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Women are less likely than men are to report receiving oral sex from their partners. Elements of sexual subjectivity may have implications for women's communication of consent to specific sexual acts. Sexually active women (n = 237) between 18 and 71 years of age (M = 28.85 years) completed an online survey measuring sociodemographic variables, entitlement to pleasure from partner, self-efficacy in achieving sexual pleasure, and consent communication at last receptive oral sex event. Participants were predominantly White (84.8%, n = 201) and in exclusive or monogamous sexual relationships (54.9%, n = 130). The authors used a 4-step test of mediation to determine whether self-efficacy in achieving sexual pleasure mediated the relation between entitlement to pleasure from partner and verbal consent communication. Self-efficacy emerged as a significant predictor of verbal consent communication (p <.01) in the fourth step, while entitlement to pleasure dropped out of the model (p >.05), indicating full mediation. Therefore, entitlement to pleasure predicted verbal consent to oral sex as a function of self-efficacy in achieving sexual pleasure. Sex-positive educational interventions may improve disparities between men and women in receiving oral sex from their partners. Results of this study offer insight into the ways in which culture-level forces affect interpersonal and intraindividual sexual health behaviors.

Sexual coercion may affect the sexual experiences of sexual minority women differently. Women (n=445) aged 18 to 71 years (Mean=30.38) answered an online survey on sexual orientation, lifetime coercion, and sexual history. Sexual minority women (45.8%, n=204) were more likely to report having been coerced into unwanted sexual behavior (56.5%) than heterosexual women (44.8 %; p=0.010). Coerced sexual minority women reported earlier ages of initiation into performing oral sex (p=0.016), penile-vaginal (p=0.024), and penile-anal (p=0.027) intercourse. In multiple logistic regression models, currently being in a partnered relationship was the sole factor related to lifetime engagement in penile-vaginal intercourse and receiving oral sex from partners. Having at least a graduate degree was the only characteristic related to engagement in lifetime penile-anal intercourse. Sexual coercion was not related to any lifetime sexual behavior outcomes. The nature of sexual initiation and coercion should be explored further among sexual minority women, with the goal of incorporating their experiences into prevention and treatment initiatives.

The relationship between body appreciation and sexual risk reduction behavior in women is under-explored. This cross-sectional study examined the relationships between body appreciation, male condom use, and sexually transmitted infection (STI) testing among a community-based sample of women (n=285). Logistic regression results revealed that after controlling for age, BMI, and sexual orientation, having more than one sexual partner moderated body appreciation and current male condom use (OR=4.21, p<.01, CI=1.510-11.726). Body appreciation was not a significant predictor of STI testing in the previous 12 months. This suggests that women with higher body appreciation may be more likely to engage in some protective sexual health behaviors. Interventions that seek to improve body appreciation instead of body size change such as weight loss or gain may encourage certain protective sexual behaviors in women., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The current study aimed to (1) offer a large-scale enumeration of college students' lifetime sexual behaviors and sexual behaviors at last event, and (2) apply a gender discrepancy lens to college students' sexual behaviors in order to examine potential gender differences in heterosexual college students' experiences. Nine-hundred and seventy college students between the ages of 18 and 27 from two large universities in the United States participated in the current study. Participants filled out a paper-pencil questionnaire during the last 30 min of class. Measures of lifetime sexual behaviors and engagement in behaviors at last sexual event were replicated from the National Survey of Sexual Health Behavior. Most college students engaged in some form of sexual behavior (manual, oral, vaginal-penile, anal). Men more frequently reported engaging in receptive sexual behaviors (e.g., receiving oral sex) where as women were more likely to engage in performative sexual behaviors (e.g., performing oral sex). At most recent sexual event, men were more likely than women to report being the sexual initiator. Findings highlight gender differences in sexual behavior and provide a foundation for social norms interventions. Holistic sexual health promotion for young adults includes acknowledging and discouraging sites of disparity in equity and pleasure. Therefore, college-level sexual health educators should pay attention to the potential pleasure gap between men and women in heterosexual encounters, and to see pleasure as an important part of sexual health that should be included in social norms campaigns.

Women of size who inhabit non-normative bodies may have different experiences with body image and sexual health than women of average body size. In this exploratory study, we interviewed four women of size recruited from a larger mixed-methodological study of body image and sexuality. Each woman was interviewed twice on topics of body image, sexuality and sexual health. Reconstructive Horizon Analysis was used to analyse the content of the interviews. Women who expressed that their bodies had inherent personal and social value regardless of size did not articulate connections between body size and their sexual health. However, those women who looked externally for validation of their attractiveness struggled with acceptance of their sexuality and bodies and spoke of ways in which their body size and appearance hindered them from having the sexually healthy lives that they wanted. Findings highlight two important components of women's sexual health as participants related them to body image: the right to pleasure and the right to engage only in wanted sexual activity. Participants described how negative body attitudes affected both of these aspects of their sexual health. Interventions targeting weight-based stigma may offer a means of indirectly promoting sexual health and autonomy in women.

Objectification theory posits internalization of an observer's gaze may negatively impact women's feelings about their bodies, which may subsequently affect their sexual function. Subjective body image and body size (i.e., body mass index [BMI]) have mixed relationships to women's sexuality, but assessment of positive body image as a sign of resistance to objectification has not been researched. This study explored relations between body appreciation and sexual function in women and assessed whether body size impacted this relationship. Cross-sectional data were collected online from 247 women, ages 18 to 58. Body appreciation scores were modestly negatively correlated with BMI, while BMI was not related to sexual function scores. After controlling for sexual orientation, partner status, and age, body appreciation predicted the arousal, orgasm, and satisfaction aspects of sexual function. Practitioners' encouragement of body appreciation may improve sexual function in a way that encouraging a reduction in body size may not., (Copyright © 2011 Elsevier Ltd. All rights reserved.)

Sexual compulsivity has been associated with higher frequencies of sexual behaviors that may increase risk for transmission of HIV and other sexually transmitted infections (STI). In a rural midwestern region where social and community resources for the sexual health of men who have sex with men (MSM) are relatively few, the patterns of partner-seeking and sexual behavior, and their relations to sexual compulsivity, may be different than findings from other assessments of men in urban centers. Using a community-based participatory approach (CBPR), data were collected from 309 men who were primarily white, identified as gay or homosexual, and had a mean age of 29.37 years (SD = 11.33), to explore relations between scores on a measure of sexual compulsivity and their sexual partner-seeking, drug and alcohol use, and sexual behaviors with men and women. The majority of men reported having engaged in sexual activity with men in the past 30 days. Those scoring higher than the sample mean (1.65 [SD = 0.66]) on the sexual compulsivity measure reported patterns of having sex with partners met online and having been the insertive or receptive partner in unprotected anal intercourse. Given the unique patterns of sexual partner-seeking in this area, interventions to decrease sexual risk-taking should take into account that the vast majority of men in rural areas are using the Internet to locate sexual partners, and prevention messages focused on rural contexts need to be tailored to include men who have a propensity for sexually compulsive behaviors. Additionally, interventions created for virtual spaces may be more sustainable with rural communities than traditional approaches to HIV/STI prevention.

Although American women are living longer after a breast cancer diagnosis, they may experience significant alterations in sexual function. However, little is known about the types of strategies that women are interested in using to address these sexual issues. This study used a reliable and valid instrument, the Sexual Function Questionnaire, to assess survivors' sexual function. Data were collected from 115 women who were younger than 50 years at diagnosis. Compared to normative controls, survivors scored significantly lower, indicating lower functioning, on most subscales of the Sexual Function Questionnaire and the overall measure, with the exception of the masturbation subscale on which they scored significantly higher. Most participants indicated moderate or strong interest in sexual enhancement products and comfort purchasing sexual enhancement products through various venues. Nurses and other health professionals might consider collaborations with entities of the adult retail industry to provide survivors with information about sexual enhancement products and their therapeutic potential.

Among men who have sex with men (MSM), sexual compulsivity has been associated with higher frequencies of sexual behaviors that may increase risk for transmission of HIV and other sexually transmitted infections (STI). In a Midwestern region where social and community resources for MSM are relatively diffuse, the patterns of partner-seeking and sexual behavior, and their relations to sexual compulsivity, may be different than findings from most other assessments of men in large urban areas. Using a community-based participatory approach (CBPR) and a cross-sectional survey, quantitative data were collected between November 2006 and January 2007 from 504 men related to sexual compulsivity, sexual partner-seeking, and sexual behavior. We sought to explore sexual behaviors in venues where men reported meeting sexual partners, based on their level of compulsivity. Venues that could be characterized as "sexualized" were better predictors of higher sexual compulsivity scores among men than those that are "social" in nature. Men who were higher in compulsivity reported patterns of saturating sexualized venues in order to find sexual partners. Given the unique patterns of sexual partner-seeking in this area, interventions to decrease sexual risk-taking should take into account that men who have a higher propensity for sexual compulsivity are visiting multiple venues, and prevention messages need to be tailored to be consistent across these contexts. In addition, these may need to be differentially designed based on the specific environment in which they are to be delivered.

Objective: To offer an empirical understanding of characteristics associated with the fit and feel of condoms among African-American men who have sex with men (MSM), a particularly high-risk group for HIV and other sexually transmitted infections (STI) in the United States., Methods: Survey data were collected from 178 adult African-American MSM attending a community event in Atlanta, Georgia., Results: Although the majority of participants reported that condoms generally fit properly and felt comfortable, a substantial number of men reported a variety of problems with the fit and feel of condoms. Specifically, 21% reported that condoms felt too tight, 18% reported that condoms felt too short, 10% reported that condoms felt too loose, and 7% reported that condoms felt too long. There were significant associations between men's reports of condom breakage and slippage, and their perceptions of condom fit and feel. Perceptions of condom fit and feel were also related to men's reports of seeking condoms for their size-specific properties., Conclusions: The fit and feel issues that men in this sample identified may be among those that contribute to their likelihood of using, or not using, condoms consistently and correctly. A better understanding of these factors will be beneficial to both condom manufacturers and sexual health professionals who share a common goal of increasing consistent and correct condom use and reducing the incidence of HIV and other STI among this and other communities.