Transportation to work by sexual orientation

We analyze differences in mode of transportation to work by sexual orientation, using the American Community Survey 2008–2019. Working individuals in same-sex couples are significantly less likely to drive to work than working men and women in different-sex couples. This gap is particularly stark among men: on average, almost 12 percentage point (or 13%) lower likelihood of driving to work for men in same-sex couples. Working individuals in same-sex couples are also more likely to use public transport, walk, or bike to work. Men and women are 7 and 3 percentage points more likely, respectively, to take public transportation to work than those in different-sex couples. Working men are also more likely to work from home–while working women are less likely–than those in different-sex couples. These differences persist after controlling for demographic characteristics, partner’s characteristics, location, fertility, marital status, occupation or industry, and family income. Additional evidence from the General Social Survey 2008–2018 suggests that these disparities by sexual orientation may be due to lesbian, gay, and bisexual individuals valuing the environment more than straight individuals.

A Latent Class Analysis of Sexual Behavior and Associations with Sex Education, Smoking, Drinking, and Pornography Use Among Chinese Youth

The incidence of sexually transmitted diseases has alarmingly increased among Chinese youth in the past decade, and newly diagnosed cases of AIDS have almost doubled between 2010 and 2015. However, little is known about classes of sexual behavior among Chinese youth and associations with their other health behavior or experience of sex education. This study aimed to first identify classes of sexual behavior using latent class analysis and then to examine their associations with sex education, smoking, alcohol drinking, and pornography use. Data were from 13,865 unmarried youth aged 18-24 from the 2009 National Youth Reproductive Health Survey. Six indicators were used: timing of the first sexual intercourse, the number of past-year sexual partners, sex outside of a relationship, incidence of pregnancy, and contraceptive use at the latest and the first sexual intercourse. Four classes were identified: no sex (Class 1, 69%), safer sex (Class 2, 13%), early risk (Class 3, 13%), and multiple risk (Class 4, 5%). Smoking, drinking, and regular pornography use were associated with increased odds of being in the multiple risk class relative to the safer sex class. Sex education, smoking, and pornography use were associated with decreased odds of being in the no sex class relative to the safer sex class. The findings revealed qualitatively different classes of sexual behavior among Chinese youth and important roles of sex education, substance use, and pornography use. Reproductive health service providers can offer individually tailored services to serve youth with different profiles and needs.

Age, sex, and other demographic trends in sexual behavior in the United States: Initial findings of the sexual behaviors, internet use, and psychological adjustment survey

It remains unclear how the seemingly ubiquitous use of the internet impacts user's offline personal relationships, particularly those that are romantic or sexual. Therefore, we conducted a national online survey to better understand the associations among internet use, sexual behavior, and adjustment called the Sexual Behaviors, Internet Use, and Psychological Adjustment Survey (SIPS). Here, we report patterns of sexual behavior in a sample of adults (N = 1987; ages 18-70) in the United States to establish its representativeness and consistency with similar recent surveys. We found age- and sex-related trends in oral, vaginal, and anal sex in terms of prevalence, frequency, number of partners, and age of initiation consistent with prior studies. We also detected differences in sexual behaviors based on relationship status and sexual orientation, but small and relatively few significant differences across racial and ethnic groups. The results confirm and expand upon trends identified in prior national surveys of sexual behavior, establishing the representativeness of the SIPS sample for use in future research examining the links among sexual behaviors and romantic relationships, internet use, and adjustment.

Sexual Development in Adolescence: An Examination of Genetic and Environmental Influences

Sexual development entails many experiences and is a major feature of adolescence. Most relevant behavioral genetic studies, however, focus primarily on sexual behaviors associated with health risks. We took a more normative, developmental perspective by examining genetic and environmental influences on five sexual behaviors ranging from dating to pregnancy in middle (M_age  = 14.90 years) and late adolescence (M_age  = 17.85 years) in a sample of twins (N = 3,762). Overall, behaviors that are more common and socially sanctioned (e.g., dating) were more heritable than behaviors that are less common and socially acceptable (e.g., sexual intercourse). That the etiology of different sexual behaviors is tied to their normativeness highlights the importance of considering the broader developmental context when studying sexual development.

Partnered Intimate Activities in Early Adolescence-Findings From the UK Millennium Cohort Study

PURPOSE

Little is known about potential influences on emerging partnered intimate behaviors in early adolescence. We investigate (1) the prevalence of partnered intimate activities and (2) associations with social relationships, parental monitoring and supervision, health behaviors, and psychosocial well-being.

METHODS

We used population-based data from the UK's Millennium Cohort Study on 11,079 participants aged 14 years. Partnered intimate activities were grouped into three categories: "light" (handholding, kissing, and cuddling); "moderate" (touching and fondling under clothes); and "heavy" (oral sex and sexual intercourse). Multinomial logistic regression models were used.

RESULTS

Thirty percent of study participants reported not engaging in partnered intimate activity. Fifty-eight percent reported "light," 7.5 percent "moderate," and 3.2 percent "heavy" activity. Associated with increased likelihood (adjusted relative risk ratios [RRRs]) of intimate activities were confiding worries in a friend (light RRR = 2.13, moderate RRR = 3.42, heavy RRR=5.32), low parental monitoring-staying out late or overnight (late: light RRR = 1.62, moderate RRR = 2.44, heavy RRR = 2.32; overnight: light RRR = 1.57, moderate RRR = 1.94, heavy RRR = 3.38), health-damaging behaviors (per unit increase: light RRR = 1.91, moderate RRR = 3.15, heavy RRR = 5.03), and depressive symptoms (per scale point increase light RRR = 1.03, moderate RRR = 1.09, heavy RRR = 1.11). Confiding in a parent was associated with lower likelihood of intimate activity (light RRR = .82, moderate RRR = .65, heavy RRR = .65).

CONCLUSIONS

Partnered intimate activity of some form is commonplace among 14-year-olds in the United Kingdom. Given the short- and long-term implications of adolescent sexual development and well-being, improving our understanding of influences could help identify opportunities for interventions with benefits across the lifecourse.

Examining Ethno-Racial Related Differences in Child Molester Typology: An MTC:CM3 Approach

Sex offender typologies have been developed in an effort to better understand the heterogeneity of sexual offending as well as offenders' varied risk and therapeutic needs. Perhaps the most well-known and validated child molester typology is the Massachusetts Treatment Center: Child Molester Typology-Version 3 (MTC:CM3). However, this typology was developed and validated using primarily White sex offenders. The current study aimed to replicate this typology in an ethno-racially diverse sample of incarcerated White, Black, and Latino child molesters ( N = 499). Overall, we found that the MTC:CM3 was applicable to non-White child molesters but that there were differences in the proportion of offenders of different ethno-racial groups in Axis I type classifications. We found no differences in Axis II type classifications. Specifically, Black offenders were more often classified as socially incompetent and sexually attracted to adults compared with White and Latino offenders. Whereas White offenders were more often classified as socially incompetent and sexually fixated on children when compared with Black offenders, Latino offenders were more often classified as high in social competence and sexually attracted to adults than Black offenders. On Axis II, the majority of all three subsamples were classified as not having sexual contact with children beyond the offense, unlikely to inflict physical harm on victims, and as not having sadistic interests. Addressing these typological characteristics in the development and implementation of prevention and treatment efforts might increase the responsiveness of specific sex offender populations.

Sexual compulsivity, anxiety, depression, and sexual risk behavior among treatment-seeking men in São Paulo, Brazil

OBJECTIVE

There is a lack of studies on negative mood states and sexual risk behavior in men of all sexual orientations who seek treatment for excessive sexual behavior (ESB). We aim to examine sexual compulsivity (SC), anxiety, depression, and sexual risk behavior in a treatment-seeking sample of men and controls.

METHODS

We enrolled 88 (37 [42%] gay or bisexual and 51 [58%] heterosexual) ESB outpatients and 64 controls. Assessments included the Sexual Compulsivity Scale (SCS), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and sexual risk behaviors.

RESULTS

Compared to controls, ESB outpatients showed increased SC, anxiety, and depression, which were correlated. Regarding sex with casual partners, ESB outpatients reported more sexual intercourse, a greater number of partners, more anal intercourse, and unprotected anal intercourse. Anxiety, depression, and SC were associated with protected vaginal intercourse with a main partner, whereas they were associated with unprotected anal intercourse with a casual partner. Depression was associated with unprotected vaginal intercourse with a casual partner. Condomless anal intercourse was predicted by SC and was also reported by the heterosexual ESB outpatients (36%).

CONCLUSION

The data contribute to the field by providing information on men of all sexual orientations who are searching for mental healthcare. The connections among these psychopathological factors and sexual risk behavior have implications for public health, clinicians, and research.

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.

Proposals for Paraphilic Disorders in the International Classification of Diseases and Related Health Problems, Eleventh Revision (ICD-11)

The World Health Organization is currently developing the 11th revision of the International Classifications of Diseases and Related Health Problems (ICD-11), with approval of the ICD-11 by the World Health Assembly anticipated in 2018. The Working Group on the Classification of Sexual Disorders and Sexual Health (WGSDSH) was created and charged with reviewing and making recommendations for categories related to sexuality that are contained in the chapter of Mental and Behavioural Disorders in ICD-10 (World Health Organization 1992a). Among these categories was the ICD-10 grouping F65, Disorders of sexual preference, which describes conditions now widely referred to as Paraphilic Disorders. This article reviews the evidence base, rationale, and recommendations for the proposed revisions in this area for ICD-11 and compares them with DSM-5. The WGSDSH recommended that the grouping, Disorders of sexual preference, be renamed to Paraphilic Disorders and be limited to disorders that involve sexual arousal patterns that focus on non-consenting others or are associated with substantial distress or direct risk of injury or death. Consistent with this framework, the WGSDSH also recommended that the ICD-10 categories of Fetishism, Fetishistic Transvestism, and Sadomasochism be removed from the classification and new categories of Coercive Sexual Sadism Disorder, Frotteuristic Disorder, Other Paraphilic Disorder Involving Non-Consenting Individuals, and Other Paraphilic Disorder Involving Solitary Behaviour or Consenting Individuals be added. The WGSDSH's proposals for Paraphilic Disorders in ICD-11 are based on the WHO's role as a global public health agency and the ICD's function as a public health reporting tool.

Sexual Behavior Latent Classes Among Men Who Have Sex With Men: Associations With Sexually Transmitted Infections

Men who have sex with men (MSM) are at disproportionate risk of acquisition of sexually transmitted infections (STIs). We used latent class analysis (LCA) to examine patterns of sexual behavior among MSM and how those patterns are related to STIs. We examined patterns of sexual behavior using behavioral and clinical data from a cross-sectional study of 235 MSM who presented to an urban sexual health clinic for STI testing. Analyzed data were collected using a combination of interviewer- and self-administered surveys and electronic health records. We used LCA to identify underlying subgroups of men based on their sexual behavior, described the demographics of the latent classes, and examined the association between the latent classes and STI status. We identified three latent classes of sexual behavior: Unprotected Anal Intercourse (UAI) Only (67%), Partner Seekers (14%), and Multiple Behaviors (19%). Men in the Multiple Behaviors class had a 67% probability of being STI positive, followed by men in the UAI Only class (27%) and men in the Partner Seekers class (22%). Examining the intersection of a variety of sexual practices indicates particular subgroups of MSM have the highest probability of being STI positive.

Cross-Validation of the JSORRAT-II in Iowa

The predictive validity of the Juvenile Sexual Offense Recidivism Risk Assessment Tool-II (JSORRAT-II) was evaluated using an exhaustive sample of 11- to 17-year-old male juveniles who offended sexually (JSOs) between 2000 and 2006 in Iowa (n = 529). The validity of the tool in predicting juvenile sexual recidivism was significant (area under the receiver operating characteristic curve [AUC] = .70, 99% confidence interval [CI] = [.60, .81], d = 0.70). Non-significant predictive validity coefficients were observed for the prediction of non-sexual forms of recidivism. Additional analyses were undertaken to test hypotheses about the tool's performance with various subsamples. The age of the JSO at the time of the index sexual offense and time at risk outside secure facility placements interacted significantly with JSORRAT-II scores to predict juvenile sexual recidivism. The implications of these findings for practice and research on the validation of risk assessment tools are discussed.

Is the Sexual Murderer a Unique Type of Offender? A Typology of Violent Sexual Offenders Using Crime Scene Behaviors

The empirical literature on sexual homicide has posited the sexual murderer as a unique type of offender who is qualitatively different from other types of offenders. However, recent research has suggested that sexual homicide is a dynamic crime and that sexual assaults can escalate to homicide when specific situational factors are present. This study simultaneously explored the utility of the sexual murderer as a unique type of offender hypothesis and sexual homicide as a differential outcome of sexual assaults hypothesis. This study is based on a sample of 342 males who were convicted of committing a violent sexual offense, which resulted in either physical injury or death of the victim. A series of latent class analyses were performed using crime scene indicators in an attempt to identify discrete groups of sexual offenders. In addition, the effects of modus operandi, situational factors, and offender characteristics on each group were investigated. Results suggest that both hypotheses are supported. A group of offenders was identified who almost exclusively killed their victims and demonstrated a lethal intent by the choice of their offending behavior. Moreover, three other groups of sex offenders were identified with a diverse lethality level, suggesting that these cases could end up as homicide when certain situational factors were present.

In the name of brevity: The problem with binary HIV risk categories

According to the 'Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations' there are five groups of people at elevated risk of HIV, including 'transgender women or transgender men who have receptive anal sex with men'. Although cost effectiveness strategies and best practice lessons recommend targeting specific populations for HIV prevention, existing risk categories lack specificity, and may in fact cause further confusion. Existing categories of risk often perpetuate notions of gender and sexuality that can erroneously exclude, alienate, and stigmatise those who are at the highest risk and thus should be prioritised. We review the troubled history of the MSM category and the problematic conflation of trans feminine individuals and MSM in much of the existing HIV literature, and how this practice has stymied progress in slowing the HIV epidemic in the most at-risk groups, including those who do not fit neatly into binary notions of gender and sex. We draw from examples in the field, specifically among trans feminine people in Beirut and San Francisco, to illustrate the lived experiences of individuals whose identities may not fit into Euro-Atlantic constructs of HIV prevention categories.

Discriminating Coercive from Sadomasochistic Sexuality

Sadomasochistic (SM) sexual interest is reported by a wide range of individuals. Within the sex offender literature, the presence of SM interest is often viewed as a herald of criminal sexual behavior; however, research indicates that SM interests are not predictive of coercive sexual behavior. In the current study, we measured a range of sexual fantasies and behaviors, and then applied cluster analyses to determine (1) if individuals endorsed elevated SM interests also endorsed coercive fantasies and, (2) to explore cluster membership correlates using measures of sensation seeking, externalizing and antisocial behaviors, attitudes toward rape, and empathic capacity. A total of 550 participants were recruited through a variety of on-line discussion areas. A four cluster solution best fit the data with distinct clusters observed for those endorsing SM behaviors and those reporting coercive sexual behavior. Additional analyses revealed greater endorsement of victim blaming attitudes and lower empathic concern among members of the coercive sexual behavior cluster. Elevated sensation seeking and externalizing behaviors were reported by members of clusters marked by SM and coercive sexual behavior. Results provide further support for the differentiation between SM and coercive sexual behaviors as representative of individuals with divergent attitudes, traits, and behaviors.

"All of My Lovers Fit Into This Scale": Sexual Minority Individuals' Responses to Two Novel Measures of Sexual Orientation

Previous qualitative research on traditional measures of sexual orientation raise concerns regarding how well these scales capture sexual minority individuals' experience of sexuality. The present research focused on the critique of two novel scales developed to better capture the way sexual and gender minority individuals conceptualize sexuality. Participants were 179 sexual minority (i.e., gay, lesbian, bisexual, pansexual, queer, asexual) individuals who identified as cisgender (n = 122) and transgender (n = 57). Participants first completed the new scales, then provided qualitative responses regarding how well each scale captured their sexuality. The Sexual-Romantic Scale enabled the measurement of sexual and romantic attraction to each sex independently (same-sex and other-sex). Participants resonated with the way the Sexual-Romantic scale disaggregated sexual and romantic attraction. Although cisgender monosexual (lesbian/gay) individuals positively responded to the separation of same- and other-sex attraction, individuals with either plurisexual (bisexual, pansexual, or fluid) or transgender identities found the binary conceptualization of sex/gender problematic. The Gender-Inclusive Scale incorporated same- and other-sex attraction as well as dimensions of attraction beyond those based on sex (attraction to masculine, feminine, androgynous, and gender non-conforming individuals). The incorporation of dimensions of sexual attraction outside of sex in the Gender-Inclusive Scale was positively regarded by participants of all identities. Findings indicate that the Sexual-Romantic and Gender-Inclusive scales appear to address some of the concerns raised in previous research regarding the measurement of sexual orientation among sexual minority individuals.

Is Hypersexuality Dimensional or Categorical? Evidence From Male and Female College Samples

The recent attempt to introduce hypersexual disorder into the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), has increased empirical scrutiny of the construct. Consensus on its definition and underlying structure remains elusive. Whereas some conceptualizations favor a categorical latent structure, others speculate that hypersexual behavior is dimensional. Research on the latent structure of hypersexual behavior, however, has been sparse. This is unfortunate, because determination of the latent structure can contribute to more accurate assessment, diagnosis, and understanding of etiological process. To date the only study on hypersexuality's latent structure found consistent evidence of a dimensional structure for males but less clear results for females. In the present study the Multidimensional Inventory of Development, Sex, and Aggression (MIDSA), a self-report, contingency-based inventory, was administered to 1,146 college students. Four indices of hypersexual behavior and six indices of sexual compulsivity were analyzed, using three taxometric methods (mean above minus below a cut [MAMBAC], maximum covariance [MAXCOV], and latent mode factor analysis [L-Mode]). Evidence supported a dimensional latent structure for hypersexuality in male and female samples. Future assessments of hypersexuality must focus on adequate reliability and discriminant validity across the continuum of sexual behavior rather than on attempts to differentiate between arbitrarily developed diagnostic categorizations.

Hebephilia: A Postmortem Dissection

In 2008, the concept of hebephilia, which denotes an erotic preference for "pubescent children," was suggested by Blanchard and his team for inclusion in the DSM-5 (Blanchard et al., 2009). Four years later, the APA's Board of Trustees opted for the status quo and rejected that proposal. This essay sheds light on the reason for this rejection. I consider three important questions related to hebephilia: Does hebephilia exist? Is it a disease? And what would have been the social consequences of including it in the DSM? I argue that if Blanchard failed to convince others that hebephilia should be included in the DSM-5, it is not because he focused too much on the first question and was unable to offer a convincing answer to the second one, but because he made the mistake of dismissing the third one as extraneous. The DSM is not intended to be a pure research manual, and a category like hebephilia cannot be evaluated without taking into account its potential forensic impact. In part or in whole, the decision to include a new diagnostic category in the DSM is, and always should be, a political decision.

Self-Reported Mental Disorders and Distress by Sexual Orientation: Results of the Minnesota College Student Health Survey

INTRODUCTION

Sexual minority college students (i.e., those not identifying as heterosexual, or those reporting same-sex sexual activity) may be at increased risk of poor mental health, given factors such as minority stress, stigma, and discrimination. Such disparities could have important implications for students' academic achievement, future health, and social functioning. This study compares reports of mental disorder diagnoses, stressful life events, and frequent mental distress across five gender-stratified sexual orientation categories.

METHODS

Data were from the 2007-2011 College Student Health Survey, which surveyed a random sample of college students (N=34,324) at 40 Minnesota institutions. Data analysis was conducted in 2013-2014. The prevalence of mental disorder diagnoses, frequent mental distress, and stressful life events were calculated for heterosexual, discordant heterosexual, gay or lesbian, bisexual, and unsure students. Logistic regression models were fit to estimate the association between sexual orientation and mental health outcomes.

RESULTS

Lesbian, gay, and bisexual students were more likely to report any mental health disorder diagnosis than were heterosexual students (p<0.05). Lesbian, gay, bisexual, and unsure students were significantly more likely to report frequent mental distress compared to heterosexual students (OR range, 1.6-2.7). All sexual minority groups, with the exception of unsure men, had significantly greater odds of experiencing two or more stressful life events (OR range, 1.3-2.8).

CONCLUSIONS

Sexual minority college students experience worse mental health than their heterosexual peers. These students may benefit from interventions that target the structural and social causes of these disparities, and individual-level interventions that consider their unique life experiences.

Between DSM and ICD: Paraphilias and the Transformation of Sexual Norms

The simultaneous revision of the two major international classifications of disease, the Diagnostic and Statistical Manual of Mental Disorders and the International Classification of Diseases, serves as an opportunity to observe the dynamic processes through which social norms of sexuality are constructed and are subject to change in relation to social, political, and historical context. This article argues that the classifications of sexual disorders, which define pathological aspects of "sexually arousing fantasies, sexual urges or behaviors" are representations of contemporary sexual norms, gender identifications, and gender relations. It aims to demonstrate how changes in the medical treatment of sexual perversions/paraphilias passed, over the course of the 20th century, from a model of pathologization (and sometimes criminalization) of non-reproductive sexual behaviors to a model that reflects and privileges sexual well-being and responsibility, and pathologizes the absence or the limitation of consent in sexual relations.

Virtual Viewing Time: The Relationship between Presence and Sexual Interest in Androphilic and Gynephilic Men

Virtual Reality (VR) has successfully been used in the research of human behavior for more than twenty years. The main advantage of VR is its capability to induce a high sense of presence. This results in emotions and behavior which are very close to those shown in real situations. In the context of sex research, only a few studies have used high-immersive VR so far. The ones that did can be found mostly in the field of forensic psychology. Nevertheless, the relationship between presence and sexual interest still remains unclear. The present study is the first to examine the advantages of high-immersive VR in comparison to a conventional standard desktop system regarding their capability to measure sexual interest. 25 gynephilic and 20 androphilic healthy men underwent three experimental conditions, which differed in their ability to induce a sense of presence. In each condition, participants were asked to rate ten male and ten female virtual human characters regarding their sexual attractiveness. Without their knowledge, the subjects' viewing time was assessed throughout the rating. Subjects were then asked to rate the sense of presence they had experienced as well as their perceived realism of the characters. Results suggested that stereoscopic viewing can significantly enhance the subjective sexual attractiveness of sexually relevant characters. Furthermore, in all three conditions participants looked significantly longer at sexually relevant virtual characters than at sexually non-relevant ones. The high immersion condition provided the best discriminant validity. From a statistical point of view, however, the sense of presence had no significant influence on the discriminant validity of the viewing time task. The study showed that high-immersive virtual environments enhance realism ratings as well as ratings of sexual attractiveness of three-dimensional human stimuli in comparison to standard desktop systems. Results also show that viewing time seems to be influenced neither by sexual attractiveness nor by realism of stimuli. This indicates how important task specific mechanisms of the viewing time effect are.

Coping and survival skills: the role school personnel play regarding support for bullied sexual minority-oriented youth

BACKGROUND

Research has shown that bullying has serious health consequences, and sexual minority-oriented youth are disproportionately affected. Sexual minority-oriented youth include lesbian, gay, bisexual, transgender, queer, or questioning (LGBTQ) individuals. This study examined the bullying experiences of sexual minority-oriented youth in a predominantly rural area of a Midwestern state. The purpose of this study was to have bullied youth describe their experiences and to present their perspectives.

METHODS

Using critical qualitative inquiry, 16 in-depth interviews were conducted in-person or online with youth, ages 15-20, who self-identified as having been bullied based on their perceived minority sexual orientation status.

RESULTS

The role of supportive school personnel was found to be meaningful, and supportive school personnel were mentioned as assisting with the coping and survival among this group of bullied sexual minority youth.

CONCLUSIONS

Supportive school personnel are crucial to the coping and survival of these youth. All school personnel need to be aware of the anti-bullying policies in their school corporations. They may then work to strengthen and enforce their policies for the protection of bullied youth.

Visual Reaction Time™ as a predictor of sexual offense recidivism

In this study, we investigated the use of Visual Reaction Time™ (VRT™) for sexual interest in children to predict recidivism of sexual offenses among men who sexually abused children and men with other sexually deviant behaviors. The authors hypothesized that study participants with a higher VRT™ to stimuli of children would be more likely to sexually reoffend compared with those with a lower VRT™ to stimuli of children. Participants included 621 adult males on parole or probation for acting on a range of sexual paraphilias who sought outpatient treatment or evaluation at two separate therapists' practices. Sample 1 consisted of 284 adult males followed up (by the lead author) during a 15-year period, while Sample 2 consisted of 337 adult males followed up (by the second author) during a 7-year period. A discrete-time hazard model found VRT™ to children to be significantly related to sexual recidivism. The researchers found that VRT™ to children measured at intake held up in its predictive ability over a 15-year period. When the participants were divided into three groups based on their VRT™, of the 97 participants who measured at least one standard deviation lower than the mean VRT™, 0% reoffended. The 432 participants in the medium-VRT™ group had an estimated recidivism rate of 7% after 15 years and the 92 participants who measured at least one standard deviation higher than the mean had an estimated recidivism rate of 27%.

Methodological issues in defining aggression for content analyses of sexually explicit material

There exists an important tradition of content analyses of aggression in sexually explicit material. The majority of these analyses use a definition of aggression that excludes consent. This article identifies three problems with this approach. First, it does not distinguish between aggression and some positive acts. Second, it excludes a key element of healthy sexuality. Third, it can lead to heteronormative definitions of healthy sexuality. It would be better to use a definition of aggression such as Baron and Richardson's (1994) in our content analyses, that includes a consideration of consent. A number of difficulties have been identified with attending to consent but this article offers solutions to each of these.

Sexual victimization using latent class analysis: exploring patterns and psycho-behavioral correlates

Sexual victimization is prevalent in the United States and overrepresented among adolescents. Research typically assesses victimization on a continuum of severity and rarely examines patterns of victimization within an individual. Using latent class analysis, the present study investigated whether meaningful classes of sexual victimization could be found based on the tactic used and severity of sexual behavior. Personal characteristics and psycho-behavioral outcomes were explored as they related to victimization classes. Peer sexual coercion experiences were examined among 657 racially diverse high school and college students, and four classes were identified: non-victims (54%), manipulated and forced fondle/intercourse (27%), poly-victimization (9.5%), and forced fondling (9.5%). Sexual victimization classes were significantly characterized in regards to childhood sexual abuse, gender, and age. The poly-victimization class (i.e., verbal coercion, substance facilitated, and physical force resulting in completed intercourse) showed the greatest level of psycho-behavioral consequences with significantly lower self-esteem, higher psychological distress, and more sexual risk taking than all other classes. The manipulated and forced class also showed significantly lower self-esteem than non-victims. Findings provide important implications for understanding patterns of sexual victimization and related consequences to help target interventions more effectively.

Mental health and risky sexual behaviors: evidence from DSM-IV Axis II disorders

BACKGROUND

Several economic studies link poor mental health and substance misuse with risky sexual behaviors. However, none have examined the relationships between DSM-IV Axis II mental health disorders (A2s) and risky sexual behaviors. A2 disorders are a poorly understood, yet prevalent and disabling class of mental health conditions. They develop early in life through an interaction of genetics and environment, and are persistent across the life course. Common features include poor impulse control, addiction, social isolation, and elevated sexual desires, although the defining features vary substantially across disorder.

AIMS OF THE STUDY

To investigate the association between A2 disorders and three measures of risky sexual behavior.

METHODS

We obtain data on adults age 20 to 50 years from Wave II of the National Epidemiological Survey of Alcohol and Related Conditions (NESARC). Our outcome measures include early initiation into sexual activity, and past year regular use of alcohol before sex and sexually transmitted disease diagnosis. NESARC administrators use the Alcohol Use Disorder and Associated Disabilities Interview Schedule to classify respondents as meeting criteria for the ten A2 disorders recognized by the American Psychiatric Association. We construct several measures of A2 disorders based on the NESARC administrators' classifications. Given their comorbidity with A2 disorders, we explore the importance of Axis I disorders in the estimated associations.

RESULTS

We find that A2 disorders are generally associated with an increase in the probability of risky sexual behaviors among both men and women. In specifications that disaggregate disorders into clusters and specific conditions, the significant associations are not uniform, but are broadly consistent with the defining features of the cluster or disorder. Inclusion of A1 disorders attenuates estimated associations for some risky sexual behaviors among men, but not for women.

DISCUSSION

We find positive associations between A2 disorders and our measures of risky sexual behaviors. Our findings are subject to several data limitations, however. The NESARC lacks information on more advanced risky sexual behaviors and our measure of early initiation into sexual activity is retrospective. Identifying the causal effects of mental health and risky sexual behaviors is complicated due to bias from reverse causality and omitted variables. We believe these sources of bias are less of a concern in our study, however. Specifically, A2 disorders develop early in life and pre-date the risky sexual behaviors, thus negating reverse causality. Because the NESARC contains a rich set of personal characteristics, we are also able to minimize potential omitted variable bias.

IMPLICATIONS FOR HEALTH CARE PROVISION AND USE

A2 disorders are significantly associated with risky sexual behaviors, which could lead to greater utilization and cost of health care services.

IMPLICATION FOR HEALTH POLICIES

Health care providers should consider A2 disorders when developing health promotion recommendations as these disorders may place individuals at elevated risk for unsafe sexual behaviors.

IMPLICATIONS FOR FURTHER RESEARCH

Future studies should examine the causal mechanisms between A2 disorders and risky sexual behaviors.

Disentangling desire and arousal: a classificatory conundrum

A controversial proposal to collapse sexual disorders of desire and arousal is forthcoming in the diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5). Yet, no study has attempted to empirically distinguish these disorders by using explicit criteria to recruit and compare distinct groups of low desire and arousal sufferers. The goal of the current study was to test the feasibility of finding medically healthy men and women meeting clearly operationalized DSM-IV-TR criteria for disorders of desire and/or arousal and compare them to matched controls. To assess operational criteria, participants completed a comprehensive telephone screening interview assessing DSM-IV-TR and DSM-5 criteria, as well as standardized self-report measures of sexual functioning. The use of operationalized DSM-IV-TR criteria to recruit participants led to the exclusion of over 75% of those reporting sexual difficulties, with the primary reason for exclusion being failure to meet at least one central diagnostic criterion. The application of the DSM-5 criteria was even more restrictive and led to the exclusion of all but four men and one woman using the original four-symptom criteria, and four men and five women using the revised three-symptom criteria. Cluster analyses supported the distinction between desire and genital arousal difficulties, and suggest that different groups with distinct clusters of symptoms may exist, two of which are consistent with the DSM-5 criteria. Overall, results highlight the need for revisions to the diagnostic criteria, which, as they stand, do not capture the full range of many people's sexual difficulties.

Computerized assessment of pedophilic sexual interest through self-report and viewing time: reliability, validity, and classification accuracy of the affinity program

Affinity is a computerized assessment tool that combines viewing time and self-report measures of sexual interest. The present study was designed to assess the diagnostic properties of Affinity with respect to sexual interest in prepubescent children. Reliability of both self-report and viewing time components was estimated to be high. The group profile of a sample of pedophilic adult male child molesters (n = 42, all of whom admitted their offenses) differed from the group profiles of male community controls (n = 95) and male nonsexual offenders (n = 27), respectively. More specifically, both ratings and viewing times for images showing small children or prejuvenile children were significantly higher within the child molester sample than in either of the other two groups, attesting to the validity of the measures. Overall classification accuracy, however, was mediocre: A multivariate classification routine yielded 50% sensitivity for child molester status at the cost of 13% false positives. The implications for forensic use of Affinity are discussed.

What is hooking up? Examining definitions of hooking up in relation to behavior and normative perceptions

Research has demonstrated ambiguity about the definition of hooking up among college students. The current research examined whether there were multiple definitions of hooking up among college students and how different definitions might be associated with the participant's own hooking up behavior and normative perceptions of peer hooking up behavior. A random sample (N = 1,468) of undergraduates (56.4% female) completed a Web-based survey composed of measures of drinking and sexual behavior. Open-ended definitions of hooking up were content-coded and analyzed using a mixture model to explore discrete definitions of hooking up among college students. Findings indicated three clusters of student definitions of hooking up: Cluster 1 had the broadest definition, referring to sex in general, not specific sexual acts, and to making out. Cluster 2 placed an emphasis on interpersonal and social aspects. Cluster 3 defined hooking up as sex with notable references to specific sexual acts. Results further indicated that hooking up behavior and normative perceptions differentiated these three groups of definitions. Clinical implications regarding the inconsistency of student definitions of hooking up and how they may impact negative consequences associated with hooking up are discussed.

Chasing sexual orientation: a comparison of commonly used single-indicator measures of sexual orientation

This research investigated the utility of single-indicator measures of sexual orientation in examining group differences. Adolescents and young adults reported their sexual orientations, preferences, and partners. Results indicate that, (a) depending on the measure of sexual orientation, 10% to 22% cannot be categorized into a sexual orientation group using a single-indicator measure; (b) self-identified sexual orientation is often incongruent with preference and behavior; (c) incongruity differs by gender and self-identified sexual orientation; and (d) detected differences in gay/lesbian, bisexual, and straight individuals vary by measure of sexual orientation. These results indicate that classification of sexual orientation by single-indicator measures can lead to inconsistent conclusions across studies.

Latent classes of heroin and cocaine users predict unique HIV/HCV risk factors

BACKGROUND

Patterns of heroin and cocaine use vary and may be associated with unique risk factors for bloodborne infections.

METHODS

Latent class analysis identified sub-populations of 552 heroin and cocaine users in Baltimore, Maryland. Using latent class regression, these classes were analyzed for associations with demographic characteristics, risky behaviors, Hepatitis C, and HIV.

RESULTS

Three classes were found: Crack/Nasal-Heroin users (43.5%), Polysubstance users (34.8%), and Heroin Injectors (21.8%). Compared to Polysubstance users, Crack/Nasal-Heroin users were almost 7 times more likely to identify as Black (OR=6.97, 95% CI=4.35-11.2). Sharing needles was over 2.5 times more likely among Polysubstance users than among Heroin Injectors (OR=2.66, 95% CI=1.49-4.75). Crack/Nasal-Heroin users were 2.5 times more likely than Polysubstance users to exchange drugs for sex (OR=2.50, 95% CI=1.22-5.13). Crack/Nasal-Heroin users were less likely than Heroin Injectors to have Hepatitis C (OR=0.10, 95% CI=0.06-0.18), but no significant differences were found for HIV.

CONCLUSIONS

Subpopulations of cocaine and heroin users differed in demographic classifications, HIV-risk behaviors, and Hepatitis C infection. All subpopulations included substantial numbers of HIV-positive individuals. Findings provide further evidence that non-injection drug users face significant infectious disease risk.

Automatic attention towards face or body as a function of mating motivation

Because women's faces and bodies carry different cues of reproductive value, men may attend to different perceptual cues as functions of their long-term versus short-term mating motivations. We tested this hypothesis in three experiments on 135 male and 132 female participants. When influenced by short-term rather than long-term mating motivations, men's attention was captured by (Study 1), was shifted to (Study 2), and was distracted by (Study 3) the waist/hip area rather than the face on photographs of attractive women. Similar effects were not found among the female participants in response to photographs of attractive men. These results support the evolutionary view that, similar to the attentional selectivity found in other domains of life, male perceptual attention has evolved to selectively capture and hold reproductive information about the opposite sex as a function of short-term versus long-term mating goals.

Is homosexuality a paraphilia? The evidence for and against

Whether homosexuality should be described as one among many paraphilic sexual interests or an altogether different dimension of sexual interest has long been discussed in terms of its political and social implications. The present article examined the question instead by comparing the major correlates and other features of homosexuality and of the paraphilias, including prevalence, sex ratio, onset and course, fraternal birth order, physical height, handedness, IQ and cognitive neuropsychological profile, and neuroanatomy. Although those literatures remain underdeveloped, the existing findings thus far suggest that homosexuality has a pattern of correlates largely, but not entirely, distinct from that identified among the paraphilias. At least, if homosexuality were deemed a paraphilia, it would be relatively unique among them, taxonometrically speaking.

Teaching sexual history-taking skills using the Sexual Events Classification System

OBJECTIVE

The authors review the literature about educational programs for teaching sexual history-taking skills and describe novel techniques for teaching these skills.

METHODS

Psychiatric residents enrolled in a brief sexual history-taking course that included instruction on the Sexual Events Classification System, feedback on residents' video-recorded interviews with simulated patients, discussion of videos that simulated bad interviews, simulated patients, and a competency scoring form to score a video of a simulated interview. After the course, residents completed an anonymous survey to assess the usefulness of the experience.

RESULTS

After the course, most residents felt more comfortable taking sexual histories. They described the Sexual Events Classification System and simulated interviews as practical methods for teaching sexual history-taking skills.

CONCLUSION

The Sexual Events Classification System and simulated patient experiences may serve as a practical model for teaching sexual history-taking skills to general psychiatric residents.

Sex redefined: the reclassification of oral-genital contact

CONTEXT

Although partially anecdotal, some evidence suggests that oral-genital contact is increasingly excluded from young people's notions of what behaviors constitute sex. Such a shift may have implications for STD prevention.

METHODS

In 2007, a convenience sample of 477 university students participated in a survey that included the question "Would you say you 'had sex' with someone if the most intimate behavior you engaged in was" each of 11 behaviors. Chi-square tests and independent samples t tests were used to assess gender differences, and chi-square analyses were used to compare the data with similar data collected in 1991. Predictors of beliefs concerning the classification of oral-genital contact were assessed using logistic regression analysis.

RESULTS

The majority of respondents indicated that penile-vaginal intercourse and penile-anal intercourse constitute sex (98% and 78%, respectively), but only about 20% believed the same was true of oral-genital contact. The proportion classifying oral-genital contact as sex in 2007 was about half that in 1991. This difference was consistent for both sexes and for both giving and receiving oral-genital stimulation. Responses did not vary by respondents' sexual experience or demographic characteristics.

CONCLUSIONS

Sociocultural conceptualizations of oral-genital contact have shifted in a way that may leave people who engage in this activity unmindful of its potential health risks. Sex education programs, which generally focus on penile-vaginal contact, could help STD prevention efforts by explaining the risks associated with oral-genital stimulation and the measures that can be taken to minimize those risks.

The impact of an AIDS vaccine in developing countries: a new model and initial results

A new model was developed to examine the potential impacts of an AIDS vaccine in developing countries. The findings suggest that even a modestly efficacious first-generation vaccine could have a profound effect on the AIDS pandemic. A vaccine with 50 percent efficacy provided to 30 percent of the population would reduce new annual infections by 34 percent (seventeen million infections avoided) over fifteen years and result in substantial financial savings. A more efficacious vaccine, combined with expanded delivery, would do even more to control the pandemic. It therefore makes sense to continue investing in AIDS vaccine research and development and the eventual manufacture and widespread distribution of a vaccine.

How, and how not, to stop AIDS in Africa

A review of Helen Epstein's book, "The invisible cure: Africa, the West, and the fight against AIDS."

Prevalence of HIV and hepatitis C virus infections among inmates of Ontario remand facilities

BACKGROUND

Each year more than 56 000 adult and young offenders are admitted to Ontario's remand facilities (jails, detention centres and youth centres). The prevalence of HIV infection in Ontario remand facilities was last measured over a decade ago, and no research on the prevalence of hepatitis C virus (HCV) infection has been conducted in such facilities. We sought to determine the prevalence of HIV infection, HCV infection and HIV-HCV coinfection among inmates in Ontario's remand facilities.

METHODS

A voluntary and anonymous cross-sectional prevalence study of HIV and HCV infections was conducted among people admitted to 13 selected remand facilities across Ontario between Feb. 1, 2003, and June 20, 2004. Data collection included a saliva specimen for HIV and HCV antibody screening and an interviewer-administered survey. Prevalence rates and 95% confidence intervals were calculated and examined according to demographic characteristics, region of incarceration and self-reported history of injection drug use.

RESULTS

In total, 1877 participants provided both a saliva specimen and survey information. Among the adult participants, the prevalence of HIV infection was 2.1% among men and 1.8% among women. Adult offenders most likely to have HIV infection were older offenders (> or = 30 years) and injection drug users. The prevalence of HCV infection was 15.9% among men, 30.2% among women and 54.7% among injection drug users. Adult offenders most likely to have HCV infection were women, older offenders (> or = 30 years) and injection drug users. The prevalence of HCV-HIV coinfection was 1.2% among men and 1.5% among women. It was highest among older inmates and injection drug users. Among the young offenders, none was HIV positive and 1 (0.4%) was HCV positive. On the basis of the study results, we estimated that 1079 HIV-positive adults and 9208 HCV-positive adults were admitted to remand facilities in Ontario from Apr. 1, 2003, to Mar. 31, 2004.

INTERPRETATION

Adult offenders entering Ontario remand facilities have a considerably higher prevalence of HIV and HCV infections than the general population.

What is sex and why does it matter? A motivational approach to exploring individuals' definitions of sex

What sexual experiences qualify as "having sex"? We investigated two assumptions apparently underlying research on how individuals make these judgments: that individuals have clear definitions regarding what qualifies as sex and that these judgments depend on how closely the activity being assessed matches their definitions of sex. Using open-ended questionnaires, 100 students, 51 women and 49 men, described their experiences that were "almost but not quite sex" or "just barely sex" and situations where there was uncertainty or disagreement about whether the experience qualified as "sex." In contrast to the above assumptions, many respondents expressed ambiguity about their definitions of sex, and their decisions about labeling an experience as "sex" often seemed influenced by the consequences of applying this label.

Deconstructing Adolescent Same-Sex Attraction and Sexual Behavior in the Twenty-First Century: Perspectives for the Clinician

The adolescent with same-sex attraction in the twenty-first century straddles ambivalent cultural and religious attitudes regarding gay, lesbian, bisexual, or transgender (GLBT) issues; rapid technologic advances that provide easy access to information on sex and sex partners; and the clinician's sensitivity about GLBT issues and his or her awareness of how adolescents can use technology for sex-seeking behavior. It is necessary to deconstruct these factors into defined frameworks. Three checklists, the Clinician's Framework Guide Questions for the GLBT Adolescent, Clinician Reaction to GLBT Issues Checklist, and Global GLBT Checklist for Biopsychosocial Risk Factors, may aid the clinician in acquiring an appreciation of the global dynamics between the gay adolescent, the clinician, and the impact of current social realities.

Factors that shape young people's sexual behaviour: a systematic review

BACKGROUND

Since nearly half of new HIV infections worldwide occur among young people aged 15-24 years, changing sexual behaviour in this group will be crucial in tackling the pandemic. Qualitative research is starting to reveal how social and cultural forces shape young people's sexual behaviour and can help explain why information campaigns and condom distribution programmes alone are often not enough to change it. We undertook a systematic review to identify key themes emerging from such research, to help inform policymakers developing sexual health programmes, and guide future research.

METHODS

We reviewed 268 qualitative studies of young people's sexual behaviour published between 1990 and 2004. We developed a method of comparative thematic analysis in which we coded each document according to themes they contained. We then identified relations between codes, grouping them accordingly into broader overall themes. Documents were classified as either primary or secondary depending on their quality and whether they contained empirical data. From the 5452 reports identified, we selected 246 journal articles and 22 books for analysis.

FINDINGS

Seven key themes emerged: young people assess potential sexual partners as "clean" or "unclean"; sexual partners have an important influence on behaviour in general; condoms are stigmatising and associated with lack of trust; gender stereotypes are crucial in determining social expectations and, in turn, behaviour; there are penalties and rewards for sex from society; reputations and social displays of sexual activity or inactivity are important; and social expectations hamper communication about sex. The themes do not seem to be exclusive to any particular country or cultural background, and all themes were present, in varying degrees, in all countries assessed.

INTERPRETATION

This study summarises key qualitative findings that help in understanding young people's sexual behaviour and why they might have unsafe sex; policymakers must take these into account when designing HIV programmes. Considerable overlap exists between current studies, which indicates the need to broaden the scope of future work.

HIV in East London: ethnicity, gender and risk. Design and methods

Background

While men who have sex with men remain the group at greatest risk of acquiring HIV infection in the UK, the number of new diagnoses among heterosexuals has risen steadily over the last five years. In the UK, three-quarters of heterosexual men and women diagnosed with HIV in 2004 probably acquired their infection in Africa. This changing epidemiological pattern is particularly pronounced in East London because of its ethnically diverse population.

Design and methods

The objective of the study was to examine the social, economic and behavioural characteristics of patients with HIV infection currently receiving treatment and care in hospitals in East London. The research focused on ethnicity, gender, sexuality, education, employment, housing, HIV treatment, stigma, discrimination, religion, migration and sexual risk behaviour. People diagnosed with HIV infection attending outpatient treatment clinics at St Bartholomew's, the Royal London, Whipp's Cross, Homerton, Newham and Barking hospitals (all in East London) over a 4–6 month period were invited to participate in the study in 2004–2005. Those who agreed to participate completed a confidential, self-administered pen-and-paper questionnaire. During the study period, 2680 patients with HIV attended the outpatient clinics in the six participating hospitals, of whom 2299 were eligible for the study and 1687 completed a questionnaire. The response rate was 73% of eligible patients and 63% of all patients attending the clinics during the survey period.

Discussion

A clinic-based study has allowed us to survey nearly 1700 patients with HIV from diverse backgrounds receiving treatment and care in East London. The data collected in this study will provide valuable information for the planning and delivery of appropriate clinical care, social support and health promotion for people living with HIV not only in East London but in other parts of the capital as well as elsewhere in the UK.

Differences in perceptions of what constitutes having "had sex" in a population of people living with HIV/AIDS

The reduction of high-risk sexual behavior among HIV-infected individuals is a major aspect of prevention strategies to reduce HIV infection in the United States. These prevention efforts assume a common understanding between clinicians and HIV-infected individuals of the terms "sex" and what constitutes having "had sex." The purpose of this study was to determine what sexual behaviors HIV-infected individuals perceive as having had sex and to examine the variability of these perceptions. Surveys were done of 279 HIV-positive adults receiving services at an HIV-focused community health center in Dallas, TX. Responses from participants about whether they perceived a given behavior as constituting having had sex were analyzed by Chi-squared analysis. Overall, only 80.9% of respondents perceived penile-vaginal intercourse as "sex," while 76.9% said they "had sex" if someone had oral contact with their genitals. There were gender and ethnicity differences in what was perceived as having had sex. Females were significantly less likely than males to perceive anal intercourse as having had sex. Variability exists among HIV-positive individuals regarding what they perceive as having had sex. Results support the need for clinicians to more precisely ascertain sexual perceptions and risks to achieve HIV prevention goals.

Desiring mates

The discourse of gay liberation reads silence surrounding personal participation in same-sex sexualized pleasures as a sign of repression, oppression and a positioning in the closet. In contrast, coming out is an important step towards accepting one's true homosexual self. The demand for the emancipation of the homosexual type further suggests that all same-sex sexualized contact signifies the homosexuality of the subjects involved, regardless of whether they recognize this or not. This compulsory homosexualization of men who have sexualized contact with men does not apply to relationships between male friends ("mates"). A "mateship" union grants a level of privacy otherwise eradicated by a gay liberation movement insistent on the public confession of a homosexual orientation. To remain silent about corporeal pleasures poses a threat to the modernist preference for control of bodies and to the established gay identity. Silence offers a space for the construction of new modes of same-sex intimate relationships within a queer framework.

Measuring sexual orientation in adolescent health surveys: evaluation of eight school-based surveys

PURPOSE

To examine the performance of various items measuring sexual orientation within 8 school-based adolescent health surveys in the United States and Canada from 1986 through 1999.

METHODS

Analyses examined nonresponse and unsure responses to sexual orientation items compared with other survey items, demographic differences in responses, tests for response set bias, and congruence of responses to multiple orientation items; analytical methods included frequencies, contingency tables with Chi-square, and ANOVA with least significant differences (LSD)post hoc tests; all analyses were conducted separately by gender.

RESULTS

In all surveys, nonresponse rates for orientation questions were similar to other sexual questions, but not higher; younger students, immigrants, and students with learning disabilities were more likely to skip items or select "unsure." Sexual behavior items had the lowest nonresponse, but fewer than half of all students reported sexual behavior, limiting its usefulness for indicating orientation. Item placement in the survey, wording, and response set bias all appeared to influence nonresponse and unsure rates.

CONCLUSIONS

Specific recommendations include standardizing wording across future surveys, and pilot testing items with diverse ages and ethnic groups of teens before use. All three dimensions of orientation should be assessed where possible; when limited to single items, sexual attraction may be the best choice. Specific wording suggestions are offered for future surveys.

THE SEXUAL ORIENTATION OF MEN WHO WERE BROUGHT UP IN GAY OR LESBIAN HOUSEHOLDS

Elsewhere the author has suggested that adolescent and adult male homosexual orientation is, in some cases, causally associated with sexual or quasi-sexual experience in childhood (James, 2004). Here it is argued that the available data on men raised by same-sex parents cannot validly be interpreted as supporting or refuting this suggestion.

Risk avoidance versus risk reduction: a framework and segmentation profile for understanding adolescent sexual activity

The teen birthrate in the United States is twice that of other industrialized nations. Adolescents in the U.S. are among high-risk groups for HIV/AIDS and other sexually transmitted diseases. As a result, the Department of Health and Human Services changed its policy on the promotion of abstinence to teenagers from a focus on a risk reduction strategy to a focus on a risk avoidance strategy. In order to create more effective risk avoidance as well as risk reduction campaigns, this study proposes a framework to illustrate the distinction that teens make between spontaneous sexual activity and planned sexual activity, as well as those teens that make a commitment to abstinence versus abstinence by default. Furthermore, this study classifies teens into three behavior segments (abstemious, promiscuous and monogamous) and then assesses specific differences that exist within these groups relative to their attitudes and perceptions concerning abstinence, sexual activity, contraception, fear and norms. This change in focus from a risk reduction to a risk avoidance strategy has important implications for social marketing, public policy and marketing theory.