Sexual History Research Articles

WTP7.7 A novel sexually transmitted infection (STI) testing and screening programme in an Ambulatory Surgical Clinic (ASC) for female patients presenting with abdominal pain

Abstract Aims Methods Women aged 18-44 years presenting to ASC were offered a voluntary self-collected high vulvovaginal swab for chlamydia and gonorrhoea at triage. Data was collected over one year (Dec 2021-Dec 2022). Testing was offered to 299 patients, 20 declined to participate and 18 samples were rejected. Positive results were referred to the Sexual Health service for treatment and contact tracing as agreed on a pre-planned referral pathway. Results 5.4% of swabs were positive (2 Gonorrhoea and 12 Chlamydia). The mean age of those testing positive was 24.5. All positive patients presented initially with lower abdominal pain. Of those testing positive 7 had further imaging (USS pelvis) and only 25% had a documented sexual history taken. 4 women had diagnostic imaging indicative of PID and 4 patients were treated for PID empirically. The remaining patients were treated for non-specific abdominal pain or unrelated pathology. Conclusions Undiagnosed sexually transmitted disease is prevalent and young females presenting with lower abdominal pain provide an excellent testing cohort. Given the high incidence of positive tests, further training of surgeons to consider and ask pertinent questions regarding an STI diagnosis is vital. The introduction of self-swab testing has been successful in assisting as a diagnostic tool and screening programme.

Risk Factors of Infection and Transmission of Viral Hepatitis B and E

Viral hepatitis is a disease burden in Africa and globally. It can be caused by RNA or DNA virus, which is hepatotropic and can pose a financial burden on the individual, their family, and society. Hepatitis B virus (HBV) is a DNA virus that can be present in blood and body fluids, including saliva, semen, and vaginal secretion. It is par-enterally transmitted with horizontal and vertical transmission. The risk of infection and transmission of hepatitis B virus infection could be a result of occupational exposure, use of unsterilized blades for traditional and cultural practices in Africa like tribal marks, level of awareness on prevention and adherence to standard or universal precautions. The risk of infection and transmission of hepatitis B virus infection also includes individual sexual history, the availability and access to vaccines, the level of occupational hazards exposure, the level of vaccine acceptance and the vaccination status of individuals. Hepatitis E virus (HEV) is a single-stranded RNA virus that is transmitted through the faeco-oral route by consumption of contaminated food and water. Low socio-economic status, poor environmental sanitation, poor water supply, poor sewage disposal facilities, level of awareness on prevention, poor social condition and decreased personal hygiene are associated factors for the risk of hepatitis E virus infection. Knowledge and community-based awareness and practice of World Health Organization (WHO) preventive practices and treatments could reduce the burden of hepatitis B and E virus infections. Mediscope 2023;10(2): 89-92

Hegemonic Monosexuality

Recent scholarly work has focused on the erasure and mistreatment of bisexuality in histories of sexuality. Such erasure is not only observed in academic work but also in the lived experiences of people who identify as plurisexuals. The present paper brings together studies on bisexuality, hegemony, and sexual politics to explain the discursively produced demarcation between sexualities and forms of sexual expression, and it supports a focus on monosexuality as a theoretical construct that productively addresses issues of discrimination and marginalization that people identifying as plurisexuals endure. What is put forward and challenged through this paper is the functional potential of monosexuality to maintain a sociodicy whereby the nuclear family and its contingent material implications remain not only unchallenged and normative but also inevitable.

They Were the Best and the Worst of Times: Reflections Illuminate Emerging Adults’ Sexual Experiences

Abstract Introduction Human sexuality courses are offered at most universities. Students often bring a breadth of experiences and a need for emotional processing of these narratives into these courses as it relates to course content. The purpose of this study was to expand research exploring emerging adults’ sexuality narratives to be inclusive of positive stories. Methods Guided by a semi-structured questionnaire, 113 students from two USA universities reflected in 2017 on their sexual history using an established educational activity asking students about their “best” and “worst” sexual experiences. Results Qualitative analysis resulted in five themes describing their “Best” and four themes describing their “Worst” sexual experiences and one theme with dual meaning. “Best of” was highlighted by student themes of romance, beyond intercourse, emotional intimacy, listening, and safety. “Worst of” was highlighted by themes of physical health factors, alcohol and/or substance use/misuse factors, exploitation and victimization, and feelings of shame. The dual meaning theme of firsts emerged in both best of and worst of. Conclusions Findings suggest that human sexuality courses must consider students’ lived experiences. Further, we propose a call-to-action for clinically trained mental health professionals, such as social workers, as sexuality educators. Policy Implications Universities should incorporate sexual health education policies that acknowledge students who bring a collection of sexuality stories to learning spaces. Centering a student’s sexual voice also would support campus programs, policies, and interventions that benefit students. Finally, policies that guide professional accreditation of social work university programs to include sexual wellness content in the curricula are warranted.

Unrecognised orgasmic phase disorders in men presenting with new-onset erectile dysfunction-Findings from a real-life, cross-sectional study.

Orgasmic phase disorders in men worsen the burden of erectile dysfunction on sexual satisfaction. To investigate the prevalence of and predictors of unreported orgasmic phase disorder in a cohort of men looking for their first urological assessment for new-onset erectile dysfunction in a real-life setting. Data from 1107 heterosexual, sexually active men consecutively assessed for new-onset erectile dysfunction were analysed. Throughout a comprehensive medical and sexual history, all patients were asked to self-report any orgasmic phase disorder and to complete the International Index of Erectile Function and the Beck's Inventory for Depression (depressive symptoms scored as Beck's Inventory for Depression ≥11). Men self-reporting orgasmic phase disorder during the interview were excluded from further analyses. The median value of the International Index of Erectile Function-orgasmic function domain was arbitrarily used to categorise men with (International Index of Erectile Function-orgasmic function ≤5) and without unreported orgasmic phase disorder (International Index of Erectile Function-orgasmic function >5). Circulating hormones were measured in every patient. Descriptive statistics and logistic regression models were used to test the association between clinical variables and unreported orgasmic phase disorder. Of 1098 patients with non-self-reporting orgasmic phase disorder, 314 (28.6%) had International Index of Erectile Function-orgasmic function ≤5. Patients with erectile dysfunction + unreported orgasmic phase disorder were older (median [interquartile range]: 58 [44-66] years vs. 51 [40-60] years), had higher body mass index [25.8 (23.7-28.1) kg/m2 vs. 25.2 (23.3-27.4) kg/m2 ], higher prevalence of type 2 diabetes (36 [11.5%] vs. 45 [5.7%]) and lower International Index of Erectile Function-erectile function scores (6 [2-10] vs. 18 [11-24]) than men with erectile dysfunction-only (all p<0.05). Patients with erectile dysfunction + unreported orgasmic phase disorder depicted higher rates of severe erectile dysfunction (75.5%vs. 25%) and Beck's Inventory for Depression ≥11 (22.6%vs. 17.9%) (all p<0.05). In the multivariable logistic regression analysis, older age (odds ratio: 1.02) and lower International Index of Erectile Function-erectile function scores (odds ratio: 0.83) were independently associated with unreported orgasmic phase disorder (all p<0.05). Almost one in three men seeking first medical help for erectile dysfunction depicted criteria suggestive of unreported orgasmic phase disorder. Men with unreported orgasmic phase disorder were older and had higher rates of severe erectile dysfunction and concomitant depressive symptoms. These real-life findings outline the clinical relevance of a comprehensive investigation of concomitant sexual dysfunction in men only complaining of erectile dysfunction to more effectively tailor patient management.

Relationship between pelvic sensations and lifetime exposure to receptive anal intercourse among people with prostates.

Despite the negative stigma on receptive anal intercourse (RAI), this behavior has a positive influence on individuals' sexual and relationship health. No large studies have previously looked at specific sensations experienced during RAI and how these sensations may change with experience. In this study we aimed to quantify commonly reported pelvic sensations during RAI and determine whether their presentation changes with increasing experience of RAI. An internet survey was conducted on sensations felt during RAI among people with prostates from July 2022-January 2023. The survey content was developed based on a mixed-methods qualitative study and inquired about demographic and sexual histories as well as sensations (pleasure, pain, urinary, and bowel) experienced during RAI. We used descriptive statistics to describe demographic and sexual histories. All data were stratified by lifetime exposure to RAI. The primary outcomes assessed included the quantification of both the primary sensations experienced during RAI and the associated bother. In total, 975 participants completed the survey. The median age was 32 (range 18-78) years. The average age of first participation in RAI was 21 ± 6.6 years. Most respondents were having sex at least once a week (65%). Nine percent of respondents reported fewer than 10 experiences with RAI, 26% reported 11-50 RAI experiences, 32% reported 51-200 experiences, 16% reported 201-500 experiences, and 18% reported >500 experiences. As the number of experiences with RAI increased (from <10 to >500 exposures), the reported frequency of pleasurable sensation increased from 41% to 92% (P < .0001), whereas severe insertional pain and symptoms of bowel urgency decreased from 39% to 13% and from 21% to 6%, respectively (P < .0001). Urinary urgency sensation did not differ by lifetime RAI experience. Lifetime RAI exposure can be readily assessed and correlates not only with pelvic sensation but also many other aspects of sexual health. These results imply that the etiology of dissatisfaction with pleasure or anodyspareunia during RAI may differ by lifetime RAI exposure. This is the first study to our knowledge to assess pelvic sensations experienced during RAI among a large sample of individuals. This is a cross-sectional study, and we cannot conclude how pelvic sensations change over time among individuals. Internet-based participants may not be representative of clinical populations. Lifetime exposure to RAI is positively associated with pleasure and is negatively associated with pain and bowel urgency. Pelvic sensations experienced during RAI appear to be dependent on lifetime RAI exposure history regardless of age.

Same-sex relationships and recriminalisation of homosexuality in Ghana

Most Ghanaians conveniently ignore or vehemently deny the existence of homosexual relationships in precolonial Ghanaian cultures. The denial of these relationships in precolonial Ghanaian cultures has gained attention due to section 104 of the Criminal Offences Act of Ghana which criminalises ‘unnatural carnal knowledge’ and the ‘promotion of proper human sexual rights and Ghanaian family values bill, 2021’ (anti-LGBTQI+ bill), currently being debated in Ghana’s Parliament. Historical evidence suggests, however, that Western European researchers who first visited Africa and Ghana suppressed evidence of homosexuality, while indigenous people unwittingly concealed homosexual relationships because of a ‘culture of silence’ surrounding sex and sexuality in precolonial Ghana. From a decolonial theoretical perspective, this article argues that the non-appreciation of precolonial Ghanaian (homo)sexual history partly accounts for the criminalisation of same-sex sexual relationships, homophobia, violence, and violations of the rights of sexual minorities in contemporary Ghana. The paper connects the presence of same-sex sexual intimacies in the Gold Coast (now Ghana), and the absence of criminal sanctions as a basis for rethinking current attempts in Parliament to recriminalise homosexual relationships, in order to chart a path of the equal legal protection of every person, regardless of their sexual orientation.

Decomposing the Gap in Contraceptive Use Among Female Adolescents and Young Women Aged 15-24 in India: An Analysis of Appended Datasets of NFHS-4 and 5.

Owing to the reproductive health needs of the budding adolescent and young population, the present study aims to determine the factors associated with and decomposing the gap in contraceptive use among adolescents and young women in India. Cross sectional design.SettingThe present study is based in India using the appended datasets (IV and V rounds) of the Indian Demographic Health Survey (DHS), also known as National Family Health Survey (NFHS) conducted in 2015-16 and 2019-21. The adequate sample size was 475,294 adolescents and young women in NFHS-4 and 229,705 in NFHS-5, totaling 704,999 adolescents (appended for NFHS-4 and 5) for the present study. Sociodemographic, sexual and reproductive history and contraceptive measures. Descriptive statistics, chi-square tests, and a binary logistic regression model were executed. Additionally, a decomposition technique called Fairlie decomposition was employed to identify the primary causes of the difference in the prevalence of contraceptive use between the two survey periods. Almost 96% of young women aged 15-24 knew about contraception, but only 12% used it. Regression analysis revealed that contraceptive use was associated with higher age (AOR 1.09), higher education (AOR 1.28), married adolescents (AOR 4.08), richest wealth quantile (AOR 2.95), joint decision making (AOR 4.40), knowledge of ovulatory cycle (AOR 1.47), interaction with a health worker about any methods of family planning (AOR 3.29) and three and above children ever born (AOR 18.54). Decomposition analysis showed that factors like decision-making of contraception, age, interaction with family planning worker, the intention of last pregnancy, place of residence and age at first sex contributed to increasing the probability of contraceptive use from NFHS-4 to 5. A target-based approach dedicated to understanding the mindset of adolescents and keeping up with their unique needs is the need of the hour.

Associations Between Sexual History Documentation in Electronic Health Records and Referral to Pre-Exposure Prophylaxis Navigator on Prescription of Pre-Exposure Prophylaxis at a Multi-Site Federally Qualified Health Center.

This cross-sectional study examined the relationships between sexual history screening (SHS) and referrals to a pre-exposure prophylaxis (PrEP) navigator (non-clinical staff member who assists patients in overcoming structural barriers to PrEP) on the proportion of days covered by PrEP for adult patients at a federally qualified health center. Patients' sociodemographics, PrEP prescriptions, referral to a PrEP navigator, and SHS data were extracted from the electronic health record (EHR). The analytic sample was 214 adult patients who were human immunodeficiency virus (HIV) negative and taking PrEP to prevent infection from January 2016 to December 2019. Mixed-effects negative binomial models were conducted accounting for clustering by patients' primary care providers. Documentation of SHS was associated with a higher proportion of days covered by PrEP (incidence rate ratio = 1.44, 95% confidence interval: 1.17-1.77). There was no significant effect of having a referral to the PrEP navigator on the proportion of days covered by PrEP, nor did having a referral to the PrEP navigator moderate the relationship between having SHS documented in the EHR and the proportion of days covered by PrEP. This study is the first to investigate the relationship between having sexual history documented in the EHR, referrals to a PrEP navigator, and their combined effect on the proportion of days covered by PrEP. Results of this study provide foundational evidence for future studies examining SHS as an opportunity to improve PrEP access and adherence and indicate the need for additional research exploring the value of PrEP navigators as an implementation strategy to overcome social and structural barriers to care.

Risk Factors for Cervical Cancer Incidence at Ibnu Sina Hospital Makassar

Cervical cancer is a malignant tumor that occurs in the cervical region at the end of the cervix. Based on data from the International Agency for Research on Cancer (IARC), it is known that the second highest cause of death is cervical cancer, reaching 460,000 cases and 230,000 women deaths. Cervical cancer is caused by HPV infection and several factors, namely age, parity, age of first sexual intercourse, number of sexual partners history, HPV vaccination history, smoking history, and oral contraceptives history. To determine the risk factors for cervical cancer incidence at Ibnu Sina Hospital Makassar. This was descriptive retrospective study method. With cross sectional research design. The total sample was 68 people with cervical cancer at Ibnu Sina Hospital Makassar. The distribution of age 30-60 years (85.3%), parity &gt;3 (57.4%), and age of first sexual intercourse &gt;17 years (85.3%). There was no history of using oral contraceptives (54.4%), HPV vaccination history (97.1%), and smoking history (98.5%). Having only 1 history of number of sexual partners (89.7%), employment history was not out of town (63.2%), and the most common type of cervical cancer was squamous cell carcinoma (76.5%). The distribution of risk factors for the incidence of Cervical Cancer at Ibnu Sina Hospital was mostly found at the age of 30-60 years, parity&gt; 3, age of first sexual intercourse &gt;17 years, no history of using oral contraceptives, no HPV vaccination history, no smoking history, having 1 history of sexual partners, work history not out of town, and the type of cervical cancer is squamous cell carcinoma.

Determination of Prostate Specific Antigen Level among Male Patients with Bacterial Urinary Tract Infections Attending Kuje General Hospital Abuja, Nigeria

Recent hospital and cancer registry data shows increasing prostate cancer incidence in Nigeria, which was previously regarded as a low incidence region. Prostate cancer is the leading cause of cancer death among men in Nigeria and second most common cancers of men worldwide and sexual history has been a consistent risk factor. Prostate specific antigen (PSA) test is still the single most important test for early detection of prostate cancer worldwide. However, not much is reported about prostate cancer in relation to urinary tract infections in Africa. This study investigates the prevalence of prostate cancer risk in and bacterial urinary tract infections among men in Abuja, Nigeria. One Hundred (100) samples each of blood and urine were collected, from fifty (50) male patients suffering from urinary tract infections and fifty (50) apparently healthy males attending Kuje General Hospital Abuja, Nigeria. All the blood samples were subjected to PSA analysis using Enzyme-linked Immunosorbent Assay procedure (Diagnostic Automation/ Cortez Diagnostics, Inc, USA) while urine analysis (microscopy, culture and biochemical identification) was performed on the urine to isolate and identify the common bacteria associated with urinary tract infections among the study population.

Psychological morbidities among spouses of men with type 2 diabetes mellitus and erectile dysfunction in a primary care setting.

Erectile dysfunction (ED) negatively affects patients' emotions. However, its effect on spouses' psychological well-being remains largely unknown. This study aimed to examine psychological morbidities and their associated factors among spouses of men with type 2 diabetes mellitus (T2DM) and ED. This cross-sectional study included 115 women recruited through their husbands who were patients at a selected government health clinic in Malaysia. A self-administered questionnaire containing the Depression Anxiety and Stress Scale-21 and items on health-related information, marital history, sexual history and perception of husband's ED was used to assess possible depression, anxiety and stress. The prevalence of psychological morbidities was 28.7% (depression=17.4%, anxiety=25.2% and stress=10.4%). Most respondents were middle-aged [median (interquartile range)=44.0 (11.0) years], were employed (55.7%) and had a low income (81.7%). About 47.0% of the spouses had a medical problem. The mean marriage duration was 18.7 (standard deviation=7.9) years. Almost all (90.4%) had sexual intercourse (SI) within the previous month. The majority had moderate-to-high interest in SI (72.2%) with a frequency of one to two times per week (69.6%). The majority (75.7%) did not perceive their husband as having ED. Multiple logistic regression demonstrated that medical illness was significantly associated with anxiety (adjusted odds ratio=2.85, 95% confidence interval=1.11-7.29, P=0.029). Psychological morbidities were present among the spouses of men with T2DM and ED. Psychological well-being was significantly affected by their medical illness. Despite their husband's ED, the women declared to have regular sexual relationships and did not perceive their husband as having erectile problems.

Psychometric Properties of the Brief Resilience Scale Among Alternative Sexuality Community Members.

Assessing resilience among alternative sexuality (alt-sex; e.g., kink, polyamory) community members is imperative as alt-sex individuals often face discrimination and possess intersecting marginalized identities. The Brief Resilience Scale (BRS) has extensive psychometric support; however, prior research indicates both a one- and two-factor (i.e., succumbing and resilience) structure. Further, the psychometric properties of the BRS have not been examined among alt-sex community members. As such, the current study examined the BRS factor structure among alt-sex individuals and measurement invariance across demographic groups (i.e., sexual orientation, gender identity, and sexual assault history). Confirmatory factor analyses and multi-groups invariance analyses were conducted. The two-factor BRS model demonstrated better fit to the data. Model fit did not differ by sexual orientation or gender identity. Measurement invariance was observed by lifetime sexual assault history, with higher factor loadings on succumbing items among alt-sex community members with a lifetime history of sexual assault. Our findings support use of the BRS to measure resilience among alt-sex individuals. Succumbing, or weakened resilience, is a salient factor for alt-sex community members who are sexual assault survivors, warranting further attention.

Multivariate Patterns of Substance Use, Minority Stress and Environmental Violence Associated with Sexual Revictimization of Lesbian and Bisexual Emerging Adult Women

This study documented between-group differences in factors associated with sexual revictimization histories in a sample of young sexual minority women. Diverse samples of lesbian (N = 204, ageM = 23.55 years) and bisexual (N = 249, ageM = 23.35 years) women from the United States were recruited using the CloudResearch platform to assess factors associated with recent experiences of intimate partner violence (IPV). Participants were categorized into four groups based on self-reports of sexual victimization (a) during childhood and (b) during adulthood in intimate relationships. Multivariate Analysis of Variance (MANOVA) was used to model between-group differences in three variable domains: Past-year substance use involvement, minority stress, and violence in relationship and community settings. Lesbian women reporting sexual revictimization in adulthood reported significantly higher scores for measures of past-year substance use involvement and negative consequences, daily discrimination experiences, relational victimization, and criminal victimization, compared to their counterparts with no history of sexual victimization. Among bisexual women, sexual revictimization was associated with a similar pattern of between-group differences. The sexual revictimization experiences of sexual minority women appear to occur in the context of multivariate patterns of harmful substance use, minority stress, and violence in both relationship and community settings. Our findings have implications for how intervention services are provided to emerging adult sexual minority women who experience multiple episodes of sexual abuse during their lifespans. Recommendations include specialized training for counseling or intervention service providers, integrated trauma-informed services that address both substance use and sexual assault issues, and affirmative services for sexual minority women.

“Stigmatization and perceived dangerousness for intrafamilial child sexual abuse of fathers with a history of sexual offenses and paraphilic interests: Results from a survey of legal psychological experts”

BackgroundIntrafamilial child sexual abuse (ICSA) is a puzzling phenomenon that is not well understood by researches. Nevertheless, psychologists are demanded to assess the risk for child maltreatment by family courts regarding male caregivers with a history of sex offenses and/or paraphilic interests. ObjectiveThe aim of this study was to assess legal psychological experts' perspective on risk assessment in family court proceedings regarding ICSA, their opinions regarding the necessity of contact limitations between fathers/stepfathers who might impose a risk for ICSA, and experts' stigmatization of minor-attracted persons. Participants and setting153 psychological experts working in family court proceedings were assessed via an online survey. MethodJahnke's Stigma Inventory was used as well as a questionnaire tapping into different contact limitations, the perception of child maltreatment risk, and parental capacity. Network analysis was conducted to multivariately investigate item intercorrelations. ResultsFathers/stepfathers with a diagnosed pedophilic disorder are being regarded as most dangerous, 71 % of the experts agreed with the necessity of a complete contact ban. Reduced parental capacity and increased risk for child maltreatment was observed with regard to sexual offending history and paraphilias. ConclusionsPsychological experts in family court proceedings hardly discriminate between sexual offending and paraphilic interests which might be associated with stigmatizing attitudes and lack of experience. An increasing cooperation between family psychologists and experts of forensic risk assessment might reduce the risk of stigmatization and may contribute to more adequate risk assessments for ICSA thus aiding to prevent children from sexual victimization or misinformed risk management interventions.

Sexual Assault History May Moderate Posttraumatic Cognition and Posttraumatic Stress Among Trauma-Exposed Sexual Minority Women

Sexual minority women (SMW) are highly vulnerable to trauma exposure and posttraumatic stress disorder (PTSD) symptoms following trauma exposure. Negative posttraumatic cognitions (i.e., negative cognitions about self, world, and self-blame following trauma exposure) are hypothesized to exacerbate and maintain the relationship between trauma exposure and PTSD symptoms. Posttraumatic cognitions are particularly important to examine in relation to PTSD symptoms among trauma-exposed SMW given their elevated risk for trauma exposure and PTSD. It is also important to understand whether the strength of this relationship differs as a function of trauma type to elucidate potentially differential pathways for risk by trauma type in this population. The current study explored whether trauma type (sexual assault vs. nonsexual trauma) moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity among a sample of trauma-exposed SMW. Participants were SMW (n = 516) users of an online survey platform, Prolific. Data were collected via 20-minute online survey. Results indicated that trauma type moderated the relationship between negative posttraumatic cognitions and PTSD symptom severity, such that the relationship was stronger among those who had experienced at least one sexual assault in their lifetime. Results suggest that negative posttraumatic cognitions may be more strongly related to PTSD symptom severity among SMW who have experienced at least one sexual assault. Notably, this difference was in magnitude only, as the posttraumatic cognition–PTSD symptom relationship remained significant among nonsexual trauma survivors. Negative posttraumatic cognitions may be an especially relevant treatment target among SMW survivors of sexual assault.

Comprehensive evaluation of hematospermia in patients with acute epididymitis compared to patients with isolated hematospermia.

Among the most commonly known causes of hematospermia are infections in the genitourinary tract, but no study exists that has comprehensively investigated hematospermia in patients with acute epididymitis. To assess the impact of hematospermia in patients with acute epididymitis and its association with clinical, microbiological, and semen parameters. Since May 2007, a total of 324 sexually active patients with acute epididymitis were recruited in a prospective cohort study. Patients received a comprehensive medical and sexual history, and clinical, sonographic, laboratory, and microbiological diagnostics. Antibiotic therapy was given according to European Association of Urology guidelines. Semen analysis was offered 14 days after the first presentation and initiation of therapy. Since 2013, a separate control group of 56 patients presenting with isolated hematospermia (=no other urogenital symptoms) was prospectively recruited, and differences between the groups were statistically evaluated. Of 324 patients with acute epididymitis, 50 patients (15%) had self-reported hematospermia. This occurred with a median of 24h before the onset of scrotal symptoms and was associated with significantly elevated prostate-specific antigen levels compared to 274 patients without hematospermia (3.1vs. 1.8ng/ml, p<0.01). The two most common etiological pathogens were Escherichia coli and Chlamydia trachomatis, and the bacterial spectrum was comparable in both epididymitis subgroups (p=0.859). Semen analysis at 14 days still showed hematospermia in 24% of patients associated with massive leukocytospermia. Compared to the hematospermia control group, the two epididymitis subgroups showed significantly increased inflammation markers (pH, leukocytes, and elastase), reduced sperm concentration, and reduced levels of alpha-glucosidase and zinc (always p<0.01). In sexually active patients who develop acute epididymitis, self-reported hematospermia is evident in 15% of patients as early as one day before the onset of scrotal symptoms. Conversely, none of the 56 patients presenting with isolated hematospermia developed epididymitis within the next 4 weeks.

Men’s engagement in and enjoyment of cunnilingus: The role of gendered attitudes, sexual scripts, and masculinity

There is currently little research investigating men’s lack of engagement in cunnilingus. This study explored reasons why some men do not engage in cunnilingus, as well as characteristics that distinguish those who engage from those who do not. A convenience sample of 935 straight and bisexual/pansexual male participants were asked to indicate whether they have ( n = 833, Mage = 37.14, SDage = 14.12) or have not ( n = 102, Mage = 21.63, SDage = 6.11) engaged in cunnilingus. Additionally, we interrogated participants’ sexual history, precarious manhood belief, sexist beliefs, sexual narcissism, homophobia, and attitudes toward women’s genitals. Our results indicated that engagement in cunnilingus is very common among men who have sex with women, with 89.09% of our sample having performed oral sex at least once and the overwhelming majority of engagers (94.47%) indicating enjoyment. However, we also identified that men who do not engage in cunnilingus demonstrated greater levels of homophobia, had more negative attitudes toward women’s genitals, and were less likely to be sexually narcissistic than men who did engage in cunnilingus. Endorsement of precarious manhood belief, benevolent sexism, and hostile sexism did not influence engagement in cunnilingus. Results also indicated that the primary reason men do not engage in or enjoy cunnilingus—aside from lack of opportunity—was the perception that cunnilingus is “gross.” Further, men who engaged in oral sex but did not enjoy it demonstrated greater endorsement of both precarious manhood belief and hostile sexism, as well as higher levels of homophobia and more negative attitudes toward women’s genitals.

Current Inpatient Screening Practices for Sexual History and STIs: An Opportunity to Seize.

The American Academy of Pediatrics recommends utilizing hospitalizations as an opportunity to provide sexual health screenings for adolescents. This study aimed to describe the current practice of sexual history documentation (SHxD) and sexually transmitted infection (STI) testing among adolescents admitted to a pediatric hospital medicine service. Retrospective cross-sectional study of adolescents (14-19 years old) admitted to the PHM service from 2017-2019 was performed at an academic children's health system. Patient (demographics, history of complex chronic condition, and insurance), hospitalization (length of stay, diagnosis, STI tests ordered/results), and physician (level of training and gender) characteristics were extracted for each encounter. A natural language processing algorithm identified the presence of SHxD. Univariate analysis and multivariable analysis were performed to detect factors associated with SHxD and STI screening. The prevalence of STIs was calculated for those who were tested. Out of 2242 encounters, SHxD and STI testing rates were 40.9% and 17.2%, respectively. Patient gender, race, lack of complex chronic condition, and resident involvement were predictive of SHxD and STI testing. SHxD increased the odds of STI testing significantly (OR 5.06, CI 3.90-6.58). Among those who were tested, the prevalence of STIs was highest for chlamydia (37/329, 11.2%). Overall, sexual health screening rates remain low in the hospital setting and future improvement initiatives are needed.

A Network Comparison of Sexual Dysfunction, Psychological Factors, and Body Dissociation between Individuals with and without Sexual Trauma Histories

ABSTRACT Sexual dysfunction is associated with psychological symptoms, including depression and anxiety. Sexual dysfunctions are often attributed to dissociation symptoms in individuals who reported sexual trauma histories. This study utilized a network approach to analyze relationships between sexual and psychological symptoms and examine whether the identified network structures differed between individuals who reported a history of sexual trauma and those who did not. Sexual dysfunction, history of sexual trauma, internalizing symptoms, dissociation symptoms, sex-related shame, and negative body image were assessed in 1,937 United States college students (women = 69.5%). Nearly half (46.8%) of the participants reported a sexual trauma history in their lifetime. Using regularized partial correlation networks, the relationships between sexual and psychological symptoms were analyzed and compared between groups with and without trauma histories. Internalizing symptoms were positively correlated with sexual dysfunction regardless of the presence of sexual trauma history. Anxiety had a stronger influence in the trauma network than in the no-trauma network. Feeling separated from the body during sexual activity was a central symptom and was related to difficulties relaxing and enjoying sex only in the trauma network. Sex-related shame appeared to play a more important role in men compared to women. To improve clinical practice of assessing and treating sexual dysfunction, researchers and clinicians should consider core symptoms that connect different aspects of sexual and psychological functioning while being aware of the unique role of dissociation in the context of traumatic stress.