Sexual excitation and sex-linked substance use predict overall cannabis use in mostly heterosexual and bisexual women

Access to HIV testing and factors associated among sexual minority women in a metropolitan region of the Brazilian Amazon

In Brazil, health policies implemented over the last three decades have enabled rapid testing for HIV to be made available in primary health care services. However, although these policies are national, the implementation of actions is not uniform, as they depend on the local management of local health systems. In this context, the study identified the proportion of women from sexual minorities who had never tested for HIV and the factors associated with access, in a Metropolitan Region of the Brazilian Amazon. This was an observational, cross-sectional study, conducted from data collected from July 21, 2022 to April 11, 2024, in the Brazilian Amazon. The study included women, aged 18 or over living in the study area who self-declare and self-identify as lesbian, bisexual, pansexual or asexual. The dependent variable: participants were asked if they had ever been tested for HIV in their lifetime. The independent variables were the access components: predisposing, facilitating and necessary. 301 women from sexual minorities participated in the study, 42.2% of whom had never tested for HIV. In the final model, multiple backward logistic regression was performed, the highest chances of never having been tested for HIV were participants aged 18 to 30 years (OR 2.99; p = 0.038); with income less than or equal to 1 minimum wage (OR 1.91; p = 0.026); participants who did not have children (OR 6.67; p = 0.012); and those who did not have an active sexual life (OR 4.73; p = 0.006). While the lowest chances of never having tested for HIV were among participants who used drugs OR 0.44; p = 0.008) and women who had already had an STI (OR 0.20; p = 0.044). Although the testing prevalence was below 50%, the study identified that the combined prevention strategy has reached the most vulnerable populations.

Validation of the multidimensional model of the subjective orgasm experience in the context of same-sex relationships

Background/objective

The Multidimensional Model of the Subjective Orgasm Experience (MMSOE) has been validated in the context of heterosexual relationships, with no evidence in the context of same-sex relationships. This study aims to examine the association of its dimensions (Affective, Intimacy, Sensory, and Rewards) with the propensity for sexual excitation, rating of sexual arousal, rating of genital sensations, and genital response.

Method

Sixty-eight young adults (34 males and 34 females) who were sexually active with people of the same sex participated in a laboratory task in which they viewed content-neutral and sexually explicit gay films. Regression models were conducted to explain the dimensions of MMSOE from measures of sexual arousal.

Results

In males, the rating of sexual arousal explained the Sensory dimension, while the genital response explained the Affective dimension, with sexual arousal as a state gaining more prominence. In females, however, the propensity for sexual excitation explained the Sensory dimension, with more salience of sexual arousal as a trait.

Conclusions

The MMSOE is shown to be a valid theoretical framework for the study of orgasmic experience in the context of same-sex relationships, with clear implications for clinical practice.

The Dual Control Model of Sexual Response: A Scoping Review, 2009-2022

The Dual Control Model proposes that sexual arousal and related processes are dependent on the balance between sexual excitation and sexual inhibition, and that individuals vary in their propensity for these processes. This scoping review provides an overview and discussion of the questionnaires used to measure the propensities for sexual excitation and inhibition, their translation and validation in other languages, and their application in empirical research on topics ranging from sexual desire and arousal, sexual (dys)function, sexual risk taking, asexuality, hypersexuality, and sexual aggression. A total of 152 papers, published between 2009 and 2022 and identified using online databases, were included in this review. The findings, consistent with those reviewed by Bancroft et al. (2009), suggest that sexual excitation is particularly relevant to sexual desire and responsivity and predictive of asexuality and hypersexuality. Sexual inhibition plays a role in sexual dysfunction. sexual risk taking, and sexual aggression, although often in interaction with sexual excitation. Suggestions for the further development of the model and for future studies are discussed.

Higher sexual excitation is associated with an increase in sex-linked substance use in women with a history of unwanted sexual contact

Survivors of unwanted sexual contact have an increased likelihood of using substances in sexual situations, which puts them at heightened risk for intoxication-related harms. Separately, research has indicated that women may intentionally use substances in sexual situations to either enhance pleasure (i.e., increase sexual excitation) and/or reduce sexual anxiety or shame (i.e., reduce sexual inhibition), a phenomenon termed sex-linked substance use (SLSU). A predominant assumption in the literature is that women with unwanted sex histories are more likely to disengage during sex, suggesting greater inhibition-related SLSU; however, there is little prior research directly examining if women who have unwanted sex histories primarily engage in SLSU to increase sexual excitation or decrease inhibitions. We conducted exploratory analyses of an online survey in a convenience sample of 516 undergraduate women including data on their history of unwanted sex, SLSU, and sexual excitation/inhibition. Sexual excitation mediated the association between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sexual histories reported higher levels of sexual excitation, which in turn was associated with a higher likelihood of using substances to increase pleasure during sexual activity. Specifically, arousability, partner characteristics, and power dynamics subfactors were significant mediators. Sexual inhibition did not mediate the relationship between a history of unwanted sexual contact and SLSU, suggesting that women with unwanted sex histories may have been less likely to use substances to reduce sexual inhibitions. If replicated, these findings suggest that sexual excitation may be a useful target of intervention surrounding SLSU, particularly in women with histories of unwanted sexual contact. Specifically, treatments targeting cognitive and affective tendencies associated with sexual excitation may help women who engage in SLSU to have safe, pleasurable sexual activity, without increasing the risk of intoxication-related harms.

Relational and Trait Factors Mediate the Associations between Women's Intoxication-Related Unwanted Sexual Experiences, Pleasure, and Desire

Despite documented negative sexual health sequelae of unwanted sexual contact (USC), it is unclear why individuals who have experienced USC within the context of intoxication (intoxication-related USC) are at particular risk for poor sexual functioning. Intoxication-related USC may impact relational factors like relationship satisfaction, as trauma symptoms interfere with emotional closeness during sex. Additionally, although individual traits - such as sexual excitation and sensation seeking - affect the relationship between trauma and sexual functioning, it is unknown whether these factors differentially impact those who have experienced intoxication-related USC. Finally, because presence of a partner may evoke trauma-related symptoms during partnered (dyadic) sexual activity, mediators may differ across solitary versus dyadic sexual pleasure and desire. We tested relational and individual trait mediators of the association between intoxication-related USC and solitary and dyadic sexual pleasure and desire in a sample of heterosexual and sexual minority women. Trait factors consistently mediated the association between intoxication-related USC and both dyadic and solitary desire and pleasure, while relational factors such as emotional closeness were inconsistently related to sexual wellbeing. If replicated, these findings would suggest that trait factors may be useful targets for clinical sexual wellness interventions among sexuality-diverse women who have experienced intoxication-related USC.