Recent Sexual Relationship Research Articles

Pre-exposure Prophylaxis (PrEP) Initiation Among Black and Latina Cisgender Women Receiving HIV Prevention Care Coordination Services in New York City

Black and Latina cisgender women are disproportionately impacted by HIV in the US. Although PrEP is effective at preventing HIV infection, uptake in this population remains low. The aim of the study was to examine sociodemographic, behavioral, clinical, and psychosocial factors associated with PrEP initiation (defined as receiving a PrEP prescription) among 565 cisgender women enrolled in an HIV prevention services coordination program in NYC from January 2017 to December 2019 who met HIV risk criteria for PrEP. Of these, 26% initiated PrEP. Latina women were significantly more likely than white women to have initiated PrEP (Latina: 29.7%; Black: 26.1%; White: 16.3%; Other: 7.4%). PrEP initiation was significantly associated with PrEP awareness, an annual income < $20,000, being unstably housed, receiving benefits navigation services, and reporting non-injection drug use and/or a recent sexual relationship with an HIV-positive partner. The relatively low rate of PrEP initiation we observed suggests the need to increase PrEP access and uptake among women, particularly Black and Latina women who continue to be disproportionately at risk for HIV.

Olfaction Is Associated With Sexual Motivation and Satisfaction in Older Men and Women

BackgroundSensory function declines with age and may impact sexual function in older adults. Indeed, the sense of smell plays a uniquely strong role in sexual motivation. Therefore, olfactory dysfunction in older adults may be intimately linked to changes in sexual desire and satisfaction. AimTo test whether impaired olfactory function is associated with decreased sexual activity and motivation in older adults. MethodsCross-sectional analysis of a nationally representative sample of community-dwelling older U.S. adults from the National Social Life, Health, and Aging Project. Outcomes2 modalities of olfactory function were measured (sensitivity to n-butanol and odor identification) via validated methods (Sniffin’ Sticks). Respondents answered survey questions about frequency of sexual thoughts (motivation) and sexual activity, and satisfaction with their most recent sexual relationship. A wide range of demographic, health, and social information were also collected. ResultsDecreased olfactory function in older U.S. adults was associated with decreased sexual motivation (odds ratio 0.93, P = .03) and less emotional satisfaction with sex (odds ratio 0.89, P = .04), but not decreased frequency of sexual activity or physical pleasure, in analyses that were adjusted for age, gender, race, education, cognition, comorbidities, and depression. Clinical ImplicationsOlfactory dysfunction may affect sexuality in older adults. Potentially treatable causes of sensory loss should be addressed by clinicians to improve quality of life. Strengths & LimitationsThese results rely on validated olfactory testing, detailed measures of sexual attitudes and behaviors, and extensive demographic, health, and social history in a nationally representative sample of older U.S. adults. Owing to the cross-sectional nature of these analyses, we cannot determine causality. ConclusionsOlfactory dysfunction in older U.S. adults is associated with decreased sexual motivation and emotional satisfaction, potentially due to evolutionarily-conserved neurological links between olfaction and sexuality.Siegel JK, Kung SY, Wroblewski KE, et al. Olfaction Is Associated With Sexual Motivation and Satisfaction in Older Men and Women. J Sex Med 2021;18:295–302.

Fatherhood and Racial/Ethnic Differences in the Progression of Romantic Relationships

AbstractObjectiveThis study examines the influence of fatherhood on the progression of men's romantic relationships.BackgroundHigh levels of relationship flux have resulted in a partner market increasingly characterized by the presence of children, but little is known about how children influence the progression of men's romantic relationships. Children could reduce the likelihood of marriage and increase chances of cohabitation for single fathers in dating relationships, just as prior literature has found for single mothers. Given high levels of racial/ethnic assortative mating, and variation in the prevalence of single parenthood across racial/ethnic groups, the influence of prior children on men's relationships may differ by race/ethnicity as well.MethodThe authors use data from adult male respondents of the 2002–2015 cycles of the National Survey of Family Growth aged 18–45 regarding the most recent sexual relationship (n = 9,255).ResultsResults of propensity score weighted event‐history analyses show that fathers in sexual relationships transition more often and more rapidly into cohabitation than do childfree men, but this pattern varies by race/ethnicity. Children from prior relationships have a strong influence on the progression of non‐Hispanic White men's relationships, hastening cohabitation, and decreasing transitions to marriage, but prior children have little association with the progression of romantic relationships among Black or Hispanic men.ConclusionAlthough fatherhood shapes the progression of men's romantic relationships, the influence of fatherhood varies across racial/ethnic groups in the United States.

Transitions From Sexual Relationships Into Cohabitation and Beyond.

Much research on cohabitation has focused on transitions from cohabitation to marriage or dissolution, but less is known about how rapidly women progress into cohabitation, what factors are associated with the tempo to shared living, and whether the timing into cohabitation is associated with subsequent marital transitions. We use data from the 2006-2013 National Survey of Family Growth to answer these questions among women whose most recent sexual relationship began within 10 years of the interview. Life table results indicate that transitions into cohabitation are most common early in sexual relationships; nearly one-quarter of women had begun cohabiting within six months of becoming sexually involved. Multivariate analyses reveal important social class disparities in the timing to cohabitation. Not only are women from more-advantaged backgrounds significantly less likely to cohabit, but those who do cohabit enter shared living at significantly slower tempos than women whose mothers lacked a college degree. In addition, among sexual relationships that transitioned into cohabiting unions, college-educated women were significantly more likely to transition into marriage than less-educated women. Finally, although the tempo effect is only weakly significant, women who moved in within the first year of their sexual relationship demonstrated lower odds of marrying than did women who deferred cohabiting for over a year. Relationship processes are diverging by social class, contributing to inequality between more- and less-advantaged young adults.

The Progression of Sexual Relationships

The authors examine factors associated with the advancement or dissolution of newly formed sexual relationships. Data from the 2006–2010 National Survey of Family Growth (NSFG) was used to examine women and men aged 18–39 (n = 2,774) whose most recent sexual relationship began within the 12 months before their interview. Results indicate that newly formed sexual relationships are often transitory. By 12 months, only 23% of respondents remained in nonresidential sexual relationships, another 27% were cohabiting with that partner, and half had ended their relationships. Sexual relationships formed before age 25 are significantly more likely to break up than to transition into cohabitation. Indicators of social class disadvantage, such as living with a stepparent, expedited cohabitation, whereas measures of advantage, such as having a college‐educated mother, deterred transitions into shared living. Racial differences also emerge: Blacks were less likely than Whites to transition rapidly into shared living.

Risk evaluations and condom use decisions of homeless youth: a multi-level qualitative investigation.

BackgroundHomeless youth are at higher risk for sexually transmitted infections and unwanted pregnancy than non-homeless youth. However, little is known about how they evaluate risk within the context of their sexual relationships. It is important to understand homeless youths' condom use decisions in light of their sexual relationships because condom use decisions are influenced by relationship dynamics in addition to individual attitudes and event circumstances. It is also important to understand how relationship level factors, sexual event circumstances, and individual characteristics compare and intersect.MethodsTo explore these issues, we conducted semi-structured interviews with 37 homeless youth in Los Angeles County in 2011 concerning their recent sexual relationships and analyzed the data using systematic methods of team-based qualitative data analysis.ResultsWe identified themes of risk-related evaluations and decisions at the relationship/partner, event, and individual level. We also identified three different risk profiles that emerged from analyzing how different levels of risk intersected across individual respondents. The three profiles included 1) Risk Takers, who consistently engage in risk and have low concern about consequences of risk behavior, 2) Risk Avoiders, who consistently show high concern about protection and consistently avoid risk, and 3) Risk Reactors, those who are inconsistent in their concerns about risk and protection and mainly take risks in reaction to relationship and event circumstances.ConclusionsInterventions targeting homeless youth should reflect multiple levels of risk behavior and evaluation in order to address the diversity of risk profiles. Relationship/partner-, event-, and individual-level factors are all important but have different levels of importance for different homeless youth. Interventions should be tailored to address the most important factor contributing to homeless youth reproductive needs.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1419-9) contains supplementary material, which is available to authorized users.

Tanzanian men’s gender attitudes, HIV knowledge, and risk behaviours

This study uses data from the 2004-05 Tanzanian Demographic and Health Survey to examine whether men's traditional gender role attitudes contribute to their sexual risk behaviours for HIV. Logistic regression with random effects were used to analyze effects on risk behaviours at last sex (partners being drunk and condom use) with the three most recent sexual relationships. Men's traditional gender attitudes increased risky sexual behaviours (e.g., not using a condom) even when they had accurate knowledge regarding HIV risks. The impact of men's gender attitudes and HIV knowledge on risky sexual behaviours did not vary by relationship type. Unexpectedly, condom use was more likely when either partner was drunk compared to neither being drunk, though the protective impact of HIV knowledge remained. Overall, these findings suggest that traditional gender attitudes present barriers to preventing HIV/AIDS that even increased knowledge about HIV risks may not overcome.

HIV Testing Among Heterosexual Young Adults: The Influence of Partners' Risk Behaviors and Relationship Dynamics

Using relational theory and survey data from the Toledo Adolescent Relationships Study (n = 665), this article examined whether individuals were tested for HIV while intimately involved in a current or recent heterosexual relationship. The analyses included the respondent's and partner's sexual risk factors (non-exclusivity and lifetime number of partners), relational variables, prior testing, and demographic characteristics. It was found that 39% of respondents had an HIV test while involved in their current or most recent sexual relationship, and women (47%), compared with men (29%), were significantly more likely to have been tested. Whereas some predictors operated similarly (number of sex partners and pressured to have sex), others displayed significant gender differences (partner's sexual exclusivity, sexual communication difficulties, and pregnancy), particularly related to women's testing behaviors. Excerpts from qualitative interviews with male respondents suggested that some relational dynamics, not well reflected in relational theory, played a role in their testing. Results highlight the need to consider gendered dynamics when targeting young adults for routine HIV testing.

The Quality of Young People’s Heterosexual Relationships: A Longitudinal Analysis of Characteristics Shaping Subjective Experience

Research on young people's sexual relationships often overlooks subjective experiences and enjoyment. Perceived quality of sexual relationships may be related to gender, background characteristics, circumstances of first intercourse and subsequent sexual history. Longitudinal data from 13-16-year-olds who participated in randomized trials of school sex education in either Scotland (N=5,356) or England (N=6,269) were used to examine young people's subjective experiences of heterosexual relationships. Logistic regression models tested for associations between selected variables and pressure and regret at first intercourse, pressure and enjoyment at most recent intercourse, and three measures of relationship quality. Of the 42% of youth who reported having had sex by follow-up, most assessed their first and most recent sexual relationships positively. Greater proportions of females than of males felt pressure at first sexual intercourse (19% vs. 10%), regretted their first time (38% vs. 20%) and did not enjoy their most recent sex (12% vs. 5%). Younger age at first sex was an important correlate of partner pressure and regret at first intercourse (odds ratios, 2.0 each, for those 13 or younger vs. 15-16-year-olds). Negative experiences were associated with less control (e.g., feeling pressure, being drunk or stoned, and not planning sex) and with less intimacy (e.g., sex with a casual partner and less frequent sex). Background social characteristics had limited influence compared with circumstances of first intercourse and subsequent sexual history. Most young people evaluated their early sexual experiences positively. The quality of relationships was enhanced by better communication and greater physical intimacy. For a vulnerable minority, however, early sexual experiences were negative. They could be protected by delaying first intercourse, restricting sexual activity to established relationships and learning skills to improve control in sexual encounters.

Measuring Sex Partner Concurrency: It’s What’s Missing That Counts

Sex partner concurrency is an important determinant of STI transmission dynamics, yet its measurement is not standardized. : We assessed the agreement, compared correlates, and investigated data quality and completeness between 2 common concurrency measures. Young adults (ages 18-26) attending public STD clinics between 2001 and 2004 in Seattle, St. Louis, and New Orleans, provided data on 2 or more sex partners in a computer-administered survey interview (N = 680). Concurrency with last partner was measured in 2 ways: (a) a direct question about other sexual contacts during the most recent sexual relationship and (b) overlapping start and end dates of the 2 most recent relationships. Although 56% reported concurrency by direct questioning and 54% by overlapping dates, the kappa statistic for agreement between measures was only fair (0.395). Indeed, 29% of those reporting concurrent partners by the direct question did not do so by overlapping dates and 26% of participants concurrent by overlapping dates were not concurrent by the direct question. Each of the measures had dissimilar correlates, and concurrency data were missing or uninterpretable more often for the overlapping dates measure (21.3%) than the direct question (1.8%). Concurrency was common by both measures but the measures were not interchangeable. Although the overlapping dates measure provided information about partnership duration, it is subject to missing or uninterpretable data. The direct question substantially minimized the amount of missing data and may be more appropriate for use with computer-administered survey interview.

Contraceptive use and consistency in U.S. teenagers' most recent sexual relationships.

Most U.S. teenage pregnancies are unintended, partly because of inconsistent or no use of contraceptives. Understanding the factors associated with contraceptive use in teenagers' most recent relationships can help identify strategies to prevent unintended pregnancy. Data on 1,468 participants in Waves 1 and 2 of the National Longitudinal Study of Adolescent Health who had had two or more sexual relationships were analyzed to assess factors associated with contraceptive use patterns in teenagers' most recent sexual relationship. Odds ratios were generated through logistic regression. Many relationship and partner characteristics were significant for females but nonsignificant for males. For example, females' odds of ever, rather than never, having used contraception in their most recent relationship increased with the duration of the relationship (odds ratio, 1.1); their odds were reduced if they had not known their partner before dating him (0.2). The odds of consistent use (vs. inconsistent or no use) were higher for females in a "liked" relationship than for those in a romantic relationship (2.6), and for females using a hormonal method instead of condoms (4.5). Females' odds of consistent use decreased if the relationship involved physical violence (0.5). Among teenagers in romantic or "liked" relationships, the odds of ever-use and of consistent use were elevated among females who had discussed contraception with the partner before their first sex together (2.9 and 2.1, respectively), and the odds increased among males as the number of presexual couple-like activities increased (1.2 for each). Teenagers must use contraception consistently over time and across relationships despite pressure not to. Therefore, they must learn to negotiate sexual and contraceptive decisions in each relationship.

AIDS, sexuality and attitude of adolescents about protection against HIV

To describe the role of sexual experience based on information and sociocultural contexts for the risk of HIV/AIDS transmission in adolescents. A questionnaire was answered by 1,386 middle school students from the state of Santa Catarina, Southern Brazil, in 2000. The instrument included the following variables: personal characteristics, sexual experience, communication context and knowledge on AIDS, attitudes towards condom use, risk and protective behaviors and feelings. Data analysis comprised statistical description and relational analysis (Chi-square and mean comparison tests). Lack of knowledge about HIV transmission was related to peers as main information source (p<0.05). Steady romantic relationships are the predominant context for sexual relationships with penetration (p<0.001). AIDS protection was associated to three factors: ongoing relationship, number of sexual partners and safe sex (p<0.001). A positive attitude for condom use is favored by talks about sexuality and the intention of condom use (p<0.001). The obstacles to condom use are: having had recent sexual relationships, risk behaviors, inadequate knowledge and dependence of television as an information source (p<0.005). The practice of safe sex is affected by adolescent's level of information, their attitudes about condom use and fear of the epidemic. Reevaluating prevention through multipliers strategy as well as reappraisal of family as mediators and the use of appropriate materials about Aids for teenagers are recommended.

Contraceptive Use and Consistency in U.S. Teenagers' Most Recent Sexual Relationships

CONTEXT: Most U.S. teenage pregnancies are unintended, partly because of inconsistent or no use of contraceptives. Understanding the factors associated with contraceptive use in teenagers' most recent relationships can help identify strategies to prevent unintended pregnancy.METHODS: Data on 1,468 participants in Waves 1 and 2 of the National Longitudinal Study of Adolescent Health who had had two or more sexual relationships were analyzed to assess factors associated with contraceptive use patterns in teenagers' most recent sexual relationship. Odds ratios were generated through logistic regression.RESULTS: Many relationship and partner characteristics were significant for females but nonsignificant for males. For example, females' odds of ever, rather than never, having used contraception in their most recent relationship increased with the duration of the relationship (odds ratio, 1.1); their odds were reduced if they had not known their partner before dating him (0.2). The odds of consistent use (vs. inconsistent or no use) were higher for females in a “liked” relationship than for those in a romantic relationship (2.6), and for females using a hormonal method instead of condoms (4.5). Females' odds of consistent use decreased if the relationship involved physical violence (0.5). Among teenagers in romantic or “liked” relationships, the odds of ever‐use and of consistent use were elevated among females who had discussed contraception with the partner before their first sex together (2.9 and 2.1, respectively), and the odds increased among males as the number of presexual couple‐like activities increased (1.2 for each).CONCLUSIONS: Teenagers must use contraception consistently over time and across relationships despite pressure not to. Therefore, they must learn to negotiate sexual and contraceptive decisions in each relationship.

Contraceptive Use and Consistency in U.S. Teenagers' Most Recent Sexual Relationships

Contraceptive Use and Consistency in U.S. Teenagers' Most Recent Sexual Relationships

Effects of child and adult sexual abuse on adult sexuality

The differential effects of child and adult sexual abuse on adult sexual functioning were examined. The Golombok Rust Inventory of Sexual Satisfaction (GRISS)1 and a sexual experiences questionnaire were administered to 201 psychology students at the University of South Florida, 175 of whom were retained in the study. GRISS variables that were analyzed consisted of anorgasmia, sexual avoidance, sexual dissatisfaction, sexual noncommunication, nonsensuality, and vaginismus. Women who were sexually abused in adulthood were more sexually dissatisfied and nonsensual than women who had no history of sexual abuse. In addition, women who had a history of sexual abuse in childhood or adulthood were less satisfied with the overall quality of their most recent sexual relationship than non-abused women and had higher numbers of unsafe sexual partners.

Sexual decision making and object relations theory.

The Sexual Decision-Making Inventory (SDMI) was developed to measure levels of sexual decision making based on the developmental concepts of Object Relations Theory. The inventory asks subjects to report on their thoughts and feelings at the time they decided to have sex in their most recent sexual relationship. The inventory was tested in a pilot study involving 45 male and 49 female undergraduates. A factor analysis was performed on the SDMI and six levels of sexual decision making were defined: Object Constancy, Ambivalence, Need for Merger, Need Gratification, Low Self-esteem, and Narcissistic Gratification. Endorsement of items on these subscales was related to perceptions of the relationship. In a second study involving 79 male and 135 female undergraduates, subjects completed the SDMI, the Bell Object Relations Self-report Inventory, and a questionnaire concerning perceptions of the relationship in which the sexual decision was made. Object Constancy was positively correlated to object relations, satisfaction with the relationship, and durability of the relationship; Ambivalence, Need Gratification, and Low Self-esteem were negatively correlated with object relations, satisfaction with the relationship, and durability of the relationship; Narcissistic Gratification was negatively correlated with object relations and most aspects of the relationship with interesting exceptions such as sexual satisfaction. Sex differences demonstrated that females were more likely to endorse items on the Object Constancy subscale; whereas males were more likely to endorse items on the Ambivalence, Need Gratification, and Narcissistic Gratification subscales. There were no sex differences, however, in quality of general object relations.