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Introduction Although a large body of previous research has examined sexual behavior and its relation to risk in men of diverse sexual identities, most studies have relied on convenience sampling. As such, the vast majority of research on the sexual behaviors of gay and bisexual men, in particular, might not be generalizable to the general population of these men in the United States. This is of particular concern because many studies are based on samples of men recruited from relatively “high-risk” venues and environments. Aims To provide nationally representative baseline rates for sexual behavior in heterosexual, gay, and bisexual men in the United States and compare findings on sexual behaviors, relationships, and other variables across subgroups. Methods Data were obtained from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of women and men at least 18 years old in the United States, with oversampling of self-identified gay and bisexual men and women. Results from the male participants are included in this article. Main Outcome Measures Measurements include demographic characteristics, particularly sexual identity, and their relations to diverse sexual behaviors, including masturbation, mutual masturbation, oral sex, vaginal sex, and anal sex. Behaviors with male and female partners were examined. Results Men of all self-identified sexual identities reported engaging in a range of sexual behaviors (solo and partnered). As in previous studies, sexual identity was not always congruent for gender of lifetime and recent sexual partners. Conclusion Patterns of sexual behaviors and relationships vary among heterosexual, gay, and bisexual men. Several demographic characteristics, including age, were related to men's sexual behaviors. The results from this probability study highlight the diversity in men's sexual behaviors across sexual identities, and these data allow generalizability to the broader population of gay and bisexual men, in particular, in the United States, which is a major advancement in research focused on individuals in a sexual minority. [ABSTRACT FROM AUTHOR]

Introduction Few previous studies have examined lubricant use among gay and bisexual men outside the context of human immunodeficiency virus risk reduction associated with condom use during penile-anal intercourse and the potential use of lubricants to deliver rectal microbicides. The vast majority of studies examining lubricant use among gay and bisexual men have employed convenience sampling strategies for participant recruitment. Additionally, most studies have collapsed gay men and bisexual men into one category of 'gay and bisexual men.' Aims This study aimed to provide overall rates of lubricant use and related factors among a nationally representative sample of self-identified gay and bisexual men. Frequencies of lubricant use, reasons for using lubricant, and perceptions of lubricant use were examined separately for subsamples of both gay and bisexual men. Methods Data were from the 2012 National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of women and men in the United States aged 18 and older, and we oversampled self-identified gay and bisexual men and women; the results from male participants are included in this article. Main Outcome Measures Measure included demographic characteristics, recent and lifetime commercial lubricant use, lubricant use during specific sexual behaviors, frequency of lubricant use, and reasons for lubricant use during sexual activity. Results Over 90% of both gay and bisexual male participants reported lifetime lubricant use. Use was most common during partnered sexual activities, particularly among men aged 25-29 years old. The most commonly reported reasons for lubricant use included to increase comfort during anal intercourse, curiosity, and to make sex more comfortable. Conclusions Most gay and bisexual men in the United States have used lubricant to enhance a wide range of sexual activities, including but not limited to anal intercourse. Findings from this study will be of utility to clinicians and other health practitioners who seek to understand and promote sexual health among gay and bisexual men and other traditionally underserved public health populations. Dodge B, Schick V, Herbenick D, Reece M, Sanders SA, and Fortenberry JD. Frequency, reasons for, and perceptions of lubricant use among a nationally representative sample of self-identified gay and bisexual men in the United States. J Sex Med 2014;11:2396-2405. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Little is known about the prevalence of sexual behaviors among the black and Hispanic populations in the United States outside the context of sexual risk and disease transmission in 'high-risk' samples. Aim. This study sought to establish current rates of sexual behaviors, sexual health care practices (i.e., experiences with testing and diagnosis of sexually transmitted infections [STIs]), and condom use in a probability sample of black and Hispanic adult men and women in the United States. Main Outcome Measures. Sexual behaviors including solo masturbation, partnered masturbation, receiving oral sex and giving oral sex, vaginal intercourse, and anal intercourse were assessed. Self-reported rates of HIV and other STI testing, and self-reported history of STI diagnosis were examined. Also assessed were rates of condom use during most recent and past 10 vaginal intercourse events. Methods. Data from a probability sample of 1246 black and Hispanic adults were analyzed to explore sexual behaviors, condom use, and STI testing and diagnosis trends. Results. Masturbation, oral sex, and vaginal intercourse were prevalent among black and Hispanic men and women throughout the life course. Anal intercourse and same-gender sexual activities were less common. Self-reported rates of HIV testing were relatively high but varied by gender across age groups. Similarly, rates of testing for other STI were high and differed by gender across age groups. Overall rates of condom use among black and Hispanic men and women were relatively high and did not appear to be related to a variety of situational factors including location of sexual encounter, relationship status, other contraceptive use, and substance use during sexual activity. Conclusion. These data provide a foundation for understanding diverse sexual behaviors, sexual health-care practices, and condom use among the general population of black and Hispanic men and women in the United States. Dodge B, Reece M, Herbenick D, Schick V, Sanders SA, and Fortenberry JD. Sexual health among U.S. black and Hispanic men and women: a nationally representative study. J Sex Med 2010;7(suppl 5):330-345. [ABSTRACT FROM AUTHOR]

Although much research has examined correlates of pain during sex, far less research has examined why women have sex despite having pain and why they avoid telling their partner. The purpose of our study was to examine women's reports of painful sex, including location of pain, whether they told their partner, factors associated with not disclosing their pain, and their reasons for not disclosing. We used data from the 2018 National Survey of Sexual Health and Behavior, a probability-based online survey of 2,007 individuals ages 14 to 49 years. We limited our sample to adult women who reported a sexual experience that was painful in the past year (n = 382; 23.2%). The primary outcome in quantitative analyses was whether women told their partner they experienced pain during sex. Associations with social identities and sexual health were explored via logistic regression. Those who did not tell their partner about painful sex were asked why; their accounts were coded and analyzed qualitatively. Women were asked, "To what extent was this sexual experience physically painful for you?" Those who reported any pain were asked, "Did you tell your partner that you were in pain during sex?" and, if applicable, "Why didn't you tell your partner that you were in pain during sex?" Of those reporting pain during sex, most said it was "a little painful" (81.6%) and occurred at the vaginal entrance (31.5%), inside the vagina (34.4%), or at or around the cervix (17.4%). Overall, 51.0% (n = 193/382) told their partner about their pain. Adjusting for age and wantedness, women who reported little or no event-level sexual pleasure had nearly 3-fold greater odds of not telling a partner about painful sex (adjusted odds ratio = 3.24; 95% CI, 1.43–7.37). Normalizing painful sex, considering pain to be inconsequential, prioritizing the partner's enjoyment, and gendered interactional pressures were the predominant themes in women's narratives. Providers should ask about painful sex, if the woman continues intercourse despite pain, and how she feels about this as a means of assessing any sexual and social pressures. Strengths include the use of social theory in nationally representative survey research to examine how contextual factors influence sexual health, but experiences were largely limited to heterosexual interactions. Many women do not discuss painful sex with their partners, lack of pleasure is significantly more likely among this group, and gender norms and cultural scripts are critical to understanding why. Carter A, Ford JV, Luetke M, et al. "Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States. J Sex Med 2019; 16:1953–1965. [ABSTRACT FROM AUTHOR]

Although withdrawal use is routinely measured as part of contraceptive surveillance in the United States, its assessment may be prone to underreporting and measurement errors. Additionally, at the population level, little is known about subjective experiences of withdrawal. To measure respondents' frequency of and reasons for engaging in extra-vaginal ejaculation in the past year, and to compare contraceptive withdrawal vs extra-vaginal/anal ejaculation during the most recent sexual event. The 2018 National Survey of Sexual Health and Behavior is a U.S. nationally representative probability survey of adolescents and adults. This study was administered in February–March 2018 via GfK Research's KnowledgePanel. Respondents who reported consensual penile-vaginal intercourse in the past year were included in the analysis. Logistic regression was used to assess factors associated with finding extra-vaginal ejaculation sexy/arousing. Main outcomes were the frequency of and reasons for extra-vaginal ejaculation in the past year, as well as reported contraceptive withdrawal use and the location of ejaculation at the most recent penile-vaginal intercourse. In the past year, approximately 60% of respondents reported engaging in any extra-vaginal ejaculation; pregnancy prevention and sexual pleasure were given as common reasons. Those who were men, white, or aged 25–29 were more likely to find extra-vaginal ejaculation sexy or arousing; no gender differences were observed in their partner's perception of this act. Prevalence of selecting withdrawal on the contraceptive inventory was 12.2% (95% CI 10.6–14.0) at last sexual event, whereas extra-vaginal/anal ejaculation was reported by 20.8% (95% CI 18.7–23.0). This lack of concordance in differing measures was observed consistently across all age groups, and approximately 12% to 14% of individuals reported an ejaculation location that did not correspond to their withdrawal use. The results of this study have implications for how healthcare providers discuss withdrawal with their patients and counsel them on using extra-vaginal ejaculation as part of their contraceptive use or part of their sexual repertoire. This is the first nationally representative study to directly compare contraceptive withdrawal to extra-vaginal ejaculation. Limited data were collected at event level regarding motivations for extra-vaginal ejaculation, pregnancy attitudes, perceptions of condoms and sexually transmitted infection prevention, or exposure to erotic media, thus limiting further assessment of relationships between various factors and extra-vaginal/anal ejaculation. We found that reporting of withdrawal as a contraceptive method vs extra-vaginal/anal ejaculation was inconsistent and that extra-vaginal/anal ejaculation was commonly used for reasons other than pregnancy prevention; future research should use more precise measures of "withdrawal." Fu TC, Hensel DJ, Beckmeyer JJ, et al. Considerations in the Measurement and Reporting of Withdrawal: Findings from the 2018 National Survey of Sexual Health and Behavior. J Sex Med 2019;16:1170–1177. [ABSTRACT FROM AUTHOR]

Introduction The diversity in self-identified lesbian and bisexual women's sexual interactions necessitates better understanding of how and when they integrate personal lubricant into different experiences. However, little is known about lesbian and bisexual women's lifetime lubricant use, particularly at the population level. Aims The aim of this study was to examine the prevalence and characteristics of lubricant use among adult lesbian and bisexual women in the United States. Methods Data were drawn from a subset of lesbian and bisexual participants who participated in the 2012 National Survey of Sexual Health and Behavior, an online questionnaire administered to a nationally representative probability sample of U. S. adults ages 18 and older. Main Outcome Measures We examined socio-demographic characteristics, recent and lifetime lubricant use, lubricant use in associated with specific sexual behaviors and condom use, frequency of use, motivations for use, as well as perception of lubricant when used. Results A majority of lesbian- (60.1%) and bisexual-identified (77.1%) women reported ever using lubricant; 25.7% of lesbian women and 32.7% of bisexual women used it in the last 30 days. Across most age groups, lubricant was commonly used during partnered sexual play, partnered sexual intercourse, or when a vibrator/dildo was used. Lesbian and bisexual women reported using lubricants to increase arousal/sexual pleasure/desire, to make sex more fun, or to increase physical comfort during sex. Conclusions Lubricant use is identified as a part of lesbian and bisexual women's sexual experience across the life span, as a part of both solo and partnered experiences. As part of evolving sexual health assessments, clinicians and health educators may find value in integrating lubricant-focused conversation with their lesbian and bisexual patients and clients, particularly. Hensel DJ, Schick V, Herbenick D, Dodge B, Reece M, Sanders SA, and Fortenberry JD. Lifetime lubricant use among a nationally representative sample of lesbian- and bisexual-identified women in the United States. J Sex Med 2015;12:1257-1266. [ABSTRACT FROM AUTHOR]

Introduction Despite the wealth of literature addressing sexual practices and condom use among men and women, very little data are available among Hispanic/ Latino populations and in the Caribbean Region. This study adds to the existing literature on sexual practices and condom use in Puerto Rico ( PR) and provides comparisons based on sex given the need for more current information on the sexual characteristics and condom use rates among understudied populations. Aim The aim of this study was to assess the rates of sexual practices and condom use among adults, aged 21-49, in PR. Methods We report the prevalence of lifetime and recent (past 3 months) sexual practices by sex, as event-level condom use rates, and condom familiarity and accessibility in an online-based sample of adult men and women in PR. Main Outcome Measures The main variables assessed include sociodemographic characteristics, solo and partnered sexual practices, and condom use frequencies, as well as familiarity and accessibility to male and female condoms. Results Overall, 93% of the sample reported having been sexually active (engaged in oral, vaginal, and/or anal sex) in their lifetime and 78% reported sexual practices in the past 3 months. As in other studies Hispanic/ Latino populations, reported rates of anal intercourse ( AI) among both men and women were relatively high. Overall, a greater proportion of men reported condom use during all sexual practices (41% vaginal intercourse ( VI); 65% receptive AI; 46% insertive AI) than women (22% VI; 18% AI). Conclusions These findings provide current sexual practice and condom use frequency rates that can aid in the understanding of the particular sexual health needs of Hispanic/ Latino populations as well as of other groups in the Caribbean. It also serves for the development of future studies and sexual health promotion programs, including comprehensive sexual health care. Rodriguez-Diaz CE, Collazo E, Dodge B, Roman-Rivera A, Candelaria-Rosa E, Colon-Colon M, and Herbenick D. 'Sexplorando': Sexual practices and condom use among an Internet-based sample of men and women in Puerto Rico. J Sex Med 2014;11:2385-2395. [ABSTRACT FROM AUTHOR]

Introduction Much scientific research focuses on assessing and understanding individuals' perceptions of sexual pleasure, enjoyment and satisfaction. Many existing measures of pleasure and satisfaction provide valuable information but are limited in their ability to assess event-level quality. Aims To develop a scale for measuring the event-level quality of a sexual experience that could be used regardless of the age, gender, sexual orientation, and relationship status of the individual and across sexual activity types. Methods Interviews about the measurement of sexual quality and pleasure were conducted with 15 experts in the field of sexual health and informed the development of an event-level scale to measure the quality of sexual experiences. Scale items were administered to a cross-sectional nationally representative probability survey of Americans ages 18 to 60. Main Outcome Measures Socio-demographic items; Quality of Sexual Experience ( QSE) scale items; event-level items related to overall sexual quality ('Quality item'), comparison to other sexual events ('Comparison item'), and orgasm ('Orgasm item'). Results QSE scores were significantly correlated with responses to the Quality Item ( r = 0.901, P < 0.001 for both women and men). Better experiences were associated with significantly higher QSE scores than were worse experiences; significant linear relationships were found for both women ( GLM F[4,1461] = 129.46, P < 0.001) and men ( GLM F[4,864] = 71.84, P < 0.001). QSE scores were significantly related to responses on the Orgasm Item for women [ F[3,1430] = 246.53, P < 0.001] and men [ F[3,858] = 117.24, P < 0.001]. Conclusions The QSE scale is a valid and reliable event-level measure of the quality of a sexual experience in both women and men with outstanding psychometric properties. Clinical and research implications are discussed. Sanders SA, Herbenick D, Reece M, Schick V, Mullinax M, Dodge B, and Fortenberry JD. The development and validation of a brief quality of sexual experience (QSE) scale: Results from a nationally representative sample of men and women in the United States. J Sex Med 2013;10:2409-2417. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Although most Americans have used condoms and/or lubricant during sex, little is known about the context of sexual events that involve the use of such products outside of experimentally manipulated studies. Aims. To assess, in a nationally representative study of men and women in the United States ages 18-59, the characteristics of condom and lubricant use during participants' most recent sexual event and the relationship of their condom and lubricant use to event-level ratings of sexual quality. Methods. Data are from the National Survey of Sexual Health and Behavior, which involved the administration of an online questionnaire to a nationally representative probability sample of the U.S. adults. Main Outcome Measures. Sociodemographic items: event-level items related to sexual behavior, condom use, lubricant use, and participants' perceptions of their arousal, pleasure, ease of erection or lubrication, and pain associated with sex. Results. During their most recent sexual experience, 27.5% of men (N = 237) and 22.3% of women (N = 175) reported using a condom. More than twice as many women as men were unsure whether the condom was lubricated (26.6% vs. 11.4%) and the material it was made of (23.6% vs. 8.9%). Participants consistently rated sex to be arousing and pleasurable whether or not they used condoms or lubricant. No significant differences were found in regard to men's ratings of the ease of their erections based on condom and lubricant use. Conclusions. Although some have concerns about how condoms or lubricants may impact their enjoyment of sex, in a nationally representative sample of men and women ages 18-59, ratings of sex were largely quite high, with few differences based on condom and lubricant use. Women, more often than men, reported being unsure about the type of condom and lubricant used, which has implications for patient education. Herbenick D, Schick V, Reece M, Sanders SA, Smith N, Dodge B, and Fortenberry JD. Characteristics of condom and lubricant use among a nationally representative probability sample of adults ages 18-59 in the United States. J Sex Med **;**:**-**. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Public health condom promotion efforts increasingly focus on the importance of sexual pleasure; however, little is known about sexual event-specific factors that may increase or decrease perceptions of sexual pleasure when condoms are used. Aims. To examine event-level factors associated with ratings of sexual pleasure during condom-protected vaginal intercourse. Methods. Data were collected in 2008 from 1,875 men during a prospective daily diary study of sexual behavior and condom use. Sexual pleasure was assessed during condom-protected vaginal intercourse considering situational, relational, intrapersonal, and behavioral predictors. Analyses were generalized estimating equation ordinal regression. Main Outcome Measures. Event-specific perceptions of sexual pleasure (three categories: not at all enjoyable to extremely enjoyable). Results. Vaginal intercourse was reported on 29.8% (N = 8,876/29,714) of diary days; complete condom use was reported for 59.1% (5,249/8,876) of all vaginal intercourse events. This was confusing by using the word 'all sexual events.' Higher sexual pleasure ratings during complete condom use were associated with older age, manual stimulation of one's genitals, receiving oral sex, and performing oral sex. Sexual pleasure ratings also increased in association with intercourse duration, intercourse intensity, ejaculation, erection perception, and condom comfort. Sexual pleasure ratings were lower with erection difficulty and partner discomfort during sex. Conclusions. These data advance understanding of sexual pleasure during condom use, suggesting that sexual pleasure increases in conjunction with specific relational, physiological, and condom perceptions. These findings offer points upon which clinicians and health educators can engage men in an ongoing dialogue about augmenting sexual pleasure in the context of condom use. Hensel DJ, Stupiansky NW, Herbenick D, Dodge B, and Reece M. Sexual pleasure during condom-protected vaginal sex among heterosexual men. J Sex Med 2012;9:1272-1276. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Little is known about the characteristics of sexual events during which individuals choose to use lubricant with condoms. Aims. The aims of this article were to evaluate the determinants of adding lubricant to condoms during baseline and at the event level, to assess the event-level variables' influence on adding lubricants to condoms, and to assess the event-level influence of using condoms with lubricant on event-level condom attitudes. Methods. A total of 1,874 men completed a 30-day Internet-based prospective daily diary study of sexual behavior and condom use. Main Outcome Measures. Baseline data included demographic variables and information about condom education. Daily diary data included reports of penile-vaginal sex regarding intercourse duration, intercourse intensity, intoxication level, condom application method, partner contraceptive method, and partner and relationship characteristics. Results. Lubricant was added to 24.3% of the study-provided condoms and 26.2% of the condoms selected by study participants. Those with more education and those who were married were more likely to add lubrication to condoms. Adding lubricant to condoms, a female partner putting the condom on with her hands and using contraception, and the event occurring with a wife (vs. girlfriend) was significantly associated with longer intercourse. Event-level lubricant and condom use significantly predicted lower willingness to buy the condom it was used with, as well as to recommend the condom. Adding exogenous lubricant was not related to the participants' confidence in condoms as a method to prevent pregnancy and sexually transmitted infections. Conclusions. The event-level nature of this study provided for a more comprehensive assessment of the situational factors that are associated with applying lubricant to condoms. Findings from this study suggest that men are adding lubricant to condoms for reasons other than to increase condom efficacy. Reece M, Mark K, Herbenick D, Hensel DJ, Jawed-Wessel S, and Dodge B. An event-level analysis of adding exogenous lubricant to condoms in a sample of men who have vaginal sex with women. J Sex Med 2012;9:672-678. [ABSTRACT FROM AUTHOR]

Little is known about event-level condom use errors during vaginal sex. The aim of this article is to examine factors associated with complete condom use compared to forms of incomplete condom use, including delayed condom application and early condom removal, over a 30-day period. Data were collected in 2008 from 1,875 men during a prospective daily diary study of sexual behavior and condom use. Incomplete condom use was assessed during vaginal intercourse considering situational, relational, intrapersonal, and behavioral predictors. Analyses were generalized estimating equation multinomial logistic regression. Condom use during vaginal sex: complete use, delayed application, early removal, and both delayed application/early removal. Of 29,714 diary reports, 30% (8,876) included vaginal intercourse. Analyses were conducted (in 2009) on 83.2% of these intercourse events (6,325), during which condoms were used and for which participants provided complete data. Incomplete condom use included penetration before applying condoms during 12% of events (749), removing condoms before intercourse ended during 3.1% (198), and both types of incomplete use during 2% (129) of events. Erection quality (less than typical erect penile length and circumference, less rigidity, and difficulty maintaining erection) was associated with greater odds of incomplete use, as was a participant's history of other recent incomplete use. Perceptions of condom comfort and recent previous complete use were protective factors against incomplete use. Men's incomplete condom use is associated with recent condom use patterns, as well as with their physiological characteristics and perceptions of condoms during sexual intercourse. Event-level analyses such as these help describe how incomplete condom use occurs among individuals incorporating condoms into their sexual activities. [ABSTRACT FROM AUTHOR]

Over the past two decades, an expanding body of research has examined women's and men's genital self-image. Support for the reliability and validity of the 7-item Female Genital Self-Image Scale (FGSIS) has been found in a convenience sample of women. The purpose of this study was to assess the reliability and validity of the FGSIS, its model of fit, and its association with women's scores on the Female Sexual Function Index (FSFI) in a nationally representative probability sample of women in the United States ages 18 to 60. A second purpose was to assess the temporal stability of the scale in a subset of this sample. A nationally representative sample of 3,800 women ages 18 to 60 were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated. Demographic items (e.g., age, race/ethnicity, marital status, sexual orientation, geographic region), having had a gynecological examination in the past year, having performed a genital self-examination in the past month, frequency of masturbation in the past month, vibrator use in the past month, the FGSIS, and the FSFI. An abbreviated 4-item version of the scale, the FGSIS-4, was a better fit to the data than the original 7-item scale. Women's scores on the FGSIS-4 were significantly related to vibrator use, frequency of masturbation, having had a gynecological exam in the past year, having performed genital self examination in the past month, and all FSFI subscales. Most of the participants felt generally positively about their genitals and female genital self-image was significantly related to female sexual function, women's sexual behavior and their sexual and genital healthcare behaviors. In addition, the FGSIS-4 has evidence of reliability, validity, and temporal stability in a nationally representative probability sample of women in the United States. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. To provide a foundation for those who provide sexual health services and programs to men in the United States, the need for population-based data that describes men's sexual behaviors and their correlates remains. Aims. The purpose of this study was to, in a national probability survey of men ages 18-94 years, assess the occurrence and frequency of sexual behaviors and their associations with relationship status and health status. Methods. A national probability sample of 2,522 men aged 18 to 94 completed a cross-sectional survey about their sexual behaviors, relationship status, and health. Main Outcome Measures. Relationship status; health status; experience of solo masturbation, partnered masturbation, giving oral sex, receiving oral sex, vaginal intercourse and anal intercourse, in the past 90 days; frequency of solo masturbation, vaginal intercourse and anal intercourse in the past year. Results. Masturbation, oral intercourse, and vaginal intercourse are prevalent among men throughout most of their adult life, with both occurrence and frequency varying with age and as functions of relationship type and physical health status. Masturbation is prevalent and frequent across various stages of life and for both those with and without a relational partner, with fewer men with fair to poor health reporting recent masturbation. Patterns of giving oral sex to a female partner were similar to those for receiving oral sex. Vaginal intercourse in the past 90 days was more prevalent among men in their late 20s and 30s than in the other age groups, although being reported by approximately 50% of men in the sixth and seventh decades of life. Anal intercourse and sexual interactions with other men were less common than all other sexual behaviors. Conclusion. Contemporary men in the United States engage in diverse solo and partnered sexual activities; however, sexual behavior is less common and more infrequent among older age cohorts. Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, and Fortenberry JD. Sexual behaviors, relationships, and perceived health among adult men in the United States: Results from a national probability sample. J Sex Med 2010;7(suppl 5):291-304. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Past surveys of sexual behavior have demonstrated that female sexual behavior is influenced by medical and sociocultural changes. To be most attentive to women and their sexual lives, it is important to have an understanding of the continually evolving sexual behaviors of contemporary women in the United States. Aims. The purpose of this study, the National Survey of Sexual Health and Behavior (NSSHB), was to, in a national probability survey of women ages 18-92, assess the proportion of women in various age cohorts who had engaged in solo and partnered sexual activities in the past 90 days and to explore associations with participants' sexual behavior and their relationship and perceived health status. Past year frequencies of masturbation, vaginal intercourse, and anal intercourse were also assessed. Methods. A national probability sample of 2,523 women ages 18 to 92 completed a cross-sectional internet based survey about their sexual behavior. Main Outcome Measures. Relationship status; perceived health status; experience of solo masturbation, partnered masturbation, giving oral sex, receiving oral sex, vaginal intercourse, anal intercourse, in the past 90 days; frequency of solo masturbation, vaginal intercourse, and anal intercourse in the past year. Results. Recent solo masturbation, oral sex, and vaginal intercourse were prevalent among women, decreased with age, and varied in their associations with relationship and perceived health status. Recent anal sex and same-sex oral sex were uncommonly reported. Solo masturbation was most frequent among women ages 18 to 39, vaginal intercourse was most frequent among women ages 18 to 29 and anal sex was infrequently reported. Conclusion. Contemporary women in the United States engage in a diverse range of solo and partnered sexual activities, though sexual behavior is less common and more infrequent among older age cohorts. Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, and Fortenberry JD. Sexual behaviors, relationships, and perceived health status among adult women in the United States: Results from a national probability sample. J Sex Med 2010;7(suppl 5):277-290. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Correct and consistent condom use remains the most effective way to reduce sexually transmissible infection/HIV transmission during sex and is a highly effective contraceptive method. Understanding correlates of condom use is vital to public health programs. Aim. To explore sociodemographic, event characteristics, and experiential correlates of condom use at last penile-vaginal intercourse (PVI). Methods. Survey data were collected from a nationally representative probability sample of adults in the United States as part of the National Survey of Sexual Health and Behavior. Main Outcome Measures. Condom use/non-use at most recent PVI was the main outcome. Logistic regression analyses predicted condom use from sociodemographic variables (i.e., age, education, race/ethnicity, sexual orientation, health status, type of relationship with sexual partner) and event characteristics (i.e., location of sexual encounter, prior intercourse experience with partner, whether partner had other sex partners in the 6 months prior to sex with the participant; other contraceptive use, alcohol use, marijuana use, and for men, erection medication use). Logistic regression analyses examined evaluations of the sexual aspects of the experience (pleasure, arousal, erection/lubrication difficulty, participant orgasm, partner orgasm) in light of condom use. Results. Condom-protected PVI was significantly greater among younger people, blacks and Hispanics, and those having PVI with a nonrelationship partner. Statistically adjusting for these differences, condom use was significantly associated with fewer previous intercourse experiences with the partner and not using other forms of contraception. The sexual aspects of experience were evaluated similarly regardless of whether or not a condom was used. Conclusion. Public health programs among youths and minorities may underlie higher condom use rates among these groups. Condom use may be further improved by continuing such programs and also expanding outreach to older persons and whites, suggesting prolonging use as relationships develop, and highlighting that condom use does not necessarily interfere with the sexual experience. Sanders SA, Reece M, Herbenick D, Schick V, Dodge B, and Fortenberry JD. Condom use during most recent vaginal intercourse event among a probability sample of adults in the United States. J Sex Med 2010;7(suppl 5):362-373. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Data on adolescents' sexual and condom use behaviors provides an empirical basis for a range of social, educational, clinical, and public health endeavors. Aims. This study has two purposes: to describe the recent and lifetime prevalence of a variety of sexual behaviors; and, to describe factors associated with condom use at last penile-vaginal intercourse. Methods. Data included those from male (N = 414) and female (N = 406) adolescents (ages 14-17 years) from a nationally representative probability sample. Survey items addressed occurrence (past 90 days, past year, lifetime) of solo masturbation, partnered masturbation, oral sex given to a partner, oral sex received from a partner, vaginal intercourse, and anal intercourse. Participants reporting partnered sexual behaviors in the past year completed additional items about condom use, location of sex, partner characteristics, other sexual behaviors, and alcohol or marijuana use at the most recent sexual event. Main Outcome Measures. Adjusted rates (by gender) of sexual behaviors, and characteristics of most recent vaginal sex event as a function of condom use/non-use. Results. Lifetime prevalence of solo masturbation was common for males (80%) and females (48%). Lifetime prevalence of penile-vaginal sex increased with each year of age for both adolescent men and women; however, penile-vaginal sex within the previous 90 days was much less frequently reported. Rates of condom use for penile-vaginal sex were 80% for males and 69% for females. Lifetime anal sex rates were 4.7% for males and 5.5% for females. Conclusion. Sexual behavior among adolescents was more prevalent and diverse in older adolescent cohorts. Condom use for penile-vaginal intercourse was reported for a majority of events. Fortenberry JD, Schick V, Herbenick D, Sanders SA, Dodge B, and Reece M. Sexual behaviors and condom use at last vaginal intercourse: A national sample of adolescents ages 14 to 17 years. J Sex Med 2010;7(suppl 5):305-314. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Although studies of specific groups of individuals (e.g., adolescents, 'high risk' samples) have examined sexual repertoire, little is known, at the population level, about the sexual behaviors that comprise a given sexual encounter. Aim. To assess the sexual behaviors that men and women report during their most recent sexual event; the age, partner and situational characteristics related to that event; and their association with participants' evaluation of the sexual event. Methods. During March-May 2009, data from a United States probability sample related to the most recent partnered sexual event reported by 3990 adults (ages 18-59) were analyzed. Main Outcome Measures. Measures included sexual behaviors during the most recent partnered sexual event, event characteristics (i.e., event location, alcohol use, marijuana use, and for men, erection medication use), and evaluations of the sexual experience (pleasure, arousal, erection/lubrication difficulty, orgasm). Results. Great diversity exists in the behaviors that occur during a single sexual event by adults, with a total of 41 combinations of sexual behaviors represented across this sample. Orgasm was positively related to the number of behaviors that occurred and age was related to greater difficulty with erections and lubrication. Men whose most recent event was with a relationship partner indicated greater arousal, greater pleasure, fewer problems with erectile function, orgasm, and less pain during the event compared with men whose last event was with a nonrelationship partner. Conclusion. Findings demonstrate that adults ages 18 to 59 engage in a diverse range of behaviors during a sexual event and that greater behavior diversity is related to ease of orgasm for both women and men. Although both men and women experience sexual difficulties related to erectile function and lubrication with age, men's orgasm is facilitated by sex with a relationship partner whereas the likelihood of women's orgasm is related to varied sexual behaviors. Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, and Fortenberry JD. An event-level analysis of the sexual characteristics and composition among adults ages 18 to 59: Results from a national probability sample in the United States. J Sex Med 2010;7(suppl 5):346-361. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. In the contemporary U.S., men and women are living longer and healthier lives. As such, many people spend greater portions of their lives as sexually active individuals. Yet, little is known about the myriad of ways that older adults experience their sexual lives. Aim. This study sought to assess the context and frequency of sexual behaviors, condom use, sexual pleasure, and sexual experience of men and women over age 50. Methods. Information regarding the sexual experiences of a nationally representative sample of men and women over age 50 within the past year was examined. Main Outcome Measures. Sexual behavior over the past year was assessed in relation to several situational and contextual characteristics (e.g., event location, type of partner, health status, condom use). Participants were also asked about their experience (i.e., pleasure, arousal, pain, lubrication/erectile difficulties, and orgasm) during their most recent partnered sexual event. Bivariate or ordinal logistic regression models were used to investigate the relationship of age, health and partner status to sexual frequency and experience. Results. Although sizable proportions (20-30%) of both men and women remained sexually active well into their 80s age was related to a lower likelihood of solo and most partnered sexual behaviors. When controlling for age, relationship status, and health remained significant predictors of select sexual behaviors. The participant's evaluation of their most recent sexual experience in terms of arousal, erectile difficulty, and orgasm all declined with age. Health status was related to men's evaluation of the experience. Relationship status was the most consistent predictor of women's evaluation of the experience. Condom use rates remained low for participants across age groups. Conclusion. Many older adults continue be sexually active well into advanced age (80+). Thus, providers need to be attentive to the diverse sexual health needs of older adults. Schick V, Herbenick D, Reece M, Sanders SA, Dodge B, Middlestadt SE, and Fortenberry JD. Sexual behaviors, condom use, and sexual health of Americans over 50: Implications for sexual health promotion for older adults. J Sex Med 2010;7(suppl 5):315-329. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Given the efficacy of latex condoms for preventing pregnancy, HIV, and most STI, their promotion remains central to global sexual health efforts. To inform the development of accurate and appropriately-targeted interventions, there is a need for contemporary condom use rates among specific populations. Aims. The purpose of this study was to establish rates of condom use among sexually active individuals in the U.S. population. Methods. Data were collected via a national probability sample of 5,865 U.S. adolescents and adults aged 14 to 94 years. Main Outcome Measures. Condom use was assessed during the most recent partnered vaginal or anal sexual event and over the past 10 vaginal and anal intercourse events. Results. Condom use by men during past 10 vaginal intercourse events was slightly higher (21.5%) than that reported by women (18.4%), and consistent with rates of condom use reported during most recent vaginal intercourse by men (24.7%) and women (21.8%). Adolescent men reported condom use during 79.1% of the past 10 vaginal intercourse events, adolescent women reported use during 58.1% of the same. Condom use during past 10 anal intercourse events was higher among men (25.8%) than women (13.2%); the same was observed for most recent anal intercourse event (26.5% for insertive men, 44.1% for receptive men, and 10.8% for receptive women). Generally, condom use was highest among unmarried adults, higher among adolescents than adults, and higher among black and Hispanic individuals when compared with other racial groups. Conclusion. These data indicate clear trends in condom use across age, gender, relationship status, and race/ethnicity. These contemporary rates of condom use will be helpful to those who lead efforts to increase condom use among individuals who may be at risk for sexually transmitted infections or who desire to prevent pregnancy. Reece M, Herbenick D, Schick V, Sanders SA, Dodge B, and Fortenberry JD. Condom use rates in a national probability sample of males and females ages 14 to 94 in the United States. J Sex Med 2010;7(suppl 5):266-276. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Despite a demonstrated relationship between sexual behaviors and health, including clinical risks, little is known about contemporary sexual behavior. Aims. To assess the rates of sexual behavior among adolescents and adults in the United States. Methods. We report the recent (past month, past year) and lifetime prevalence of sexual behaviors in a nationally representative probability sample of 5,865 men and women ages 14 to 94 in the United States (2,936 men, 2,929 women). Main Outcome Measures. Behaviors assessed included solo masturbation, partnered masturbation, giving and receiving oral sex, vaginal intercourse, and anal intercourse. Results. Masturbation was common throughout the lifespan and more common than partnered sexual activities during adolescence and older age (70+). Although uncommon among 14- to 15-year olds, in the past year 18.3% of 16- to 17-year-old males and 22.4% of 16- to 17-year-old females performed oral sex with an other-sex partner. Also in the past year, more than half of women and men ages 18 to 49 engaged in oral sex. The proportion of adults who reported vaginal sex in the past year was highest among men ages 25-39 and for women ages 20-29, then progressively declined among older age groups. More than 20% of men ages 25-49 and women ages 20-39 reported anal sex in the past year. Same-sex sexual behaviors occurring in the past year were uncommonly reported. Conclusions. Men and women engage in a diverse range of solo and partnered sexual behaviors throughout the life course. The rates of contemporary sexual behavior provided in this report will be valuable to those who develop, implement, and evaluate programs that seek to improve societal knowledge related to the prevalence of sexual behaviors and to sexual health clinicians whose work to improve sexual health among the population often requires such rates of behavior. Herbenick D, Reece M, Schick V, Sanders SA, Dodge B, and Fortenberry JD. Sexual behavior in the United States: Results from a national probability sample of men and women ages 14-94. J Sex Med 2010;7(suppl 5):255-265. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction. Recent reports indicate that vibrator use during solo and partnered sexual activities is common among heterosexual men and women in the United States. However, little research has comprehensively assessed vibrator use among gay and bisexually identified men. Aims. This study sought to document the extent to which gay and bisexually identified men report using vibrators, the sexual and relational situations within which they use them, and how men use vibrators on their own and their partners' bodies. Methods. Data were collected from 25,294 gay and bisexually identified men from 50 U.S. states and from the District of Columbia via an internet-based survey. Main Outcome Measure. Measures included sociodemographics, health-related indicators, sexual behaviors, and those related to recent and past use of vibrators during solo and partnered sexual interactions with other men. Results. Approximately half (49.8%) of gay and bisexually identified men reported having used vibrators. Most men who had used a vibrator in the past reported use during masturbation (86.2%). When used during partnered interactions, vibrators were incorporated into foreplay (65.9%) and intercourse (59.4%). Men reported frequent insertion of vibrators into the anus or rectum when using them during masturbation (87.3%), which was also common during partnered interactions (∼60%), but varied slightly for casual and relationship sex partners. For both masturbation and partnered interactions, men overwhelmingly endorsed the extent to which vibrator use contributed to sexual arousal, orgasm, and pleasure. Conclusions. Vibrator use during both solo and partnered sexual acts was common among the gay and bisexually identified men in this sample and was described by men as adding to the quality of their sexual experiences. Reece M, Rosenberger JG, Schick V, Herbenick D, Dodge B, and Novak DS. Characteristics of vibrator use by gay and bisexually identified men in the United States. J Sex Med 2010;7:3467-3476. [ABSTRACT FROM AUTHOR]

Introduction. While vibrating products have been recommended by clinicians for the treatment of male sexual dysfunctions, knowledge is lacking with regard to the prevalence of vibrator use among men in the United States, the characteristics of men who use vibrators, and whether there are relations between vibrator use and sexual function among men. Aims. To establish lifetime and recent prevalence rates for vibrator use by men in the United States, to document the characteristics of men who use vibrators and their reasons for using vibrators, and to explore relations between men's vibrator use and sexual function. Methods. During April 2008, data were collected from a population-based cross-sectional survey of 1,047 men aged 18–60 years in the United States. Analyses were conducted using poststratification data weights. Main Outcome Measure. Measures included sociodemographics, health status and health-related behaviors, sexual behaviors, vibrator use, and sexual function. Results. For both solo and partnered sexual activities, the prevalence of men who had incorporated a vibrator into sexual activities during their lives was 44.8%, with 10.0% having done so in the past month, 14.2% in the past year, and 20.5% over 1 year ago. Men who had used vibrators, particularly those with more recent use, were more likely to report participation in sexual health promoting behaviors, such as testicular self-exam. Men who had used vibrators recently also scored higher on four of the five domains of the International Index of Erectile Function (erectile function, intercourse satisfaction, orgasmic function, and sexual desire). Conclusions. Among men in the United States, vibrator use during solo and partnered sexual interactions is common and is associated with a wide array of positive sexual health characteristics. Future research should continue to explore ways in which men incorporate vibrators into solo sexual acts, partnered sexual play, and sexual intercourse. Reece M, Herbenick D, Sanders SA, Dodge B, Ghassemi A, and Fortenberry JD. Prevalence and characteristics of vibrator use by men in the United States. J Sex Med 2009;6:1867–1874. [ABSTRACT FROM AUTHOR]

Introduction. Although vibrators are commonly recommended by clinicians as adjunct to treatment for female sexual dysfunction, and for sexual enhancement, little is known about their prevalence or correlates of use. Aim. The aim of this study was to determine the lifetime and recent prevalence of women's vibrator use during masturbation and partnered sex, and the correlates of use related to sociodemographic variables, health behaviors, and sexual function. Methods. A nationally representative sample of 3,800 women aged 18–60 years were invited to participate in a cross-sectional Internet-based survey; 2,056 (54.1%) participated. Main Outcome Measures. The prevalence of vibrator use, the relationship between vibrator use and physical and psychological well-being (as assessed by the Centers for Disease Control and Prevention [CDC] Healthy Days measure) and health-promoting behaviors, the relationship between vibrator use and women's scores on the Female Sexual Function Index, and an assessment of the frequency and severity of side effects potentially associated with vibrator use. Results. The prevalence of women's vibrator use was found to be 52.5% (95% CI 50.3–54.7%). Vibrator users were significantly more likely to have had a gynecologic exam during the past year ( P < 0.001) and to have performed genital self-examination during the previous month ( P < 0.001). Vibrator use was significantly related to several aspects of sexual function (i.e., desire, arousal, lubrication, orgasm, pain, overall function) with recent vibrator users scoring higher on most sexual function domains, indicating more positive sexual function. Most women (71.5%) reported having never experienced genital symptoms associated with vibrator use. There were no significant associations between vibrator use and participants' scores on the CDC Healthy Days Measures. Conclusions. Vibrator use among women is common, associated with health-promoting behaviors and positive sexual function, and rarely associated with side effects. Clinicians may find these data useful in responding to patients' sexual issues and recommending vibrator use to improve sexual function. Further research on the relationships between vibrator use and sexual health is warranted. Herbenick D, Reece M, Sanders S, Dodge B, Ghassemi A, and Fortenberry JD. Prevalence and characteristics of vibrator use by women in the United States: Results from a nationally representative study. J Sex Med 2009;6:1857–1866. [ABSTRACT FROM AUTHOR]

An introduction is presented in which the editor discusses various topics within the issue including sexual behaviors, use of condoms in age group of 14-94 years and sexual events.