Do romantic partners' responses to entry dyspareunia affect women's experience of pain? : the roles of catastrophizing and self-efficacy.

Introduction Entry dyspareunia is a sexual health concern which affects about 21% of women in the general population. Characterized by pain provoked during vaginal penetration, introital dyspareunia has been shown by controlled studies to have a negative impact on the psychological well-being, sexual function, sexual satisfaction, and quality of life of afflicted women. Many cognitive and affective variables may influence the experience of pain and associated psychosexual problems. However, the role of the partner's cognitive responses has been studied very little. Aim The aim of the present study was to examine the associations between partners' catastrophizing and their perceptions of women's self-efficacy at managing pain on one side and women's pain intensity, sexual function, and sexual satisfaction on the other. Methods One hundred seventy-nine heterosexual couples (mean age for women = 31, SD = 10.0; mean age for men = 33, SD = 10.6) in which the woman suffered from entry dyspareunia participated in the study. Both partners completed quantitative measures. Women completed the Pain Catastrophizing Scale and the Painful Intercourse Self-Efficacy Scale. Men completed the significant-other versions of these measures. Main Outcome Measures Dependent measures were women's responses to (i) the Pain Numeric Visual Analog Scale; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction scale. Results Controlled for women's pain catastrophizing and self-efficacy, results indicate that higher levels of partner-perceived self-efficacy and lower levels of partner catastrophizing are associated with decreased pain intensity in women with entry dyspareunia, although only partner catastrophizing contributed unique variance. Partner-perceived self-efficacy and catastrophizing were not significantly associated with sexual function or satisfaction in women. Conclusions The findings suggest that partners' cognitive responses may influence the experience of entry dyspareunia for women, pointing toward the importance of considering the partner when treating this sexual health problem.

Provoked vestibulodynia : mediators of the associations between partner responses, pain, and sexual satisfaction.

Provoked vestibulodynia (PVD) is a chronic, recurrent vulvo-vaginal pain condition affecting 12% of the general population, and is associated with sexual dysfunction, psychological distress, and reduced quality of life. There is growing interest in the role of interpersonal variables in PVD, which have been widely neglected. In a sample of 175 couples, the present study examined the mediating roles of partner and participant catastrophizing and self-efficacy in the association between solicitous partner responses and pain intensity, and that of dyadic adjustment in the association between solicitous and negative partner responses and sexual satisfaction. Couples completed measures of partner responses, catastrophizing, self-efficacy, dyadic adjustment, and depression. Women also completed measures of pain, sexual satisfaction, and sexual function. Controlling for depression and solicitousness perceived by the other member of the couple, catastrophizing and self-efficacy partially mediated the association between higher solicitous responses and higher pain during intercourse, accounting for 26 and 25% of the variance in this association for participant and partner-perceived responses, respectively. For both participant and partners, only pain catastrophizing was a unique mediator. Controlling for depression, sexual function and partner-perceived responses, dyadic adjustment partially mediated the association between higher participant-perceived solicitous responses and higher sexual satisfaction, and between higher participant-perceived negative responses and lower sexual satisfaction, accounting for 26% of the variance in each association. The current findings suggest that catastrophizing and dyadic adjustment may constitute a route by which partner responses exacerbate pain and increase or decrease sexual satisfaction in PVD couples.

Woman and partner-perceived partner responses predict pain and sexual satisfaction in vestibulodynia couples

Introduction.  Provoked vestibulodynia (PVD) is a highly prevalent vulvovaginal pain condition that results in significant sexual dysfunction, psychological distress, and reduced quality of life. Although some intra-individual psychological factors have been associated with PVD, studies to date have neglected the interpersonal context of this condition. Aim.  We examined whether partner responses to women's pain experience—from the perspective of both the woman and her partner—are associated with pain intensity, sexual function, and sexual satisfaction. Methods.  One hundred ninety-one couples (M age for women = 33.28, standard deviation [SD] = 12.07, M age for men = 35.79, SD = 12.44) in which the woman suffered from PVD completed the spouse response scale of the Multidimensional Pain Inventory, assessing perceptions of partners' responses to the pain. Women with PVD also completed measures of pain, sexual function, sexual satisfaction, depression, and dyadic adjustment. Main Outcome Measures.  Dependent measures were women's responses to: (i) a horizontal analog scale assessing the intensity of their pain during intercourse; (ii) the Female Sexual Function Index; and (iii) the Global Measure of Sexual Satisfaction Scale. Results.  Controlling for depression, higher solicitous partner responses were associated with higher levels of women's vulvovaginal pain intensity. This association was significant for partner-perceived responses (β = 0.29, P < 0.001) and for woman-perceived partner responses (β = 0.16, P = 0.04). After controlling for sexual function and dyadic adjustment, woman-perceived greater solicitous partner responses (β = 0.16, P = 0.02) predicted greater sexual satisfaction. Partner-perceived responses did not predict women's sexual satisfaction. Partner responses were not associated with women's sexual function. Conclusions.  Findings support the integration of dyadic processes in the conceptualization and treatment of PVD by suggesting that partner responses to pain affect pain intensity and sexual satisfaction in affected women.

Uso del preservativo en estudiantes de secundaria de Mozambique. Diferencias en razón del género y del tipo de pareja = Condom use amongst high school students in Mozambique differences by gender and kind of partners

La mayor parte de las nuevas infecciones con el VIH en el mundo se producen por transmisión sexual entre adultos jóvenes y se aprecia una mayor vulnerabilidad en las mujeres (Gregson et al., 2002). Los principales objetivos de este trabajo son: estudiar la prevalencia del uso auto informado del preservativo durante la última relación sexual en los estudiantes de secundaria de Mozambique y la intención de emplearlo en las futuras relaciones, sea con la pareja actual o con una ocasional. Los resultados muestran que: 1) el 47% de los va rones y el 62% de las mujeres no utilizaron el preservativo, 2) tanto ellos como ellas están más seguros de que lo utilizarán con una pareja ocasional que con la actual y 3) los que emplearon el preservativo en su última relación sexual tienen más intención de volver a usarlo que aquellos que no lo emplearon

Análisis de la incidencia de la ACDI y de la red ECPAT internacional sobre la erradicación de la explotación sexual infantil en niños, niñas y adolescentes en el contexto del turismo, proyecto “La Muralla soy yo” (2009-2011), Cartagena de indias

La Explotación Comercial sexual de los niños, niñas y adolescentes – ESCNNA ha ocasionado graves repercusiones en la sociedad, sometiendo a los menores a situaciones que atentan contra su integridad física y psicológica. Por ello, en el marco internacional y nacional se han adelantado diferentes iniciativas para erradicar dicho fenómeno. La Cooperación Internacional para el desarrollo- CI ha sido una valiosa herramienta en el tratamiento del flagelo dados los diferentes canales de ayuda los cuales han contribuido para su intervención. En este sentido, la CI por medio de la Agencia Canadiense para el desarrollo internacional- ACDI y la Fundación Renacer- ECPAT Internacional (End Child Prostitution, Pornography & Trafficking of Children for Sexual Purposes) hicieron posible junto con otros actores el proyecto de CI en Cartagena llamado: “La Muralla soy yo”, el cual buscó la prevención y futura erradicación de la Explotación Sexual de niños y adolescentes en el turismo- ESNAT en la ciudad. En el presente estudio de caso se pretende identificar cómo la CI incide por medio de la ACDI y la red ECPAT Internacional en instituciones locales de Cartagena para la prevención y posible erradicación del problema de la Explotación comercial sexual infantil en niños, niñas y adolescentes, en el contexto del turismo.

Teleconsultation in sexual and reproductive health for young adults through mobile devices: Experience in Colombia

Background: Sexual risk behaviors associated with poor information on sexuality have contributed to major public health problems in the area of sexual and reproductive health in teenagers and young adults in Colombia. Objective: To measure the perception of changes in sexual and reproductive risk behavior after the use of a teleconsultation service via mobile devices in a sample of young adults. Methods: A before and after observational study was designed, where a mobile application to inquire about sexual and reproductive health was developed. The perception of changes in sexual and reproductive health risk behaviors in a sample of young adults after the use of the application was measured using the validated survey “Family Health International (FHI) – Behavioral Surveillance Survey (BSS) – Survey for Adults between 15 to 40 Years”. Non-probabilistic convenience recruitment was undertaken through the study´s web page. Participants answered the survey online before and after the use of the mobile application for a six month period (intervention). For the inferential analysis, data was divided into three groups (dichotomous data, discrete quantitative data, and ordinal data), to compare the results of the questions between the first and the second survey. For all tests, a confidence interval of 95% was established. For dichotomous data, the Chi-squared test was used. For quantitative data, we used the Student’s t-test, and for ordinal data, the Mann-Whitney-Wilcoxon test. Results: A total of 257 subjects were registered in the study and met the selection criteria. The pre-intervention survey was answered by 232 subjects, and 127 completely answered the post-intervention survey, of which 54.3% did not use the application, leaving an effective population of 58 subjects for analysis. 53% (n=31) were female, and 47% (n=27) were male. The mean age was 21 years, ranging between 18 and 40 years. The differences between the answers on the first and the second survey were not statistically significant. The main risk behaviors identified in the population were homosexual relations, non-use of condoms, sexual relations with non-regular and commercial partners, the use of psychoactive substances, and ignorance about the symptoms of sexually transmitted diseases and HIV transmission. Conclusions: Although there were no differences between the pre- and post-intervention results, the study revealed different risk behaviors among the participating subjects. These findings highlight the importance of promoting educational strategies on this matter and the importance of providing patients with easily accessible tools with reliable health information.

Effectiveness of a treatment programme for immigrants who committed gender-based violence against their partners

Resumen tomado de la publicación

¿Qué entienden los jóvenes universitarios por monogamia y sexo sin penetración, como estrategias preventivas de la transmisión sexual del virus del SIDA? = What university students understand by monogamy and sex without penetration as preventive strategies of sexual transmission of AIDS virus?

Monogamy and sex without penetration are behaviors recommended by the WHO to avoid AIDS virus sexual transmission. Seven hundred and fifty university students from 18 to 25 years (67.7% women) were surveyed and they were asked to give a maximum of three free definitions of the words monogamy and sex without penetration to prevent AIDS virus sexual transmission. Their participation was voluntary and anonymous. Although the majority of the answers was correct, there was a considerable percentage of wrong answers, either for monogamy (3.7% masturbation; 2.1% to have many partners; 0.9% homosexual relations), or for sex without penetration (20.5% oral sex; 1.1% anal coitus; 0.8% coitus without orgasm; 0.4% coitus interruptus). Some definitions or examples differ by gender. The amount of wrongs or incomplete answers put researchers on the alert about insufficient preventive knowledge in a population with a high educational level

Interação sexual: perspectiva etológica do dimorfismo sexual humano

A interação sexual no sentido de ação conjunta ou recíproca supõe a existência de parceiros dimorficamente caracterizados a partir da estrutura cromossomial X-X ou X-Y. A diferenciação do sexo, entretanto, não depende apenas da condição cromossomial, podendo mesmo ser invertida quando a ação hormonal for alterada. Os dados disponíveis apontam os andrógenos como um dos principais agentes de diferenciação, afetando o organismo "básico" feminino num sentido masculinizante. A medida que se progride na escala animal, contudo, os aspectos estritamente biológicos perdem em importância e as condições ambientais aos poucos se impõem . Nos primatas superiores, caso não se estabeleçam condições adequadas de aprendizagem, o desenvolvimento sexual não se completa e a cópula se torna inviável. No ser humano, além dessa aprendizagem, fatores socio-culturais respondem pelo comportamento considerado masculino ou feminino que supostamente será exibido por cada parceiro da interação. Também as noções de estética são seriamente determinadas pela tradição cultural, com cada povo tendendo a valorizar os próprios traços raciais como ideal de beleza. Do ponto de vista físico, entretanto, pode-se tentar estabelecer algumas constantes, como as formas arredondadas para a mulher e o porte atl6tico ou capacidades gerais , para o homem. Uma vez estabelecida a atração e encontrado local e momento adequado, a interação sexual tende a uma progressiva intensificação e genitalização, que, nas sociedades de tradição judaico-cristã se reflete numa sequência, mais ou menos previsível, envolvendo carícias gerais, beijos, acariciamento de seios e genitais até a união genito-genital o significado e a forma como cada cultura desenvolve os contatos físicos de intercambio erógeno revelam tão grande variedade que já se apontou essa polimorfismo corno aquisição típica do ser humano. Assim, ao contrário do que faz supor o ideal de abstinência, é na capacidade de buscar e estender o prazer além da s1mples atividade orgânico-sexual que o homem, em sexo, se liberta da limitação animal.

Saúde sexual e reprodutiva de mulheres vivendo com HIV/AIDS atendidas em Hospital Dia

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Characteristics of sexual violence against adolescent girls and adult women

Background: Sexual violence is considered a serious violation of human rights which affects mainly young women and adolescents. There is little information about the conditions under which sexual offences occur. We evaluated characteristics of sexual violence against adolescent girls and adult women.Method: This is a quantitative, retrospective, descriptive study of sexual violence against adolescent girls and adult women. Analyses were carried out on data collected from 1118 women, 546 adolescents (10-19 years) and 572 adults (>= 20 years), with a complaint of rape treated at Hospital Perola Byington, Sao Paulo, between 1994 and 1999. The age limit of the adolescent sample met the World Health Organization's (WHO) criteria. We analyzed the type of sexual contact, degree of intimidation, perpetrator and activity of the victim during the approach.Results: Crimes without penetration were five times more frequent in adolescents and use of threats of death or intimidation was common in both groups. Mental illness was more prevalent in adult victims and the majority of adolescent victims were aged < 14 years. Uncle and stepfather perpetrators were more frequent among adolescents and partners or former intimate partners in adult women. In most cases the approach occurred in public places, although sex crimes at the perpetrator's residence were more frequent amongst adolescents.Conclusions: Although children and adolescents require the same intervention measures and legal protection, a considerable proportion of adolescent sex offenders can face conditions similar to those of adult women.

Alternative reproductive tactics, sexual selection and the effects of inbreeding in the ant Hypoponera opacior

Inbreeding can lead to a fitness reduction due to the unmasking of deleterious recessive alleles and the loss of heterosis. Therefore, most sexually reproducing organisms avoid inbreeding, often by disperal. Besides the avoidance of inbreeding, dispersal lowers intraspecific competition on a local scale and leads to a spreading of genotypes into new habitats. In social insects, winged reproductives disperse and mate during nuptial flights. Therafter, queens independently found a new colony. However, some species also produce wingless sexuals as an alternative reproductive tactic. Wingless sexuals mate within or close to their colony and queens either stay in the nest or they found a new colony by budding. During this dependent colony foundation, wingless queens are accompanied by a fraction of nestmate workers. The production of wingless reproductives therefore circumvents the risks associated with dispersal and independent colony foundation. However, the absence of dispersal can lead to inbreeding and local competition.rnIn my PhD-project, I investigated the mating biology of Hypoponera opacior, an ant that produces winged and wingless reproductives in a population in Arizona. Besides the investigation of the annual reproductive cycle, I particularly focused on the consequences of wingless reproduction. An analysis of sex ratios in wingless sexuals should reveal the relative importance of local resource competition among queens (that mainly compete for the help of workers) and local mate competition among males. Further, sexual selection was expected to act on wingless males that were previously found to mate with and mate-guard pupal queens in response to local mate competition. We studied whether males are able to adapt their mating behaviour to the current competitive situation in the nest and which traits are under selection in this mating situation. Last, we investigated the extent and effects of inbreeding. As the species appeared to produce non-dispersive males and queens quite frequently, we assumed to find no or only weak negative effects of inbreeding and potentially mechanisms that moderate inbreeding levels despite frequent nest-matings.rnWe found that winged and wingless males and queens are produced during two separate seasons of the year. Winged sexuals emerge in early summer and conduct nuptial flights in July, when climate conditions due to frequent rainfalls lower the risks of dispersal and independent colony foundation. In fall, wingless sexuals are produced that reproduce within the colonies leading to an expansion on the local scale. The absence of dispersal during this second reproductive season resulted in a local genetic population viscosity and high levels of inbreeding within the colonies. Male-biased sex ratios in fall indicated a greater importance of local resource competition among queens than local mate competition among males. Males were observed to adjust mate-guarding durations to the competitive situation (i.e. the number of competing males and pupae) in the nest, an adaptation that helps maximising their reproductive success. Further, sexual selection was found to act on the timing of emergence as well as on body size in these males, i.e. earlier emerging and larger males show a higher mating success. Genetic analyses revealed that wingless males do not actively avoid inbreeding by choosing less related queens as mating partners. Further, we detected diploid males, a male type that is produced instead of diploid females if close relatives mate. In contrast to many other Hymenopteran species, diploid males were here viable and able to sire sterile triploid offspring. They did not differ in lifespan, body size and mating success from “normal” haploid males. Hence, diploid male production in H. opacior is less costly than in other social Hymenopteran species. No evidence of inbreeding depression was found on the colony level but more inbred colonies invested more resources into the production of sexuals. This effect was more pronounced in the dispersive summer generation. The increased investment in outbreeding sexuals can be regarded as an active strategy to moderate the extent and effects of inbreeding. rnIn summary, my thesis describes an ant species that has evolved alternative reproductive tactics as an adaptation to seasonal environmental variations. Hereby, the species is able to maintain its adaptive mating system without suffering from negative effects due to the absence of dispersal flights in fall.rn

Using human rights for sexual and reproductive health: improving legal and regulatory frameworks

This paper describes the development of a tool that uses human rights concepts and methods to improve relevant laws, regulations and policies related to sexual and reproductive health. This tool aims to improve awareness and understanding of States' human rights obligations. It includes a method for systematically examining the status of vulnerable groups, involving non-health sectors, fostering a genuine process of civil society participation and developing recommendations to address regulatory and policy barriers to sexual and reproductive health with a clear assignment of responsibility. Strong leadership from the ministry of health, with support from the World Health Organization or other international partners, and the serious engagement of all involved in this process can strengthen the links between human rights and sexual and reproductive health, and contribute to national achievement of the highest attainable standard of health.

"Cutting for love": genital incisions to enhance sexual desirability and commitment in KwaZulu-Natal, South Africa

Several studies have documented women's use of vaginal practices in South Africa to enhance their desirability to men. This article describes a little known practice of this kind among women in KwaZulu-Natal. It involves the use of small incisions in the genital area (and often abdomen and breasts) to introduce herbal substances, described as love medicines, into the body through the incisions. In-depth interviews were carried out with 20 key informants and 20 women, and eight focus group discussions with women and men, in a rural and urban site in 2005-06. A province-wide household survey was then conducted using a multi-stage cluster sample design among 867 women aged 18-60. Forty-two per cent of the women in the household survey had heard of genital incisions; only 3% had actually used them. The main motivation was the enhancement of sexual attractiveness and long-term partner commitment. It appears to be a very recent practice, but may be an extension of an older healing practice not involving the genitals. It was most prevalent among rural women aged 24-29 (although not significant), those with less education, and those who suspected their partners of having other partners. It is linked to the modern popularity of love medicines, which in turn illustrates the troubling state of gender relations in KwaZulu-Natal today.

Are There Sex Differences in Reaction to Different Types of Sexual Infidelity?

Evolutionary theory based research shows that women and men can differ in their responses to sexual and emotional infidelity. However, research has not examined the question of whether men and women react similarly or differently to a partner’s engagement in different types of sexual infidelity. The present re-search sought to answer this question. Based on the aforementioned prior research, and short term mating desires, sex differences in reactions to different types of sexual infidelity were not expected. Both women and men were expected to report higher levels of upset when a partner engaged in sexual intercourse rather than when a partner engaged in oral sex, heavy petting, or kissing with another person. The results were consistent with the hypothesis. Both men and women were most upset by a partner’s engagement in sexual intercourse with another person. These findings are discussed in terms of prior research.