Use Of Sex Toys Research Articles

Sexual intercourse activity and activities associated with sexual interaction in Norwegians of different sexual orientations and ages

To study different subgroups of Norwegians’ frequency of sexual intercourse and the activities that Norwegians engage in during intercourse. Data were collected from a questionnaire survey of a representative web sample of 4,160 Norwegians aged 18 to 89 years. The response rate was 35%. The majority of men (65%) and women (61%) reported sexual intercourse activity during the past month, and it was most common to report such activity 2 or 3 times per month. Partnered participants most often reported having intercourse weekly. The intercourse frequency of 2 to 3 times per week declined from 35% in participants aged 18 to 29 years to 8% in participants 60 years and older. The most common heterosexual activities reported were vaginal sex, stimulated genitals with the hands or mouth, use of sex toys, and anal sex. Younger and middle-aged Lesbian, Gay, Bisexual, Transgender/Transsexual, Intersex, Asexual [LGBTIA] men most often reported activities such as mutual masturbation, oral sex, and anal sex. Younger and middle-aged LGBTIA women most frequently reported mutual masturbation, vaginal sex, and oral sex. There seems to be a generational shift in types of activities in participants 59 years or younger, and those 60 years and above.

Sex During Pandemic: Panic Buying of Sex Toys During COVID-19 Lockdown

The COVID-19 pandemic has affected almost every part of human life which reveals several peculiar human behaviors. Panic buying is one of the erratic phenomenon that has been observed in many countries of the world during this COVID-19 pandemic. The selling of online sex dolls, lingerie, and sex toys was increased during the COVID-19 lockdown in several countries like Australia, UK, Denmark, Colombia, New Zealand, Italy, Spain, France, India, North America, and Ireland. The increase in sex toy market turnover has several implications such as customization of recreational facilities, limitations in alternative sources of pleasure, need to have sex and unfortunately, and unavailability of a partner. We speculate that people may buy sex toys in response to perceived scarcity, perceived short supply, the anticipation of price hike, or to get control over the environment. However, there could be other factors such as an extra time to explore sexuality, and being apart from the partners. There is a need to study the sexual behavior and sex toy use among people in the post-pandemic era and their repercussions on the intimate relationship.

Initial Impacts of COVID-19 on Sexual Behaviour in Britain: Findings from a Large, Quasi-Representative Survey (Natsal-COVID)

Background: Social restrictions imposed to combat COVID-19 dramatically altered sexual lifestyles but the specific impacts on sexual behaviour are still emerging. We examined sexual activity, frequency, and satisfaction following lockdown in Britain in March 2020 and compared to pre-lockdown. Methods: Weighted analyses of web-panel survey data collected July/August 2020 from a quota-based sample of 6,654 people in Britain (18-59yrs). Multivariable regression examined independent associations of relationship status, age, and gender with perceived changes in frequency and satisfaction. Findings: Most participants (86.7%) reported some form of sex in the four months following lockdown with physical activities more commonly reported than virtual activities (83.7% vs. 52.6%). Altogether, 63.2% reported sex with someone (‘partnered sex’) since lockdown, three-quarters of whom were in steady cohabiting relationships. With decreasing relationship formality, partnered sex was less frequently reported, while masturbation, sex toy use, and virtual activities were more frequently reported. Around half of all participants perceived no change in partnered sex frequency compared to the three months pre-lockdown, but this was only one-third among those not cohabiting, who were more likely to report increases in non-partnered activities than those cohabiting. Two-thirds of participants perceived no change in sexual satisfaction; declines were more common among those not cohabiting. Relationship informality and younger age were independently associated with perceiving change in both frequency and satisfaction. Interpretation: COVID-19 restrictions led to significant shifts in sexual repertoires, frequency, and satisfaction for a minority in Britain; predominantly those not cohabiting and young people. Funding: Natsal (Wellcome/ESRC/NIHR), MRC/CSO, and UCL COVID-19 Rapid Response Fund. Declaration of Interest: The other authors declare that they have no conflicts of interest. Ethical Approval: We obtained ethics approval from University of Glasgow MVLS College Ethics Committee (reference 20019174) and London School of Hygiene and Tropical Medicine Research Ethics committee (reference 22565).

Gendered morality in the sex toy market: Entitlements, reversals, and the irony of heterosexuality

This article characterizes norms of sexual morality in the sex toy market, revealing a core contradiction in the morality of gendered heterosexuality. Taking a novel approach to the study of the sex industry, the study’s data focus on producers rather than consumers of sex toys. Sex toy professionals understand women as ideal users whose sexual desire and consumption are morally defensible. Not only do girl-power sex positivity discourses valorize women’s orgasms, but men’s sex toy use is disavowed and even openly reviled by producers. This seems to upend existing configurations of heterosexual privilege, which ordinarily benefit men’s sexual desire. However, the reversal reveals a shared moral feature of gendered heterosexuality, which privileges women as sexually purer than men, who are encumbered with tainting lasciviousness.

ISLAMIC LAW REVIEW USE OF SEX TOYS

This study aims to uncover how Islamic law observations of the tools used to meet the biological needs of humans, called sex toys, are lately used by many groups, both Muslim and non-Muslim, both inside and outside Indonesia, in this article the author will discuss the sex toys law in view of Islam starting from; First, the opinions of scholars in the four schools of thought on the use of sex toys as a medium to meet human biological needs in various conditions. Second, examine the arguments put forward by these schools and the way istidlal or istinbath law. Third, analyze the opinions that are most relevant to be held today with logical and istidlal arguments that are the closest to the truth between the proposition and the reality faced by people in this modern era.

Much a-Douche About Nothing? Rectal Douching, HIV, and Sexually Transmitted Infection Risks Among Men Who Have Sex With Men.

A recent systematic review and meta-analysis identified a significant association between rectal douching and being diagnosed with HIV (odds ratio [OR], 2.80; 95% confidence interval [CI], 2.32–3.39) or other sexually transmitted infections (STIs; OR, 2.46; 95% CI, 1.95–3.11) among men who have sex with men (MSM).1 Douching is widely practiced in this population,2 which remains at significantly higher risk of HIV and STI acquisition in many settings despite recent advances in prevention technologies. However, the nature of the association, the potential causal mechanisms, and the implications of this finding for research and practice remain uncertain. This uncertainty can be resolved by considering relevant social and behavioral perspectives in study design.3 The review finds that people who report douching are more likely to report positive HIV and STI diagnoses. The hypothesized causal mechanism is physical or biochemical disruption of the anorectal epithelia, which continually produce a thin film of mucus that facilitates fecal transit and mobilizes immune cells. This disruptive effect has been observed in laboratory studies of douching with plain water and with preservative ingredients used in water-based lubricants.4 The resulting inflammation may facilitate HIV and STI acquisition. Cautions should be taken when interpreting the association observed in the review. Douching is an act done in preparation for receptive anal intercourse, which carries greater risk of HIV acquisition than insertive sex (OR, 6.90; 95% CI, 5.50–8.60).5 Thus, significant collinearity between douching and receptive anal intercourse may exist. Although the review included a subanalysis of studies that undertook multivariate regression, it may not be possible to disentangle the effect of potential confounders using data from cross-sectional survey designs. The diversity of sexual cultures and practices among MSM may be masked by survey questions that ask about receptive anal intercourse, particularly when answers are recoded into dichotomous or categorical variables, creating potential for residual confounding. For example, social research identifies sexual practices that are more prevalent among HIV-positive MSM6 and associated with HIV incidence among HIV-negative MSM.7,8 These include condomless anal intercourse with casual partners, group sex, use of sex toys, fisting, and “long play” sessions facilitated by stimulant drugs.9 All of these practices require douching for hygiene and comfort. A question about receptive anal intercourse, not otherwise specified, will fail to distinguish between risks attributable to douching versus sexual practices that require douching. A Dutch study that asked about toys, fisting, rimming, and other practices found no association between douching and current, laboratory-confirmed anorectal STI.10 Douching may therefore be a marker of higher-risk sexual practices,7 requiring more detailed inquiry into sexual practices to clarify its relationship with HIV/STI incidence. Moreover, the low transmission efficiency of HIV means the baseline risk is also low, and that is before a person adopts prevention strategies available to him/her. A person who correctly uses preexposure prophylaxis has almost no risk of infection, whereas a person living with HIV on effective treatment cannot pass the virus on, whether he/she douches or not.11 In populations and settings in which douching continues to predict HIV/STI incidence, sexual health care should make HIV treatment and preexposure prophylaxis widely accessible. Additional research is required to understand the nature of the association and the extent to which it represents a modifiable risk behavior, a marker of particular sexual cultures and practices as well as unmet prevention needs. In crafting educational responses, the experienced practitioner avoids the risk-framed, “just say no” message with its ever-present danger of provoking reactance.12 Nobody likes being told what (not) to do. What matters is identifying what can practicably be done to moderate the risk. To this end, we need to better understand the social practices and sexual contexts in which douching plays a part.

Types of Group Sex and Their Association with Different Sexual Risk Behaviors Among HIV-Negative Men Who Have Sex with Men.

The current study sought to identify types of group sex acts among HIV-negative men who have sex with men (MSM) and assess their association with different sexual risk behaviors using cross-sectional data of group sex acts reported during 6 waves (2015-2018) of the Amsterdam MSM Cohort Study. Latent class analysis was performed to identify group sex types based on size, familiarity with partners, location, planning, and drug use. Associations between group sex types and sexual behaviors were evaluated using logistic regression with generalized estimating equations, employing the sample mean as a reference. Data at the level of group sex acts were analyzed, while correcting variance estimations for repeated measurements within MSM. A total of 392 MSM engaged in group sex ≥ 1 times, totaling 1033 group sex acts. Four types of group sex emerged: familiar (29%), intimate (27%), impromptu (36%), and party (8%). Familiar group sex (characterized by high proportions of mostly known partners, occurring in private places and involving drug use) had an increased adjusted odds of risky fingering (aOR 1.6, 95%CI 1.3-2.0) and of risky fisting and/or use of sex toys (aOR 2.3, 95%CI 1.6-3.1). Intimate group sex (characterized by high proportions of threesomes, occurring in private places, and not involving drug use) had a decreased adjusted odds of risky fisting and/or use of sex toys (aOR 0.6, 95%CI 0.4-0.9). Impromptu group sex (characterized by high proportions of spontaneity, mostly unknown partners, and taking place in public places) had a decreased adjusted odds of risky fisting and/or use of sex toys (aOR 0.5, 95%CI 0.3-0.7) and of condomless anal intercourse (CAI) (OR 0.6, 95%CI 0.5-0.8). Party group sex (characterized by high proportions of larger groups, mostly unknown partners, and being planned) had an increased adjusted odds of risky fisting and/or use of sex toys (aOR 1.6, 95%CI 1.0-2.7) and of CAI (aOR 1.5, 95%CI 1.1-2.1). The identified types of group sex reflect different dynamics and characteristics, with some types riskier for STIs and others riskier for HIV. HIV and STI prevention efforts could be tailored accordingly. For example, in certain type of public sex environments (e.g., cruising parks), traditional HIV and STI prevention efforts, such as promoting of condom use and PrEP, might be sufficient. However, in other settings (e.g., private parties), where group sex is more likely to be planned and where behaviors such as fisting, sharing of sex toys, and CAI are more likely to take place, which carry different levels of risk for HIV and STI transmission, including that of Hepatitis C, different approaches might be needed, such as broader HIV and STI prevention education efforts or targeting the organizers of group sex events.

Using Sex Toys and the Assimilation of Tools into Bodies: Can Sex Enhancements Incorporate Tools into Human Sexuality?

The use of vibrators, dildos and other sex toys for sexual stimulation and pleasure is common among women and is growing in popularity. While the phenomenon has positive benefits, it might equally present adverse consequences to users. This research aims to assess the popularity of sex toy use among women from different nations. Furthermore, the study aims to find out if the use of other household items for sexual stimulation is popular among women between the ages of 18 and 50. Finally, the study attempts to discover if sex toy users observe changes arising from the use of various sex toys and if such variations can be attributed to the assimilation of the sex toy used. I employed a convenience sampling in eight countries. The study observed that sex toys are popular among women between the ages of 18 and 50, but sex toy use appears to produce varying effects on users. It was also evident that a majority of participants use vibrating sex toys without a clinician’s recommendation. Some women observe changes in sensitivity levels of their sexual responses after using sex enhancements. It was observed that while there is a crackdown on the use of sex toys in Islamic nations, religion itself has a certain influence on the individual adherent’s desire to explore use of sex enhancements.

Escaping into Sexual Play: A Consumer Experience Perspective

Sexual play may offer an escape from everyday stress. As the consumer culture has extended into our bedrooms, escapism through sexual play can be regarded as an affective consumer experience. This study analyses how experiential value is created through escapism in sexual play enabled by the use of sex toys. The study follows a mixed-methods strategy, combining results from a consumer survey (n = 517) with expert interviews (n = 26). A principal outcome is an advanced conceptual framework where playfulness operates as a dynamic motor for consumers’ sexual boundary transgressions. Loosening these sexual boundaries may have its downsides. The larger is the realm of regular sexual life, the harder it is to escape it to gain experiential value. The balance between sexual play and everyday life ensures that the dynamic motor of playfulness operates steadily, upkeeping the elasticity of boundaries. The practical implications are discussed.

Teledildonics and rape by deception

ABSTRACTIt is now possible to buy sex toys that connect to the user’s phone or computer via Bluetooth and can be controlled remotely. The use of such Internet-enabled haptic sex toys involves an ineliminable risk of being deceived about particular features of one’s sexual partner and/or about which person one was having ‘sex’ with. Where this occurs, it is possible that the user would become the victim of rape-by-deception. We argue that determining whether a person using an Internet-enabled haptic sex toy has been raped or not when they are involved in a sexual encounter with someone – or something – other than that they intended requires us to confront difficult questions about the definition and significance of sexual intercourse and about the nature and harm of rape. Our discussion of these topics suggests that the use of such devices is more ethically fraught than has been appreciated to date.

Sexuality in male partners of women with fibromyalgia syndrome: A qualitative study.

The aim of our study was to understand how male partners of women diagnosed with fibromyalgia syndrome perceive sexuality. Gadamerian hermeneutic phenomenology and the Roy Adaptation Model provided the overall framework for this research study. Eighteen participants were recruited through convenience and purposive sampling. Data collection was conducted between February and July of 2017 and included a focus group and twelve in-depth interviews. Two main themes were extracted: "facing a new sex life" and "resisting the loss of the couple’s sexuality". Fibromyalgia syndrome compromises the couple’s sex life. Enhancing intimacy, skin-to-skin contact (during acute FMS outbreaks), finding new positions, non-coital sex and use of sex toys can increase female desire and help coping.

Sex Education for Transgender and Non-Binary Youth: Previous Experiences and Recommended Content

BackgroundTransgender and non-binary (TNB) youth face disparities in sexual health risks compared with cisgender peers. Comprehensive sex education programs have the potential to result in delayed sexual debut, increased condom and contraceptive use, and reduced sexual risk-taking; however, little research has explored the specific sex education needs of TNB youth. AimTo use insights from TNB youth, parents of TNB youth, and healthcare affiliates to understand deficits in sex education experienced by TNB youth, and to elicit recommended content for a comprehensive and trans-inclusive sex education curriculum. MethodsWe conducted 21 in-depth interviews with non-minor TNB youth (n = 11) and with parents (n = 5) and healthcare affiliates (n = 5) of TNB youth recruited from Seattle Children’s Gender Clinic and local TNB community listerv readerships. Data was analyzed using theoretical thematic analysis. OutcomesParticipants described prior sex education experiences and content needs of TNB youth. ResultsParticipants described 5 key sources where TNB youth received sexual health information: school curricula, medical practitioners, peers, romantic partners, and online media. Inapplicability of school curricula and variable interactions with medical practitioners led youth to favor the latter sources. 8 content areas were recommended as important in sex education for TNB youth: puberty-related gender dysphoria, non-medical gender-affirming interventions, medical gender-affirming interventions, consent and relationships, sex and desire, sexually transmitted infection prevention, fertility and contraception, and healthcare access. Clinical ImplicationsDependence on potentially inaccurate sex education sources leaves TNB youth vulnerable to negative outcomes, including sexually transmitted infections, pregnancy, unsanitary/unsafe sex toy use, and shame about their body or sexual desires. Strengths & LimitationsStrengths included capturing perspectives of an underserved population using open-ended interview questions, which allowed topics of greatest importance to participants to arise organically. Limitations included a sample size of 21 participants, and racial and geographic homogeneity of youth and parent participants. Only 1 author identifies as TNB. One-on-one interview methods may have omitted participants who would otherwise have been willing to share their perspective in a more impersonal format. ConclusionThis study demonstrates that TNB youth have unique sex education needs that are not well covered in most sexual health curricula. Recommended content for this population includes standard sex education topics that require trans-inclusive framing (eg, contraception), topics specific to TNB youth (eg, gender-affirming medical interventions), and topics absent from standard curricula that warrant universal teaching (eg, information on consent as it relates to sex acts aside from penile-vaginal sex).Haley SG, Tordoff DM, Kantor AZ, et al. Sex Education for Transgender and Non-Binary Youth: Previous Experiences and Recommended Content. J Sex Med 2019;16:1834–1848.

Sexual participation within fan cultures: Considering a sex toy as a mode of reception for The Shape of Water

This article considers how the purchase and use of film-inspired sex toys interacts with current understandings of fan practice. Using existing critical frameworks, including Jonathan Gray’s work on fan-made paratexts, this article will consider how these toys operate as paratextual engagements with The Shape of Water that reify some of the queer elements that have been adopted by a portion of the film’s fandom. It is this article’s position that the devices in question offer fascinating (if not entirely unprecedented) forms of textual engagement that suggest a continuation of the film’s defence of queer love through their enabling of tentraphilic masturbation. It is the aim of this article to consider how the pleasures offered by such devices can be understood in relation to established and emerging forms of fan practice, whilst illustrating one of the more unique forms of reception operating beyond the realm of licensed ephemera.

Group B streptococcus prevalence, serotype distribution and colonization dynamics in Western Australian pregnant women.

Streptococcus agalactiae, or group B streptococcus (GBS), is a leading neonatal pathogen that causes sepsis, meningitis and pneumonia. Globally, strategies have been implemented to address vertical transmission, and in Western Australia (WA), culture-based screening at 35-37 weeks' gestation is part of routine care and guides antibiotic administration. Previous Australian studies have focused on other regions or included low sample-size representatives; we aimed to describe antenatal GBS colonization in WA. A cohort of 814 pregnant women attending antenatal clinics (2015-2017) self-collected vaginal and rectal swabs at ≤22 weeks (n=814) and ≥33 weeks' (n=567) gestation. These were assessed for GBS presence using culture and PCR, and serotyping was conducted using molecular methods. Lifestyle questionnaires and medical data were collected. We observed an overall GBS colonization rate of 24%, with 10.6 % of positive participants transiently colonized. Ethnicity (Aboriginal, Torres Strait Islander and African), maternal age ≥25 years, vitamin use, frequent sexual intercourse (≥5 times/week) and use of sex toys were associated with GBS colonization. The dominant serotypes identified were Ia (27.9%), III (20.9%), II (16.3%), V (15.8%), Ib (8.4%), VI (5.1%), IV (2.8%), NT (1.9), VIII (0.5%) and IX (0.5%) at visit one, with V (18.9%) preceding serotype II (18.2%) at visit two. Serotype VII was not detected. This is the first cohort study to assess GBS colonization in Western Australian pregnant women and will be highly beneficial for guiding clinical practice and future therapeutic options, in particular, the selection of suitable vaccine candidates.

Experiences with Diverse Sex Toys Among German Heterosexual Adults: Findings From a National Online Survey

ABSTRACT Studies from English-speaking countries show that sex toy use is common in various populations and often associated with sexual well-being. Empirical data on sex toy use and perceived effects in other countries is still missing. Based on the Positive Sexuality framework and the Positive Technology framework, this study documented the prevalence of sex toy use in solo and partnered sex among heterosexual-identified women and men in Germany, as well as perceived positive and/or negative effects of sex toy use on sexual well-being. A survey was conducted with a national online sample of 1,723 heterosexual-identified adults in Germany (Mage = 42.71, SD = 13.25, 49% women, 51% men). The majority (52%) reported sex toy use in partnered sex, and 45% reported sex toy use in solo sex. Stronger positive than negative perceived effects of sex toy use were reported by women and men alike. Findings indicate that professionals in sexual health/sexuality education should consider sex toy use as a common and beneficial sexual behavior. Future studies could explore specific effects of sex toy use and their predictors in more detail.

Sexual Activity and Attitudes as Predictors of Sexual Satisfaction During Pregnancy: A Multi-Level Model Describing the Sexuality of Couples in the First 12 Weeks

The sexual satisfaction of couples during pregnancy is an under-researched area of study. Several limitations exist within the current literature, including a lack of inquiry into attitudes about sex during pregnancy, analysis of the relationship between sexual satisfaction and sexual behaviors, and analysis of dyadic interactions within the couple. The purpose of the current study was to examine the relationships between attitudes toward having sex during pregnancy, various sexual behaviors, and sexual satisfaction among expectant couples via multilevel structural equation modeling. Recruitment focused on mixed-gender monogamous couples where the pregnant individual was between 8 and 12weeks of gestation, and both partners were soon-to-be first time parents. Touching, hugging, or holding, kissing, vaginal and oral sex, and rubbing each other's genitals were all common behaviors among the 116 couples in the current investigation. Anal sex and sex toy use were less common, but far from absent. According to our model, attitudes toward having sex during pregnancy significantly predicted sexual satisfaction by operating through specific sexual behaviors: kissing, vaginal fingering, and vaginal intercourse, while use of a toy alone and use of a toy with partner were independent predictors of sexual satisfaction. Gender had a direct relationship with satisfaction (men were more satisfied), as well as indirect relationship with satisfaction through an interaction with vaginal fingering and use of a sex toy alone. While multiple past month sexual behaviors were likely to increase satisfaction among pregnant and non-expectant couples alike, this improvement might depend on which behaviors are included and the gender of the individual.

Phallocentricism, female penile choices, and the use of sex toys in Ghana

Although the penis forms an important aspect of sexual practices, we know little about how women and men construct the penis in relation to sex and gender in Africa. In this exploratory study from urban Ghana with 34 interviewees, I argue that the changing notions of sex and the penis, in terms of the form they take and in terms of ownership, offer women and men the space to negotiate sexual scripts and to highlight women’s penile preferences. The findings show that while women and men emphasize a biological representation of the penis (due to cultural and religious values), there are nuanced narratives that also acknowledge the social and symbolic importance of the penis to include self-sexual gratification and the use of sex toys. The study contests notions that project female vulnerability vis-a-vis male dominance in matters of sex and that project female sexual choices in Africa.

A cross-sectional survey of sex toy use, characteristics of sex toy use hygiene behaviours, and vulvovaginal health outcomes in Canada

Researchers' interest in the use of sex toys has increased in the past 10 years as products become more accepted in mainstream media, and incorporated into individuals' sexual scripts. Though researchers and health educators have emphasized the importance of sex toy use hygiene behaviours, few studies have addressed the extent to which individuals are sharing, cleaning and covering their sex toys. The current research examined 1) the prevalence, frequency, predictors, and types of sex toys use/used, 2) the prevalence/frequency of sex toy use hygiene behaviours (e.g., cleaning, sharing, covering) and 3) whether sex toy use hygiene behaviours were related to vulvovaginal health outcomes among a sample of Canadian participants. As part of a larger survey examining genital health and hygiene practices, 1435 participants across Canada completed an anonymous online survey. Prevalence of sex toy use was 52.3%. Sex toys users were more likely to report a bisexual, lesbian, queer or questioning identity and were more likely to report engaging in additional partnered sexual activities such as oral and anal sex. Participants used a wide variety of sex toys including vibrators, butt plugs, BDSM toys, and household items. Most participants indicated that they cleaned their sex toys regularly using soap and water and 21.7% reported sharing their sex toy(s) with a partner. Sex toy use is common among Canadian women and individuals report using a variety of sexual enhancement products. Implications for educators and medical practitioners working with sexually active clients are also discussed.

Heterosexual Women’s Anal Sex Attitudes and Motivations: A Focus Group Study

Focus group methods were used to explore heterosexual women’s receptive anal sex attitudes and motivations. Behaviors under investigation included penile–anal intercourse (PAI), manual–anal stimulation, oral–anal contact, and the use of sex toys. A total of 33 self-identified heterosexual women ages 18 to 30 recruited from two metropolitan areas in the Midwestern United States participated in one of six focus groups. The findings suggest that women viewed heterosexual anal sex as an emerging norm. Attitudes and motivations were complex and varied by behavior. Dominant themes included curiosity, pain, pleasure, and stigma. Relational factors, including acquiescence, coercion, and consent, were also salient among participants. Factors that influence anal sexual behaviors may not be entirely distinct from those that influence other sexual behaviors; however, factors that influence anal intercourse may be distinct from those that influence nonintercourse anal sex. Improved understanding will allow scientists to better understand the integration of anal sex behaviors into the broader sexual repertoire.

P178 Traumatic recto-vaginal fistula after consensual sexual activity: a case series

IntroductionConsensual vaginal intercourse may be associated with relatively minor genital injury, such as mucosal abrasions, tears or ecchymoses. More severe genital injury is more likely to be associated with rape or sexual assault by penetration with an object. Conversely, we know that the absence of genital injury does not mean that rape or serious sexual assault did not occur.MethodsWe report a small series of patients presenting with severe and life-threatening genital injury after consensual sexual activity.ResultsAn adult woman presented with lower abdominal pain and faeculent vaginal discharge after sexual activity with her intimate partner involving consensual and simultaneous insertion of two sex toys (oneper rectumand anotherper vaginam). She had sustained a 100mm defect in the posterior vaginal and antero-lateral rectal walls. Despite surgery and faecal diversion, she developed severe sepsis that required extended critical care.A second patient presented with faeculent dischargeper vaginamafter consensual, ‘conventional’ peno-vaginal intercourse. On examination, she was found to have a 30 × 20 mm low recto-vaginal fistula; on this occasion not associated with peritoneal contamination or serious septic response.DiscussionTraumatic recto-vaginal fistulae are rare with implications for both immediate morbidity and mortality and long-term physical and mental well-being. These cases demonstrate the extreme spectrum of genital injury that may be associated with consensual sexual activity. Recognition that this severity of injury can occur following consensual activity is important and our first patient’s story also highlights some of the public health implications concerning the use and regulation of sex toys.