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Item Androstadienone sensitivity is associated with attention to emotions, social interactions, and sexual behavior in older U.S. adults(Public Library of Science, 2023-01-13) Kern, David W.; Kaufmann, Gabriel T.; Hummer, Tom A.; Schumm, L. Philip; Wroblewski, Kristen E.; Pinto, Jayant M.; McClintock, Martha K.; Psychiatry, School of MedicineΔ 4,16-androstadien-3-one (androstadienone) is a putative human pheromone often linked to sexual attraction in young adults, although specific associations with sexual behavior are not yet established. Androstadienone also serves a broader social-emotional function beyond the sexual domain, specifically tuning the brain to efficiently process emotional information. Whether these effects persist throughout the lifespan into post-reproductive life is unknown. In a laboratory study of older adults, those with greater androstadienone odor sensitivity paid greater attention to subliminal emotional information, specifically, angry faces (p = 0.05), with a similar relationship to happy faces. In contrast, the physical odor n-butanol (a control) did not affect emotional attention (p = 0.49). We then extended this laboratory research and determined whether sensitivity to androstadienone affects the everyday lives of older adults by measuring their social and sexual behavior. In this second study, we surveyed in a nationally representative sample of US older adults living in their homes (National Social Life and Aging Project, 62-90 years; n = 2,086), along with their sensitivity to androstadienone, general olfactory function, health and demographics. Greater sensitivity to androstadienone was associated with richer social lives: having more friends, increased communication with close friends and family, and more participation in organized social events and volunteer activities (all p's ≤ 0.05, generalized linear models, adjusted for age and gender). It was also associated with more recent sexual activity, more frequent sexual thoughts, and viewing sex as an important part of life (all p's ≤ 0.05). General olfactory function did not explain these associations, supporting a specialized function for this pheromone during everyday life, and expanding its role to social life as well as sexual behavior, likely mediated by enhanced attention to emotional information.Item Community Engagement and Venue-Based Sampling in Adolescent Male Sexually Transmitted Infection Prevention Research(Elsevier, 2018-03) Ott, Mary A.; Moon, Julianne; Imburgia, Teresa M.; Yang, Ziyi; Tu, Wanzhu; Auerswald, Colette L.; Pediatrics, School of MedicineOBJECTIVES: Middle adolescent males are a difficult group to recruit for community sexually transmitted infection (STI) prevention research. We describe a process of community engagement, and venue-based sampling of 14-17-year-old adolescent males, and compare rates of STIs and STI risk behaviors by venue. METHODS: Community engagement consisted of (1) informational meetings with organizations; (2) participation in community meetings and events; (3) hiring community members as study personnel; and (4) an adolescent advisory board recruited from the community. Venues were identified and assessed at different times of the day and days of the week using a structured tool. At selected venues, males ages 14-17 years were invited to participate in a brief survey and provide a urine sample and an optional anal swab for DNA-based STI testing. RESULTS: Venues were assessed (n = 249), and 31 were selected for recruitment, including parks, apartment complexes, community events, entertainment venues, a community school, and community programs for LGBT (gay, lesbian, bisexual, transgender) and adjudicated youth. We enrolled 667 participants, average age 15.7 years. Participants reported high rates of sexual and STI risk behaviors, but had low rates of STIs. These rates differed by venue, with more structured venues recruiting youth reporting fewer STI risk behaviors and less structured venues within the highest STI prevalence zip code recruiting youth reporting more STI risk behaviors. CONCLUSION: Venue-based sampling is a feasible mechanism to target recruitment and enrollment adolescent males with high STI risk behaviors in community settings, with risk profiles varying by setting.Item Effects of relationship context and social factors on women's solo masturbaton and vibrator use(2015-08) Sherrow, Ashley Reneé; Hensel, Devon J.; Foote, Carrie E.; Latham, Kenzie E.Little existing research has examined women’s solo masturbation and vibrator usage in a way that highlights the importance of both sexual agency and the sexual/romantic relationship context. This research evaluates if and how social factors, partnership status and the relationship context, and sexual self-concept impact a woman’s behaviors and attitudes toward masturbation and vibrator use. Using cross-sectional survey data from adult women (N=112), descriptive and bivariate analyses were used to explore a variety of factors. Single and partnered women did not differ significantly on a majority of measures, suggesting that partnership status may play an insignificant role in predicting women’s solo sex attitudes and behaviors. Regarding the relationship context, partner communication and positivity toward masturbation and vibrator use significantly varied together. Finally, greater sexual openness and sexual entitlement were associated with higher masturbation frequency. Results from this study suggest that masturbation and vibrator use are common among adult women, and women are capable of sexual agency in relation to masturbation and vibrator use, whether they are in established partnerships or not.Item Human papillomavirus vaccine-related risk perceptions and subsequent sexual behaviors and sexually transmitted infections among vaccinated adolescent women(Elsevier, 2016-07-25) Kowalczyk Mullins, Tanya L.; Zimet, Gregory D.; Rosenthal, Susan L.; Morrow, Charlene; Ding, Lili; Huang, Bin; Kahn, Jessica A.; Pediatrics, School of MedicineOBJECTIVE: To examine the association between risk perceptions after human papillomavirus (HPV) vaccination and sexual behaviors and sexually transmitted infection (STI) diagnosis over 30months following vaccination. METHODS: Participants included 112 sexually experienced girls aged 13-21years who were enrolled at the time of first HPV vaccination and completed ⩾2 of 4 follow-up visits at 2, 6, 18, 30months and including 30months. At each visit, participants completed surveys assessing risk perceptions (perceived need for safer sexual behaviors, perceived risk of STIs other than HPV) and sexual behaviors. STI testing was done at 6, 18, and 30months. Outcomes were condom use at last intercourse with main male partner, number of sexual partners since last study visit, and STI diagnosis. Associations between risk perceptions and sexual behaviors/STIs were examined using generalized linear mixed models. RESULTS: Mean age was 17.9years; 88% were Black; 49% had a history of STI at baseline. Scale scores for perceived need for safer sexual behaviors did not change significantly over time. Scale scores for perceived risk of STIs other than HPV significantly changed (p=0.027), indicating that girls perceived themselves to be more at risk of STIs other than HPV over 30months following vaccination. Multivariable models demonstrated that greater perceived need for safer sexual behaviors following vaccination was associated with condom use (p=0.002) but not with number of partners or STI diagnosis. Perceived risk of STIs other than HPV was not associated with the three outcomes. CONCLUSIONS: The finding that perceived risk for STIs other than HPV was not associated with subsequent sexual behaviors or STI diagnosis is reassuring. The association between perceived need for safer sexual behaviors and subsequent condom use suggests that the HPV vaccination visit is an important opportunity to reiterate the importance of safer sexual behaviors to sexually experienced girls.Item Human Papillomavirus Vaccine-Related Risk Perceptions Do Not Predict Sexual Initiation Among Young Women Over 30 Months Following Vaccination(Elsevier, 2018-02) Mullins, Tanya L. Kowalczyk; Rosenthal, Susan L.; Zimet, Gregory D.; Ding, Lili; Morrow, Charlene; Huang, Bin; Kahn, Jessica A.; School of NursingPURPOSE: We examined longitudinally the relationship between human papillomavirus (HPV) vaccine-related risk perceptions and initiation of sexual activity among adolescent women over 30 months after HPV vaccination. METHODS: Participants included 91 sexually inexperienced women aged 13-21 years receiving the HPV vaccine who completed at least three of five study visits. At every visit, participants completed surveys assessing HPV vaccine-related risk perceptions (perceived risk of sexually transmitted infections [STIs] other than HPV, perceived need for safer sexual behaviors), and sexual initiation. Outcomes were sexual initiation and age of sexual initiation. Associations between risk perceptions and outcomes were examined using ordered logistic regression models for sexual initiation and interval censored survival analyses for age of sexual initiation. RESULTS: Mean age at baseline was 14.9 years (standard deviation [SD] 1.4). Most participants perceived themselves to be at risk of STIs other than HPV (mean scale score = 4.0/10; SD 2.1) and perceived a need for safer sexual behaviors (mean scale score = 1.5/10; SD 1.5). By 30 months, 65 participants (78%) initiated sex. Perceived risk of STIs and perceived need for safer sexual behaviors were not associated with sexual initiation or age of sexual initiation. Older age at baseline was associated with sooner sexual initiation (p = .02) and older age at sexual initiation (p < .001). Results of ordered logistic regression and survival analyses were unchanged when controlling for baseline age. CONCLUSIONS: HPV vaccine-related risk perceptions were not associated with sexual initiation or age of sexual initiation, providing further support that HPV vaccine-related risk perceptions are unlikely to lead to riskier sexual behaviors.Item A longitudinal daily diary analysis of condom use during bleeding-associated vaginal sex among adolescent females(BMJ, 2016) Hensel, Devon J.; Tanner, Amanda E.; Sherrow, Ashley; Fortenberry, J. Dennis; Medicine, School of MedicineObjective: Sex during bleeding is a risk factor for sexually transmitted infection (STI) and other bloodborne viruses, including HIV. We examined daily predictors of adolescent women's male condom use during bleeding-associated vaginal sex. Methods: Adolescent females (N=387; 14-17 years) were recruited from primary care clinics for a longitudinal cohort study of STIs and sexual behaviour. Data were daily partner-specific sexual diaries; generalised estimating equation logistic regression assessed the likelihood of condom use during bleeding-associated vaginal sex. Results: Less than 30% of bleeding-associated vaginal sex events were condom protected. Condom use during these events was less likely with younger age, higher partner support, higher partner negativity or past week bleeding-associated sex with a given partner; condom use was more likely with high individual mood and past week condom use during bleeding-associated vaginal sex with a given partner. Conclusions: Low condom rates during bleeding-associated vaginal sex can increase STI and bloodborne virus risk. Providers should consider integrating partner-specific and behavioural factors when they deliver sexual health messages to young women.Item Sex and Relationships Pre- and Early- COVID-19 Pandemic: Findings from a Probability Sample of U.S. Undergraduate Students(Springer, 2022-01-03) Herbenick, Debby; Hensel, Devon J.; Eastman-Mueller, Heather; Beckmeyer, Jonathon; Fu, Tsung-Chieh; Guerra-Reyes, LuciaIn the wake of the COVID-19 pandemic, most U.S. colleges closed their campuses-including residence halls-causing significant disruption to students' lives. Two waves of data were collected from undergraduate students enrolled at a large U.S. Midwestern university: Wave 1 was a confidential online survey of 4989 randomly sampled undergraduate students collected in January/February 2020; Wave 2 was collected in April/May 2020 following campus closure. Our research aimed to: (1) assess how the COVID-19 related campus closure affected college students' romantic/sexual relationships, (2) examine students' past month sexual behaviors prior to the pandemic in comparison with their sexual behaviors during campus closure, and (3) compare participants' pre-pandemic event-level sexual behaviors with those occurring during campus closure. Of 2137 participants who completed both waves (49.8% women, mean age = 20.9), 2.6% were living at home in Wave 1 compared to 71.0% at Wave 2. Of those in relationships, 14.5% experienced a breakup and 25.3% stayed in their relationship but returned home to different cities. There were no statistically significant differences in participants' prior month reports of solo masturbation or sending/receiving nude/sexy images between Waves 1 and 2; however, participation in oral, vaginal, and anal sex significantly decreased across waves. Examining participants' most recent sexual events, Wave 2 sex more often occurred with a cohabiting or relationship partner and was rated as more wanted, emotionally intimate, and orgasmic. Implications for sexual health professionals are discussed.Item The International Sexual Health And REproductive Health during COVID-19 (I-SHARE) Study: A Multicountry Analysis of Adults from 30 Countries Prior to and During the Initial Coronavirus Disease 2019 Wave(Oxford University Press, 2022) Toller Erausquin, Jennifer; Tan, Rayner K.J.; Uhlich, Maximiliane; Francis, Joel M.; Kumar, Navin; Campbell, Linda; Zhang, Wei Hong; Hlatshwako, Takhona G.; Kosana, Priya; Shah, Sonam; Brenner, Erica M.; Remmerie, Lore; Mussa, Aamirah; Klapilova, Katerina; Mark, Kristen; Perotta, Gabriela; Gabster, Amanda; Wouters, Edwin; Burns, Sharyn; Hendriks, Jacqueline; Hensel, Devon J.; Shamu, Simukai; Strizzi, Jenna Marie; Esho, Tammary; Morroni, Chelsea; Eleuteri, Stefano; Sahril, Norhafiza; Low, Wah Yun; Plasilova, Leona; Lazdane, Gunta; Marks, Michael; Olumide, Adesola; Abdelhamed, Amr; López Gómez, Alejandra; Michielsen, Kristien; Moreau, Caroline; Tucker, Joseph D.; International Sexual Health And REproductive Health during COVID-19 Research Consortium; Pediatrics, School of MedicineBackground: There is limited evidence to date about changes to sexual and reproductive health (SRH) during the initial wave of coronavirus disease 2019 (COVID-19). To address this gap, our team organized a multicountry, cross-sectional online survey as part of a global consortium. Methods: Consortium research teams conducted online surveys in 30 countries. Sampling methods included convenience, online panels, and population-representative. Primary outcomes included sexual behaviors, partner violence, and SRH service use, and we compared 3 months prior to and during policy measures to mitigate COVID-19. We conducted meta-analyses for primary outcomes and graded the certainty of the evidence. Results: Among 4546 respondents with casual partners, condom use stayed the same for 3374 (74.4%), and 640 (14.1%) reported a decline. Fewer respondents reported physical or sexual partner violence during COVID-19 measures (1063 of 15 144, 7.0%) compared to before COVID-19 measures (1469 of 15 887, 9.3%). COVID-19 measures impeded access to condoms (933 of 10 790, 8.7%), contraceptives (610 of 8175, 7.5%), and human immunodeficiency virus/sexually transmitted infection (HIV/STI) testing (750 of 1965, 30.7%). Pooled estimates from meta-analysis indicate that during COVID-19 measures, 32.3% (95% confidence interval [CI], 23.9%-42.1%) of people needing HIV/STI testing had hindered access, 4.4% (95% CI, 3.4%-5.4%) experienced partner violence, and 5.8% (95% CI, 5.4%-8.2%) decreased casual partner condom use (moderate certainty of evidence for each outcome). Meta-analysis findings were robust in sensitivity analyses that examined country income level, sample size, and sampling strategy. Conclusions: Open science methods are feasible to organize research studies as part of emergency responses. The initial COVID-19 wave impacted SRH behaviors and access to services across diverse global settings.Item Women's techniques for pleasure from anal touch: Results from a U.S. probability sample of women ages 18-93(PLOS, 2022-06-29) Hensel, Devon J.; von Hippel, Christiana D.; Lapage, Charles C.; Perkins, Robert H.; Pediatrics, School of MedicineThe study purpose was to assess, in a U.S. probability sample of women, the specific ways women have discovered to experience pleasure from anal touch. Through qualitative pilot research with women that informed the development of the survey instrument used in this study, we identified three previously unnamed, but distinct, anal touch techniques that many women find pleasurable and that expand the anal sexual repertoire beyond the more commonly studied anal intercourse behaviors: Anal Surfacing, Anal Shallowing, and Anal Pairing. This study defines each technique and describes its prevalence among U.S. adult women. Weighted frequencies were drawn from the Second OMGYES Pleasure Report-a cross-sectional, online, national probability survey of 3017 American women's (age 18-93) sexual experiences and discoveries. Participants were recruited via the Ipsos KnowledgePanel®. Data suggest that 40% of women find 'Anal Surfacing' pleasurable: sexual touch by a finger, penis, or sex toy on and around the anus. Approximately 35% of women have experienced pleasure using 'Anal Shallowing': penetrative touch by a finger, penis, or sex toy just inside the anal opening, no deeper than a fingertip/knuckle. Finally, 40% of women make other forms of sexual touch more pleasurable using 'Anal Pairing': touch on or inside the anus that happens at the same time as other kinds of sexual touch such as vaginal penetration or clitoral touching. These data provide techniques that women can and do use to explore the anus as a pleasurable region for touch-which can enable women to better identify their own preferences, communicate about them and advocate for their sexual pleasure.