intercourse in the last 6 months, but no significant association was found compared with anal intercourse without condom. Knowledge of HIV-serostatus concordance with the last sexual partner was positively correlated with sexual satisfaction. Having had sexual intercourse with non-steady partners only in the last 6 months was negatively correlated. The more positive participants perceived their work/school, parents and friends/acquaintances' attitudes towards gay or bisexual persons, the higher the odds they were satisfied with their sexual life. CONCLUSION: Using a single item on sexual satisfaction in a bio-behavioural study, our analysis has shown that it is associated with individual, interpersonal and social/structural factors and has proven its usefulness as a sexual health indicator among men who have sex with men.


Subject(s)
HIV Infections , Homosexuality, Male , Personal Satisfaction , Sexual Health , Sexually Transmitted Diseases , Humans , Male , Adult , Europe , Cross-Sectional Studies , HIV Infections/prevention & control , Homosexuality, Male/psychology , Sexually Transmitted Diseases/prevention & control , Middle Aged , Young Adult , Sexual Behavior , Adolescent , Sexual Partners/psychology , Surveys and Questionnaires
20.
PLoS One ; 19(4): e0299069, 2024.
Article in English | MEDLINE | ID: mdl-38626011

ABSTRACT

Reproductive coercion and abuse is a hidden and poorly recognised form of violence against women. It refers broadly to behaviours that interfere with or undermine a person's reproductive autonomy, specifically to promote or prevent pregnancy. Reproductive coercion and abuse can involve physical, sexual, financial or psychological abuse in order to achieve these aims, and is overwhelmingly perpetrated by men against women. As an emerging field of scholarship, conceptual understanding of reproductive coercion and abuse is still in its infancy; however, it is often described as being linked to coercive control. In this article, we seek to highlight the complexity of this relationship through qualitative analysis of in-depth interviews with 30 victim/survivors in Australia recruited from the community, focusing on their perceptions of the perpetrator's motivations. We developed four themes from our analysis: 1) His needs came first; 2) The illusion of a perfect father; 3) Creating a weapon of control; and 4) My body was his. Perceived perpetrator motivations ranged from entitlement and self-interest to a deep desire for domination and entrapment. Pregnancy preventing behaviour was more likely to be linked with entitlement and self-interest, whereas pregnancy promoting behaviour tended to be described by participants in relationships where there was a broader pattern of ongoing control and entrapment. Thus, we suggest that coercive control is a motivating factor for some, but not all men who perpetrate reproductive coercion and abuse. A greater understanding perpetrator motivations may be important for practitioners, particularly those working in sexual and reproductive health services, since it could be relevant to women's level of risk for coercive controlling behaviour or more extreme forms of physical or sexual violence.


Subject(s)
Intimate Partner Violence , Sex Offenses , Male , Pregnancy , Humans , Female , Coercion , Motivation , Sexual Behavior , Sexual Partners/psychology , Sex Offenses/psychology , Intimate Partner Violence/psychology
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