Marital Conflict and Healthy Dietary Habits Among Preschoolers: A Study of the Experience of Coupled Women in Urban Mexico.

In Mexico social dynamics are changing toward less traditional arrangements. With a qualitative interview study, we explore the link between marital conflict and mothers' ability to foster healthy dietary habits. Sample consisted of 21 middle-class cohabitating mothers of preschoolers. Results suggests that marital conflict leads women to experiences of tension, ambivalence, or inaction on fostering healthy eating habits. Parents' mismatch in gender beliefs, food preferences, time orientation, and risk aversion play a role in creating disagreements. When men participate, women feel "helped" and grateful, but the forms and extent of desired participation may vary among traditional, ambivalent and non-traditional women.

#ChokeMeDaddy: A Content Analysis of Memes Related to Choking/Strangulation During Sex.

Recent research indicates that some young people initially learn about sexual choking through Internet memes. Thus, a qualitative content analysis was performed on 316 visual and textual memes collected from various social media websites and online searches to assess salient categories related to choking during sex. We identified nine main categories: communication, gendered dynamics, choking as dangerous, choking as sexy, sexualization of the nonsexual, shame and worry, romance/rough sex juxtaposition, choking and religious references, instructional/informational. Given that memes, through their humor, can make difficult topics more palatable and minimize potential harm in the phenomenon they depict, more concerted, synergistic effort that integrates media literacy into sexuality education programming on the potential risks that may ensue for those engaging in sexual choking is warranted.

Mexican Parents' Beliefs About Drinking Plain Water in Front of Their Preschoolers.

Because children learn habits from observing their parents, we assessed the top-of-the-mind beliefs held by parents about "drinking plain water in front of their preschool child during lunch one day this coming weekend." We recruited a convenience sample of 34 Mexican parents from daycares in Guadalajara and conducted a content analysis. Main advantage identified was getting healthier, followed by being a good example for the child. Few parents identified disadvantages. Most reported to have at least one approver within their families. The most frequent facilitator was "having it," while "not having it" was the main barrier.

Meanings of Rough Sex across Gender, Sexual Identity, and Political Ideology: A Conditional Covariance Approach.

The purpose of this study was to investigate how various subgroups based on gender, sexual identity, and political ideology conceptualize rough sex. We used available data from a 2020 survey of randomly sampled undergraduate students at a large public university in the Midwestern U.S. (n = 4,989). The dichotomous responses to 13 items on the rough sex meaning scale were analyzed using a conditional covariance approach to better understand which behaviors commonly described as rough sex behaviors were prevalent. Our results showed that rough sex was conceptualized largely as a two-dimensional construct for vast majority of subgroups. Across all subgroups, nine of the 13 behaviors clustered along two dimensions in the same way. Specifically, four behaviors related to hair pulling, being pinned down, hard thrusting, and throwing someone onto a bed clustered together as one dimension (spanking and tearing clothes off being present along this dimension for vast majority of the subgroups). Being tied up, slapping, choking, punching, and making someone have sex behaviors formed a separate dimension of rough sex across all studied groups (with biting and scratching being associated with this dimension for vast majority of subgroups).

"If Their Face Starts Turning Purple, You Are Probably Doing Something Wrong": Young Men's Experiences with Choking During Sex.

Choking/strangulation during sex has become prevalent in the United States. Yet, no qualitative research has addressed men's choking experiences. Through interviews with 21 young adult men, we examined the language men use to refer to choking, how they first learned about it, their experiences with choking, and consent and safety practices. Men learned about choking during adolescence from pornography, partners, friends, and mainstream media. They engaged in choking to be kinky, adventurous, and to please partners. While many enjoyed or felt neutral about choking, others were reluctant to choke or be choked. Safety and verbal/non-verbal consent practices varied widely.

Non-Fatal Strangulation/Choking During Sex and Its Associations with Mental Health: Findings from an Undergraduate Probability Survey.

Choking/strangulation during sex is prevalent among young adults in the United States. We examined associations between having ever been choked and participants' current mental health symptoms (e.g., feeling depressed, anxious, sad, lonely) in the prior 30 days and in the prior year. Participants were 4352 randomly sampled undergraduates who completed a confidential online survey and reported lifetime partnered sexual activity. 33.6% of women and 6.0% of men reported having been choked more than five times. After adjusting for demographic characteristics, having been choked remained significantly associated with all four mental health outcomes, except for overwhelming anxiety among men.

"It Was Scary, But Then It Was Kind of Exciting": Young Women's Experiences with Choking During Sex.

Choking/strangulation during sex is prevalent among young adults, with one study finding that 58% of women college students had ever been choked during sex. However, no qualitative study has examined women's experiences with choking/strangulation during sex outside of intimate partner violence. The purpose of our qualitative interview study was to investigate women's experiences with choking and/or being choked during partnered sex. Through in-depth interviews with 24 undergraduate and graduate women students ages 18 to 33, we sought to understand how women communicate about choking, their learning about and initiation into choking, their feelings about being choked and choking others, as well as consent and safety practices used in relation to choking. We found that women had first learned about choking through diverse sources including pornography, erotic stories, magazines, social media, friends, and partners. While all 24 women had been choked during sex, only 13 of 24 had ever choked a partner. They described having engaged in choking with men as well as women and with committed as well as more casual partner types. Participants described consensual and non-consensual choking experiences. While many women enjoyed choking, others did it largely to please their sexual partner. Women described different methods and intensities of having been choked. Although very few had ever sought out information on safety practices or risk reduction, and only some had established safe words or safe gestures with partners, participants consistently expressed a belief that the ways in which they and their partner(s) engaged in choking were safe.

Sex and Relationships Pre- and Early- COVID-19 Pandemic: Findings from a Probability Sample of U.S. Undergraduate Students.

In the wake of the COVID-19 pandemic, most U.S. colleges closed their campuses-including residence halls-causing significant disruption to students' lives. Two waves of data were collected from undergraduate students enrolled at a large U.S. Midwestern university: Wave 1 was a confidential online survey of 4989 randomly sampled undergraduate students collected in January/February 2020; Wave 2 was collected in April/May 2020 following campus closure. Our research aimed to: (1) assess how the COVID-19 related campus closure affected college students' romantic/sexual relationships, (2) examine students' past month sexual behaviors prior to the pandemic in comparison with their sexual behaviors during campus closure, and (3) compare participants' pre-pandemic event-level sexual behaviors with those occurring during campus closure. Of 2137 participants who completed both waves (49.8% women, mean age = 20.9), 2.6% were living at home in Wave 1 compared to 71.0% at Wave 2. Of those in relationships, 14.5% experienced a breakup and 25.3% stayed in their relationship but returned home to different cities. There were no statistically significant differences in participants' prior month reports of solo masturbation or sending/receiving nude/sexy images between Waves 1 and 2; however, participation in oral, vaginal, and anal sex significantly decreased across waves. Examining participants' most recent sexual events, Wave 2 sex more often occurred with a cohabiting or relationship partner and was rated as more wanted, emotionally intimate, and orgasmic. Implications for sexual health professionals are discussed.

Beyond the Boundaries: Exploring the Identity-Related Experiences of Biracial/Multiracial and Bisexual Adults.

Most prior bisexual research takes a monolithic approach to racial identity, and existing racial/ethnic minority research often overlooks bisexuality. Consequently, previous studies have rarely examined the experiences and unique health needs of biracial/multiracial and bisexual individuals. This exploratory qualitative study investigated the identity-related experiences of biracial/multiracial and bisexual adults within the context of health and well-being. Data were collected through 90-min semi-structured telephone interviews. Participants were recruited through online social network sites and included 24 adults between ages 18 and 59 years. We aimed to explore how identity-related experiences shape biracial/multiracial and bisexual individuals' identity development processes; how biracial/multiracial and bisexual individuals negotiate their identities; how the blending of multiple identities may contribute to perceptions of inclusion, exclusion, and social connectedness; and how biracial/multiracial and bisexual individuals may attribute positive and negative experiences to their identities. Interview transcripts were analyzed using an inductive thematic approach. Analysis highlighted four major themes: passing and invisible identities, not measuring up and erasing complexity, cultural binegativity/queerphobia and intersectional oppressions, and navigating beyond boundaries. Our findings imply promoting affirmative visibility and developing intentional support networks may help biracial/multiracial and bisexual individuals cultivate resiliency and navigate sources of identity stress. We encourage future research to explore mental health and chronic stress among this community.

Frequency, Method, Intensity, and Health Sequelae of Sexual Choking Among U.S. Undergraduate and Graduate Students.

Although sexual choking is now prevalent, little is known about how people engage in choking in terms of frequency, intensity, method, or potential health sequelae. In a campus-representative survey of undergraduate and graduate students, we aimed to: (1) describe the prevalence of ever having choked/been choked as part of sex; (2) examine the characteristics of choking one's sexual partners (e.g., age at first experience, number of partners, frequency, intensity, method); (3) examine the characteristics of having been choked during sex; and (4) assess immediate responses of having been choked including the extent to which frequency and method (e.g., hand, ligature, limb) of having been choked predicts the range of responses endorsed by participants. A total of 4254 randomly sampled students (2668 undergraduate, 1576 graduate) completed a confidential online survey during Spring 2021. The mean age of first choking/being choked was about 19, with more undergraduates than graduate students reporting first choking/being choked in adolescence. Women and transgender/gender non-binary participants were significantly more likely to have been choked than men. Participants more often reported the use of hands compared to limbs or ligature. Common responses to being choked were pleasurable sensations/euphoria (81.7%), a head rush (43.8%), feeling like they could not breathe (43.0%), difficulty swallowing (38.9%), unable to speak (37.6%), and watery eyes (37.2%). About 15% had noticed neck bruising and 3% had lost consciousness from being choked. Greater frequency and intensity of being choked was associated with reports of more physical responses as was use of limb (arm, leg) or ligature.

Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey.

BACKGROUND: Probability-based surveys of college students typically assess sexual behaviors such as oral, vaginal, and anal sex. Little is known about the broader range of sexual behaviors in which students engage. AIMS: In a random sample survey of undergraduate students, we aimed to: (1) describe how recently participants had engaged in solo and partnered sexual behaviors, (2) examine how frequently participants enacted certain rough sex sexual behaviors (e.g., light spanking, hard spanking, choking, slapping, and others), (3) assess participants' frequency of experiencing certain rough sex behaviors, (4) describe participants' frequency of threesome/group sex, (5) assess the characteristics of participants' experiences with choking during sex; and (6) examine choking and face slapping in regard to consent. METHODS: A confidential, online cross-sectional survey of 4,989 randomly sampled undergraduate students at a large U.S. university. OUTCOMES: Participants reported having engaged in a broad range of solo and partnered sexual activities, including rough sex behaviors. RESULTS: The most prevalent general sexual behaviors were solo masturbation (88.6%), oral sex (79.4% received, 78.4% performed), penile-vaginal intercourse (73.5%), and partnered masturbation (71.1%). Anal intercourse was the least prevalent of these behaviors (16.8% received, 25.3% performed). Among those with any partnered sexual experience, 43.0% had choked a partner, 47.3% had been choked, 59.1% had been lightly spanked and 12.1% had been slapped on the face during sex. CLINICAL TRANSLATION: College health clinicians and educators need to be aware of the diverse and evolving range of solo and partnered sexual behaviors reported by students. In addition to counseling students about pregnancy and sexually transmitted infection risk, clinicians might assess patients' engagement in diverse sexual behaviors, such as choking/strangulation during sex, given the risk for serious outcomes including death. STRENGTHS AND LIMITATIONS: Strengths of our research include the large sample size, use of random sampling, high response rate for college populations, broad range of behaviors assessed, and novel data on choking during sex. Among our limitations, we did not assess to what extent the experiences were wanted, pleasurable, or appealing to participants. Except for in relation to choking and slapping, we also did not assess issues of consent. CONCLUSION: Participants reported engaging in diverse sexual behaviors, some of which have important clinical implications, are understudied, and warrant further research. Herbenick D, Patterson C, Beckmeyer J, et al. Diverse Sexual Behaviors in Undergraduate Students: Findings From a Campus Probability Survey. J Sex Med 2021;18:1024-1041.

What Is Rough Sex, Who Does It, and Who Likes It? Findings from a Probability Sample of U.S. Undergraduate Students.

Using data from an undergraduate probability sample, we aimed to: (1) describe the prevalence and demographic characteristics of students who reported having engaged in rough sex with their current partner; (2) assess which sexual behaviors students consider to be rough sex; (3) describe the frequency with which participants report engaging in rough sex as well as their reports of initiating and liking rough sex, in relation to gender and sexual identity; and (4) examine predictors of rough sex frequency. Participants were 4998 students randomly sampled from a large Midwestern university who completed a confidential Internet-based survey (2453 women, 2445 men, 41 gender non-binary, 36 transgender or other gender non-conforming identities). Within these, 1795 individuals who reported a romantic/sexual partner of at least 3 months responded to questions about engaging, liking, and initiating rough sex. The most common behaviors participants considered to be rough sex were choking, hair pulling, and spanking. Transgender and gender non-binary students more often endorsed behaviors as rough sex. Also, rough sex was conceptualized as multidimensional, with one cluster being more consistent with earlier conceptualizations of rough sex (e.g., hair pulling, spanking) and the second cluster including behaviors such as choking, slapping, punching, and making someone have sex. About 80% of those with a current sexual or romantic partner engaged in rough sex with them and most who engaged it liked it. Bisexual women reported greater rough sex frequency and enjoyment (54.1% indicated enjoying it "very much"). Implications for sexuality research and education are discussed.

Managing Precarity: Understanding Latinas' Sexual and Reproductive Care-Seeking in a Midwest Emergent Latino Community.

In this qualitative interview study, we took a two-pronged approach to understand the complexities of sexual and reproductive health (SRH) care access for Latinas in an emerging Latino community (ELC). Phase 1 assessed the SRH resources available for uninsured Latinas through provider interviews. In Phase 2, we interviewed 15 Latina-identified women about their considerations for SRH care-seeking. The scant options for SRH care are focused largely on contraception and pregnancy. Providers viewed themselves as prevention-oriented and perceived Latinas did not prioritize preventive care. Women described compounding challenges and precarious conditions. Annual checkups, accessing contraception, and treating vaginal infections were identified as needs. Barriers to SRH care were enhanced in an ELC. Participants described too much paperwork and limited time as organizational barriers which aggravated others, such as language limitations and feeling embarrassed to ask questions. Further research on SRH care using a reproductive justice approach is needed in ELCs.

Inequitable Experiences Between Black and White Women Discussing Sexual Health With Healthcare Providers: Findings From a U.S. Probability Sample.

BACKGROUND: In the United States, efforts to achieve health equity and reduce sexual health disparities remain a national priority; however, limited research has focused on understanding racial differences in patient/provider discussions about sexual health. AIM: To quantify racial differences between black and white women (aged 18-49 years) in the United States discussing sexual health with a healthcare provider in the past year. METHODS: Data were analyzed from a subset of 1,654 women aged 18-49 years who participated in the 2018 National Survey of Sexual Health and Behavior. Measures of interest included visiting a healthcare provider and discussing sexual health with the provider in the past year. Log binomial models were developed to estimate risk ratios for the likelihood of sexual health topics encountered by black women; models were adjusted for age, marital status, education level, and annual income. MAIN OUTCOME: Black women were significantly more likely to report having a healthcare visit in the past year compared to white women and were more likely to have discussed their sexual health activities. RESULTS: The adjusted risk ratio (ARR) for black women who reported discussing sex or sexual health with a healthcare provider was 1.16 (95% CI: 1.06-1.26). The ARR for black women who were asked if they were sexually active was 1.16 (95% CI: 1.06-1.26) and about their condom use was 1.49 (95% CI: 1.27-1.74). Black women were nearly 2 times more likely to be offered sexually transmitted disease testing (ARR: 1.72, 95% CI: 1.46-2.02) and to report that they were provided condoms for future use (ARR: 1.94, 95% CI: 1.12-3.36). CLINICAL TRANSLATION: Healthcare providers are encouraged to have routine sexual health discussions with all patients; however, we found that there are differences among black and white women in discussing their sexual health activities. STRENGTHS & LIMITATIONS: The present study utilized a nationally representative probability survey, including an oversample of black women. The study focused on sexual health discussions of black and white women with a healthcare provider, and therefore, women who did not have a healthcare visit in the past year were excluded from the analysis. CONCLUSION: Black women reported having conversations about their sexual activities (eg, condom use) and were offered sexually transmitted disease testing more often than white women. These data provide insights that will impact patient/provider communication and aid in improving the delivery of sexual healthcare for all women. Townes A, Rosenberg M, Guerra-Reyes L, et al. Inequitable Experiences Between Black and White Women Discussing Sexual Health With Healthcare Providers: Findings From a U.S. Probability Sample. J Sex Med 2020;17:1520-1528.

'Somebody that looks like me' matters: a qualitative study of black women's preferences for receiving sexual health services in the USA.

Research dedicated to understanding the sexual experiences of Black women has historically been framed around adverse outcomes. There are limited data that can be used to understand the lived experiences of Black women related to sexual health care. Twenty-five Black women aged 18- 35 from across nine US states were interviewed to gain insight into their experiences and preferences for receiving sexual health services. Three themes were developed from their accounts: individual and structural barriers affect access to and perceived quality of care; service provider race and gender impact sexual health care experiences; and personalised care improves engagement. Findings suggest the need for culturally informed training for sexual health practitioners working with Black women.

Performing purity: reproductive decision-making and implications for a community under threat of zika in iquitos, Peru.

The long-term management and prevention of Zika virus requires understanding of reproductive and sexual health behaviours, including mechanisms of partnered decision-making. In this article, we report on a qualitative study conducted before the arrival of Zika in Iquitos, Peru. We assessed existing patterns of reproductive decision-making among partnered men and women in a community under threat of Zika and discuss how these may impact Zika prevention in the long-term. We used a rapid qualitative assessment methodology, including in-depth semi-structured interviews with partnered women (28) and men (21). Deeply unequal gender role expectations limit discussion of reproductive decisions until after a first child is born. Women needed to perform a domestic 'of-the-house' role to be considered suitable partners, leading them to hide their knowledge of sexual and reproductive health. Condoms symbolise risk and are unused with partners in committed relationships. A shared perception that men must take care of female partner's sexual health, translates into male sexual and reproductive preferences overcoming female desires. Existing decision-making patterns lead to an increased risk of Zika exposure. Long-term response should expand Zika virus information and preventive messages to men and young people, in addition to engaging with broader societal challenges to gender inequity.

Social support relationships for sexual minority women in Mumbai, India: a photo elicitation interview study.

Little research exists on women who do not identify as heterosexual in India. Social support for sexual minority women may protect against the effects of discrimination. An examination of significant social relationships may point to both strengths and weaknesses in this support. We aimed to understand relationship prioritisation and communication patterns associated with the social support of sexual minority women in Mumbai. In partnership with the Humsafar Trust, India's oldest and largest sexual and gender minority-advocacy organisation, we conducted photo-elicitation interviews with 18 sexual minority women, using participants' photographs to prompt dialogue about their social support. Intimate partners were a source of dependable support and many of those without relationships were seeking them. Participants' extended networks included friends and family as well as less formal relationships of social support. Participants mediated their communication with particular social network members, which involved filtering information sexual identity, romantic interests, and personal aspirations, among others. The diverse relationships that sexual minority women have in their social support networks may be used to guide programmes to improve health outcomes.

Knowledge of Zika and perception of risk among sexually-active adults in the United States of America: results from a nationally representative sample.

OBJECTIVE: To examine knowledge of Zika transmission and risk perception and to assess variability by condom use in a probability sample of sexually-active adults in the United States. METHODS: Data for this study came from the 2016 wave of the National Survey of Sexual Health and Behavior, a nationally representative probability sample of adults in the United States. Data were collected in November 2016 via a cross-sectional Internet-based survey administered to members of a Knowledge Panel, an address-based random sample service managed by GfK. A weighted subsample (n = 1 713) of sexually active adults, 18 - 50 years of age, was included in analyses. RESULTS: More than 90% of men and women reported low or no perceived risk of Zika. Most participants identified mosquito bite as a route of transmission, while significantly fewer identified sexual intercourse (≈ 40%) and vertical (29% men, 41% women) transmission routes. CONCLUSION: Sexually-active adults in the United States, especially young men, lack awareness of sexual and vertical transmission of Zika Virus. Given the likely endemic nature of Zika, this low-risk perception is an important prevention challenge. Zika prevention messaging should address lesser known transmission routes, emphasize male education, and promote correct and consistent condom use.

Sexual Behaviors, Experiences of Sexual Violence, and Substance Use among Women Who inject Drugs: Accessing Health and Prevention Services in Puerto Rico.

OBJECTIVE: People who inject drugs (PWID) face numerous gender-specific health risks, which increase their susceptibility to adverse outcomes, including violence. There is a need for research on female PWID to capture their unique experiences and understand behavioral and gender-based differences. This study aimed to understand which drug use and sexual behaviors are the most prevalent among female PWID accessing health services in Puerto Rico and to gather preliminary information on those individuals' experiences of sexual violence. METHODS: Utilizing a transformative theoretical perspective, a mixed-methods study was conducted with a sample of 90 Puerto Rican women who reported recent (past 12 months) injection drug use (IDU) This manuscript focused on Phase 1, in which participants completed an interviewer-administered survey eliciting information about sexual behaviors, drug use, experiences of sexual violence, and access to healthcare services. Phase 2 involved an in-depth interview focused on sexual health and access to healthcare services. RESULTS: Female PWID were found to engage in a variety of sexual behaviors throughout their lifespans and at their most recent sexual events. There were significant differences across age groups for participants, those being time of most recent sexual event (p = 0.007), partner's sex (p = 0.039), relationship with partner (p = 0.023), contraception method used (p = 0.057), and reports of partner orgasm (p = 0.055). Over half of all participants reported having experienced sexual violence in their lifetime. CONCLUSION: This study extends the literature on PWID in Puerto Rico by underscoring the diversity of female PWID sexual experiences and needs while illustrating how those experiences are often mediated by drug use. The findings highlight the need for further research on female PWID in Puerto Rico to better develop programs that include sexual violence prevention as part of future interventions for this population.

Postpartum Health Information Seeking Using Mobile Phones: Experiences of Low-Income Mothers.

Objectives To assess low-income mothers' perceptions of their postpartum information needs; describe their information seeking behavior; explore their use of mobile technology to address those needs; and to contribute to the sparse literature on postpartum health and wellness. Methods Exploratory community-based qualitative approach. Interviewees were recruited among clients of community partners and had children aged 48 months and under. A survey assessing demographics was used to identify low-income mothers. 10 low-income mothers were recruited from survey participants to complete in-depth interviews regarding postpartum information needs, information seeking, and technology use. Interviews were transcribed verbatim and coded by three researchers independently. Narratives were analyzed along predetermined (etic) and emergent (emic) categories. Results Establishing breastfeeding and solving breastfeeding problems were central postpartum concerns leading to information seeking. Interviewees reported almost exclusive use of mobile phones to access the Internet. Mobile applications were widely used during pregnancy, but were not valuable postpartum. Face-to-face information from medical professionals was found to be repetitive. Online information seeking was mediated by default mobile phone search engines, and occurred over short, fragmented time periods. College graduates reported searching for authoritative knowledge sources; non-graduates preferred forums. Conclusions for Practice Low-income postpartum women rely on their smartphones to find online infant care and self-care health information. Websites replace pregnancy-related mobile applications and complement face-to-face information. Changes in searching behavior and multitasking mean information must be easily accessible and readily understood. Knowledge of page-rank systems and use of current and emergent social media will allow health-related organizations to better engage with low-income mothers online and promote evidence-based information.