Intersectional Microaggressions, Sexual Identity Concealment, and Mental Health of Young Black Sexual Minority Men and Transgender Women.

Previous research has demonstrated associations between experiences of microaggressions and negative mental and physical health outcomes, and national organizations such as the Centers for Disease Control and Prevention have acknowledged racism as a public health issue. Individuals with multiple marginalized identities, such as young Black men who have sex with men and transgender women, are commonly affected by discrimination and stigma, contributing to health disparities. One possible path by which microaggressions are linked to negative health outcomes for these groups is their impact on individuals' decisions to conceal their sexual identity, in some cases leading to increased stress and use of maladaptive coping strategies. We surveyed 280 young Black male (86%) and transgender or non-binary (14%) individuals between the ages of 16-25 years old (M = 21.68, SD = 2.73) who reported being recently sexually active with men about their experiences with intersectional microaggressions, concealment of their sexual identity, psychological distress, and substance use before and during sexual activity. Structural equation modeling revealed that experiences of microaggressions were associated with greater sexual identity concealment, and concealment partially mediated the relationship between microaggressions and psychological distress. While microaggressions were associated with greater substance use, sexual identity concealment did not mediate this relationship. Findings have implications for addressing health disparities among this population.

Intersectional Discrimination and PrEP uSe Among Young Black Sexual Minority Individuals: The Importance of Black LGBTQ Communities and Social Support.

Intersectional stigma and discrimination have increasingly been recognized as impediments to the health and well-being of young Black sexual minority men (YBSMM) and transgender women (TW). However, little research has examined the relationship between intersectional discrimination and HIV pre-exposure prophylaxis (PrEP) outcomes. This study with 283 YBSMM and TW examines the relationship between intersectional discrimination and current PrEP use and likelihood of future PrEP use. Path models were used to test associations between intersectional discrimination, resilience and social support, and PrEP use and intentions. Individuals with higher levels of anticipated discrimination were less likely to be current PrEP users (OR = 0.59, p = .013), and higher levels of daily discrimination were associated with increased likelihood of using PrEP in the future (B = 0.48 (0.16), p = .002). Greater discrimination was associated with higher levels of resilience, social support, and connection to the Black LGBTQ community. Social support mediated the effect of day-to-day discrimination on likelihood of future PrEP use. Additionally, there was a significant and negative indirect effect of PrEP social concerns on current PrEP use via Black LGBTQ community connectedness. The results of this study highlight the complexity of the relationships between discrimination, resilience, and health outcomes.

Sexual violence history predicts changes in vaginal immune parameters during sexual arousal.

OBJECTIVE: To examine the influence of sexual arousal on vaginal mucosal inflammatory cytokine and antibody production in healthy women with and without histories of childhood and/or adult sexual violence. METHODS: Ninety-one premenopausal healthy women (ages 18-42) attended a single laboratory session in which they provided vaginal fluid samples before and after viewing one neutral and one erotic film. While viewing the films, participants' vaginal sexual arousal was recorded using vaginal photoplethysmography. RESULTS: Of the 91 participants, 41 (45%) reported no history of sexual violence, 17 (19%) reported a history of childhood sexual abuse (CSA) only, 19 (21%) reported a history of adult sexual assault (ASA) only, and 10 (11%) reported a history of both CSA and ASA, with 4 participants choosing not to provide information on their sexual violence history. For women with a history of ASA but not CSA, there was a significant increase in vaginal IL-1ß following arousal, while for women with a history of CSA (with or without ASA), there was a significant decrease. Women without CSA histories had a significant increase in vaginal IgA following sexual arousal, while women with CSA histories had a decrease. CONCLUSION: Sexual arousal possibly plays a role in modifying vaginal immune responses in young, healthy women. Moreover, these effects may vary depending upon sexual assault histories, such that relative to women without assault histories, women with a history of early life sexual trauma showed significantly altered vaginal immune responses following sexual arousal. If replicated, these findings may help explain the increased risk for sexually transmitted infections observed among women with sexual assault histories.

Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples.

BACKGROUND: Inflammation has been linked to a variety of mental and physical health outcomes that disproportionately impact women, and which can impair sexual function; thus, there is reason to expect a link between inflammation and women's sexual functioning. AIM: To test the hypothesis that higher concentrations of C-reactive protein (CRP), a general biomarker of inflammation, would predict women's lower sexual desire. METHOD: As 2 independent research teams, we conducted 3 separate studies (total n = 405) that assessed salivary CRP and various measurements of sexual desire in different women populations. OUTCOMES: Female Sexual Function Index, Sexual Desire Inventory-2, Decreased Sexual Desire Screener, and Sexual Interest and Desire Inventory. RESULTS: Regardless of the way sexual desire was measured (e.g., state vs trait; general desire vs. desire functioning) and the population sampled (i.e., healthy vs. clinically diagnosed with sexual dysfunction), all the studies revealed null results. CLINICAL IMPLICATIONS: While exploratory, the convergence of these null results across studies and researchers suggests that if there is an association between inflammation and women's sexual desire, it is likely very subtle. STRENGTHS & LIMITATIONS: Across 2 independent research teams, 3 unrelated studies, and various measurements of sexual desire, results were consistent. These points lend to the generalizability of the results. However, study designs were cross-sectional. CONCLUSIONS: Future research may reveal (i) a non-linear threshold effect, such that inflammation does not begin to impact women's sexual desire until it is at a high level, (ii) inflammatory biomarkers other than CRP might be more sensitive in detecting associations between inflammation and desire, should they exist, or (iii) the mechanisms underlying sexual dysfunction may differ between sexes. Clephane K, et al. Lack of Evidence for a Relationship Between Salivary CRP and Women's Sexual Desire: An Investigation Across Clinical and Healthy Samples. J Sex Med 2022;19:745-760.

The Impact of Sexual Arousal and Emotion Regulation on Men's Sexual Aggression Proclivity.

Extant literature supports a relationship between sexual arousal and increased likelihood of sexually coercive behavior in men. The present study investigated the impact of sexual arousal on sexual coercion proclivity and the degree to which emotion regulation moderated this relationship in the context of two separate affect inductions. We predicted that sexual arousal would more strongly predict sexual coercion likelihood for men scoring lower on emotion regulation ability compared with men with above average emotion regulation abilities. Male participants with (n = 38) and without (n = 40) self-reported histories of sexual coercion were recruited from urban sexually transmitted infection testing clinics. Participants completed a measure of emotion regulation, underwent a positive and negative affect induction, viewed an erotic video, and reported on their level of sexual arousal immediately prior to completing a hypothetical sexual coercion likelihood laboratory task. Relationships between emotion regulation, sexual arousal, and sexual coercion likelihood were examined using moderation analyses. Sexual arousal was associated with greater reported sexual coercion likelihood. For men with poorer emotion regulation, sexual arousal significantly and positively predicted sexual coercion likelihood in the positive affect condition. Sexual arousal did not significantly predict sexual coercion for men with above average emotion regulation. Findings may have implications for the assessment of individual risk for coercive sexual behavior as well as primary prevention efforts.

Inflammation Predicts Sexual Arousability in Healthy Women.

Background: Though many women report sexual arousal difficulties, the mechanisms driving these difficulties are unclear. Sexual response relies on a host of psychophysiological processes that have bidirectional relationships with inflammation. Additionally, chronic inflammation may impair genital blood flow, which in turn may impact sexual arousal. C-reactive protein (CRP) is an acute-phase marker of inflammation produced in response to cytokine signaling throughout the body, which makes it a useful marker of systemic inflammation. Aim: The present study examined interactions between inflammation and women's sexual arousal. Methods: CRP, self-reported frequency of partnered sexual activity, and subjective and vaginal arousal were assessed in 91 healthy, pre-menopausal women. Data were collected during a single laboratory session. Main Outcome Measures: Subjective sexual arousal and vaginal pulse amplitude (a measure of vaginal arousal) were the main outcome measures. Results: Change in subjective sexual arousal in response to a sexual film was unaffected by baseline CRP and sexual frequency. However, there were significant interactions between inflammation and sexual frequency in predicting vaginal arousal during the sexual film. Among women reporting more frequent sexual activity, higher CRP predicted lower magnitude arousal response and longer time to maximum vaginal arousal. Among women reporting less frequent sex, higher CRP predicted shorter time to maximum arousal and greater magnitude of arousal response. Controlling for cortisol strengthened the effects seen for time to maximum vaginal arousal but weakened those observed for percent change. Conclusions: Among healthy young women, higher CRP may be associated with vaginal arousal, but not subjective sexual arousal. Specifically, our results suggest that higher baseline CRP is associated with lower genital sexual arousal for women who have sex frequently, which is consistent with clinical evidence that elevated inflammation can be detrimental to sexual function.

Affect and Sexual Responsivity in Men With and Without a History of Sexual Aggression.

Despite increased attention to understanding risk factors for sexual aggression, knowledge regarding the emotional and sexual arousal patterns of sexually aggressive men remains limited. The current study examined whether sexually aggressive men exhibit unique profiles of affective responsivity, in particular to negatively valenced stimuli, as well as sexual arousal patterns that differentiate them from nonaggressive men. We presented 78 young men (38 sexually aggressive; 40 nonaggressive) with a series of videos designed to induce positive, sad, or anxious affect. Affect and subjective sexual arousal were assessed following each film and erectile responses were measured continuously. Sexually aggressive men reported significantly higher levels of sexual arousal following both the positive and negative conditions as compared to nonaggressive men. Erectile responses of sexually aggressive men were significantly greater than nonaggressive men's following the positive affect induction. Self-reported positive affect, but not negative affect, was a significant predictor of subjective sexual arousal for both groups of men. Compared to nonaggressive men, sexually aggressive men showed significantly weaker correlations between subjective and physiological sexual arousal. Findings suggest that generalized heightened propensity for sexual arousal may be a risk factor for sexually aggressive behavior.