The latest medical research on Sexual Health Medicine

background
objective
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strengths and limitations

Erogenous sensation zones (ESZs) elicit sexual pleasure upon stimulation. General ESZ maps exist, but they do not assess internal areas of the body, differentiate between individual structures, or quantify the importance of individual ESZs to sexual pleasure. Maps of aversive sensation zones (ASZs), or bodily areas individuals dislike having touched during sex, have not been described.

To create detailed erogenous and aversive sensory maps of the vulva, vagina, and breasts, and assess the importance of each erogenous structure to sexual pleasure.

An anonymous online questionnaire was administered to 441 sexually active cisgender women (mean age 48.9 ± 15.5 years) from March to June 2020 via Qualtrics. Respondents selected ESZs and ASZs from anatomic illustrations and rated each ESZ's importance to their sexual pleasure. Respondents' reasoning for choosing each ASZ was queried.

More respondents selected ≧1 areas of the vulva as erogenous (82.0%), in comparison to the breasts (77.4%) and vagina (59.4%). The two most erogenous areas of the breast were also the most aversive: breast tissue (57.8% ESZ selection; 5.4% ASZ) and nipples (42.7%; 6.5%). Respondents most commonly reported these areas as aversive due to: "It's overly sensitive" and "It hurts."The most frequently selected ESZs of the vulva were the vaginal introitus (50.8%), periurethra (42.6%), and glans clitoris (41.3%). The top ASZs were the anus (34.0%) and perineum (7.9%), with primary reasons being: "It's gross," "It hurts," and "I'm ashamed/embarrassed."Of the five ESZs of the vagina, the superficial anterior (48.1%) and superficial posterior (32.9%) regions were the most selected. The cervix (6.8%), superficial posterior (5%), and deep posterior (3.4%) regions were the top ASZs due to "It hurts" and/or "It's overly sensitive."

Erogenous sensation was most prominent in the vulvar structures, including the vaginal introitus and glans clitoris, followed by the superficial surface of the vaginal canal. Aversive sensation associated with the anus primarily came from feelings of judgment and shame, while other ASZs were reportedly due to pain and sensitivity.

This study captured detailed maps of internal and external ESZs and ASZs of the breasts, vulva, and vagina. Limitations include recall bias and inclusion of only cisgender women, rather than all people who share the same anatomy, irrespective of gender identity.

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Despite mounting evidence showing that kissing (tongue-kissing) may transmit gonorrhoea between men who have sex with men (MSM), little data exists on factors influencing the duration of kissing while they are above and/or lying underneath a partner for this population group.

Between May 2019 and March 2020, we invited MSM aged ≥18 years who attended the Melbourne Sexual Health Centre (MSHC) to participate in a survey about the duration of their kissing (minutes) and intimate position while kissing (i.e., kissing while above, or while lying underneath) their most recent partner. Univariable and multivariable negative binomial regressions were performed to examine the associations between the duration of kissing in different intimate positions, and demographic and behavioural characteristics (including age, region of birth, HIV status or PrEP use, and role in anal sex).

Of the 965 men with a recent male kissing partner, 89.0% (n = 859) also had sex with that partner. Of the 166 men with a recent female kissing partner, 71.7% (n = 119) also had sex with that partner. Our adjusted analyses showed that, on average, men born in Asia (mean 8.52 vs 11.69 min, p < .001) and South America or the Caribbean (mean 8.61 vs 11.69 min, p = .022) spent less time kissing compared to men born in Oceania, and the same was also observed for kissing while above or lying underneath. Men who had only receptive anal sex spent less time kissing while above than those who only had insertive anal sex (mean 3.04 vs 5.86 min, p < .001).

Our study is the first to examine factors that influence duration of kissing in different intimate positions. These factors could be associated with oropharyngeal gonorrhoea if saliva transmitted gonorrhoea and if gravity played a role.

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Mental health (MH) care for people living with HIV (PLWH) emerges as an important unmet need, yet there are no integrated HIV-MH clinics in Turkey. Our aim is to determine MH service use and its associated factors in PLWH followed up in the HIV/AIDS outpatient clinics in Istanbul/Turkey.

A cross-sectional study was conducted at the HIV/AIDS outpatient clinics of the Infectious Diseases (ID) departments in hospitals affiliated with the ACTHIV-IST Study Group. Structured interviews were performed using questionnaires that covered psychiatric state, medical history, and help-seeking behavior.

Out of 172 outpatients, 121 (70.3%) reported MH complaints after infection, and 65.6% felt a need to see MH professionals. Among those, 59% shared their MH distress with the ID team. However, only 20.7% applied to an MH service, and 16.5% received psychiatric treatment. Previous MH diagnoses (AOR = 4.11; 95%CI = 1.26-13.39), sharing the disease with the ID team (AOR = 4.18; 95%CI = 1.24-14.11), and being hospitalized due to HIV (AOR = 6.54; 95%CI = 1.21-35.39) emerged as the predictors of MH service use among those who would like to see an MH professional in logistic regression.

Closer contact with the healthcare system may increase the chances of PLWH receiving MH care. Thus, integrating MH services in HIV/AIDS care would help reach more PLWH who are distressed.

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Pudendal neuralgia (PN) is a sexual pain disorder characterized as pain of the genital and/or perineal regions, and despite the lack of clinical evidence supporting its use, pelvic floor physical therapy (PFPT) is a recommended treatment for PN.

An online anonymous cross-sectional survey was administered to participants through convenience sampling conducted on May 19 to September 19, 2023 to understand the self-reported efficacy of PFPT as a treatment for PN. Participants' measures included sociodemographics, Patient Global Impression of Change (PGIC), and satisfaction scores.

The average self-reported PGIC score among participants was 4.6 ± 1.3 (n = 144), indicating no to minimal improvement in symptoms. Most participants (66%) scored 4 or 5, suggesting no change to minimal improvement. Twelve percent of participants scored 3 or lower, indicating worsening of symptoms, and only 22% scored 6 or 7, indicating much or very much improvement of symptoms. Participants who only participated in PFPT (n = 24) had a lower PGIC score of 4.4 ± 1.3. For self-reported satisfaction with PFPT as a treatment for PN, participants self-reported a score of 4.9 ± 3.0, indicating slight dissatisfaction. For those who experienced symptom improvement, the median number of sessions before noticing improvement was five sessions.

Based on self-reported results, PFPT is a minimally effective, and sometimes harmful, treatment for PN. Patients should receive greater transparency regarding the lack of efficacy of PFPT and its potential harm.

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We explored participants' experiences in a randomized controlled trial that evaluated the Home-Based Intervention Strategy (HIS-UK) to improve male condom use skills/experiences.

25 men (18-25 years) who had reached the first 6 months of the intervention were interviewed. We used a codebook approach to thematic analysis to analyze the data.

Four themes were identified: Perceived benefits of online versus in-clinic recruitment; Perceptions of the educational content; Benefits of the condom kit; Acceptability of condom testing and monthly questionnaire.

Participants valued the intervention, especially the condom kit that provided a range of different condoms and lubricants.

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The contraception and reproductive health of adolescents and youth is critical to their development and global public health. In order to provide useful references for choosing and optimizing adolescent contraception and reproductive health measurement instruments, the objective of this review is to summarize existing relevant measurement instruments and analyze them in terms of application characteristics, comparison of traditional and newly developed instruments, and psychometric properties.

A literature search was conducted of three databases (PubMed, Web of Science, and Embase Database) on articles published between database creation and March 2023, involving contraception and reproductive health measurement instruments for adolescents and youth. After critical appraisal, inductive content analysis was conducted.

Eventually 14 measuring instruments that met the criteria were included. Most of these instruments have been developed for adolescents and youth and are reliable. Five of the instruments were developed specifically for females and none for male adolescents. In contrast to traditional instruments measuring adolescents' contraceptive knowledge and contraceptive self-efficacy, newly developed instruments in recent years have focused on including the community and the family in their measurement.

This review systematically summarizes existing measurement instruments for contraception and reproductive health among adolescents and youth. It provides a solid basis for promoting the use of existing instruments and the development of new ones.

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Understanding the impact of external stressors on human sexuality, especially during war, remains a complex and understudied area. The study's goals were to observe and understand shifts in sexual behavior during the 2023 Israel-Hamas War, with a focus on gender differences. The primary goal is to explore the anticipated decline in sexual activity during wartime, while remaining open to unexpected findings.

Utilizing a cross-sectional retrospective design, an online survey was distributed to Israeli adults. Participants (N = 1207) met specific inclusion criteria, and the survey, conducted from October 31 to November 7, 2023, assessed changes in individual and partnered sexual behaviors attributed to the war experience.

Approximately 50% reported stability in pornography and masturbation habits, while 40% reported a decrease in all sexual behaviors. Gender differences were notable, with women more likely to report no change in individual sexual behaviors, and men displaying varied responses. Factor analysis identified Emotional Reasons and Disturbances as key factors influencing decreased sexual behavior, with women attributing greater relevance to these factors than men. Finally, ANOVA tests indicated that age, religiousness, spirituality, and exposure to war-related stress differentiated changes in sexual behavior frequency in various ways.

This study offers nuanced insights into the complex interplay between war-induced stress and human sexuality. Gender differences highlight the need for gender-sensitive interventions. The findings challenge assumptions about a universal decline in sexual activity during wartime, recognizing potential unexpected increases. Overall, the study deepens our understanding of how individuals navigate intimate relationships amid challenging circumstances.

There has been growing recognition of the need to address the sexual and reproductive health (SRH) needs of men and boys, including a need for more...

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We investigated how internalized homonegativity and dyadic stress predicted relationship satisfaction in same-sex romantic relationships and explored the moderating roles of dyadic coping and relationship duration in the aforementioned associations.

The actor-partner interdependence moderation model (APIMoM) was introduced to deal with mutual influences between both partners in 241 same-sex romantic relationships.

(1) individual internalized homonegativity, dyadic stress, and dyadic coping predict their own relationship satisfaction (i.e., actor effect); (2) individual dyadic stress predicts their partner's relationship satisfaction (i.e., partner effect), but only for those with a shorter relationship duration (i.e., ≤ 36 months); and (3) dyadic coping buffers the effect of individual dyadic stress on their own relationship satisfaction, but only for those in the group with a longer relationship durations (i.e., > 36 months).

These findings highlight the importance of a dyadic approach to further understand the impact of stress on relationship satisfaction. We reflect that interventions on couple-oriented coping could improve relationship well-being and sexual health among same-sex couples.

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We tested whether social activities and interactions as part of a condom campaign strengthened young adults' condom-use intentions and normative perceptions of condoms compared to simple exposure to campaign information.

Data from 3,041 young adults collected after four annual condom campaigns were analyzed and combined into a meta-analysis.

Interaction about the campaign and engagement in campaign-related activities was associated with higher condom use intention and more positive pro-condom norms.

The authors call for a greater emphasis on social influence in youth-aimed sexual health campaigns. Implications for the research are discussed.

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Gay men experience heterosexist harassment, rejection, and discrimination because of their sexual orientation, which leads to mental health problems, such as substance use. Due to anti-gay laws and regulations in Iran, which are based on fundamental interpretations of Islam, gay men are likely to experience more discrimination than in Western countries.

We used the HHRDS to assess heterosexist harassment, rejection, and discrimination and the ASSIST 3.0 to measure substance use in N = 156 Iranian gay men.

Lifetime use was as follows: 64.1% for tobacco products, 36.5% for alcoholic beverages, 25.6% for cannabis, 8.3% for opioids, and 7.1% for sedatives or sleeping pills. All three HHRDS subscales were significantly associated with all substance use scales. In addition, when descriptively comparing HHRDS scores with those of US samples, Iranian gay men reported more discrimination. In a MANOVA, total discrimination strongly predicted tobacco and cannabis consumption, while total discrimination predicted alcohol, opioid, and sedative/sleeping pill use to a moderate degree.

Substance use in Iranian gay men can be seen as a primary mental-health issue resulting from discrimination. It also likely reflects a maladaptive coping strategy related to these experiences. To improve Iran gay men's mental health, structural and interpersonal discrimination should be eliminated and specialized psychological services should be established.

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Our study aimed to assess perspectives of the Thai transgender adults toward three diagnostic criteria: 1) transsexualism (the World Health Organisation's International Statistical Classification of Diseases and Related Health Problems, tenth revision; ICD-10), 2) gender incongruence (the International Classification of Diseases, eleventh revision; ICD-11), and 3) gender dysphoria (the Diagnostic and Statistical Manual of Mental Disorders, fifth edition; DSM-5). We also gathered comments and suggestions on these criteria for future refinement, especially specific to Thai sociocultural contexts.

During February to November 2023, we conducted a survey among transgender individuals from five major Thai transgender communities. Participants were requested to 1) indicate their agreement whether each criterion could describe their identity and be suitable for the Thai transgender community using ten-point Likert scales, 2) select three keywords from each criterion and one most appropriate criterion, and 3) provide additional suggestions.

A total of 266 transgender individuals, participated in the study (62.4% and 25.2% transgender men and women, and 12.4% other identities). Both ICD-10 and DSM-5 criteria received the highest levels of agreement, averaging scores of 8.7 across most categories. Suggestions for refining criteria included a sufficiently long duration, using terms indicating inclusivity of all identities as a person, and noting positive outcomes of transitioning within the criteria.

The DSM-5 criteria garnered the highest levels of agreement in terms of identity description and suitability for the Thai sociocultural contexts. Nonetheless, further refinement can be improved, especially to ensure the inclusivity of transgender individuals with identities beyond the binary.

The latest medical research on Sexual Health Medicine

Anatomic maps of erogenous and aversive sensation zones of the breasts, vulva, and vagina: a questionnaire-based study.

Duration of kissing in different intimate positions among men who have sex with men: A cross-sectional study.

Mental health service utilization among patients followed up in tertiary HIV/AIDS clinics in Turkey: A need for integrated care.

Pelvic Floor Physical Therapy is Self-Reported as a Minimally Effective, and Sometimes Harmful, Treatment for Pudendal Neuralgia: A Cross-Sectional Study.

Evaluating the Home-Based Intervention Study (HIS-UK) to Improve Condom Use Skills and Experience: A Qualitative Study.

Contraception and Reproductive Health Measurement Instruments for Adolescents and Youth: A Scoping Review.

Changes in Individual and Dyadic Sexual Behavior Frequencies During Wartime in Israel: How Much, Who, and Why?

Are We Getting Any Closer to Including Men and Boys in Sexual and Reproductive Health? A Multi-Country Policy Analysis on Guidance to Action in East and Southern Africa.

Minority Stress and Dyadic Stress in Same-Sex Couples: The Role of Dyadic Coping and Relationship Duration.

Let's Talk About Condoms: Social Engagement in a Sexual Health Intervention Targeting Young Adults in Denmark.

The Relationship Between Discrimination, Heterosexist Harassment, Rejection, and Substance Use in Iranian Gay Men.

Perspectives of Thai Transgender Adults on Diagnostic Criteria for Transsexualism, Gender Incongruence, and Gender Dysphoria.

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