Quality Of Sexual Relationship Research Articles

SLEEP AND SEXUALITY AMONG CAREGIVERS AND THEIR PARTNERS

Abstract Older adult caregivers have increased risk of disturbed sleep, which is associated with declines in sexual frequency. Spousal caregivers engage in less sexual activity than caregivers of non-spouses. We examined whether the associations between sleep behaviors (duration, napping frequency, feeling rested) and couples’ sexual frequency, quality, and pleasure were similar among dyads in which one spouse was providing care to a spouse (n = 146) or a parent or other care recipient (n = 211). Using Wave 2 of the NSHAP and actor-partner interdependence models, we found significant differences (p <.01) between dyads. For all spouses, only frequency of sharing a bed was related to frequency of sexual activity in the previous 12 months. Sleep duration was not associated with any outcomes. In both groups, frequency of sharing a bed was positively associated with reports of physical pleasure (b’s ranged from .20 to .50). In spousal caregiver couples, caregivers’ greater napping frequency was negatively associated (b = -.29, p <.01) with their partner’s reports of a physically pleasurable relationship, and their reports of feeling rested were positively (b = .17, p < .01) associated with their own reports of pleasure. For couples in which the caregiver was caring for a non-spouse, there were actor effects for caregivers’ and noncaregivers’ napping frequency on lower reports of sexual relationship quality (b = .19 and .49, respectively), and a partner effect for non-caregivers (b = .25). These results point to the importance of understanding the context of caregiving, sleep behaviors, and sexual relationships.

Predictors of Male Sexual Dysfunction in Urologic Chronic Pelvic Pain Syndrome (UCPPS), Other Chronic Pain Syndromes, and Healthy Controls in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network

BackgroundSexual dysfunction (SD), including erectile (ED) and ejaculatory dysfunction, is associated with diminished quality of life (QoL) in men with UCPPS (chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) and/or interstitial cystitis/bladder pain syndrome (IC/BPS)). AimWe sought to compare SD among male patients with UCPPS, other chronic pain conditions (positive controls, PC), and healthy controls (HC) without chronic pain, and to evaluate the association of comorbidities, psychosocial factors, and urologic factors of SD in all 3 groups. MethodsBaseline data from male UCPPS participants, PC (irritable bowel syndrome, chronic fatigue syndrome, fibromyalgia) and HC enrolled in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network Epidemiology and Phenotyping Study were included in the analysis. Sexual function was assessed using the International Index of Erectile Function-Erectile Function Domain (IIEFEF) and Ejaculatory Function Scale (EFS). Male ED was defined as a composite IIEF-EF score <21. Higher EFS score indicated worse sexual dysfunction; no threshold to define SD was identified for the EFS. Multivariable logistic and linear regression was used to investigate associations of comorbidities, psychosocial factors, and urologic factors with ED and ejaculatory, respectively. OutcomesComorbidities, genital pain, and psychosocial factors are associated with SD across the study population and male patients with UCPPS had a high prevalence of ED and greater ejaculatory dysfunction. ResultsThere were 191 males with UCPPS; 44 PC; and 182 HC. Males with UCPPS had worse SD compared to PC and HC including lower mean IIEF-EF scores, greater degree of ejaculatory dysfunction, and lower quality of sexual relationships. Among all 3 cohorts, depression, stress, and pain were associated with ED in univariable and multivariable analysis, as was diabetes mellitus. Pain in the genitalia, severity of urinary symptoms, depression, stress, and history of childhood sexual trauma were associated with ejaculatory dysfunction in univariable and multivariable analysis. Clinical ImplicationsA multidisciplinary approach that addresses the identified risk factors for SD may improve overall QoL in males with UCPPS. Strengths and LimitationsOur study is strengthened by its use of validated, patient-reported questionnaires and inclusion of healthy and positive controls. Our understanding of the role of IC in this study is limited because only 1 patient in the study had IC/BPS as a sole diagnosis. ConclusionsWhen compared to healthy controls and patients with other chronic pain conditions, males with UCPPS experience higher degrees of SD, including erectile and ejaculatory dysfunction.Loh-Doyle JC, Stephens-Shields AJ, Rolston R, et al. Predictors of Male Sexual Dysfunction in Urologic Chronic Pelvic Pain Syndrome (UCPPS), Other Chronic Pain Syndromes, and Healthy Controls in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network. J Sex Med 2022;19:1804–1812.

Trauma Chronicity and the Long-Term Needs of Childhood Sexual Trauma Survivors

Research has linked childhood sexual trauma (CST) with adverse adult outcomes (AAOs) that span physical, psychological, and social domains of functioning. Differences in conceptualizing and measuring CST, however, have inhibited the examination of trauma-related variables hypothesized to impact adult outcomes. We used National Sexual Health Survey (NSHS; 1995–1996) data to examine trauma chronicity (i.e., duration) and AAOs (domains: physical and mental health, close relationships, and achievement). The NSHS (N = 6537, 18–70 years) assessed duration using perpetrator-specific CST reports. Adjusting for background characteristics, we examined CST duration in relation to AAOs and CST-related help-seeking. Approximately 8% of participants reported CST. Chronic (vs. single-exposure) CST survivors were at substantially higher risk of experiencing AAOs [i.e., mean AAOs and specific AAOs (e.g., physical and emotional health problems, divorce/separation, and poverty)]. CST had direct effects on sexual dysfunction and satisfaction, and on relationship stressors which may impact sexual relationship quality. Although 62% of CST survivors did not seek help, those with more chronic CST histories reported a higher prevalence of trauma-related help-seeking. Our work underscores the importance of examining CST chronicity in relation to long-term developmental outcomes. Chronicity assessment may be an important screening tool in the therapeutic context and in broader community screening efforts.

Interpersonal autonomic synchrony and sexual satisfaction: A preliminary examination

IntroductionA growing body of literature has increased our understanding of interpersonal autonomic synchrony (IAS), or exchanges across biological systems resulting in physiological covariation. While research suggests that IAS is more likely in relationships characterized by emotional intimacy, no research to date has examined the connection between IAS and the quality of sexual relationships.ObjectivesThe current study seeks to elucidate the relationship between IAS and sexual satisfaction (SS) using tasks that have previously been used to assess synchrony (i.e.,gazing, mirroring), as well as several conversation-based tasks (i.e., neutral and sex-related conversation tasks).MethodsCouples (n=28) completed procedures in a laboratory-based setting where they completed survey measures of SS before connecting to an electrocardiogram. Subsequently, heart rate (HR) data for each dyad were analyzed using a moderated multi-level modeling approach.ResultsIAS was detected, with men reliably predicting the HR of female partners, and women reliably predicting the HR of male partners (respectively, β=0.383, p&lt;0.001; β=0.222, p&lt;0.001). AIC values indicate a better fitting model for men predicting female HR. As such, moderation analyses were conducted for that model by study task, finding a significant interaction between SS and observed IAS during the mirroring task (β=0.004, p=0.009) and neutral-conversation task (β=0.016, p=0.009).ConclusionsThese findings reflect evidence that IAS may be relevant to SS at the couple-level. The ability of couples to coregulate while attempting to synchronize (as in the mirroring task) or exchange information (as in the neutral-conversation task) may meaningfully change how they experience their sexual relationship.DisclosureNo significant relationships.

Psychological Distress, Relationship Quality, and Well-Being Among Malaysian Couples During the COVID-19 Pandemic.

With the imposition of the Movement Control Order (MCO) or lockdown due to the coronavirus disease 2019 (COVID-19) pandemic, there are drastic changes in the movement and activity among Malaysians: increased psychological distress due to perception of COVID-19 as a health threat, increased time spent with families, and decreased time away from home could either intensify relationship problems or draw families closer to each other. This study aimed to examine the perceived psychological distress and relationship quality among couples before and during MCO in Malaysia and factors predictive of participants’ well-being. The Depression Anxiety Stress Scale-21, Perceived Relationship Quality Component Inventory, and the Warwick–Edinburgh Mental Well-being Scale were disseminated through the snowball sampling technique. The study found that the participants (N = 124) perceived significantly higher levels of depression, anxiety, and stress during MCO compared with before MCO. However, no significant differences between the couples were found before and during MCO in relationship quality, except in the trust subscale. Trust on the couple was higher during MCO. Multiple regression results showed that depression and stress predicted participants’ well-being negatively during MCO. In contrast, total relationship quality, sexual relationship quality, satisfaction, and trust predicted participants’ well-being positively.

The Impact of Pre-exposure Prophylaxis on Sexual Well-Being Among Men Who Have Sex with Men.

Pre-exposure prophylaxis (PrEP) is a promising strategy to reduce HIV incidence among men who have sex with men (MSM). How and when PrEP is used could in part be influenced by its impact on the sexual well-being of its users. Yet, the impact of PrEP on sexual well-being has received little attention in current literature and is not well-understood. We conducted 43 in-depth interviews (June 2017-June 2018) with HIV-negative MSM who started PrEP within the Amsterdam PrEP study. We used purposive sampling to select participants who (1) reported changes on well-being indicators; (2) switched between PrEP-dosing regimens; (3) neither changed regimens nor changed on well-being indicators. Transcribed interviews were qualitatively analyzed by means of an open-coding process. Results showed that PrEP minimized HIV-related fear, increased self-esteem, and reduced stigma and shame about having condomless anal sex. The psychological relief provided by PrEP also enabled relaxation which reduced pain during anal sex. PrEP use increased the diversity of partner choices and improved the perceived quality of sexual relationships and the ability to develop relationships. Along with this positive impact, almost half of interviewees reported concurrent negative experiences. In some cases, PrEP triggered more extreme sexual behaviors and/or problematic increases in preoccupation with sex and drug use. These were perceived as having a negative impact on sexual relationships, sexual well-being, PrEP adherence, and general health. In conclusion, our findings suggest that PrEP contributes to improvements in sexual well-being that go beyond protection from HIV. Counseling strategies should be devised to help PrEP users mitigate possible co-existing negative consequences of PrEP use.

Is there any possibility to convert personalism to practice of psychological research? A case of quality of sexual relationship in marriage

Dzisiaj możemy obserwować kryzys relacji seksualnych między mężczyzną a kobietą. Są one często skoncentrowane na sobie, nietrwałe i oderwane od relacji małżeńskiej. Tą prawidłowość można dostrzec w badaniach nad satysfakcją seksualną, które nie uwzględniają aspektu relacyjnego i są skupione na jednostce. Autor artykułu pragnie zaproponować skalę personalnego postrzegania małżonka, która oparta jest na personalizmie chrześcijańskim i na teologii ciała a ma za zadanie uwzględnić relacyjny aspekt współżycia seksualnego. Jest to propozycja narzędzia, które może wzbogacić badania nad seksualnością człowieka.

A kiss is not just a kiss: kissing frequency, sexual quality, attachment, and sexual and relationship satisfaction

Kissing can be thought of as a relationship maintenance behavior and/or as part of the sexual repertoire. Using data from 1,605 participants in committed relationships for at least two years, we analyzed how kissing frequency was associated with specific aspects of the two most recent sexual experiences, attachment, and global sexual and relationship satisfaction using a structural equation model. Kissing frequency had a significant, positive association with all specific aspects of recent sexual experiences (levels or arousal, experience of orgasm, and event-specific sexual satisfaction) and global sexual and relationship satisfaction. Kissing frequency had a significant, negative association with anxious and avoidant attachment. The associations with attachment and specific aspects of recent sexual experiences only partially mediated the relationship between kissing frequency and global relationship and sexual satisfaction. The results indicated that kissing frequency was a strong indicator of both specific sexual quality and global relationship connectivity and may be a promising variable to utilize as a barometer of both the more immediate quality of sexual relationships as well as overall relationship quality.

Elagolix reduced dyspareunia and improved health-related quality of life in premenopausal women with endometriosis-associated pain

Objectives: The objective was to evaluate the effects of elagolix on dyspareunia in women with endometriosis-associated pain. Methods: Data were pooled from two similar, randomized, double-blind, placebo-controlled, 6-month phase 3 studies (Elaris Endometriosis-I and Elaris Endometriosis-II) of elagolix at two doses (150 mg QD and 200 mg BID) in women with endometriosis-associated pain. In this post hoc analysis, dyspareunia responders were defined as having a clinically meaningful decrease from baseline in the dyspareunia score and decreased or stable use of rescue analgesic agents, as recorded in a daily electronic diary. Sexual relationship was assessed using the 30-item Endometriosis Health Profile questionnaire sexual relationship module. Results: A total of 1384 women reported ⩾1 day of sexual activity at baseline (35 days prior to and including day 1 of treatment). Of these 1384 women, 1297 (94%) reported ⩾1 day of any dyspareunia (mild, moderate, or severe), of which 51% reported ⩾1 day of severe dyspareunia. Among sexually active women who reported any dyspareunia at baseline, both elagolix doses led to improvements in dyspareunia. Women in the 200-mg BID group showed more months at which the dyspareunia response rates were statistically significantly greater than placebo, particularly in a subgroup of women with severe dyspareunia at baseline. Compared to placebo, both elagolix doses led to statistically significantly greater improvements in the mean 30-item Endometriosis Health Profile sexual relationship module score. Conclusion: Up to 6 months of elagolix treatment improved dyspareunia in women with endometriosis-associated pain in a dose-dependent manner, with 200-mg BID dose showing the most significant improvements in dyspareunia and quality of sexual relationships compared with placebo.

Validation of an Event-Level, Male Sexual Pleasure Scale (EMSEXpleasure) Among Condom-Using Men in the U.S.

Sexual pleasure is a key determinant of condom use. We developed and validated a male, event-level sexual pleasure scale (EMSEXpleasure) among a sample of condom-using men in the U.S. in order to facilitate improved measurement of sexual pleasure. Based on an expert panel process, a 12-item scale was developed. An online sample of 169 men who have sex with men and 162 men who have sex with women were recruited. Factor analysis yielded a two-factor solution that matched domains identified a priori by the expert panel, general pleasure and condom-specific pleasure, indicating internal validity of the instrument. One item was deleted from the scale due to poor validity performance. The overall EMSEXpleasure scale, and each subscale, had high (>0.8) Cronbach's alpha coefficients, indicating internal reliability. The scale demonstrated convergent validity, with theoretically related constructs associated both with individual scale items and with scale totals. Overall relationship quality (b 3.0, 95%CI 2.0, 4.0), sexual relationship quality (b 2.9, 95%CI 2.0, 4.0), foreplay quality (b 7.5, 95%CI 2, 13), positive feelings about condoms (b 18.8, 95%CI 15, 23), and erection problems while using condoms (b -17.9, 95%CI -22, -14) were associated with the EMSEXpleasure scale in expected directions. The validated EMSEXpleasure event-level scale may be advantageous for future assessments of the ephemeral experience of sexual pleasure, including clinical trials of condoms and other interventions, because it can be used immediately after sex, potentially limiting recall error.

THE STUDY OF THE EFFECTIVENESS OF TRAINING THE PRINCIPLES OF IMPROVING THE RELATIONSHIPS BASED ON GOTTMAN'S METHOD ON COUPLES' MARITAL SATISFACTION IN TEHRAN

Background and Aims: marital satisfaction is one of the most important factors of progress and achieving life goals which is affected by couples' emotional stability. Therefore, the purpose of this research was to study the effectiveness of training the principles of improving the relationships based on Gottman's method on couples' marital satisfaction in Tehran. Materials and Method: It was a quasi- experimental research with pretest-posttest and control group. Statistical population involved all the couples without child that at least two years have passed since their marriage and they referred to psychotherapy and family health clinics in Tehran in 2013 and 2014. The sample included 40 couples who referred to these clinics to get marital counseling and they were selected by random cluster sampling. Then, they randomly divided into control and experimental groups (20 couples in each group). ENRICH couple scale (1997) and Gottman's couples' therapy scale (2009) was used to collect data in both pretest and posttest. The experimental group exposed to the independent variable (training the principles of improving the relationships based on Gottman's method) for two sessions of five hours. Statistical analyses performed to analyze data included ANCOVA test. Findings: The findings showed that training the principles of improving the relationships based on Gottman's method had no significant effect on couples' marital satisfaction (P > .05); but has been effective on its subscales (emotional relationships, quality of sexual relationships s, trust, compromise and commitment) (P ≤ .05). Results: The results showed that training the principles of improving the relationships based on Gottman's method can be a very effective way to increase marital satisfaction subscales and improve the couples' relationships.

Dyadic perspectives on marital quality and loneliness in later life

Previous research on married couples has indicated that loneliness, an unrealized desire for close relationships, can affect even partnered adults. In addition to individual perceptions of the marital relationship, partner perceptions of the relationship might also heighten married adults’ experiences of loneliness. I employed a dyadic approach derived from the emotion-in-relationships model to examine the extent to which individual and partner reports of four dimensions of relationship quality are risk factors for loneliness among married older adults. Using structural equation modeling with dyadic data from 779 opposite-sex couples in the National Social Life, Health, and Aging Project (2010–2011), I found that spouses’ reports of positive and negative relationship quality were associated with loneliness beyond individuals’ reports. For positive relationship quality, a partner’s report had an effect equal to one’s own report. For negative relationship quality, one’s own and one’s partner’s perceptions operated in opposite ways. There were no differences between husbands and wives, and neither partner’s reports of shared marital activities or sexual relationship quality were associated with loneliness. Overall, results suggest that for married older persons, dyadic approaches to therapy might most effectively alleviate loneliness.

The effect of marital counselling on sexual satisfaction of couples

Introduction: Aspects of one's sexual behaviours such as expectations, frequency, and types of behaviours affect one's sexual satisfaction. The current study investigated both sexual and non-sexual variables associated with sexual satisfaction. Nowadays, because of sexual dissatisfaction 50% of marriages are not successful. Since the unhealthy relationship between couples makes them dissatisfied, misunderstanding along with other circumstances make the foundation of the family unstable and possibly divorce will be increased. Therefore, marital counselling can give couples the necessary information for a good sexual life and helps the stability of the family and creates a healthy society. The purpose of this study is the effect of marital counselling on sexual satisfaction of couple in Shiraz. Methods: The research method is quasi-empirical in two groups of experimental and control. The sample contains 60 couples who are selected voluntarily but not randomly and then divided into two groups of experimental and control randomly. All the data are gathered by a questionnaire in two parts, demographic characteristics (with 6 questions) and Larsson ISS sexual satisfaction questionnaire. In the pre-test, data were based on a questionnaire which its validity and reliability were approved. Then a 4-month educational intervention program was used for the experimental group. After 1-month post-test was done for the two groups, and the data were analysed by statistical tests in the P ≤ 05. Results: This study showed that 46.67% of women in experimental group and 53.33% in control group were 20–24 years old and t -test did not show any significant differences between the two groups ( P > 0.05). Also, 53.3% of men in the experimental group and 50% in the control group were 25–29 years old and t -test did not show any significant difference between the two groups ( P ≥ 0/05). Chi-square test showed that in post-test there was a significant difference in men and women sexual satisfaction ( P = 0/002). Conclusion: The research findings showed that marital counselling effects on the quality of sexual relationship and increase couples' sexual satisfaction. Marital counselling, with the prevention of sexual diseases and sexual dysfunctions, is one of the most effective methods of health education to help people to improve their quality of life through the improvement of sexual satisfaction and their relationships.

Sexual concerns among kidney transplant recipients.

Little is known about the specific sexual concerns of kidney transplant (KTx) recipients. The primary objectives of this study were to: (i) describe the importance of sexuality to KTx recipients; (ii) investigate the sexual concerns of KTx recipients; and (iii) examine the relationship between sexual concerns and quality of life (QOL). A secondary objective was to examine potential sexual concern differences by gender, pre-transplant dialysis status, and donor type. This study employed a cross-sectional, descriptive, correlational design. Sexual concerns were identified using the Sexual Concerns Questionnaire, which contains seven subscales. QOL was measured with the SF-8 and the QOL Uniscale. Nearly 73% of subjects rated sexuality as important. Subscales indicating highest area of sexual concerns were communication with healthcare providers about sexuality (Mean (M)=2.70) and sexual pleasure concerns (M=2.45). Higher concern ratings regarding health consequences of sexual activity, quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly, inversely related to QOL. Women had significantly higher scores on the Sexual Pleasure and Communication with Healthcare Providers subscales than men. This study reports the sexual concerns of KTx recipients' who are an average of fouryr since surgery, and the relationship of these concerns to QOL.

Sexual Concerns Among Simultaneous Kidney Pancreas (SPK) Transplant Recipients.

The aims of this study are to 1) describe sexual concerns of SPK transplant recipients, 2) examine the relationship between sexual concerns and Quality of Life (QoL) after transplant, and 3) examine changes in sexual concerns from pre to post transplant. Participants were sent questionnaires which included demographic and disease related questions, QoL measures (SF-12 and QoL uniscale), and Sexual Concerns Questionnaires (SCQ). The SCQ-pre transplant contains 24 questions and 6 subscales and the SCQ-post transplant contains 28 questions and 7 subscales. Participants rate each item on a 6-point scale from 0 (Not at all) to 5 (Extremely). Higher scores indicate a higher level of concern. Mean age of the sample (n = 145) was 50 years, 54.9% were male, 94.4% were white, and 71.5% were in a relationship. Subscales indicating the highest area of sexual concerns after transplant were sexual pleasure concerns and communication with providers about sexuality. Participants were most concerned about spontaneity of sexual activity, sexual concerns being important to providers, ED, sex drive, and vaginal lubrication. Having concerns about quality of sexual relationship, sexual pleasure, sexual functioning problems, and pessimistic beliefs about treatment were significantly associated with lower QoL (p < .01) after transplant. Thirteen sexual concerns got significantly worse from pre to post SPK transplant. These concerns were related to sexual functioning (i.e. vaginal dryness, ED, and sex drive) and partner concerns (i.e. partner finding sexually attractive and satisfying needs). Seven sexual concerns improved after transplant. These concerns were related to communicating with providers about sexuality. Figure 1 illustrates effect sizes of select concerns that significantly changed from pre to post transplant.Figure: No Caption available.Findings provide a more comprehensive understanding of sexual concerns after SPK transplant and the link to QoL. This study dispels the assumption that all aspects of QoL improve after transplantation, as sexuality, an important component of QoL, did not improve.

The Effectiveness of Sexual Education Focused on Cognitive Schemas, on the Improvement of Sexual Functioning among Female Married Students

Background: Sexual relationship plays a decisive role in human’s health and it seems that sexual education can enhance the quality of sexual relationship. Aim: Investigating the effectiveness of sexual education focused on cognitive schemas, on the improvement of sexual functioning of female married students. Methods: This research was carried out semi-experimentally and a pretest-posttest designed control group was used. A total of 28 persons were selected and put into two groups. Sexual education was offered to the experimental group for eight 90-minute sessions. In both groups, the degree of sexual functioning was measured and registered before and after intervention using women’s sexual functioning index questionnaire (FSFI), and was analyzed with SPSS version 16 and t-test. Results: T-test results showed significant relationship between the two groups in the overall scores of sexual functioning, sexual desire components, psychological arousal, moisture, orgasm and sexual satisfaction, in a way that in all cases the scores of the experimental group were significantly higher than those of the control group (p<0.001). However, t-test reported no significant difference between the two groups in terms of sexual pain component Conclusion: The present research demonstrated that sex education with focuse on cognitive schemas was an effective method for improving sexual functioning, and therefore, it is proposed that this matter should be taken into consideration by clinical therapists for enhancing the quality of couples’ relationships.

Adult Attachment Among Partnered Gay Men: Patterns and Associations with Sexual Relationship Quality

Previous research has found secure adult attachment to be associated positively with dimensions of main partner relationship quality and negatively with sexual risk taking and sex with casual partners among heterosexuals in primary relationships. Potential associations between adult attachment and aspects of relationship functioning have received limited attention among gay men. Data were collected from both members of 344 gay male couples as part of a community survey (M age=38.6, SD=9.4). Participants completed a shortened version of the Adult Attachment Inventory (Collins & Read, 1990) and the Dyadic Sexual Communication Scale (Catania, 1998). They reported the frequency of sex with main partners and the number of casual male unprotected sex partners. Data were analyzed using the Actor-Partner Interdependence Model. Securely attached individuals reported the highest levels of sexual communication and men with securely attached partners were the most likely to report having sex with their partners as least once per week. Avoidantly attached men reported significantly more casual unprotected anal intercourse (UAI) partners compared to other attachment styles. Having an avoidantly attached partner was also associated with an increase in the number of UAI partners reported. Attachment style is relevant to the sexual relationship quality and sexual safety of partnered gay men. Cognitive-interpersonal intervention approaches developed to target attachment-related cognitions and behaviors may be relevant to HIV prevention efforts in this population.

Sexual compulsivity and interpersonal functioning: Sexual relationship quality and sexual health in gay relationships.

The present study examined the role of sexual compulsivity (SC) in four aspects of interpersonal functioning relevant to main partnerships-sexual satisfaction, sexual communication, the presence of weekly sexual activity with main partner, and the number of recent casual male sex partners (i.e., outside of the relationship) with whom participants had unprotected anal intercourse (UAI). Data were collected using a street-intercept strategy from both members of 172 gay male couples (N = 344 individuals) attending gay-community events together. SC was measured using the Sexual Compulsivity Scale; sexual satisfaction using a modified version of the Sexual Functioning Inventory (SFI); and sexual communication using a shortened version of the Dyadic Sexual Communication (DSC) Scale. Men high on SC were as likely to be partnered with men low on SC as they were to be partnered with others having high levels of SC. SC was negatively associated with sexual satisfaction and sexual communication. Individuals with higher SC scores and those whose partners had higher SC scores engaged in UAI with a greater number of male partners outside their relationship. SC was unrelated to frequency of sex with main partners. SC was associated with lower sexual relationship quality and increased potential for human immunodeficiency virus (HIV) transmission from a casual partner and subsequent transmission to (or reinfection with) a primary partner. Couples interventions for SC may be relevant to individual and public health. They provide a platform to practice communication skills, identify preferred sexual activities, and negotiate sexual safety.

Non-monogamy and sexual relationship quality among same-sex male couples.

Relationship arrangements about sex with outside partners are common among gay couples, and meaningful distinctions in psychological and behavioral health correlates have been found among nonmonogamous agreement types. The goal of this study was to investigate the relationship between sexual agreements and partners' sexual relationship quality. Data were collected from both members of 161 gay male couples (n = 322 individuals). Couples were categorized as monogamous (52.8%), open (13.0%), monogamish (14.9%), and discrepant (19.3%). We used the actor-partner interdependence model (APIM) to assess associations of relationship arrangement with four aspects of sexual relationship quality: sexual satisfaction, sexual communication, sexual jealousy, and the occurrence of at-least weekly sex between main partners. We found that sexual arrangements were not associated with sexual satisfaction, communication, or frequency. However, monogamous men reported significantly higher levels of sexual jealousy. Our findings indicate that gay men engage in a range of relationship agreements, and nonmonogamous agreements are associated with levels of sexual relationship quality equivalent to monogamous agreements.

A Practical Approach to Premature Ejaculation

How can a couple in which the man is unable to control his ejaculation be defined? This situation is the “asynchronous” couple in which quantitative sex is still possible, but the quality of sexual relationship is lost. We have, obviously, a much more scientific and evidence-based definition of premature ejaculation (PE), which will be used throughout this special issue of the Journal of Sexual Medicine. However, for practicing clinicians who are dealing with patients' perceptions, the translation of the technical term “PE” as sexual asynchrony would be an efficient way to understand this particular dysfunctional couple.