Kent Patrick

Associations Between Early First Sexual Intercourse and Later Sexual and Reproductive Outcomes: A Systematic Review of Population-Based Data

The assumption that early sexual debut leads to adverse outcomes has been used as justification for sexual health interventions and policies aimed at delaying sexual initiation, yet research in the area has been limited. This review identified and synthesized published literature on the association between early first sexual intercourse and later sexual/reproductive outcomes. Literature searches were conducted in Medline, Embase, PsycINFO, and Current Contents. In all, 65 citations met the selection criteria (industrialized, population-based studies). By far the most common sexual behavior to have been investigated has been sexual partners. Studies consistently reported early first intercourse to be associated with more recent, lifetime, and concurrent sexual partners. Early initiators were also more likely to participate in a wider range of sexual practices and report increased sexual satisfaction (among men). Furthermore, early first intercourse, in some studies, was shown to increase the risk of teen pregnancies, teen births, and having an abortion, while findings on STIs and contraceptive use have been mixed. These findings, however, must be interpreted with caution due to methodological problems and limitations present in the research, including a lack of consensus on what constitutes early sexual intercourse and inconsistencies and problems with analyses.

Association between sexual behavior and cervical cancer screening.

BACKGROUND Not much is known about whether women who follow Pap testing recommendations report the same pattern of sexual behavior as women who do not. METHODS Data come from part of a larger population-based computer-assisted telephone survey of 8656 Australians aged 16-64 years resident in Australian households with a fixed telephone line (Australian Longitudinal Study of Health and Relationships [ALSHR]). The main outcome measure in the current study was having had a Pap test in the past 2 years. RESULTS Data on a weighted sample of 4052 women who reported sexual experience (ever had vaginal intercourse) were analyzed. Overall, 73% of women in the sample reported having a Pap test in the past 2 years. Variables individually associated with Pap testing behavior included age, education, occupation, cohabitation status, residential location, tobacco and alcohol use, body mass index (BMI), lifetime and recent number of opposite sex partners, sexually transmitted infection (STI) history, and condom reliance for contraception. In adjusted analyses, women in their 30s, those who lived with their partner, and nonsmokers were more likely to have had a recent Pap test. Those who drank alcohol at least weekly were more likely to have had a recent test than irregular drinkers or nondrinkers. Women with no sexual partners in the last year were less likely to have had a Pap test, and women who reported a previous STI diagnosis were more likely to have had a Pap test in the past 2 years. CONCLUSIONS There are differences in Pap testing behavior among Australian women related to factors that may affect their risk of developing cervical abnormalities. Younger women and regular smokers were less likely to report a recent test. Screening programs should consider the need to focus recruitment strategies for these women.

Body mass index, sexual difficulties and sexual satisfaction among people in regular heterosexual relationships: a population-based study.

Background/Aims:  The aims of this study were to clarify the relationship between body mass index (BMI) and sexual difficulties and to investigate if BMI influenced sexual satisfaction, over and above the effects of sexual difficulties.

Incidence and Persistence/Recurrence of Men's Sexual Difficulties: Findings from the Australian Longitudinal Study of Health and Relationships

This study presents data on the prevalence, incidence, and persistence/recurrence of 8 sexual difficulties among men. Participants were 3,157 Australian men who were administered 2 computer-assisted interviews approximately 12 months apart. Analyses were based on a weighted sample of 2,158 men who were 20–64 years of age, sexually active in the past 12 months, and in the same heterosexual relationship at both interviews. Upon recruitment, a third of men (34%) reported having 1 or more sexual difficulties. At follow-up, 21% reported a new sexual difficulty. The 2 highest incident difficulties were “lacking interest in having sex” (11%) and “reaching orgasm too quickly” (7%). In addition, 51% of men with 1 or more sexual difficulties at recruitment reported having at least 1 of these difficulties again at follow-up. While “trouble keeping an erection” had the highest persistence/recurrence (48%), “taking too long to orgasm” had the lowest (24%). Logistic regression modeling revealed a greater incidence of orgasmic difficulties among older and less educated men. There were few sociodemographic predictors of persistence/recurrence. These data should assist clinicians and other health service providers in identifying the potential challenges faced by men who experience sexual difficulties.

Demographic Predictors of Consistency and Change in Heterosexuals' Attitudes toward Homosexual Behavior over a Two-Year Period

This study investigated demographic predictors of consistency and change in heterosexual peoples attitudes toward homosexual behavior. A nationally representative sample of Australian men and women were recruited via random digit dialling in 2004 through 2005. Participants completed annual computer-assisted telephone interviews over the next five years. Questions about attitudes toward male and female homosexual behavior were assessed at Wave 1 (2004–2005) and Wave 3 (2006–2007) of the study. The majority of the sample reported tolerance of both male and female homosexual behavior (with women slightly more tolerant than men). Multivariate analyses showed that those who regularly attended religious services were more likely to consistently disapprove of homosexual behavior and more likely to change from tolerant to disapproving. Among those who were initially tolerant, younger respondents and those with higher educations were less likely to become homophobic. The results of this study show that individual attitudes toward homosexual behavior are open to change, particularly toward a more tolerant position. Religiosity appears to be consistently associated with the development and reinforcement of homophobic tendencies.

Demographic and behavioural correlates of six sexting behaviours among Australian secondary school students

UNLABELLED Background There has been increasing attention on assessing rates of sexting in adolescents and of the potential negative effects of the behaviour. Our aim was to assess rates and correlates of sexting in Australian students in years10, 11 and 12. METHODS The current study was part of The Fifth National Survey of Australian Secondary Students and Sexual Health and reports on responses of 2114 students (811 male, 1303 female). Sexting was assessed using six items: sending a sexually explicit written text message; receiving a sexually explicit text message; sending a sexually explicit nude or nearly nude photo or video of themselves; sending a sexually explicit nude or nearly nude photo or video of someone else; receiving a sexually explicit nude or nearly nude photo or video of someone else; and using a social media site for sexual reasons. RESULTS Approximately half of the students had received (54%, 1139/2097) or sent (43%, 904/2107) a sexually explicit written text message. Sexually explicit images had been received by 42% (880/2098) of students, one in four students had sent a sexually explicit image of themselves (26%, 545/2102) and one in 10 had sent a sexually explicit image of someone else (9%, 180/2095). Finally, 22% (454/2103) of students had used social media for sexual reasons. Sexting was associated with several correlates. CONCLUSIONS Sexting was relatively common in this sample of year 10, 11 and 12 Australian students, particularly among older students, those who are sexually active, and those who use recreational substances.

Sexual Practices and the Duration of Last Heterosexual Encounter: Findings from the Australian Longitudinal Study of Health and Relationships

This study investigated the association between sexual practices and duration of a sexual encounter. Using data from a population-based computer-assisted telephone survey of 8,656 Australians aged 16 to 64 years, four distinct patterns of sexual practices among respondents were found: “basic sexual encounter” (involving mainly kissing, cuddling, stroking ones partner and being stroked, and vaginal intercourse), “basic sexual encounter plus oral sex,” “all assessed sexual practices” (all sexual behaviors included in the survey), and “mainly vaginal intercourse” (characterized by lower levels of kissing, cuddling, and stroking). For both men and women, respondents classified in the basic sexual encounter plus oral sex, and all assessed sexual practices clusters reported significantly longer durations than those in the basic sexual encounter group, whereas respondents in the mainly vaginal intercourse cluster reported shorter durations. These differences were found even after allowing for demographic differences in sexual duration—specifically, age and partner type of the most recent opposite-sex partner. These findings add to the understanding of what typically happens in a sexual encounter. Overall, longer sexual encounters appear to be associated with the inclusion of the least common sexual practices—namely, oral sex and self-stimulation.

Fertility knowledge and intentions to have children in a national study of Australian secondary school students

Objective: This paper reports on fertility knowledge and intentions to have children among a national sample of students in years 10–12.

A population-based study investigating the association between sexual and relationship satisfaction and psychological distress among heterosexuals.

This study examined whether sexual/relationship satisfaction are differentially associated with mental health issues. Using data from a population-based computer-assisted telephone survey, the authors included in this study 3,800 respondents who had a regular heterosexual partner. The authors used 2 methods of scoring the K6 to produce measures of moderate psychological distress and serious psychological distress. Overall, 8.8% of men and 12.1% of women were classified as having moderate psychological distress, whereas 1.6% of men and 3.2% of women were classified as currently experiencing serious psychological distress. The association between satisfaction and mental health was influenced by sex and the severity of the mental health issue but not by type of satisfaction. After adjusting for demographic differences in mental health, low ratings of sexual/relationship satisfaction were both consistently associated with higher levels of moderate psychological distress in men and women and higher proportions of serious psychological distress in men. Although women may be able to resolve their satisfaction issues during less severe stages of psychological distress, for men there was a strong association between low sexual/relationship satisfaction and serious psychological distress.

“Dude, I’m Seventeen … It’s Okay Not to Have Sex by This Age”: Feelings, Reasons, Pressures, and Intentions Reported by Adolescents Who Have Not Had Sexual Intercourse

This study investigated feelings, reasons, pressures, and previous sexual experiences reported by students who have not had sexual intercourse and how these factors are associated with self-rated likelihood of having sex during the next year. Using data from the Fifth National Survey of Australian Secondary Students and Sexual Health (n = 783), this study found, in general, students had positive feelings about not having sex. Reasons for not having sex such as being proud to say no and not being ready were rated higher in importance than fear of potential outcomes or religious/cultural beliefs. Students reported limited pressure from parents and friends and, despite not having sexual intercourse, more than half of the sample had experienced some form of sexual activity. Stronger likelihoods of having sex during the next year were reported by students who had previously engaged in other sexual practices, reported more pressure from friends to have sex, and had negative feelings about not having sex. Sexuality educators can use these findings to guide approaches to sex education, emphasizing feelings, intentions, and reasoning over fear tactics. Discussion of a range of sexual practices will address more closely the experiences of young students as they begin their sexual lives.