Changes In Sexual Practices Research Articles

Acceptance and Commitment Therapy for Hypersexuality: A Pilot Study

Hypersexuality refers to the inability to control sexual desire. Despite it has shown serious consequences for physical, psychological and social health, the evidence of available psychological interventions is still insufficient. In this open-label pilot study, an Acceptance and Commitment Therapy (ACT) intervention was conducted with adults with clinically significant levels of hypersexuality aimed to examine its feasibility and usefulness. The intervention consisted of eight weekly online individual psychological intervention sessions. Outcome self-report measures were administered at baseline, after the intervention and a 3 months follow-up. Behavioral and subjective informed changes in sexual practices were weekly assessed through self-monitoring. Twelve participants (M age = 38.8 ± 11.5 years, 83.3% male, 66.7% homo or bisexual) completed the intervention. The feasibility was found to be good, with all the participants completing the training and high levels of satisfaction. Hypersexuality, psychological flexibility, cognitive fusion and mindfulness scores significantly improved after the ACT intervention, with large effect sizes. Clinically significant changes in hypersexuality were found for the vast majority of participants, besides reductions in the time dedicated to planning and practicing sex and the sexualized drug use. Results indicate that ACT-based interventions may be considered feasible and potentially effective therapeutic alternatives for hypersexuality.

Early sexual experiences of adolescent men who have sex with men

Background There are limited studies examining the early experiences of adolescent men who have sex with men (MSM), and the magnitude of changes in sexual practice among adolescent MSM is unclear. Therefore, we compared the sexual practice and trajectory among adolescent men who are MSM aged 16–20 years in two cohorts, 5 years apart in Melbourne, Australia. Methods A total of 200 self-identified same-sex attracted men aged 16–20 years were recruited in each of HYPER1 (2010–2012) and HYPER2 (2017–2018) using similar methodology. Men completed a questionnaire about their sexual practices. Men were also asked to report the age of first sex with different sexual activities with men and women. Results Compared to HYPER1, the median age at first sex with men was slightly increased in HYPER2: receiving oral sex (17.2 years in HYPER2 vs 16.5 years in HYPER1), performing oral sex (17.3 years vs 16.4 years), receptive anal sex (18 years vs 17.0 years) and insertive anal sex (18 years vs 17.3 years). Similar patterns were also observed in sexual practice with women: performing oral sex (17.0 years in HYPER2 vs 16.8 years in HYPER1), receiving oral sex (17.0 years vs 16.3 years) and vaginal sex (17.0 years vs 16.7 years). Conclusions In general, there was a small delay in first-sex activity among adolescent MSM between two cohorts 5 years apart. Most adolescent MSM started their sexual practices before the age of 18 years and have engaged in activities that are at risk of HIV and STI. Health education and promotion, including regular sexual health check-ups, are important for HIV and STI prevention and intervention in this population.

Mpox knowledge, vaccination and intention to reduce sexual risk practices among men who have sex with men and transgender people in response to the 2022 mpox outbreak: a cross-sectional study in Victoria, Australia.

The first mpox case was reported in May 2022 in Australia. Most cases have been diagnosed in men who have sex with men (MSM). This study aimed to examine community understanding of mpox, attitudes towards vaccination, and potential changes in sexual practices surrounding the mpox outbreak among MSM and transgender people in Victoria, Australia. Participants were recruited from sexual health clinics and communities in Victoria, Australia, in August-October 2022. Participants were asked about their understanding and knowledge of mpox, vaccination uptake and intentions to change sexual practices. Univariable and multivariable logistic regression was performed to examine the factors associated with mpox vaccine uptake. Most participants (97.8%, 525/537) had heard about mpox and 10.5% (55/525) knew someone who had had mpox. Of the 12 mpox knowledge questions, the median score of correct answers was 10 (IQR=8-11) out of a maximum of 12. More than a third (36.6%, 191/522) had been vaccinated against mpox. MSM who had a good knowledge of mpox had the highest odds of receiving mpox vaccine compared with those who had poor knowledge (aOR=4.05; 95% CI: 1.54-10.61). To prevent mpox, half reported they would reduce having sex with casual partners, stop having chemsex (used drugs for the purpose of sex), stop attending sex-on-premises-venues, and stop having group sex. A quarter reported they would increase condom use for anal sex. One-third of high-risk participants and a substantial proportion of participants intended to reduce or stop certain practices, which may explain the large reduction in mpox cases.

‘I did not have sex outside of our bubble’: changes in sexual practices and risk reduction strategies among sexual minority men in Canada during the COVID-19 pandemic

In efforts to prevent the spread of COVID-19, jurisdictions across the globe, including Canada, enacted containment measures that affected intimacy and sexual relations. This article examines how public health measures during COVID-19 impacted the sexual practices of sexual minority men— gay, bisexual, queer and other men who have sex with men—and how they adopted and modified guidelines to prevent the transmission of COVID-19, HIV and other sexually transmitted infections (STIs). We conducted 93 semi-structured interviews with men (n = 93) in Montreal, Toronto and Vancouver, Canada, between November 2020 to February 2021 (n = 42) and June to October 2021 (n = 51). Across jurisdictions, participants reported changes to sexual practices in response to public health measures and shifting pandemic contexts. Many men indicated that they applied their HIV/STI risk mitigation experiences and adapted COVID-19 prevention strategies to continue engaging in casual sexual behaviours and ensure sexual safety. ‘Social bubbles’ were changed to ‘sex bubbles’. Masks were turned into ‘safer’ sex tools. ‘Outdoor gathering’ and ‘physical distancing’ were transformed into ‘outdoor sex’ and ‘voyeuristic masturbation’. These strategies are examined in connection to the notion of ‘reflexive mediation’ to illustrate how sexual minority men are simultaneously self-responsibilising and resistant, self-monitoring and creative.

Assessing the Impact of HIV Preexposure Prophylaxis Scale-Up on Gonorrhea Incidence Among Gay and Bisexual Men in Sydney: A Mathematical Modeling Study.

The rollout of preexposure prophylaxis (PrEP) for HIV prevention among gay and bisexual men (GBM) is associated with increases in condomless anal intercourse, potentially increasing the incidence of other sexually transmissible infections (STIs). We developed an individual-based mathematical model to simulate the transmission of Neisseria gonorrhoeae among GBM in Sydney, accounting for changes in sexual practices, STI testing, and PrEP use. We calibrated and validated the model using reported incidence rates for HIV-positive and HIV-negative GBM from 2010 to 2019. Scenarios were run with varying PrEP uptake, PrEP-related STI testing, and PrEP-related sexual behavior and testing intervals up to 2030 to assess the impact of PrEP use on gonorrhea incidence. Preexposure prophylaxis uptake and associated 3-monthly STI testing from 2015 onward resulted in a predicted increase from 20 to 37 N. gonorrhoeae infections per 100 person-years among HIV-negative GBM by the end of 2020. This is lower than the counterfactual predictions of 45 per 100 person-years if PrEP were not scaled up and 48 per 100 person-years with nonadherence to 3-monthly STI testing. Increasing the time between STI tests for PrEP users by 1 month from 2018 results in the incidence rate among HIV-negative GBM increasing by 8% by 2030. If PrEP coverage doubles from 24% to 53%, incidence among HIV-negative GBM declines by ~25% by 2030. Behavior change due to widespread PrEP use may lead to significant increases in gonorrhea incidence in GBM, but the recommended quarterly STI testing recommended for PrEP users should reduce incidence by 18% by 2030.

"Compared to COVID, HIV Is Nothing": Exploring How Onshore East Asian and Sub-Saharan African International Students in Sydney Navigate COVID-19 versus BBVs/STIs Risk Spectrum.

Background: While a large body of evidence indicates changes in alcohol and other drug use among young people as a result of the COVID-19 pandemic, there is a lack of evidence around changes in sexual practices and how the pandemic may be impacting the potential spread of blood-borne viruses and sexually transmissible infections (BBVs/STIs). Most of what we know about sex during COVID-19 lockdowns is largely based on solitary sexual practices, which may not answer the critical question around how the pandemic may be shaping sexual practices among young people. Against this backdrop, this study explored how the COVID-19 pandemic may be shaping BBVs/STIs risk and protective practices among a sample of onshore African and Asian international students in Sydney, Australia. Methods: This phenomenological qualitative study involved semi-structured telephone and face-to-face interviews with 16 international university students in Sydney, between September 2020–March 2021. Generated data were coded using NVivo and analysis was guided by reflexive thematic analysis. Results: Participants reported elevated mental health distress because of the COVID-19 pandemic. Some participants reported engaging in casual sexual hook-ups as a strategy to mitigate the mental health distress they were experiencing. Some of these sexual hook-ups were condomless partly because COVID-related disruptions impacted condom accessibility. Additionally, the preventive practices of some participants who were sexually active during the lockdowns were focused on preventing COVID-19, while the risk of BBVs/STIs were downplayed. Conclusions: This study indicates a need for a comprehensive public health response to the evolving and near-endemic COVID-19 situation. Such a comprehensive approach should focus on empowering young people to prevent both SARS-CoV-2 and BBVs/STIs.

HPV: Impact on Women’s Lives

The increase in the rates of Sexually Transmitted Infections (STIs) has been considering the behavioral change in sexual practices in society, being transmitted through sexual contact (oral, vaginal and anal) without the use of condoms, which can still occur in the form of vertical transmission during pregnancy, childbirth and through breastfeeding [1].

Behavior Change and Sexually Transmitted Incidence in Relation to PREP Use Among Men Who Have Sex with Men in Kenya

We measured change in sexual practices and the incidence of C. trachomatis (CT) and N. gonorrhoeae (NG) within a prospective cohort of Kenyan MSM taking PrEP in Kenya. Over the one year of study participation, CT and NG were diagnosed in urine at baseline, 6- and 12- months. Multivariable Cox regression identified factors associated with incident infection. Sexual practices were assessed at baseline and every 3months. We evaluated changes over time and in relation to PrEP adherence via generalized estimating equation analysis. From October 2017-January 2018, 158 participants initiated PrEP, having 10.3% baseline CT/NG prevalence (either or both). The incidence was 17.2 cases per 100 person-years (95% CI 11.7-25.5). Incident CT/NG increased with report of: transactional male sex partner (adjusted Hazard Ratio (aHR) = 2.46, p = 0.016, z = 2.40), regular female sex partner (aHR = 2.22, p = 0.051, z = 1.96), greater social support (highest vs. lowest quartile, aHR = 6.24, p = 0.012, z = 2.51), and CT/NG infection prior to enrollment (aHR = 2.90, p = 0.002, z = 3.03). Multiple sex partners, condomless sex, and transactional sex decreased over time and were not associated with PrEP adherence. Urethral CT/NG incidence remained high and there was no evidence of PrEP-related behavioral change. There is need for ongoing etiologic testing, improved understanding of risk from female sex partners, and development of more effective risk reduction interventions.

IMPACT OF COVID-19 ON THE SEXUALITY OF A SAMPLE OF MOROCCAN PATIENTS RECOVERED FROM THE CORONA VIRUS

Since December 2019, the COVID-19 pandemic has known a rapid and distressing spread. Little is known about the sexual impact on infected patients. However, several studies have reported a significant psychological impact on the population.The objective of our study is to assess the impact of the COVID19 pandemic on the sexuality of individuals who have been infected with the virus.Our study focuses on a population of 50 Moroccan patients initially declared to have COVID-19, using a multiple choice questionnaire on sexuality before and after infection with the virus. All participants were part of a couple in which at least one of the two partners had been infected with SARS-CoV-2.The results showed that all subjects were sexually active before their infection, of which 20% were dissatisfied with their sex life. At the time of our study, 78% of the recovered patients had not resumed sexual activity. 60% said they were anxious about having sex and 81% said the pandemic had altered their sex life. Only one patient reports an increase in libido and an improvement in the quality of orgasm. A couple reported having resumed sexual activity but with a change in their relationships.Anxiety and fear of infecting the other are major concerns, which affect the resumption of normal sexual activity and which sometimes lead to a change in sexual practices.

Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia

ObjectivesIn the 2010s, there has been an increase in sexually transmitted infections (STI) in men who have sex with men (MSM) in Australia, and since 2015 also in urban heterosexuals....

Risky Sexual Practice, Sexually Transmitted Infection and Associated Factors Among Newly Diagnosed HIV-positive People in Northwest Ethiopia.

PurposeRisky sexual practice expose for the acquisition of sexually transmitted infection (STI) including human immunodeficiency virus (HIV). This study was conducted to fill the knowledge gap on the prevalence of risky sexual practice, STIs and associated factors among newly diagnosed HIV-positive people in northwest Ethiopia.Patients and MethodsThis study was a cross-sectional study design which was conducted on 745 newly diagnosed HIV patients. An interviewer-administered questionnaire was used to interview patients within seven days of HIV diagnosis using client exit interview approach. Data were entered to EpiData and exported to SPSS version 24 for analysis. Binary logistic regression analysis was employed to select factors for multivariate logistic regression at p-value of less than 0.25. Two separate logistic regression models were used for risky sexual practice and STI as dependent variables. The strength of statistical association was quantified using an adjusted odds ratio (AOR) with a 95% confidence level.ResultsThe prevalence of risky sexual practices and STIs among newly diagnosed HIV-positive people were 15.8% (95%CI: 13.1–18.4) and 6.6% (95%CI: 4.8–8.5), respectively. Although there were no statistically significant factors associated with STI, having two or more lifetime sexual partners (AOR=3.19; 95%CI: 1.57–6.49) and frequent use of alcohol (AOR=3.10; 95%CI: 1.34–7.19) were the factors associated with risky sexual practice.ConclusionRisky sexual practice and STI were found to be low among newly identified HIV patients. Factors associated with risky sexual practice failed to explain STI diagnosis using the syndromic approach. Therefore, revisiting the definition of risky sexual practice is necessary for the universal test and treat approach since sustained viral suppression may leave the need for consistent use of condoms among HIV patients who are on ART especially with regular sexual partners. Further study is also recommended to measure changes in sexual practice after initiating antiretroviral therapy.

Chlamydia and Gonorrhea: Shifting Age-Based Positivity Among Young Females, 2010–2017

Introduction:This study aims to determine if and how the age distribution of Chlamydia trachomatis and Neisseria gonorrhoeae infections in women evolved from 2010 to 2017, given changes in sexual practices over this time.Methods:All Chlamydia trachomatis/Neisseria gonorrhoeae co-testing laboratory results from females aged 12–30 years tested at Quest Diagnostics during 2010–2017 (n=17,794,680) were evaluated to assess trends in Chlamydia trachomatis and Neisseria gonorrhoeae positivity over time. Data were collected and analyzed in November 2018.Results:Age-based positivity shifted toward older ages from 2010 to 2017 for both Chlamydia trachomatis and Neisseria gonorrhoeae. There was a declining trend in Chlamydia trachomatis positivity from 2010 to 2017 for the youngest age group (12–17 years; 17% decline, 8.9% to 7.4%, p<0.0001) but increasing trends for both those aged 18–24 years (21% increase, 6.1% to 7.4%, p<0.0001) and 25–30 years (50% increase, 2.2% to 3.3%, p<0.0001). The Chlamydia trachomatis positivity rate for 27-year-olds in 2017 (3.5%) and 24-year-olds in 2010 (3.5%) was the same. Similarly, there was a declining trend in Neisseria gonorrhoeae positivity from 2010 to 2017 for the youngest age group (12–17 years; 14% decline, 1.33% vs 1.17%, p<0.0001) but increasing trends for both those aged 18–24 years (27% increase, 0.79% vs 1.00%, p<0.0001) and 25–30 years (117% increase, 0.29% vs 0.63%, p<0.0001). For Neisseria gonorrhoeae, 30-year-old women tested in 2017 had an identical positivity rate to 23-year-old women tested in 2010, at 0.5%.Conclusions:Healthcare providers may want to consider this positivity rate age shift in Chlamydia trachomatis and Neisseria gonorrhoeae to inform prevention and control strategies, including considering the potential for increased risk in women aged 25–30 years.

Young People, Sexuality and the Age of Pornography

Recently interest into the effects of pornography on children and young people’s sexual development has increased leading to an increase in studies in the area, laws being changed and public concern growing. This paper aims to recap these findings including more recent studies carried out in the UK. The literature shows links between viewing pornography and sexually explicit material and young people’s attitudes and behaviours. This suggests that young people’s sexuality is affected by sexual imagery and that this influences children and young people’s sexual attitudes and behaviours. The impact is contingent on the young person’s support network, social learning and other demographic factors, not least gender which has been consistently found to be significant. Recent studies have found changes in sexual practices of young people which are attributed to viewing pornography such as an increase in anal sex and casual attitudes to consent. Links between porn use and sexual coercion have also been found. How and in what ways children and young people are affected by such imagery—and what can be done to reduce the negative impact on young people is debated in the light of the gaps in the literature and the issues with the existing literature. Further need for study is discussed.

Sexual practices of female sex workers in Melbourne, Australia: an anonymous cross-sectional questionnaire study in 2017-18.

This cross-sectional study was conducted among FSW at Melbourne Sexual Health Centre between September 2017 and March 2018. Participants were asked about current sexual practices with male clients in an average working week. The frequency and proportion of each sexual practice was calculated. There were 180 questionnaires included in the analysis. The median age of the FSW was 28 years (interquartile range [IQR]: 25-34). Most FSW (80.6%) worked in brothels. In an average working week, FSW had a median of 10 (IQR: 7-20) male clients. The most common sexual practices included: vaginal sex (98.3%), fellatio (97.2%), cunnilingus (92.2%) and tongue-kissing (83.7%). FSW had a median number of 10 (IQR: 6-18) vaginal, 10 (IQR: 5-18) fellatio, 7 (IQR: 2-10) cunnilingus and 6 (IQR: 2-10) tongue-kissing clients. Consistent condom use with all clients was highest for vaginal sex (97.1%), followed by anal sex (92.3%), then fellatio (78.9%). Only 3.1% used dental dams consistently for cunnilingus. Consistent condom use with all clients was high among FSWs, especially for vaginal and anal sex. However, one-fifth of FSW had condomless fellatio during an average working week. Tongue-kissing was more common than previously published. Peer-led sexual health education on safe sex practice for FSW is of high importance.

Clinical presentation of asymptomatic and symptomatic women who tested positive for genital gonorrhoea at a sexual health service in Melbourne, Australia.

Gonorrhoea cases in women have been rising in Australia in the 2010s but the cause of the increase is not well understood. This cross-sectional study aimed to describe the characteristics of genital gonorrhoea infection in women attending the Melbourne Sexual Health Centre, Australia. Gonorrhoea cases were diagnosed by nucleic acid amplification test (NAAT) and/or culture. Genitourinary specimens were obtained in 12 869 clinic visits in women aged 16 years or above between August 2017 and August 2018. Genital gonorrhoea was detected in 142 (1.1%) of the visits. Almost half of the cases were asymptomatic, 47.9% [95% confidence interval (CI) 39.8-56.1%]; yellow, green or pus-like vaginal discharge was present in 11.3% (95% CI 7.0-17.6%) and other genital symptoms in 40.8% (95% CI 33.1-49.1%) of the cases. The mean time between last sexual contact and onset of symptoms was 7.3 days and between the onset of symptoms to presentation to the clinic was 12.1 days. Half of the cases of genital gonorrhoea among women are asymptomatic and these cases would have been missed by testing of only symptomatic women. Further epidemiological and behavioural research is required to understand the temporal changes in sexual practices among women in Australia.

Oral Transmission of Sexually Transmissable Infections: A Narrative Review.

Over the last few decades, behavioral changes in sexual practices have made oral transmission of traditional sexually transmissibleinfections increasingly recognized. Patients harboring a sexually transmissible infection may first present lesions on the oral cavity,as these may be visible and interfere with basic functions such as speech or swallowing. Moreover, the oral cavity may function asa reservoir for future spread of these infections. In order to successfully control this problem, a greater focus on oral sex should bepersued, along with promotion of the use of condom and education on safe oral sex practices. Furthermore, examination of the oralcavity should is essential when evaluating any patient suspected of harboring a sexually transmissible infection. In this article, oraltransmission of several viral and bacterial infections is reviewed, including human papillomavirus infection, genital herpes, syphilis andgonorrhea, among others.

TEENAGE GIRLS, FEMALE FRIENDSHIP AND THE MAKING OF THE SEXUAL REVOLUTION IN ENGLAND, 1950–1980

AbstractHow can we explain rising levels of pre-marital sex in post-war Britain? Focusing on the experiences of young women growing up in Britain between 1950 and 1980, this article argues that changes in sexual practice were brought about by shifts in the social value of sexual knowledge and experience. While the figure of the ‘nice girl’ was still central to understandings of respectable femininity, across this period social status and reputation became linked to demonstrations of attractiveness and sexual knowing. For girls of the post-war generation, discussions of sex were central to how they related to those around them, and the decisions that teenagers made about their own sexual practice were informed by their perceptions of what their friends and peers would think of them. The article argues that, by considering the history of sexuality at a ‘local’ scale between the macro-level of culture and the micro-level of individual sexual selfhood, we not only gain an important new perspective on the everyday sexual experience but also uncover new processes of socio-sexual change.

The Growing Threat of Gonococcal Blindness.

Antibiotic-resistant gonorrhea is now a reality, as well as the consequences of untreatable infections. Gonococcal eye infections result in blindness if not properly treated; they accounted for the vast majority of infections in children in homes for the blind in the pre-antibiotic era. Neisseria gonorrhoeae infects the eyes of infants born to mothers with gonorrhea and can also infect the eyes of adults. Changes in sexual practices may account for the rise in adult gonococcal eye infections, although some cases seem to have occurred with no associated genital infection. As gonorrhea becomes increasingly difficult to treat, the consequences for the treatment of gonococcal blindness must be considered as well. Monocaprin was shown to be effective in rapidly killing N. gonorrhoeae, and is non-irritating in ocular models. Repeated passage in sub-lethal monocaprin induces neither resistance in gonococci nor genomic mutations that are suggestive of resistance. Here, we show that 1 mM monocaprin kills 100% of N. gonorrhoeae in 2 min, and is equally effective against N. meningitidis, a rare cause of ophthalmia neonatorum that is potentially lethal. Monocaprin at 1 mM also completely kills Staphylococcus aureus after 60 min, and 25 mM kills 80% of Pseudomonas aeruginosa after 360 min. Previously, 1 mM monocaprin was shown to eliminate Chlamydia trachomatis in 5 min. Monocaprin is, therefore, a promising active ingredient in the treatment and prophylaxis of keratitis, especially considering the growing threat of gonococcal blindness due to antimicrobial resistance.

O10 Aetiology of and trends in anogenital herpes diagnoses in england from 2006–2015

IntroductionAnogenital herpes (AH), associated with significant physical and psychological morbidity, is the second most commonly diagnosed viral sexually transmitted infection (STI) in England and is caused by infection with Herpes Simplex Virus (HSV) Type-1 or Type-2. We investigated the epidemiological and serotype characteristics of AH diagnoses in England and changes over time.MethodsWe performed a descriptive analysis of socio-demographic and clinical characteristics of AH using data from the national surveillance system for STIs (GUMCADv2), and calculated the proportion of new episodes by serotype using data from the national laboratory surveillance system in England from 2006–2015.ResultsThere were 31,312 first and 25,356 recurrent AH episodes in 2015, and diagnosis rates of first episode AH increased 55% from 38 to 59 per 100,000 population since 2006. In 2015, diagnosis rates were highest among women (73.5), people aged 20-24 (243.1), those of Black Caribbean ethnicity (176.3), and London residents (93.8). Although MSM only accounted for 4.6% (n=1430) of diagnoses in 2015, there was an 18% increase in diagnoses since 2011; overall 28% of MSM diagnosed with AH were HIV-positive. The distribution of HSV-1/HSV-2 has remained stable since 2006: in 2015, 48% of women and 36% of men with AH were diagnosed with HSV-1 infection.DiscussionIncreased diagnoses of AH may be due to changes in sexual practices or improved test sensitivity. Differences by socio-demographic characteristics can be used to inform prevention strategies, while those by serotype are essential for guiding vaccine development.

Sext and gender: examining gender effects on sexting based on the theory of planned behaviour

ABSTRACTThe emergence and popularity of new communication tools provide opportunities for new sexual behaviours, among which is sexting. Sexting refers to sending nude or sexually suggestive pictures of oneself to another person through digital media. Extending Walrave, Heirman, and Hallam’s work [2014. “Under Pressure to Sext? Applying the Theory of Planned Behaviour to Adolescent Sexting.” Behaviour & Information Technology 33 (1): 86–98], the present study addressed gender effects on sexting based on the theory of planned behaviour (TPB). We examined whether women and men differ in their attitude, subjective norm, self-efficacy, perceived control regarding sexting, and their likelihood to sext. We also tested the moderating effect of gender on the association between TPB variables and sexting. Respondents were 381 Chinese students aged 17–24 years. Mediation analysis showed that compared with women, men had higher levels of attitude, subjective norm, and self-efficacy surrounding sexting, and therefore had a stronger tendency to sext. Simple slope analysis revealed that the positive relationship between subjective norm and sexting only existed among women. Perceived control was negatively associated with sexting, and this association was stronger among men. These findings demonstrate that contemporary gender construction provides men with more facilitating factors to sexual activities and restricts women to non-desiring subjects. Although changes in sexual practices occur in the digital culture, gender inequality in sexuality persists.