Heterosexual Respondents Research Articles

Intimacy, Orgasm Likelihood, and Conflict Predict Sexual Satisfaction in Heterosexual Male and Female Respondents

Anonymous data provided by 417 female and 179 male sexually active heterosexual respondents showed that in long term sexual relationships, sexual satisfaction was positively correlated with two different intimacy variables, the respondent's orgasm likelihood, and negatively correlated with conflict in the relationship. Multiple linear regression permitted us to measure the effect sizes of these variables as predictors of sexual satisfaction. These findings have important implications for treatment of symptomatic couples.

Victimization, Substance Use, and HIV Risk Behaviors Among Gay/Bisexual/Two-Spirit and Heterosexual American Indian Men in New York City

secondary aims included describing condom-use attitudes, beliefs about HIV/AIDS in the Indian community, HIV knowledge, HIV status, and preference for and access to HIV prevention services in this population. A survey was mailed to all members of an American Indian community organization in New York City. The 20 men self-identifying as gay, two-spirit, or bisexual (hereafter, "two-spirit") were more likely to report being victimized and engaging in HIV risk behaviors than the 51 heterosexual respondents, although they reported comparable levels of recent substance use. Overall, victimization was associated with lifetime HIV risk behaviors (even after control for sexual orientation) but not with substance use or unsafe sex in the past 12 months. The percentage of HIV infection was surprisingly high (10% of two-spirit men and 6% of heterosexual men). Two-spirit men are a vulnerable population whose victimization must be understood within an appropriate historical and political context.

Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: results from the 2000 National Alcohol Survey.

Few population-based studies have explored differences in alcohol consumption by sexual orientation. This study examined the prevalence of abstinence, drinking, heavier drinking, alcohol-related problems, alcohol dependence and help-seeking among homosexual and bisexual women and men compared with heterosexuals. Data are from the 2000 National Alcohol Survey, a national population-based survey of adults (N = 7,612), a Random Digit Dialing telephone survey of all 50 states of the United States and Washington, DC. Four categories of sexual orientation were created using questions on both sexual orientation self-identification and behavior: homosexual identified, bisexual identified, heterosexual identified with same sex partners and exclusively heterosexual. Five alcohol measures (past year) were used in the analyses: (1) mean number of drinks, (2) days consuming five or more drinks on a single occasion, (3) drunkenness, (4) negative social consequences (2 or more) and (5) Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, alcohol dependence. A lifetime measure of help-seeking for an alcohol problem was also analyzed. Few significant differences were found among men by sexual orientation. By contrast, both lesbians and bisexual women had lower abstention rates and significantly greater odds of reporting alcohol-related social consequences, alcohol dependence and past help-seeking for an alcohol problem. These findings suggest that alcohol dependence and alcohol-related consequences differ by sexual orientation, particularly among women. These findings also emphasize the need for the inclusion of sexual-orientation items in population-based surveys so that prevalence rates within these subgroups can be effectively monitored.

Health Risk-Factors for Gay American Indian and Alaska Native Adolescent Males

ABSTRACT Having multiple identities as a homosexual American Indian or Alaska Native adolescent male increases the likelihood for poorer health and diminished well-being. This study assessed the differences in self-perceived health status between gay adolescent males and their heterosexual counterparts. A national nonrepresentative sample of 5,602 Indian and Native adolescent males was surveyed about issues of sexual behavior, physical and sexual abuse, mental health status, substance use, attitudes about school, participation in violence, and access to health care. Results indicate that there were no real differences between gay and heterosexual male respondents for substance use or attitudes about school. Statistically significant differences were found, however, in areas of mental health, as well as physical and sexual abuse. Gay adolescents were twice as likely to have thought of or attempted suicide. Gay adolescents were twice as likely to have been physically abused and nearly six times more likely to have been sexually abused. Gay American Indian or Alaska Native adolescent males constitute a very vulnerable population and are clearly in need of targeted health and social services. Unfortunately, the benefits seen by adults of the “two-spirited” gay and lesbian American Indian movement have not been accessible to Indian and Native adolescents.

Sexual risk behaviours and STIs in drug abuse treatment populations whose drug of choice is crack cocaine.

We investigated sexually transmissable infection (STI) prevalence in 407 drug users in three drug treatment programmes in two Texan cities and associated demographic and sexual behaviours. Data analysis focused on differences between those for whom crack cocaine was the drug of preference compared with other drugs, since crack is associated with sexual arousal and a sex for drugs economy. Data indicate that having crack as a drug of preference is significantly associated with increased levels of previous STIs, previous drug treatment, African-American race, selling or buying sex for drugs or money, and increased infection markers for syphilis, chlamydia and herpes simplex-2. Crack preference was also significantly associated with lower rates of injecting drugs or sharing injection equipment and hepatitis C infection markers. Crack preference in heterosexual respondents was significantly associated with increased partner numbers in the past four weeks, more female partners for men and more vaginal sex contacts for men. Analysis of sex differences comparing those for whom crack was the preferred versus nonpreferred drug indicated that female crack users were significantly more likely to engage in oral sex. This supports previous ethnographic data suggesting that oral sex is a common mode of sex for drugs exchange in crack houses. In 7.4% of the total sample (14.4% of the crack-preferring sample), treatable STIs were detected. These data suggest that drug users generally, and crack-using populations in particular, in drug treatment programmes should be routinely screened for STIs as an integral part of drug treatment.

Gender Gaps in Public Opinion about Lesbians and Gay Men

Using data from a 1999 national RDD survey (N = 1,335), this article examines gender gaps in heterosexuals' attitudes toward lesbians, gay men, and a variety of topics related to homosexuality. Attitudes toward lesbians differed from attitudes toward gay men in several areas, and significant differences were observed between male and female heterosexual respondents. Survey participants generally were more likely to regard gay men as mentally ill, supported adoption rights for lesbians more than for gay men, and had more negative personal reactions to gay men than to lesbians. Overall, heterosexual women were more supportive than men of employment protection and adoption rights for gay people, more willing to extend employee benefits to same-sex couples, and less likely to hold stereotypical beliefs about gay people. Heterosexual men's negative reactions to gay men were at the root of these gender differences. Of all respondent-by-target combinations, heterosexual men were the least supportive of recognition of same-sex relationships and adoption rights for gay men, most likely to believe that gay men are mentally ill and molest children, and most negative in their affective reactions to gay men. Heterosexual men's response patterns were affected by item order, suggesting possible gender differences in the cognitive organization of attitudes toward gay men and lesbians. The findings demonstrate the importance of differentiating lesbians from gay men as attitude targets in survey research

Suicidality and Sexual Orientation in Five Continents: Asia, Australia, Europe, North America, and South America

This study examined the relation between suicidality and sexual orientation in an intercontinental sample (Asia, Australia, Europe, North America, and South America). Participants responded to a survey hosted on the Internet Website of an international news organization. Categorical analyses compared homosexual and bisexual respondents' history of suicide attempts and suicide ideations to those of heterosexual respondents, by total sample, males only, and females only. A relation between male sexual orientation and suicide attempts was found for every continent except Europe (odds ratio [OR] 1.5; 95% confidence interval [CI] = 0.3, 6.9). A relation between female sexual orientation and suicide attempts was not found in any continent except North America (OR = 2.1; 95% CI % 1.7, 2.5). These data provide preliminary evidence of intercontinental variation in the relation between suicidality and sexual orientation.

Risk behaviors related to heterosexual transmission from HIV-infected persons. Supplement to HIV/AIDS Surveillance Study Group.

To monitor heterosexually acquired HIV infection, it is important to understand transmission from persons infected with HIV to their sex partners. To describe sexual behaviors of persons infected with HIV that are related to transmission. Cross-sectional interviews were conducted from January 1995 to December 1998. Of 4743 heterosexual respondents who had known about their HIV infection for 1 year or longer, 42% were not sexually active and 13% had one sex partner with HIV; the remaining 2099 comprised the sample for analysis. Most respondents were male, black, and of low socioeconomic status. Approximately 60% reported one or more sexual risk behavior. Steady partner's HIV status was the strongest predictor in most models for risk behaviors; those with a partner who was not infected were significantly less likely than those with an infected partner to report any sexual transmission risk behavior (P < 0.05). The findings point to a continued need to focus on behavioral prevention measures that reduce the heterosexual transmission of HIV.

Ambiguous communication of sexual intentions as a risk marker of sexual aggression

Three studies are reported that explored the role of ambiguous communication of sexual intentions as a risk factor for sexual aggression and victimization. Two main forms of ambiguous communication were distinguished: token resistance (saying “no” when you mean “yes”) and compliance (saying “yes” when you mean “no”). Two samples of heterosexual men and women and a sample of homosexual men with a total N of 1284 completed a measure of sexual victimization or aggression and indicated whether or not they had ever shown token resistance or compliance in a sexual encounter. Moreover, the heterosexual male respondents indicated whether they had ever perceived token resistance or compliance in a female partner. Logistic regression analyses revealed that the risk of experiencing sexual victimization was significantly increased as a function of token resistance. Two of the three studies also showed compliance to be a risk factor for sexual victimization. For the male respondents, token resistance was consistently linked to a higher likelihood of perpetrating sexually aggressive acts in the three studies. Perceived compliance was also found to increase the risk of sexual aggression in three of four analyses. Support for a link between perceived token resistance and sexual aggression was found in the first study only. Overall, the findings suggest that the use of ambiguous communication in negotiating sexual encounters is associated with an increased risk of sexual victimization as well as perpetration of sexually aggressive acts in both heterosexual and homosexual contacts. The implications of the findings are discussed with respect to the issue of rape prevention.

Sexual Intercourse, Abuse and Pregnancy Among Adolescent Women: Does Sexual Orientation Make a Difference?

Although a limited amount of research has retrospectively explored the childhood and adolescent heterosexual experiences of lesbians, little is known about the prevalence of heterosexual behavior and related risk factors or about pregnancy histories among lesbian and bisexual teenagers. A secondary analysis was conducted using responses from a subsample of 3,816 students who completed the 1987 Minnesota Adolescent Health Survey. Behaviors, risk factors and pregnancy histories were compared among adolescents who identified themselves as lesbian or bisexual, as unsure of their sexual orientation and as heterosexual. Overall, bisexual or lesbian respondents were about as likely as heterosexual women ever to have had intercourse (33% and 29%, respectively), but they had a significantly higher prevalence of pregnancy (12%) and physical or sexual abuse (19-22%) than heterosexual or unsure adolescents. Among sexually experienced respondents, bisexual or lesbian and heterosexual women reported greater use of ineffective contraceptives (12-15% of those who used a method) than unsure adolescents (9%); bisexual or lesbian respondents were the most likely to have frequent intercourse (22%, compared with 15-17% of the other groups). In the sample overall, among those who were sexually experienced and among those who had ever been pregnant, bisexual or lesbian women were the most likely to have engaged in prostitution during the previous year. Providers of reproductive health care and family planning services should not assume that pregnant teenagers are heterosexual or that adolescents who say they are bisexual, lesbian or unsure of their sexual orientation are not in need of family planning counseling. Further research should explore the interactions between adolescent sexual identity development and sexual risk behaviors.

Attitudes toward Suicide in Patients with HIV/AIDS

This study investigated the attitudes toward suicide of HIV positive patients, a population at substantial risk for suicide. Such attitudes have not been studied, and it is quite possible that the depression and stress associated with HIV may be mediated by such attitudes. The Suicide Opinion Questionnaire, the Beck Depression Inventory, the Hopelessness Scale, and a demographic questionnaire were administered to three male samples ( n = 36 each). The first sample consisted of HIV positive gay men, with the diagnosis of AIDS or AIDS related complex (ARC). The second sample consisted of HIV negative gay men who had no symptoms for AIDS or ARC. The third sample consisted of thirty-six heterosexual males in good physical health with no evidence of AIDS, ARC, or other major medical conditions. The three samples were matched on age, ethnicity, education, and reported annual income. The three samples differed significantly on both depression and hopelessness, with HIV positive scoring highest, HIV negative scoring intermediate, and heterosexual scoring lowest. Depression correlated significantly with scores on the SOQ mental illness and cry for help scales for both HIV groups, but not for the heterosexual group. Hopelessness scores correlated significantly with the SOQ mental illness scale for the HIV negative and heterosexual groups, but not for the HIV positive group. Significant differences in attitude toward suicide between HIV positive and the other two samples were obtained on four of the SOQ scales. No significant differences were obtained between HIV negative and heterosexual respondents. These results suggest that as the HIV/AIDS entity progresses, attitudes toward suicide are altered in order to cope with the stress and to maintain cognitive balance.

Decision making in HIV testing among a group with low HIV risk.

Relatively little is known about how individuals (apart from gay and bisexual men) decide to have an HIV test and how, once they have presented for testing, they make decisions about proceeding through the testing trajectory. This paper reports on a qualitative study in which 55 mainly heterosexual respondents with low HIV risk were interviewed about their experiences of decision making around HIV testing. Reasons for deciding to be tested centred on a desire for reassurance and the circumstances of the respondents' current relationship. The most common relationship reason focused on a desire to confirm HIV status before beginning sexual relations or engaging in unprotected sex with a partner. Although some respondents recognized that other individuals had influenced their decision to be tested, few said that pre-test counselling had been influential in this respect. Instead, it was said to have promoted feelings of 'ownership' of a decision which had already been taken prior to counselling. The potential effects of HIV testing on HIV risk behaviour were also examined and a non-significant increase in unprotected sex was reported between the month before the test and the month after. The implications of these findings for the provision of HIV testing services are explored.

Movement patterns of persons with HIV receiving treatment in public clinics in the Southern Health Region, Puerto Rico.

Health planners suspect there is a pattern of movement, dubbed the "air bridge," between Puerto Rico and the continental United States by persons living with human immunodeficiency virus (HIV) who are seeking health services. The authors tested this hypothesis in publicly supported HlVclinics in the Puerto Rican Southern Health Region (SHR). A survey was conducted of 187 patients who were at least 18 years of age, confirmed HIV positive, and not incarcerated. Only 7% of the respondents had been outside the SHR for 2 weeks or more in the past year. Intravenous drug users and men who have sex with men were 7 to 8 times more likely to have traveled than were heterosexual respondents. Fifty-seven percent of all movement was within Puerto Rico, and no one had traveled to the United States primarily to receive medical services. Thus the results of this study do not support the concept of an "air bridge. "

The relationship between suicide risk and sexual orientation: Results of a population-based study

OBJECTIVES: This study examined the relationship between sexual orientation and suicide risk in a population-based sample of adolescents. METHODS: Participants were selected from a cross-sectional, statewide survey of junior and senior public high school students. All males (n = 212) and females (n = 182) who described themselves as bisexual/homosexual were compared with 336 gender-matched heterosexual respondents on three outcome measures: suicidal ideation, intent, and self-reported attempts. Logistic regression analyses were used to examine the association between sexual orientation and outcome measures with adjustment for demographic characteristics. RESULTS: Suicide attempts were reported by 28. 1 % of bisexual/homosexual males, 20.5% of bisexual/homosexual females, 14.5% of heterosexual females, and 4.2% of heterosexual males. For males, but not females, bisexual/homosexual orientation was associated with suicidal intent (odds ratio [OR] = 3.61 95% confidence interval [CI = 1.40, 9.36) and attempts ...

HIV as a surrogate marker for drug use: a re-analysis of the San Francisco Men's Health Study.

Our analysis of drug use and morbidity data from a cohort of 1034 men yields the following results: 1) HIV infection is a strong indicator of drug use-HIV-positive respondents reported an average lifetime dose of recreational drugs (excluding marijuana) 2.3 times higher than HIV-negative respondents. 2) Homosexuality is a strong indicator of drug use-homosexual respondents reported an average lifetime dose 2.0 times higher than heterosexual respondents. 3) The incidence of AIDS-defining diseases was not limited to respondents infected with HIV, but was almost completely limited (98%) to respondents who reported using drugs. We also address a previous report (Ascher et al., 1993) that was based on the same database and purported to show that HIV alone correlates with the development of AIDS. Specifically, we show that the relationship between HIV infection and CD4+ T Cell loss is weaker than reported by Ascher et al., and provides little evidence for a causative relationship. These results support the hypothesis that long-term, habitual drug use can cause the conditions known as AIDS (independent of the presence of HIV), and refute the hypothesis that HIV alone causes these conditions independent of drug use.

Social transmission routes of HIV. A combined sexual network and life course perspective

A combined sexual network and lifecourse perspective is proposed as a basis for reconstructing the sexological infrastructure of HIV dissemination. Necessary data are drawn from a representative sample survey of 1001 adults (age range 18–50 years) in the Netherlands. Heterosexual respondents' behavioural risk level, expressed in the number of unprotected sexual interconnections with primary and secondary partners, is found to be related to both age and relational status, though these variables cannot fully predict risk. While those under 24 years of age are over-represented in the larger components of sexual networks, above 32 years of age there is a small group who follow a lifestyle of regularly changing sexual partners.

HIV infection and risk behaviors among heterosexuals in alcohol treatment programs

<h3>Objective.</h3> —To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcohol treatment. <h3>Design.</h3> —Cross-sectional survey. <h3>Setting.</h3> —Five public alcohol treatment centers. <h3>Subjects.</h3> —Consecutive sample of 888 heterosexual clients entering treatment between October 1990 and December 1991. Respondents were 51% black, 10% Hispanic, 33% white, and 76% male. The overall response rate was 68%. <h3>Measurements.</h3> —Structured interview and serotesting for HIV antibodies. <h3>Results.</h3> —The overall seroprevalence of HIV infection was 5% (95% confidence interval, 3% to 6%). There were no significant differences in rates of infection by age, gender, or race. The prevalence of infection in heterosexual respondents without a history of injection drug use was 3% in men and 4% in women, several times higher than published estimates from a similar community-based heterosexual sample. Unsafe sexual practices were common: 54% of respondents reported multiple sexual partners in the previous year, 97% of nonmonogamous respondents did not use condoms during all sexual encounters, and few respondents consistently asked new sexual partners about previous high-risk behaviors. <h3>Conclusions.</h3> —There is a substantial prevalence of HIV infection among heterosexual clients in San Francisco (Calif) alcohol treatment programs, much of which is not associated with injection drug use. Because of this and the high prevalence of unsafe sexual behaviors, there is a relatively high likelihood of heterosexual spread of HIV among the large population of clients seeking treatment for alcohol dependency. Interventions to prevent HIV spread should become a standard part of alcohol treatment programs. (<i>JAMA</i>. 1994;271:515-518)

HIV Infection and Risk Behaviors Among Heterosexuals in Alcohol Treatment Programs

To measure the prevalence of human immunodeficiency virus (HIV) infection and high-risk behaviors among heterosexuals in alcohol treatment. Cross-sectional survey. Five public alcohol treatment centers. Consecutive sample of 888 heterosexual clients entering treatment between October 1990 and December 1991. Respondents were 51% black, 10% Hispanic, 33% white, and 76% male. The overall response rate was 68%. Structured interview and serotesting for HIV antibodies. The overall seroprevalence of HIV infection was 5% (95% confidence interval, 3% to 6%). There were no significant differences in rates of infection by age, gender, or race. The prevalence of infection in heterosexual respondents without a history of injection drug use was 3% in men and 4% in women, several times higher than published estimates from a similar community-based heterosexual sample. Unsafe sexual practices were common: 54% of respondents reported multiple sexual partners in the previous year, 97% of nonmonogamous respondents did not use condoms during all sexual encounters, and few respondents consistently asked new sexual partners about previous high-risk behaviors. There is a substantial prevalence of HIV infection among heterosexual clients in San Francisco (Calif) alcohol treatment programs, much of which is not associated with injection drug use. Because of this and the high prevalence of unsafe sexual behaviors, there is a relatively high likelihood of heterosexual spread of HIV among the large population of clients seeking treatment for alcohol dependency. Interventions to prevent HIV spread should become a standard part of alcohol treatment programs.

“Who wears the trousers?”: Sexual harassment in research settings

This article draws upon the experiences of four women in Glasgow (The Researching AIDS Women's Group -RAW) who were involved in four different studies about HIV-related risk behaviours. Field research was conducted in a number of research settings and included asking respondents about details of their sexual behaviour. On a number of occasions this was viewed as ‘provocative’ by male heterosexual respondents and led to overt or covert sexual harassment. This article collates some of these experiences and the strategies we developed to deal with them. Comparing our experiences with other fieldworkers we conclude that the combination of a ‘sexy’ subject matter, in-depth interviewing, and our age and gender and that of our respondents made us particularly vulnerable to being sexually harassed during fieldwork, but that all fieldworkers are potentially vulnerable. We therefore urge that safety of field workers be given greater consideration.

Mandatory Aids Testing: Factors Influencing Public Opinion

A survey of 341 persons, 82% of whom were university students whose median age was 27.0 yr., was conducted to investigate the relationship between their attitudes regarding mandatory AIDS testing for various groups, attitudes toward the disease, sexual orientation and behavior, and attitudes toward homosexuals. Homosexual and bisexual respondents were less supportive of mandatory testing for anyone than were heterosexual respondents. Greater homophobia and attitudes in favor of legal sanctions against persons with AIDS were correlated for heterosexual respondents, with attitudes supporting mandatory testing for everyone and homosexuals in particular. However, concern about contracting AIDS was unrelated to heterosexual attitudes favoring mandatory testing. Social and political considerations in an era of growing and potentially militant public health concern are discussed.