Browsing by Subject "Sexuality"

Now showing 1 - 8 of 8
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    Afraid of AIDS: AIDS Panic and Gay Discrimination through State of Indiana v. Herb Robbins
    (2024-09) Gackle, Dalton; Haberski, Raymond J.; Guiliano, Jennifer; Minor, Kyle
    In 1988 Herb J. Robbins, a 17-year-old male prostitute, murdered prominent Indianapolis attorney Donald L. Jackson. Robbins then used a “fear of AIDS” defense in court to escape murder charges. This defense highlighted the discrimination faced by gay men and the heightened fear of acquired immunodeficiency syndrome (AIDS) then a little-understood disease. This story fits into larger discussions about AIDS and our cultural and governmental response to it. For Indiana’s population in the 1980s, a fear of AIDS meant a fear of gay men, as gay men were the first people identified with AIDS – in 1981 and 1982 AIDS was known as GRID: gay-related immunodeficiency disease. This opened the door for discrimination in all facets of society – including in the courts – leading to the successful ‘fear of AIDS’ defense in 1988. That ingrained discrimination has had lasting effects on Indiana’s residents and especially on its gay communities including, but not limited to, the criminalization of persons with human immunodeficiency virus (HIV). In 1985, many states, including Indiana responded to HIV in the blood supply by closing blood banks and passing laws making it illegal for people with HIV/AIDS to donate. The Food and Drug Administration, as well, banned gay or bisexual men from donating blood for fear they might have HIV/AIDS. Indiana also passed a law requiring people with HIV to notify any potential sexual partner about their HIV positive status. The laws criminalizing people living with HIV were created in direct response to a fear of AIDS in the blood supply, which was only amplified by Ryan White’s infamous story. Connecting gay and bisexual men in Indiana’s HIV laws and the FDA’s policy on HIV/AIDS only further stigmatized gay men and people living with HIV by associating them with criminal activity, including the criminalization of Donald Jackson when Herb Robbins testified that he killed Jackson for fear he could have gotten AIDS from him. This paper seeks to understand 1) Why was Indianapolis a place where this “fear of AIDS” defense could succeed? and 2) How does this defense reflect broader discrimination and stigmatization directed toward the gay community?
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    Associations of Future Cognitive Decline with Sexual Satisfaction among Married Older Adults
    (Taylor & Francis, 2021) Smith, Allison G.; Bardach, Shoshana H.; Barber, Justin M.; Williams, Andrea; Rhodus, Elizabeth K.; Parsons, Kelly K.; Jicha, Gregory A.; Psychiatry, School of Medicine
    Objectives: This study sought to explore changes in longitudinal cognitive status in relation to baseline measures of intimacy and sexuality in cognitively intact, married older adults. Methods: Baseline intimacy and sexuality survey data from 155, cognitively intact, married, older adults were collected using a novel survey instrument that explored the domains of: 1) romance with one's partner, 2) sexual satisfaction, 3) beliefs about sexuality, and 4) social support and emotional intimacy. These data were analyzed in relation to change in cognitive status over a 10-year follow-up period using binary logistic regression modeling. Exploratory factor analysis was used to assess the shared variance of survey items attributable to intimacy and sexuality without specification of an a priori hypothesis regarding the association of intimacy and sexuality with future change in cognitive status. Results: Over the 10-year study period, 33.5% (n = 52) of individuals developed cognitive impairment. Participants with greater sexual satisfaction scores at baseline were statistically less likely to convert from cognitively intact to mild cognitive impairment or dementia in the future (p = .01). The domains of romance with one's partner, beliefs about sexuality, and social support/emotional intimacy were not predictive of future longitudinal changes in cognitive status. Conclusions: Sexual satisfaction is associated with longitudinal cognitive outcomes in cognitively intact, married, older adults. Clinical implications: Clinicians should routinely assess for sexual satisfaction among older adults and refer to appropriate providers, such as couples or sex therapists, when appropriate.
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    Reclaiming Sexuality Through Art: Art Therapy Applications and Recommendations in Adolescent Psychiatric Facilities with Patients who have a History of Trauma
    (2014-05) Graham, Uriah; Itczak, Michelle; King, Juliet; Misluk, Eileen
    This thesis utilizes an integrative review of literature to examine how art therapy interventions can be used to explore sexuality and assist in reducing sexual misbehaviors for adolescents in a residential psychiatric facility with a history of trauma. Adolescents in residential psychiatric facilities often lack the means to explore and understand their sexuality due to rules and regulations that must be in place as a protective measure. Lacking the means to explore sexuality, however, may lead to sexual misbehaviors. Through a search of the literature, it was discovered that there is a gap in research using art therapy in this specific context. Through an exploration of the topics of mental illness, art therapy, sexuality, and trauma, previous research and writings are integrated into the conceptualization of the potential benefits and challenges that would come from the exploration of sexuality through art therapy with this population. This is followed by an outline of an art therapy treatment plan that addresses the exploration of sexuality that could be used with adolescents in residential psychiatric facilities. This treatment plan is supported by conclusions based on the integrative literature review. It is recommended that through an understanding of the integrated information and the treatment plan, art therapists can implement this plan with this population and study its effectiveness in reducing sexual misbehavior in the population.
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    Sexual activity and function of adult men with spina bifida
    (Elsevier, 2023-06) Szymanski, Konrad M.; Roth, Joshua D.; Hensel, Devon J.; Wiener, John S.; Younsi, Nina; Stein, Raimund; Whittam, Benjamin; Kaefer, Martin; Rink, Richard C.; Cain, Mark P.; Misseri, Rosalia; Urology, School of Medicine
    Objective Data on sexual function of men with spina bifida (SB) is limited. We aimed to assess sexual activity and erectile dysfunction (ED) in a large international sample of men with SB. Methods Men with SB (≥18yo) were recruited in an international online survey via clinics and social media. We collected data on demographics, ambulation (Hoffer classification), penile rigidity (Erection Hardness Score), sexual activity and ED (International Index of Erectile Function). Non-parametric tests were used. Results A total of 162 men (median age 35, 62% shunted, 38% community ambulators) reported sexual desire similar to the general population (p = 0.82), but 55% were dissatisfied with their sex life (Summary Table). Overall, 36% reported full penile rigidity with erections, more commonly with better ambulation (p = 0.01), 69% had ever experienced orgasm and 84% ejaculated. In 44 men (27%) attempting sexual intercourse in the last 4 weeks, 59% had ED (11% severe, 7% moderate, 14% mild-moderate, 27% mild). In this group, 91% of men reporting less than full penile rigidity had ED, compared to 30% with full penile rigidity (p = 0.001). Overall, partnered non-genital contact in the last 3 months was reported by 56%, solo masturbation: 62%, partnered intercourse: 48% (31% vaginal). Of 54 men who used phosphodiesterase type 5 inhibitors (PDE5I), 80% reported improved erections, 56% improved intercourse. Overall, 40% reported non-genital erogenous zones as most pleasurable, especially with poorer ambulation (p = 0.002, chest/nipples: 73%). Comment Strengths of this study include anonymous, voluntary, online participation maximizing participation of a heterogenous, international population. Whenever available, we compared findings to published values for the general population. Since romantic and sexual activity is a complex intersection of interest, opportunity and ability, a more comprehensive assessment was beyond the study's scope. Future work will focus on the interplay with issues like incontinence. Conclusions ED was frequent among men with SB, especially in men with poorer ambulation. PDE5 inhibitors may be beneficial. Partnered sexual activity was reported by half of the men, although it may not involve penetrative intercourse.
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    Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity
    (American Psychological Association, 2015-09) Bonfils, Kelsey A.; Firmin, Ruth L.; Salyers, Michelle P.; Wright, Eric R.; Department of Psychology, School of Science
    OBJECTIVE: Limited research has focused on sexuality for those diagnosed with a severe mental illness. We aimed to extend existing work by exploring relationships between mastery (perception of control of one's life and future), sexual self-esteem (perceptions of one's capacity to engage in healthy sexual behavior), sexual attitudes (permissive ideas about sexuality), and perceived importance of relationships/sexuality and number of sexual partners. METHOD: A secondary analysis of survey data from adult participants living with a severe mental illness (N = 401) in the Indiana Mental Health Services and HIV-Risk Study (Perry & Wright, 2006) was conducted. Analysis of covariance (controlling for marital status) compared those with 0 partners, 1 partner, or multiple partners over the past 3 months on the dependent variables of mastery, sexual self-esteem, sexual attitudes, and perceived importance. RESULTS: Participants with more permissive attitudes, greater perceived importance, and higher mastery were more likely to be sexually active with multiple partners. Self-esteem did not differentiate groups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Given the key role of sexual satisfaction in quality of life and the high rates of sexual risk behavior in this population, it is important that clinicians systematically assess mastery, perceived importance, and attitudes about sexuality when working with consumers diagnosed with a severe mental illness. Individually tailoring existing interventions on the basis of consumers' levels of mastery, related to self-efficacy for implementing changes in life, could improve long-term outcomes for these programs. Future research should examine other constructs that may account for more variance in sexual activity, such as perceptions of risk, intentions for sexual safety, or romantic relationship functioning.
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    Sexuality talk during adolescent health maintenance visits
    (AMA, 2014-02) Alexander, Stewart C.; Fortenberry, J. Dennis; Pollak, Kathryn I.; Bravender, Terrill; Davis, J. Kelly; Østbye, Truls; Tulsky, James A.; Dolor, Rowena J.; Shields, Cleveland G.; Department of Pediatrics, Indiana University School of Medicine
    IMPORTANCE: Physicians may be important sources of sexuality information and preventive services, and one-on-one confidential time during health maintenance visits is recommended to allow discussions of sexual development, behavior, and risk reduction. However, little is known about the occurrence and characteristics of physician-adolescent discussions about sexuality. OBJECTIVE: To examine predictors of time spent discussing sexuality, level of adolescent participation, and physician and patient characteristics associated with sexuality discussions during health maintenance visits by early and middle adolescents. DESIGN, SETTING, AND PARTICIPANTS: Observational study of audio-recorded conversations between 253 adolescents (mean age, 14.3 years; 53% female; 40% white; 47% African American) and 49 physicians (82% pediatricians; 84% white; 65% female; mean age, 40.9 years; mean [SD] duration in practice, 11.8 [8.7] years) coded for sexuality content at 11 clinics (3 academic and 8 community-based practices) located throughout the Raleigh/Durham, North Carolina, area. MAIN OUTCOMES AND MEASURES: Total time per visit during which sexuality issues were discussed. RESULTS One hundred sixty-five (65%) of all visits had some sexual content within it. The average time of sexuality talk was 36 seconds (35% 0 seconds; 30% 1-35 seconds; and 35% ≥ 36 seconds). Ordinal logistic regression (outcome of duration: 0, 1-35, or ≥ 36 seconds), adjusted for clustering of patients within physicians, found that female patients (odds ratio [OR] = 2.58; 95% CI, 1.53-4.36), older patients (OR = 1.37; 95% CI, 1.13-1.65), conversations with explicit confidentiality discussions (OR = 4.33; 95% CI, 2.58-7.28), African American adolescents (OR = 1.58; 95% CI, 1.01-2.48), and longer overall visit (OR = 1.07; 95% CI, 1.03-1.11) were associated with more sexuality talk, and Asian physicians were associated with less sexuality talk (OR = 0.13; 95% CI, 0.08-0.20). In addition, the same significant associations between adolescent, physician, and visit characteristics were significantly associated with greater adolescent participation. CONCLUSIONS AND RELEVANCE: Our study may be the first to directly observe sexuality talk between physicians and adolescents. We found that one-third of all adolescents had annual visits without any mention of sexuality issues; when sexuality talk occurred, it was brief. Research is needed to identify successful strategies physicians can use to engage adolescents in discussions about sexuality to help promote healthy sexual development and decision making. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01040975.
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    Social support and well being: a quantiative study of the effects of friends on the sexual well-being of older adults
    (2015-06) Williams, Monica May; Latham, Kenzie E.; Hensel, Devon J.; Foote, Carrie E.
    Social support has been shown to positively impact various aspects of health across the lifespan, including sexual health and well-being. While past research on sexual well-being has tended to focus on the earlier stages of the life course, notably adolescence and young adulthood, this is a largely ignored area of research past the reproductive stage of life. Current research finds that while social support, from partners, family, and friends alike, has generally positive influences on health in mid to late adulthood, these outcomes are varied in regards to sexual well-being. This thesis aims to (1) assess the role of friend support in the sexual well-being of older adults and (2) to explore if physical and mental health are significant mediators of this relationship, using data from Wave II of the National Social Life, Health, and Aging Project (NSHAP). This study found that sixty two percent of older adults are not having sex as much as they would like and 61% feel that their sex life is lacking in quality. Increased feelings of openness with friends was associated with satisfaction with sexual frequency (p=.055). However, a significant association could not be established between satisfaction with quality of sex life and friend support. In addition, physical and mental health status were not found to be significant mediators.
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    Stop calling it a choice: Biological factors drive homosexuality
    (The Conversation US, Inc., 2019-09-03) Sullivan, Bill