Sex redefined: the reclassification of oral-genital contact

Not Who You Are, But Who You Are With: Re-examining Women's Less Satisfying Sexual Debuts

Gender differences in appraisals of first intercourse are among the largest in sexuality research, with women indicating less satisfying "sexual debuts" than men. Dispositional or "actor-level" explanations for this gender gap are pervasive, yet research has largely examined heterosexual debuts in which actor gender and partner gender are confounded. We assessed whether women's less satisfying sexual debuts are better explained by actor gender or partner gender, comparing experiences of women who debuted with men (WDM) with those of men and women who debuted with women (MDW, WDW). Retrospective accounts of sexual debut were collected from 3033 adults. At first intercourse, we found that WDW had equal physical and emotional satisfaction to MDW, and more satisfaction than WDM, suggesting satisfaction gaps owing to partner gender, not actor gender. This pattern did not extend to a comparison event (first masturbation), where WDW and WDM had similar satisfaction, but less satisfaction than MDW, suggesting an actor gender gap. To identify sources of satisfaction gaps, we probed for corresponding differences in the circumstances of sexual debut. Sexual circumstances were more strongly implicated than nonsexual ones, with relative deprivation of glans stimulation explaining relative dissatisfaction at first intercourse, but not first masturbation, and orgasm explaining it at both. Findings challenge the view that the satisfaction gap at first intercourse reflects an inherent difference between genders. Indeed, they demonstrate similarities when partner gender does not differ and suggest strategies for ensuring equal sexual satisfaction-and equal sexual rights realization-at (hetero) sexual debut.

Oral-Genital Contact and the Meaning of "Had Sex": The Role of Social Desirability

Previous studies have found that a large proportion of college students do not consider oral-genital contact as having "had sex." In all studies, the questions posed were hypothetical. In the present study, university students were asked about their own personal sexual experiences. From a large pool of participants, two subgroups were identified: those who responded "No" to having "had sex" but responded "Yes" to having had oral-genital contact (No-Yes), and those who responded "Yes" to having had both sex and oral-genital contact (Yes-Yes). None of the participants in these two subgroups self-reported vaginal or anal intercourse. The No-Yes group was significantly higher in social desirability (p < .0005) as measured by the Marlowe-Crowne scale and was also significantly higher in religiosity (p < .01) as measured on a 7-point Likert scale. There was a modest correlation between level of religiosity and social desirability (r = .25, p < .01). It was concluded that many students who have had oral-genital contact but deny having had sex do so because of impression management, i.e., a desire to present themselves more positively. These results provide further evidence that social desirability responding is a serious problem for sex researchers, one that affects even the most basic questions about having had sex.

A systematic review of international students' sexual health knowledge, behaviours, and attitudes

The demand for higher education has increased student mobility across the world. Studying abroad provides an opportunity for young adults to engage in sexual behaviours, some of which may be risky. Yet, little is known about international students' current sexual health knowledge or practices. The aim of this review was to identify their sexual health knowledge, behaviours, and attitudes. A search of five databases yielded 21 studies that met inclusion criteria. These studies used quantitative (n=13), qualitative (n=7) and mixed methods (n=1) and included a total of 4666 international and exchange students from diverse cultural backgrounds. Findings were grouped into three themes: sexual health knowledge, sexual behaviours, and sexual health attitudes. Asian international students had poorer levels of knowledge, suggesting a need for culturally appropriate sex education. They were less sexually experienced and were older than domestic students at first age of sex. Fewer engaged in risky sexual behaviours when compared to domestic students. They also reported fewer sexual partners and higher condom usage. However, culture influenced the sexual behaviours and attitudes of international students; in particular, Asian female international students, who tested risk-taking behaviours, such as casual sex, in more liberal Western countries. Appropriate intervention and further education are needed to decrease international students' sexual health risks.

Sexual sensation seeking, hookups, and alcohol consumption among first-year college students

OBJECTIVE

To explore sexual sensation seeking (SSS) among an ethnically-diverse sample of first-year college students and their hookup behaviors.

PARTICIPANTS

1,480 first-year college students who hooked up in the last 30 days were recruited from four universities in 2016.

METHODS

Students completed an online survey before completing an online STI and alcohol prevention intervention.

RESULTS

Male and sexual minority students had significantly higher SSS scores compared to female and heterosexual students respectively. Students with higher SSS scores were less likely to report condom use at last vaginal and anal hookup, more likely to hookup under the influence of alcohol and participate in a wide range of sexual behaviors. There were no significant mean differences in SSS scores by level of intoxication during their last hookup.

CONCLUSION

These findings highlight the role of SSS in predicting sexual risk behaviors of first-year college students and the overall low SSS scores among this sample.

Meanings Ascribed to Sex and Commitment Among College-Attending and Non-College Emerging Adults: A Replication and Extension

The purpose of this study was to examine how meanings ascribed to sex and commitment vary based on educational background, gender, and other correlates using a large sample of college-attending and non-college emerging adults (ages 18-25; N = 669). Findings from our content analysis replicated previous research by identifying meanings focused on commitment (47.8%), flexibility (22.7%), and recreation (17.8%). We also found two additional meanings focused on finding a sexual connection (termed Connectors; 9.1%) and using sex to test relationship compatibility (termed Testers; 2.5%), which were not found in previous studies on sex and commitment. A greater proportion of women than men were in the Committers group, whereas a greater proportion of men than women were in the Recreationers group. A greater proportion of heterosexual than sexual minority participants were in the Committers group, whereas a greater proportion of sexual minority than heterosexual participants were in the Flexibles and Testers groups. A greater proportion of those in committed relationships than those in casual or no relationships were in the Committers group, whereas a greater proportion of those in casual relationships than those in committed or no relationships were in the Recreationers group. Those in the Recreationers group reported the greatest average number of hookup partners in the last 12 months (compared to all others), and those in the Recreationers and Testers groups reported the greatest average number of lifetime sexual partners (compared to all others). Implications for future research and sexual health education for emerging adults are discussed.

Motives to Have Sex: Measurement and Correlates With Sociodemographic, Sexual Life, and Psychosexual Characteristics

Knowledge of diverse sexual motivations can have profound implications for our comprehension of the causes, correlations, and consequences of sexual behavior. This study had two objectives: on the one hand, to determine the different motives why young Spanish university students have sex and their relationship with different sociodemographic and psychosexual variables and sexual behavior; on the other hand, to review and improve the psychometric properties of the Sexual Motivations Scale and validate it in Spanish. Participants were 805 university students of both sexes (78% women, 74% heterosexuals), aged between 18 and 26 years (M_age = 20.88), who completed a battery of online questionnaires. Significant associations were found between young people's sexual motives, especially the motives of coping, peer pressure, and enhancement, the sociodemographic variables (sex, age sexual orientation, relational status), sexual behavior (age of initiation), and psychosexual variables (sociosexuality, self-esteem as a sexual partner, satisfaction with sex life). Also, a new structure of the Sexual Motivations Scale was proposed, with the elimination of the factor of Self-Affirmation. The discussion highlights the relevance of the results obtained due to their implications in the promotion of sexual health, in addition to achieving the first instrument validated in Spanish for the evaluation of sexual motivations.

Sexual Practices and Satisfaction among Gay and Heterosexual Men in Romantic Relationships: A Comparison Using Coarsened Exact Matching in a U.S. National Sample

Gay men are underrepresented in research on sexual satisfaction. We examined sexual satisfaction and over 50 sexual practices in an online U.S. national survey of men in relationships. Coarsened exact matching created comparable samples of heterosexual (n = 3527) and gay (n = 452) men on six demographic factors, including relationship length. Results identified many similarities between the groups, including sexual frequency, orgasm frequency, duration of sex, and sexual satisfaction. The majority of heterosexual and gay men expressed physical or emotional affection during their last sexual encounter, reporting that they or their partner said "I love you" (66%; 57%) and engaged in deep kissing (69%; 75%) or gentle kissing (82%; 72%). Heterosexual men were less likely than gay men to usually-always receive (27%; 61%) or give (37%; 68%) oral sex when intimate in the past month; were less likely to view pornography with their partner (35%; 61%); but were more likely to give their partner massages in the past year to improve their sex lives (71%; 58%). Number of sexual communication behaviors was a strong predictor of sexual satisfaction, particularly for gay men (β =.36). These findings enhance our understanding of heterosexual and gay men's sexual lives.

What Constitutes Rape? The Effect of Marital Status and Type of Sexual Act on Perceptions of Rape Scenarios

Many people believe that rape is always perpetrated by a stranger and involves vaginal intercourse. To clarify perceptions of rape that do not follow traditional beliefs, participants were presented with a vignette that described a rape in which the marital status and sexual act were manipulated. Participants were then asked to assess the incident’s severity and the victim’s responsibility. Results indicated that there was no difference in perceptions between vignettes based on marital status. However, rapes involving vaginal intercourse were associated with lesser degrees of victim blame and minimization than were rapes involving forced oral sex or digital sex.

Graded Structure in Sexual Definitions: Categorizations of Having "Had Sex" and Virginity Loss Among Homosexual and Heterosexual Men and Women

Definitions of sexual behavior display a robust hierarchy of agreement regarding whether or not acts should be classed as, for example, sex or virginity loss. The current research offers a theoretical explanation for this hierarchy, proposing that sexual definitions display graded categorical structure, arising from goodness of membership judgments. Moderation of this graded structure is also predicted, with the focus here on how sexual orientation identity affects sexual definitions. A total of 300 18- to 30-year-old participants completed an online survey, rating 18 behaviors for how far each constitutes having "had sex" and virginity loss. Participants fell into one of four groups: heterosexual male or female, gay male or lesbian. The predicted ratings hierarchy emerged, in which bidirectional genital acts were rated significantly higher than unidirectional or nonpenetrative contact, which was in turn rated significantly higher than acts involving no genital contact. Moderation of graded structure was also in line with predictions. Compared to the other groups, the lesbian group significantly upgraded ratings of genital contact that was either unidirectional or nonpenetrative. There was also evidence of upgrading by the gay male sample of anal intercourse ratings. These effects are theorized to reflect group-level variation in experience, contextual perspective, and identity-management. The implications of the findings in relation to previous research are discussed. It is suggested that a graded structure approach can greatly benefit future research into sexual definitions, by permitting variable definitions to be predicted and explained, rather than merely identified.

Moving Beyond Age: An Exploratory Qualitative Study on the Context of Young African American Men and Women's Sexual Debut

African American youth continue to be disproportionately affected by HIV. Early sexual debut has been identified as a major determinant of HIV risk. However, emerging research suggests that the overarching context in which first sex occurs may have greater implications for sexual health than simply age alone. The purpose of this exploratory, qualitative study was to better understand the broader context of African Americans' sexual debut. In-depth, semi-structured interviews were conducted with 10 African American men and women aged 18-24 years. Thematic analysis was used to analyze the data. The mean age at sexual debut for the sample was 15.4 (SD = 3.3), and youth framed their sexual debut as positive (50%), negative (30%), and both positive and negative (20%). The majority of youth initiated pre-sex conversations with their partners to gauge potential interest in engaging in sexual activity, and all youth utilized at least one HIV/sexually transmitted infection and pregnancy prevention method. However, most youth failed to talk to their partners prior to sex about their past sexual histories and what the experience meant for their relationship. Key differences emerged between youth who framed the experience as positive and those who framed the experience as negative or both positive and negative in terms of their motivations for initiating sex (i.e., readiness to initiate sex, pressure, and emotionally safety) and post-sex emotions (i.e., remorse and contentment). Findings provide further support for examining the broader sexual context of African American's sexual debut. A more comprehensive understanding of sexual debut will aid in the development and tailoring of sexual risk reduction programs targeting African American youth.

Oral sex and oropharyngeal cancer: The role of the primary care physicians

BACKGROUND

We aimed to study the prevalence of oral sex and its possible association with human papillomavirus (HPV) 16 infection in the development of oropharyngeal cancer in the US population for possible prevention.

METHODS

We conduct a systemic review on the prevalence of oral sex among Americans among different age groups, the prevalence of HPV 16 infection reported in oropharyngeal cancer, and correlation between oral sex and oropharyngeal cancer.

RESULTS

Oral sex is prevalent among adolescents and sexually active adults. Sixty percent of oropharyngeal cancer reported in the United States is associated with HPV 16 infections. Individuals who practiced oral sex with multiple partners are at risk for developing oropharyngeal cancer and need to be informed about practicing safe sex or getting vaccination.

CONCLUSION

Family physicians will play a key role in prevention and educating the public about the risk of oral sex.

Testing the Invariance of the National Health and Nutrition Examination Survey's Sexual Behavior Questionnaire Across Gender, Ethnicity/Race, and Generation

Federal and state policies are based on data from surveys that examine sexual-related cognitions and behaviors through self-reports of attitudes and actions. No study has yet examined their factorial invariance--specifically, whether the relationship between items assessing sexual behavior and their underlying construct differ depending on gender, ethnicity/race, or age. This study examined the factor structure of four items from the sexual behavior questionnaire part of the National Health and Nutrition Examination Survey (NHANES). As NHANES provided different versions of the survey per gender, invariance was tested across gender to determine whether subsequent tests across ethnicity/race and generation could be done across gender. Items were not invariant across gender groups so data files for women and men were not collapsed. Across ethnicity/race for both genders, and across generation for women, items were configurally invariant, and exhibited metric invariance across Latino/Latina and Black participants for both genders. Across generation for men, the configural invariance model could not be identified so the baseline models were examined. The four item one factor model fit well for the Millennial and GenerationX groups but was a poor fit for the baby boomer and silent generation groups, suggesting that gender moderated the invariance across generation. Thus, comparisons between ethnic/racial and generational groups should not be made between the genders or even within gender. Findings highlight the need for programs and interventions that promote a more inclusive definition of "having had sex."

Gender and casual sexual activity from adolescence to emerging adulthood: social and life course correlates

The prevalence of casual sexual activity among teens and emerging adults has led to much public attention. Yet limited research has investigated whether the number of casual sexual partners per year changes as heterosexual men and women transition from adolescence into emerging adulthood. We considered the influence of social context and life course factors on the number of casual sex partners. We examined four waves of interviews from the Toledo Adolescent Relationships Study (TARS) and used negative binomial growth curve models to investigate patterns of change in the number of casual sex partners (N = 1,196) ages 15 to 22. Men and women both reported increases in the number of casual sex partners over time and did not differ from each other in the rate of change over time. In all, 40% of respondents reported a recent casual sex partner at age 22. Number of prior dating relationships, education status, substance use, and perceptions of peer sexual behavior significantly influenced the number of casual sex partners. Emerging adults who did not complete high school, compared to those enrolled in four-year degree programs, reported significantly more partners. The findings contribute to research on intimate relationships and provide insights for programs targeting emerging adults.

Abstinence-related word associations and definitions of abstinence and virginity among missouri high school freshmen

BACKGROUND

The ways in which adolescents define and view sex, abstinence, and virginity impact the efforts of sexuality educators and sexual health professionals. This study examined terminology used by nonsexually active high school students to define abstinence and virginity and identified words students associate with these terms. Purposes included (1) describing words/phrases associated with abstinence; (2) describing phrases for "being abstinent until marriage" and "being a virgin;" (3) assessing concordance between word dyads associated with abstinence; and (4) assessing concordance between phrases defining "abstinent until marriage" and "a virgin."

METHODS

In this study, 216 freshmen provided information about beliefs, behaviors, and perceptions. Pearson chi-square tests and Wilcoxon sign-rank tests assessed sex-based differences, definitions, and levels of concordance were conducted.

RESULTS

Girls' friends took an abstinence pledge (p = .004) and their parents (p = .025) and best friends (p < .001) think they should abstain. Male counterparts reported being dissatisfied with current sex status (p = .002) and high acceptance of sex before marriage (p = .011). Boys were more likely to endorse "negative" words than girls.

CONCLUSIONS

Professionals need to use relevant materials incorporating terminology that resonates with adolescents and programs that engage coherent participant discussions.

Sex, commitment, and casual sex relationships among college men: a mixed-methods analysis

Using a sample of 200 emerging adult male college students, we examined how men varied in the meanings they gave to sex and their self-reported engagement in two types of casual sex relationships (hookups and friends with benefits). Using qualitative methods, we conducted a content analysis of men's written responses to a series of questions about the meanings they ascribed to sex (i.e., intercourse), their perceived connection between sex and commitment, and how they believed these meanings were related to their sexual behavior. Three groups of men emerged: Committers, Flexibles, and Recreationers. Groups were then compared on social desirability, demographic characteristics (e.g., race/ethnicity, year in school, religious service attendance), and self-reported casual sexual behaviors in the past 12 months. Analyses showed that men in the Flexibles and Recreationers groups engaged in significantly more hookups and had significantly more friends with benefits partners in the past 12 months than did men in the Committers group. Implications for relationship education intervention aimed at men and research on casual sex relationships are discussed.

Associations between patterns of emerging sexual behavior and young adult reproductive health

CONTEXT

Identifying young adult outcomes associated with adolescent sexual behavior, including patterns of first oral, vaginal and anal sex, is critical to promoting healthy sexual development.

METHODS

Associations between patterns of emerging sexual behavior, defined using latent class analysis, and young adult sexual and reproductive health were examined among 9,441 respondents to Waves 1 (1994-1995), 3 (2001-2002) and 4 (2008) of the National Longitudinal Study of Adolescent Health. Logistic regression analyses examined associations between class membership and young adult outcomes, and tested for interactions by race and ethnicity.

RESULTS

Compared with respondents who initiated vaginal sex first and reported other sexual behaviors within two years, those who initiated oral and vaginal sex during the same year had similar odds of having had an STD diagnosis ever or in the last year, of having had concurrent sexual partnerships in the last year and of having exchanged sex for money. However, respondents who postponed sexual activity had reduced odds of each outcome (odds ratios, 0.2-0.4); those who initiated vaginal sex and reported only one type of sexual behavior had reduced odds of reporting STD diagnoses and concurrent partnerships (0.4-0.6). Respondents who reported early initiation of sexual activity combined with anal sex experience during adolescence had elevated odds of having had concurrent partnerships (1.6). The data suggest racial and ethnic disparities even when patterns of emerging sexual behavior were the same.

CONCLUSIONS

Patterns of early sexual behavior considered high-risk may not predict poor sexual and reproductive health in young adulthood.

"Having sex" as a graded and hierarchical construct: a comparison of sexual definitions among heterosexual and lesbian emerging adults in the U.K

Research into definitions of "having sex" has tended to employ a dichotomous response design (following Sanders & Reinisch, 1999). However, conceptions of sexual activity may be far less clear-cut (c.f. Faulkner, 2003 ; Peterson & Muehlenhard, 2007). More refinement is also needed regarding the impact of sexual orientation on the construction of what counts as sex. This research employed a continuous response design, asking 124 emerging adults (40 male heterosexuals, 42 female heterosexuals, & 42 lesbians) to judge 13 sexual acts using a graded, six-point scale. Overall, there was substantial agreement that intercourse (vaginal and anal) was "definitely," and kissing "definitely not," sex. However, across the various acts, participants also consistently made use of options between these extremes, such that a clear hierarchy of sexual behaviors emerged. The lesbian group considered a range of forms of genital stimulation to be significantly more constitutive of sex than either heterosexual group, while judgments by male and female heterosexuals did not significantly differ for any listed act. The implications of graded definitions of sex, a hierarchy of sexual behaviors, and the role of sexual behaviors in hetero- and homosexual identity management are explored.

Sexual intercourse and oral sex among public middle school students: prevalence and correlates

CONTEXT

Early sexual initiation is associated with elevated teenage pregnancy and STD risk, yet little is known about the prevalence and correlates of sexual behavior among young adolescents. Better information is needed to guide interventions to prevent early sexual debut.

METHODS

Data from a 2005 survey of 4,557 sixth-, seventh- and eighth-grade students at 14 urban public schools in Southern California were analyzed using chi-square tests and logistic regression, to identify correlates of oral sex, intercourse and both.

RESULTS

Overall, 9% of youth had ever had sexual intercourse, and 8% had had oral sex. Three percent reported having had oral sex only, 4% intercourse only and 5% both. Among those who reported intercourse, 69% had used a condom at last intercourse, and 43% had had multiple partners. Being male, being black and having at least one friend who had ever been involved in a pregnancy were positively associated with having had intercourse only and both intercourse and oral sex (odds ratios, 1.7-4.2). Being in eighth grade, expecting to have intercourse in the next six months and currently having a boyfriend or girlfriend were positively associated with all three outcomes (2.1-7.2). Intercourse and oral sex were highly correlated.

CONCLUSIONS

Interventions addressing oral sex, intercourse and multiple partners should begin before sixth grade and continue throughout the middle school years. Health professionals should target adolescent risk reduction counseling toward males, blacks, youth with a boyfriend or girlfriend, and those with a friend who has been involved in a pregnancy.