Wednesday, November 19, 2008

More teens, young adults: anal intercourse

PROVIDENCE, RI – A new study by researchers at the Bradley Hasbro Children's Research Center suggests that the incidence of heterosexual anal sex is increasing among teens and young adults – particularly those who have recently had unprotected vaginal sex. These findings mirror recent data that show anal sex rates among adults doubled between the years 1995 and 2004.

The study, published online by the American Journal of Public Health, is among the first to report on the little-known factors associated with heterosexual anal intercourse among adolescents and young adults.

"The topic of anal intercourse is often considered taboo – especially when discussed in the context of youth relationships – even though we know that this behavior is a significant risk factor for HIV and other sexually transmitted infections. It's critical that we recognize that more and more young people are engaging in anal sex so we can open the lines of communications and help them protect their sexual health," says lead author Celia Lescano, PhD, of the Bradley Hasbro Children's Research Center (BHCRC).

Researchers assessed the sexual behavior of 1,348 adolescents and young adults between the ages of 15 and 21 who had unprotected sex in the previous three months. They found that 16 percent had engaged in heterosexual anal intercourse within the timeframe, with condoms being used just 29 percent of the time.

Females who had heterosexual anal sex were more likely to be living with their partners, to have two or more sexual partners and to have previously experienced coerced intercourse. Males who engaged in heterosexual anal intercourse were more likely to identify themselves as being homosexual, bisexual or undecided.

"These findings suggest that the factors associated with anal intercourse among females in the study relate to the context and power balance of sexual relationships," says Lescano, who's also an assistant professor of psychiatry (research) at the Warren Alpert Medical School of Brown University. "We must teach teen girls and young women how to be assertive in sexual relationships, such as refusing unwanted sexual acts and negotiating for safer sex, whether it's anal or vaginal."

However, there were several factors related to anal intercourse that were consistent in both genders. In general, those who felt that using condoms decreased the pleasure of sex and those who used drugs at the time of intercourse engaged in riskier behaviors, suggesting that interventions should emphasize that sex can be both pleasurable and safe.

"An open dialogue between health care providers and their young patients about anal intercourse is becoming increasingly important, and clinicians should ask about anal sex during discussions about vaginal intercourse and protection – regardless of the patient's gender or reported sexual orientation," says Lescano.

Study participants in Atlanta, Miami and Providence completed a self-interview designed to measure sexual risk behaviors, relationships, sexual risk attitudes, substance use and mental health. The majority of the group (92 percent) defined themselves as being heterosexual. Overall, 56 percent were female; approximately half of the participants were African American, 24 percent were Hispanic and 20 percent were white.

Tuesday, November 11, 2008

Sexual intimacy and breast cancer survivors

An Indiana University study found that young, female breast cancer survivors often suffer from sexual and intimate relationship issues and are interested in using sexual enhancement products to treat these problems.

The study, "Young Female Breast Cancer Survivors: Their sexual function and interest in sexual enhancement products and services," was published Nov. 4 in the journal Cancer Nursing.

The study was funded by The Patty Brisben Foundation, a non-profit organization dedicated to furthering research related to women's sexual health.

The study found that a significant number of women reported vaginal dryness, genital pain, premature menopause, fatigue and fertility problems. In addition, survivors experienced significant problems related to sexual arousal, desire and orgasm.

"Although previous work has documented the sexual difficulties faced by young breast cancer survivors, strikingly little work has addressed strategies women might take to address these sexual problems," said Debby Herbenick, lead researcher and associate director of the Center for Sexual Health Promotion at IU Bloomington's School of Health, Physical Education and Recreation.

Herbenick adds that more than 2 million breast cancer survivors are living in the United States, according to the National Cancer Institute.

"Given advances in early detection and treatment, more women survive breast cancer, which requires researchers to focus on important relationship and quality of life issues for survivors," said Jessica Johnston, executive director of The Patty Brisben Foundation.

Most of the women surveyed reported interest in using personal lubricants and massage lotions/oils to help treat these issues. Half of the women surveyed were interested in using vibrators or dildos and more than one-third were interested in sex games.

The women in the study also indicated comfort in purchasing sexual enhancement products through in-home parties held in someone's own home or during one's regular breast cancer support group meeting, and to a lesser extent from adult Web sites and adult bookstores or novelty stores. Researchers conclude that these venues might be possible places for nurses, doctors and support group leaders to refer their clients.

"Documenting the sexual problems experienced by survivors is important, but we also need to understand the broad and diverse ways that women want to address these sexual problems so that they can experience their intimate lives in ways that feel comfortable, pleasurable and that enhance their relationships," said Herbenick. "Many women expressed interest in these products, which makes sense given that so many had experienced genital pain, vaginal dryness, low desire or lack of orgasm."

Thursday, November 6, 2008

Serial Cohabiters Less Likely Than Others to Marry

A new study in the Journal of Marriage and Family found that serial cohabiters are less likely than single-instance cohabiting unions to result in marriage. Similarly if serial cohabiters marry, divorce rates are very high.


Daniel T. Lichter of Cornell University and Zhenchao of Ohio State University used data from the National Longitudinal Survey of Youth to track the experiences of serial cohabiters, or women who have cohabited with more than one partner.


Serial cohabiters were less likely than couples who cohabited only once to end in marriage. If serial cohabiters did marry, divorce rates were very high – more than twice as high as for women who cohabited only with their eventual husbands.


Results indicate that only a minority of cohabiting women (15 to 20 percent) were involved in multiple cohabitations. Also, serial cohabitations were overrepresented among economically disadvantaged groups, especially those with low income and education.


“Understanding the myriad motivations of cohabiters may be more important than ever, especially if cyclical serial cohabiting couples with children have increased among recent cohorts as a percentage of all cohabitations,” Lichter notes.

Saturday, November 1, 2008

Sexual problems in women: What, me worry?

While prevalent, sexual problems in women not always associated with distress

The largest such study ever published finds that, while about 40 percent of women surveyed report having sexual problems, only 12 percent indicate that those issues are a source of significant personal distress. The report led by a Massachusetts General Hospital (MGH) physician appears in the November issue of Obstetrics & Gynecology.

"Sexual problems are common in women, but problems associated with personal distress, those which are truly bothersome and affect a woman's quality of life, are much less frequent." says Jan Shifren, MD, of the MGH Obstetrics and Gynecology Service, who led the study. "For a sexual concern to be considered a medical problem, it must be associated with distress, so it's important to assess this in both research studies and patient care."

Several studies and surveys of sexual problems in women have found problems with low desire, diminished arousal or difficulties with orgasm in approximately 40 percent of women, but few of those have asked about levels of distress associated with those problems. The current study surveyed 32,000 women aged 18 to over 100 from across the U.S. using a well-established survey of sexual function supplemented by a validated measure of a woman's distress related to her sex life – including feelings of anger, guilt, frustration, and worry.

Some level of sexual problem was reported in 43 percent of respondents – with 39 percent reporting low levels of desire, 26 percent problems with arousal and 21 percent difficulties with orgasm. But distress related to any of these problems was reported by only 12 percent of study participants. Although the prevalence of sexual problems was highest in women over 65, that group reported the lowest levels of distress, while distress was reported most frequently in women aged 45 to 64. The youngest group – those from 18 to 44 – had lower levels of both problems and distress. Women with depression were more than twice as likely to report distress over any type of sexual problem as those not suffering from depression.

"Although sexual problems were very common in women over age 65, these problems often weren't associated with distress," Shifren says. "Several factors could be behind the lower levels of distress in the oldest group. If their partners also have low desire, it may not be looked on as a problem, or additional health issues could be of greater concern.

"While distressing sexual problems are much less common in women than sexual problems overall, they still affect approximately one in eight adult women," she adds. "As part of a thorough health assessment, it's important that health care providers ask their female patients if they have sexual concerns and if those problems are associated with distress. Although this study did not examine treatments for sexual problems, effective options are available – including relationship counseling, treatment of associated medical conditions and sex therapy." Shifren is an associate professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School.