Sexual Health Challenges in Emerging Nations, Populations, and Minorities: Research, Applications, and Recommendations

A special issue of Sexes (ISSN 2411-5118).

Deadline for manuscript submissions: closed (20 October 2021) | Viewed by 281852

Special Issue Editor


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Guest Editor
Department of Psychology, Valparaiso University, Valparaiso, IN 46383, USA
Interests: sexual psychology; sexual behavior; sexual response; sexual dysfunction in men and women; psychological distress; sexual health; sexual psychophysiology; cross-cultural perspectives
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

At a time when the world is focused on mega-health issues surrounding infectious disease and its control, issues of sexual health, choice, and wellness are at risk of receding into the background. Yet as people become increasingly isolated from their social networks and withdrawn into immediate family circles due to pandemic and contagion, the day-to-day impact of sexuality and relationships has become increasingly relevant. The need for intensified investigation of sexual issues within new and vulnerable populations remains as critical as ever, given that the sexual psychological and relationship well-being of individuals is often linked to racial, cultural, economic, and educational disparities.

In this Special Issue, we invite and welcome papers that bring new insights to understudied populations, whether they be related to specific geo-cultural regions, specific sexual and ethnic minority groups, specific disorders, or specific challenges (e.g., domestic abuse, infertility, STI’s, etc.). A diversity of perspectives is encouraged, ranging from physical, biomedical, psychological, sociological, and anthropological/cross-cultural to public health, legal, and historical. The goal is to generate awareness and promote cross- and inter-disciplinary understanding and conversation regarding issues impacting the sexual health and well-being of youth and adults, with an eye toward providing realistic and culturally-acceptable applications, recommendations, and solutions for the problem under study.

Prof. Dr. David L. Rowland
Guest Editor

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Keywords

  • sexual and/or reproductive health
  • sexual behavior and practices
  • sexual attitudes
  • sexually transmitted infections (STIs)
  • sexual psychology
  • sexual dysfunctions and disorders
  • sexual and gender minorities
  • sexual relationships and partner issues
  • sexual rights and choice
  • ethnic/minority/special populations

Published Papers (13 papers)

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Research

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11 pages, 267 KiB  
Article
Similar Sexual Behaviour yet Different Outcomes: Comparing Trans and Gender Diverse and Cis PrEP Users in Germany Based on the Outcomes of the PrApp Study
by Max Nicolai Appenroth, Ulrich Marcus, Stefan Albrecht, Klaus Jansen, Barbara Gunsenheimer-Bartmeyer, Viviane Bremer and Uwe Koppe
Sexes 2022, 3(1), 178-188; https://doi.org/10.3390/sexes3010014 - 23 Feb 2022
Cited by 2 | Viewed by 2725
Abstract
Little knowledge about pre-exposure prophylaxis (PrEP) use in trans and gender diverse (TGD) communities in Germany exists. The PrApp Study collected data on PrEP use and sexual behaviour among PrEP users in Germany. Descriptive methods and logistic regression were used to describe PrEP [...] Read more.
Little knowledge about pre-exposure prophylaxis (PrEP) use in trans and gender diverse (TGD) communities in Germany exists. The PrApp Study collected data on PrEP use and sexual behaviour among PrEP users in Germany. Descriptive methods and logistic regression were used to describe PrEP use among TGD and cis persons. A total of 4350 PrEP users in Germany were included, with 65 (1.5%) identified as TGD. Compared to cis participants, TGD participants were younger (median age 29 vs. 37 years) and more likely to have a lower income (adjusted odds ratio (aOR) = 4.4; 95% confidence interval (CI) = 2.4–8.2) and be born outside Germany (aOR = 2.5; 95% CI = 1.3–4.5). On-demand PrEP use was higher in TGD participants (aOR = 1.9; 95% CI = 1.0–3.5) and numerically more TGD obtained PrEP from informal sources (aOR = 1.8; 95% CI = 0.9–3.5). Testing behaviour, condom use, and number of sexual partners were comparable between both groups. Socioeconomic disparities may constitute structural barriers for TGD people to access PrEP, leading to more informal and on-demand use. PrEP providers need to reduce access barriers for TGD PrEP users and provide information on safe PrEP use for this population. Full article
14 pages, 249 KiB  
Article
A Longitudinal Look at Family Communication about Sexual Issues
by Jennifer M. Grossman and Amanda M. Richer
Sexes 2022, 3(1), 164-177; https://doi.org/10.3390/sexes3010013 - 23 Feb 2022
Cited by 3 | Viewed by 3413
Abstract
Parent–child communication about sex and relationships can protect adolescents from risky sexual behaviors, but few studies investigate how family talk may change over the course of development from adolescence to emerging adulthood. This current study uses thematic analysis to explore continuity and change [...] Read more.
Parent–child communication about sex and relationships can protect adolescents from risky sexual behaviors, but few studies investigate how family talk may change over the course of development from adolescence to emerging adulthood. This current study uses thematic analysis to explore continuity and change in perceived talk with parents about sex and relationships, following a United States sample of 15 adolescent participants over three time points: early adolescence (age 13–14), middle adolescence (age 15–16), and emerging adulthood (age 20–21). Analyses addressed participants’ experiences of talk with parents about sex and relationships (comfort, engagement) and the content of talk: dating and relationships, pregnancy and parenting, protection, STIs, and sexual behavior. Findings show that family communication about sex and relationships extends from early adolescence to emerging adulthood, but changes in content to reflect shifts in adolescent and emerging adult development. Further, while positive engagement and comfort with talk about sex remain relatively high over time, participants’ discomfort and negative engagement appear to increase, highlighting challenges for ongoing family communication. These findings suggest a meaningful, ongoing role for parents in family communication about sex and relationships as their children develop, and suggest some opportunities and challenges that parents may face through this process. Full article
10 pages, 477 KiB  
Article
Dyadic Satisfaction and Shared Affectivity Are Associated with Psycho-Sexual Functioning in Elderly Men and Women
by Erika Limoncin, Daniele Mollaioli, Andrea Sansone, Elena Colonnello, Giacomo Ciocca, Giancarlo Balercia, Nguyễn Hoài Bắc, Thắng Nguyễn Cao and Emmanuele Angelo Jannini
Sexes 2022, 3(1), 68-77; https://doi.org/10.3390/sexes3010006 - 12 Jan 2022
Cited by 1 | Viewed by 2567
Abstract
Objectives The quality of sexual life of elderly people represents an understudied topic of sexual medicine and of psycho-sexology. Hence, we aimed to evaluate the association of specific psycho-relational variables, such as intimacy, increased affective gestures towards a partner (AGtP), daily shared activities, [...] Read more.
Objectives The quality of sexual life of elderly people represents an understudied topic of sexual medicine and of psycho-sexology. Hence, we aimed to evaluate the association of specific psycho-relational variables, such as intimacy, increased affective gestures towards a partner (AGtP), daily shared activities, and dyadic satisfaction, with the psychosexual wellbeing of elderly people, expressed in terms of sexual satisfaction. Methods: A cohort of elderly people was selected from a sample of a broader study evaluating the role of sexual activity in protecting the emotional wellbeing of a population subjected to quarantine due to the COVID-19 pandemic. Specifically, the presence of sexual dysfunctions, the emotional wellbeing (i.e., absence of anxiety and/or depression), and the quality of the partners’ relationships were studied. For the study’s purpose, the Sexual Health Inventory for Males (SHIM), the Female Sexual Function Index (FSFI), the Orgasmometer and the Orgasmometer-F, the Generalized Anxiety Disorder scale (GAD-7), the Patient Health Questionnaire (PHQ-9), and the Dyadic Adjustment Scale were adopted. Results: A group of 124 elderly subjects (≥60) was selected for the study’s purposes. Among these, 84% were males (120/124), and 16% were females (20/124). All the subjects declared to be in a stable relationship and to be sexually active during the first lockdown period. Gender differences were found for the Dyadic Satisfaction subscale (males: 37.04 ± 6.57; females: 32.85 ± 10.04; p < 0.05) and the Orgasmometer (males: 7.64 ± 1.30; females: 6.60 ± 2.46; p < 0.01). Linear regression analysis showed the association between higher Orgasmometer scores and: (i) the absence of sexual dysfunctions (β = −1.213; SE = 0.271; p < 0.0001), (ii) higher dyadic satisfaction (β = 0.042; SE = 0.019; p < 0.05), and (iii) reduced shared activities with partner (β = −0.463; SE = 0.143; p < 0.01) and increased affective gestures towards partner (DAS measured AGtP) (β = 0.595; SE = 0.065; p < 0.0001). Post hoc analysis of ANCOVA with the Bonferroni correction method showed a significant difference in the Orgasmometer scores between subjects with and without sexual dysfunction (mean difference: 2.102; SE = 0.340; pBonf < 0.001), with healthy subjects reporting higher scores compared to dysfunctional ones. Conclusions: It is reasonable to suppose that, beyond the presence of sexual dysfunctions, the sexual health of elderly people may benefit from the quality of the relationship, and, specifically, from the presence of affective gestures towards the partner and the dyadic satisfaction. To the contrary, the quantity of time spent together, sharing specific activities, may be considered a factor worsening relational and sexual health. These data should be considered during the evaluation of sexual health among elderly people. Full article
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11 pages, 2531 KiB  
Article
Sexual Fantasies across Gender and Sexual Orientation in Young Adults: A Multiple Correspondence Analysis
by Mattia Nese, Greta Riboli, Gianni Brighetti, Raffaele Visciano, Daniel Giunti and Rosita Borlimi
Sexes 2021, 2(4), 523-533; https://doi.org/10.3390/sexes2040041 - 15 Dec 2021
Cited by 5 | Viewed by 12595
Abstract
Differences in the content of sexual fantasies across gender have been widely documented, while less attention was given to the role of sexual orientation. Previous studies focused on differences in the prevalence of broad themes consisting of sets of contents. The current study [...] Read more.
Differences in the content of sexual fantasies across gender have been widely documented, while less attention was given to the role of sexual orientation. Previous studies focused on differences in the prevalence of broad themes consisting of sets of contents. The current study aimed to increase the knowledge about sexual fantasies in heterosexual, homosexual, and bisexual men and women. A descriptive approach that allows visualizing the patterns of fantasies reported by different groups using Multiple Correspondence Analysis (MCA) is presented. A sample of 3136 of young adults, 1754 women (Mage = 22.50, SD = 1.72, range 18–25) and 1382 men (Mage = 22.50, SD = 1.70, range 18–25), completed an online questionnaire assessing the presence of 29 different sexual fantasies. The prevalence of each fantasy among each group is shown. Also, relationships between fantasies and the distribution of groups along the two principal dimensions highlighted by MCA are represented. Heterosexuals women reported fewer fantasies and showed opposite patterns of response compared to heterosexual men. There was a substantial overlapping in the fantasies reported by gay and bisexual men, while responses of lesbian and bisexual women were more differentiated. These results indicate that the content of sexual fantasies varies according to both gender and sexual orientation. Full article
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8 pages, 251 KiB  
Article
Premature Ejaculation Symptoms Are Associated with Sexual Excitability: Empirical Support for the Hyperarousability Model
by Daniel Ventus and Patrick Jern
Sexes 2021, 2(3), 345-352; https://doi.org/10.3390/sexes2030027 - 2 Aug 2021
Cited by 5 | Viewed by 4602
Abstract
Premature ejaculation (PE) is a common sexual complaint among men, but its etiology is poorly understood. Previous studies on the dual control model of sexuality has revealed that propensities for sexual excitation and inhibition can contribute to sexual dysfunctions, but few studies have [...] Read more.
Premature ejaculation (PE) is a common sexual complaint among men, but its etiology is poorly understood. Previous studies on the dual control model of sexuality has revealed that propensities for sexual excitation and inhibition can contribute to sexual dysfunctions, but few studies have included a measure of premature ejaculation. We sought to explore whether PE is associated with sexual excitation or inhibition. We applied structural equation models to data from a large population-based sample of Finnish adult men. The analyses supported a four-factor solution for the sexual inhibition/sexual excitation short-form scale. The clearest result was that increased symptoms of PE were associated with a greater propensity for sexual excitation (β = 151, p < 001, n = 2953). Importantly, this excitation was intrapersonal, as opposed to stemming from social activities. The results imply that men with PE may have stronger and more rapid reactions to sexual stimuli, which in turn may lead to ejaculating earlier than desired. Full article
14 pages, 263 KiB  
Article
Perceived Changes in Sexuality during the COVID-19 Pandemic among Adults in the United States
by Jessamyn Bowling, Erika Montanaro, Sarai Guerrero-Ordonez, Stuti Joshi and Diana Gioia
Sexes 2021, 2(3), 331-344; https://doi.org/10.3390/sexes2030026 - 11 Jul 2021
Cited by 12 | Viewed by 5227
Abstract
In the United States, the COVID-19 pandemic has decreased partnered sexual behavior and increased the use of enhancement (e.g., toys). This has been partly attributed to reduced social interactions and stress. However, individuals’ perceptions of changes are missing in research. This study aims [...] Read more.
In the United States, the COVID-19 pandemic has decreased partnered sexual behavior and increased the use of enhancement (e.g., toys). This has been partly attributed to reduced social interactions and stress. However, individuals’ perceptions of changes are missing in research. This study aims to examine how adults perceive changes in their sexuality during the pandemic. We conducted a nationwide survey of US adults from April–June 2020 (N = 326). This qualitative study examines the open-ended responses using thematic analyses. The following themes emerged from the data: (1) changes in the purpose of sex; (2) changes in sexual identity; (3) decreases in sex drive and desire; (4) increases in sex drive and desire; (5) fluctuations in sex drive and desire; (6) increased sexual experimentation and reflection. The stress, changes in home responsibilities and living situations, and time spent with partners (more or less) has affected individuals by increasing or decreasing their sex drive and desire. Participants responded to changes with self-reflection and awareness, and incorporating new practices (e.g., technology, kink). The purpose of sex has shifted in order to gain intimacy or connect, or to pass time. These changes were perceived as both positive and negative, and more research is needed to determine the durability of these changes. Full article
12 pages, 1550 KiB  
Article
Male Sexual Health and Sexual Behaviors during the First National COVID-19 Lockdown in a Western Country: A Real-Life, Web-Based Study
by Andrea Sansone, Daniele Mollaioli, Angelo Cignarelli, Giacomo Ciocca, Erika Limoncin, Elena Colonnello, Giancarlo Balercia, Yacov Reisman and Emmanuele A. Jannini
Sexes 2021, 2(3), 293-304; https://doi.org/10.3390/sexes2030023 - 5 Jul 2021
Cited by 7 | Viewed by 22733
Abstract
Restriction measures enacted during the COVID-19 pandemic had severe effects on male sexual and reproductive health. We aimed to investigate the real-life impact and perception of sexual function in 2020 in Italy, as the first Western country experiencing a national lockdown by measuring [...] Read more.
Restriction measures enacted during the COVID-19 pandemic had severe effects on male sexual and reproductive health. We aimed to investigate the real-life impact and perception of sexual function in 2020 in Italy, as the first Western country experiencing a national lockdown by measuring relative search volume for keywords pertaining to sexual health and behaviors provided by Google Trends and sales data for pro-erectile treatments. No significant change was observed for erectile dysfunction and premature ejaculation. Interest towards most phosphodiesterase type 5 inhibitors decreased significantly during lockdown (e.g., sildenafil, p = 0.0002; tadalafil p = 0.0016), then reverted to pre-lockdown levels (e.g., sildenafil, p < 0.0001; tadalafil p < 0.0001), mirroring a concomitant sales decrement (p = 0.0292). A subsequent recovery to previous levels at the end of the social confinement was also found (e.g., after vs. before lockdown, sildenafil, p = 0.8459; tadalafil p = 0.1166). During lockdown, interest towards pornography significantly increased during restrictions (p = 0.0053) and remained high (after vs. before lockdown, p = 0.0004), whereas interest towards paid and casual sex declined (p = 0.0015 and p = 0.049, respectively), then reverted to previous levels (after vs. before lockdown, p = 0.3969 and 0.8373, respectively). During the first Italian lockdown, we observed a transient but measurable decrease of sexual health-seeking behaviors and changes in sexual behaviors, with unknown impact for sexual medicine and public health. Full article
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9 pages, 341 KiB  
Article
A Pilot Study on the Quality of Sexual Life of Patients Receiving Home Palliative Care in Poland
by Marcin Janecki, Izabela Kaptacz, Zuzanna Janecka and Violetta Skrzypulec-Plinta
Sexes 2021, 2(2), 174-182; https://doi.org/10.3390/sexes2020015 - 20 Apr 2021
Cited by 1 | Viewed by 1863
Abstract
Background: Quality of life, physical, psychic, and social functioning assessments in patients suffering from chronic, progressive, and incurable diseases are one of the most significant aims of the palliative care home teams. Sexuality and intimacy can be one of the most important elements [...] Read more.
Background: Quality of life, physical, psychic, and social functioning assessments in patients suffering from chronic, progressive, and incurable diseases are one of the most significant aims of the palliative care home teams. Sexuality and intimacy can be one of the most important elements of a person’s life, even at the end of it. Unfortunately, there is very little interest in this topic among medical staff of palliative care units. The objective of the study: The aim of this study was to assess the health status, the quality of life, the quality of sexual life, and the recognition and resolution of sexual problems by the palliative care team in adult patients in the advanced stage of terminal illness, who were receiving home palliative care. Research methods: The study involved 342 adult patients in the advanced stage of incurable, progressive disease, covered by home palliative care in 15 facilities in Poland. A generic EuroQoL 5-Dimension 3-Level health and quality of life assessment questionnaire and a questionnaire developed by the researchers, including questions about sexual problems, were used in this prospective study. Results: The presented results are the part of the more extensive study. The assessment of health status and quality of life of the study patients showed that the evaluation was the lowest for performing ordinary daily activities. The quality of sexual life after diagnosis in more than half of the study patients has worsened. Almost half of the respondents felt that the palliative care team did not recognize or address their sexual concerns. Patients indicated nurses and physicians as the members of the palliative care team most helpful in identifying and addressing sexual concerns. Conclusions: Members of the palliative care team should receive training in communication with patients concerning their sexual life, their needs and expectations and have knowledge about options for obtaining specialized sexological care. It is necessary to prepare and validate simple tools that will facilitate the initiation of appropriate communication between patients and members of the medical staff. It will be important to conduct more detailed and targeted research on sexuality and intimacy in the Polish palliative care patient population. Full article
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10 pages, 503 KiB  
Article
Sexually Transmitted Infections among Street, Hotel, and Residence-Based Female Sex Workers in Dhaka, Bangladesh: Prevalence from Three HIV/STI Drop-in-Centers
by Tasmia Jebin Farabi, Yamin Tauseef Jahangir, Afrin Ahmed Clara, Mohammad Hayatun Nabi and Mohammad Delwer Hossain Hawlader
Sexes 2021, 2(1), 69-78; https://doi.org/10.3390/sexes2010006 - 21 Jan 2021
Cited by 2 | Viewed by 30546
Abstract
Introduction: Considering a growing number of female sex workers (FSWs) in Bangladesh, there remains a greater need to reduce sexually transmitted infection (STI) rates, as lower social and cultural status cause FSWs to have less access to education, employment opportunities, and health care, [...] Read more.
Introduction: Considering a growing number of female sex workers (FSWs) in Bangladesh, there remains a greater need to reduce sexually transmitted infection (STI) rates, as lower social and cultural status cause FSWs to have less access to education, employment opportunities, and health care, including opportunities for HIV tests, counseling, and medical care. Methods: A cross-sectional study was conducted among 546 street, hotel, and residence-based FSWs. This current study aimed to identify the prevalence and to ascertain the associated risk factors among the FSW populations in Dhaka. Results: We found a majority of the participants were in the working age of more than 26 years for the FSW profession, with a mean age of 28 years. While the majority were unemployed (42.5%), alcohol abuse (p = 0.01) and drug dependency (p = 0.01) had an association, and inconsistency of condom use had a higher risk factor (AOR = 3.54) for a new STI case. Conclusions: FSW-oriented service platform should be integrated with health literacy interventions in urban and rural locations in Bangladesh. Understanding the differences in risk patterns and tailoring intervention will increase contraception use and lower STI cases and improve overall FSW quality of life. Full article
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15 pages, 638 KiB  
Article
Diagnostic Criteria for Premature Ejaculation: Clarifying the Role of “Ejaculatory Control” and “Bother/Distress”
by Philippe Cote-Leger and David L. Rowland
Sexes 2020, 1(1), 72-86; https://doi.org/10.3390/sexes1010007 - 18 Dec 2020
Cited by 6 | Viewed by 2477
Abstract
“Ejaculatory control” and “bother/distress” are key criteria for diagnosing men with premature ejaculation (PE), yet compared with ejaculatory latency (EL), these constructs have received only minimal attention. In addition, they have not been characterized in men having different sexual orientations or subtypes of [...] Read more.
“Ejaculatory control” and “bother/distress” are key criteria for diagnosing men with premature ejaculation (PE), yet compared with ejaculatory latency (EL), these constructs have received only minimal attention. In addition, they have not been characterized in men having different sexual orientations or subtypes of PE. This study aimed to characterize relationships among ejaculatory control, bother/distress, and EL; to assess differences across men having different sexual orientations, PE status, and PE subtypes (i.e., lifelong vs. acquired); and to determine the importance of ejaculatory control to men’s sexual partners. In total, 1071 men and sexual partners of men rated their ejaculatory control and bother/distress and estimated their EL; these measures were compared across sexual orientation, PE status, PE subtype, and male and female partners of men. Results revealed a monotonic though slightly curvilinear relationship between ejaculatory control and bother/distress. These PE criteria differed significantly between PE and non-PE men, to a lesser extent between gay and straight men, and not at all between men having lifelong vs. acquired PE. Female and male partners of men affirmed the importance of ejaculatory control during partnered sex, indicating lack of control as a potential reason for ending a relationship. Full article
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19 pages, 985 KiB  
Article
Misconceptions and Unmet Need for Modern Contraception among Cambodian Females: A Mix Methods Study
by Farwa Rizvi, Joanne W. Williams, Steven J. Bowe and Elizabeth Hoban
Sexes 2020, 1(1), 41-59; https://doi.org/10.3390/sexes1010005 - 12 Nov 2020
Viewed by 4265
Abstract
(1) Background: Women using unreliable traditional contraception need to be included in the proportion of women having an ‘unmet need for modern contraception’ instead of the current classification which presumes they have a ‘met need’. (2) Methods: Mix methods research design comprising initial [...] Read more.
(1) Background: Women using unreliable traditional contraception need to be included in the proportion of women having an ‘unmet need for modern contraception’ instead of the current classification which presumes they have a ‘met need’. (2) Methods: Mix methods research design comprising initial quantitative analyses utilizing data from the nationally representative 2014 Cambodian Demographic and Health Survey (CDHS) for 4823 Cambodian, sexually active females aged 15–29 years. Then a qualitative phase explored knowledge about the menstrual cycle and misconceptions about modern contraception with 30 females aged 15–29 years in urban Cambodia using semi-structured interviews, transcribed verbatim with quality checks. Purposive and snowball sampling strategies were used until data saturation was reached. Inductive thematic data analysis was conducted; (3) Results: Unmet need for modern contraception increased to 25.4% when traditional contraception users were included. The qualitative themes show women have a lack of information about the menstrual cycle and misconceptions about modern contraception which contributed to increased use of traditional contraception; (4) Conclusion: Major drivers of increased unmet need for modern contraception include lack of literacy, misconceptions and low autonomy to choose modern contraception. Cambodia needs to endorse a policy shift to implement targeted, countrywide sexual and reproductive health literacy and family planning services. Full article
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Review

Jump to: Research

9 pages, 698 KiB  
Review
Does Bed Sharing with an Infant Influence Parents’ Sexual Life? A Scoping Review in Western Countries
by Eleni Vousoura and Chryssa Ekizoglou
Sexes 2021, 2(4), 406-414; https://doi.org/10.3390/sexes2040032 - 29 Sep 2021
Cited by 1 | Viewed by 179742
Abstract
Bed sharing—the sharing of a sleeping surface by parents and children—is a common, yet controversial, practice. While most research has focused on the public health aspect of this practice, much less is known regarding its effect on the marital relationship. The aim of [...] Read more.
Bed sharing—the sharing of a sleeping surface by parents and children—is a common, yet controversial, practice. While most research has focused on the public health aspect of this practice, much less is known regarding its effect on the marital relationship. The aim of the present study was to conduct a scoping review on the impact of parent–infant bed sharing sleeping practices on the sexual and marital relationship of couples. The qualitative synthesis of six studies on this topic suggests that overall, bed sharing does not exert a significant negative impact on family functioning; when it does, it appears to be related to incongruent parental beliefs and expectations, especially when bed sharing is not an intentional choice of sleep arrangement, and there are other confounding factors such as fatigue and psychological distress. Suggestions for future studies and clinical implications are discussed. Full article
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19 pages, 295 KiB  
Review
Understanding Sexual Agency. Implications for Sexual Health Programming
by Ine Vanwesenbeeck, Marianne Cense, Miranda van Reeuwijk and Judith Westeneng
Sexes 2021, 2(4), 378-396; https://doi.org/10.3390/sexes2040030 - 23 Sep 2021
Cited by 11 | Viewed by 7311
Abstract
Debates on human agency, especially female and sexual agency, have permeated the social scientific literature and health educational practice for multiple decades now. This article provides a review of recent agency debates illustrating how criticisms of traditional conceptions of (sexual) agency have led [...] Read more.
Debates on human agency, especially female and sexual agency, have permeated the social scientific literature and health educational practice for multiple decades now. This article provides a review of recent agency debates illustrating how criticisms of traditional conceptions of (sexual) agency have led to a notable diversification of the concept. A comprehensive, inclusive description of sexual agency is proposed, focusing on the navigation of goals and desires in the wider structural context, and acknowledging the many forms sexual agency may take. We argue there is no simple relation between sexual agency and sexual health. Next, we describe the implications of such an understanding of sexual agency for Comprehensive Sexuality Education (CSE) and for sexual health and rights (SHR) programming more generally. We put forward validation of agentic variety, gender transformative approaches, meaningful youth participation, and multicomponent strategies as essential in building young peoples’ sexual agency and their role as agents of wider societal change. We also show that these essential conditions, wherever they have been studied, are far from being realized. With this review and connected recommendations, we hope to set the stage for ongoing, well-focused research and development in the area. Full article
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