Analyzing Reddit Forums Specific to Abortion That Yield Diverse Dialogues Pertaining to Medical Information Seeking and Personal Worldviews: Data Mining and Natural Language Processing Comparative Study.

BACKGROUND: Attitudes toward abortion have historically been characterized via dichotomized labels, yet research suggests that these labels do not appropriately encapsulate beliefs on abortion. Rather, contexts, circumstances, and lived experiences often shape views on abortion into more nuanced and complex perspectives. Qualitative data have also been shown to underpin belief systems regarding abortion. Social media, as a form of qualitative data, could reveal how attitudes toward abortion are communicated publicly in web-based spaces. Furthermore, in some cases, social media can also be leveraged to seek health information. OBJECTIVE: This study applies natural language processing and social media mining to analyze Reddit (Reddit, Inc) forums specific to abortion, including r/Abortion (the largest subreddit about abortion) and r/AbortionDebate (a subreddit designed to discuss and debate worldviews on abortion). Our analytical pipeline intends to identify potential themes within the data and the affect from each post. METHODS: We applied a neural network-based topic modeling pipeline (BERTopic) to uncover themes in the r/Abortion (n=2151) and r/AbortionDebate (n=2815) subreddits. After deriving the optimal number of topics per subreddit using an iterative coherence score calculation, we performed a sentiment analysis using the Valence Aware Dictionary and Sentiment Reasoner to assess positive, neutral, and negative affect and an emotion analysis using the Text2Emotion lexicon to identify potential emotionality per post. Differences in affect and emotion by subreddit were compared. RESULTS: The iterative coherence score calculation revealed 10 topics for both r/Abortion (coherence=0.42) and r/AbortionDebate (coherence=0.35). Topics in the r/Abortion subreddit primarily centered on information sharing or offering a source of social support; in contrast, topics in the r/AbortionDebate subreddit centered on contextualizing shifting or evolving views on abortion across various ethical, moral, and legal domains. The average compound Valence Aware Dictionary and Sentiment Reasoner scores for the r/Abortion and r/AbortionDebate subreddits were 0.01 (SD 0.44) and -0.06 (SD 0.41), respectively. Emotionality scores were consistent across the r/Abortion and r/AbortionDebate subreddits; however, r/Abortion had a marginally higher average fear score of 0.36 (SD 0.39). CONCLUSIONS: Our findings suggest that people posting on abortion forums on Reddit are willing to share their beliefs, which manifested in diverse ways, such as sharing abortion stories including how their worldview changed, which critiques the value of dichotomized abortion identity labels, and information seeking. Notably, the style of discourse varied significantly by subreddit. r/Abortion was principally leveraged as an information and outreach source; r/AbortionDebate largely centered on debating across various legal, ethical, and moral abortion domains. Collectively, our findings suggest that abortion remains an opaque yet politically charged issue for people and that social media can be leveraged to understand views and circumstances surrounding abortion.

A Mixed-Methods Approach to Understanding the Disconnection between Perceptions of Abortion Acceptability and Support for Roe v. Wade among US Adults.

The relationship between people's attitudes about abortion acceptability and the Supreme Court decision in Roe v. Wade-two distinct but related issues-has not been rigorously explored. The authors used a mixed-methods approach for analyzing in-depth interviews to better understand how participants' feelings toward abortion acceptability are related to perceptions of whether abortion should be legal. The authors then assessed (1) correlations between abortion acceptability and different measures of support for Roe v. Wade, and (2) how the phrasing of survey items related to Roe v. Wade may evoke different responses via an online survey fielded in 2018. The study's qualitative results highlight that there is a disjuncture between people's moral feelings toward abortion and their attitudes toward abortion legality. The study's quantitative results further demonstrate that correlations between abortion acceptability and support for Roe v. Wade are moderate, and the differences in responses to the phrasing of survey items related to Roe v. Wade are moderated by knowledge. The authors recommend that when researchers develop survey items, they avoid ambiguities of abortion as a general construct, especially when public opinion measures on abortion are employed for research and the design of social and health policy and practice.

Effects of Typical and Binge Drinking on Sexual Consent Perceptions and Communication.

Young adults frequently engage in sexual activity after consuming alcohol and, consequently, may try to communicate sexual consent while intoxicated. We aimed to assess how people's drinking behaviors relate to their consent perceptions and communication with their current sexual partners. Using aggregated data from a 30-day daily diary study, young adults (n = 86, 77.9% women, 86% in a monogamous relationship) reported instances of partnered sexual activity and their perceptions of whether that activity was consensual. For each partnered sexual event, participants reported what they said or did to perceive the sexual activity as consensual. Responses were coded as active consent communication (i.e., using verbal or nonverbal cues) or tacit knowledge (i.e., using context to understand consent). During an exit survey, participants retrospectively reported how many days they drank (i.e., typical drinking) during the 30-day study and whether they binge drank. Typical and binge drinking were associated with identifying sexual experiences as consensual. Participants who binge drank relied less on active consent communication and more on context compared with those who did not binge drink. Young adults who binge drink may rely more on tacit knowledge because alcohol impedes their ability to process complex stimuli-such as active consent cues.

Momentary versus Retrospective Sexual Consent Perceptions.

Perceiving potential indicators of a person's willingness is an integral component of sexual consent. Preliminary qualitative evidence using vignettes suggested that consent perceptions can change over the course of a sexual scenario. In the present study, we extended previous research by directly comparing momentary and retrospective sexual consent perceptions using a quantitative study design. Employing a staggered vignette protocol, we examined participants' (n = 962; 72.0% female) momentary perceptions of fictional characters' sexual consent and compared them with participants' retrospective perceptions of the characters' consent. We hypothesized that participants would demonstrate a hindsight bias in that they would retrospectively indicate they thought the fictional characters were first willing to engage in sexual behavior earlier than when they did momentarily. We found that differences in participants' momentary versus retrospective perceptions of characters' sexual consent varied by the type of behavior. As we expected, participants demonstrated a hindsight bias for making out. Contrary to our hypothesis, participants were hesitant to retrospectively report that the characters were willing to engage in the other sexual behaviors (e.g., oral, vaginal, anal sex) at a point earlier than their momentary perceptions. That momentary and retrospective sexual consent perceptions significantly differ corroborates previous recommendations that sexual consent be conceptualized as an ongoing process.

Sexual Consent Perceptions of a Fictional Vignette: A Latent Growth Curve Model.

Sexual consent can be conceptualized as a process of accumulating cues that build toward and continue throughout a consensual sexual encounter. How people perceive the cues of others during this process is an important aspect of consent. However, previous research has not investigated the trajectories of people's consent perceptions throughout such a process. Using a novel staggered vignette protocol, we examined participants' (N = 1218; 64.4% female) perceptions of fictional targets' sexual consent at 11 time points. We tested latent growth curve models using multilevel structural equation modeling to examine trajectories in consent perceptions over the course of the vignette. We hypothesized that mean differences and rates of change would be associated with several constructs relevant to sexual consent. We found that initial consent perceptions and trends over the course of the vignette varied by whether the participant was a university student, by an alcohol manipulation in the vignette, by the fictional target's sex, and by type of sexual behavior. Researchers should examine whether our findings on consent perceptions of a fictional vignette extend to people's actual sexual encounters, including potential associations between the three primary aspects of sexual consent: perceptions, feelings, and communication.

Sexual Consent in Committed Relationships: A Dyadic Study.

Sexual consent is a multidimensional construct that requires the participation of all involved in a sexual encounter; however, previous research has almost exclusively relied on one person's perspective. To address this, we collected open- and closed-ended data on sexual consent from 37 dyads in committed sexual relationships (N = 74). We found that relationship length was associated with sexual consent and couples who accurately perceived each other's consent communication cues reported elevated levels of internal consent feelings. Communicating willingness to engage in sexual activity remains important even within committed relationships. Preliminary findings suggest that further investigations of dyadic nuances of sexual consent are warranted.

Internal and external sexual consent during events that involved alcohol, cannabis, or both.

Background Substance-involved sexual activity is common. Even though people recognise that substance-related impairment can be a barrier to people's ability to consent to sexual activity, most do not believe that substance use automatically negates sexual consent. We extended previous work on substance-related effects on internal and external consent by investigating sexual events that involved alcohol, cannabis, or both. METHODS: For 28 days, 113 participants (MAge = 29.2 years, 57.5% women, 70.8% White) responded to three surveys per day on their personal devices. At time points when participants reported having engaged in partnered sexual activity, they were asked to report their alcohol use, cannabis use, internal consent feelings, and external consent communication. RESULTS: Across 1189 partnered sexual events, 31.5% involved alcohol, cannabis, or both. Sexual events that involved combined use were associated with diminished feelings of safety/comfort and feelings that the sexual act was consensual, compared with events that involved neither substance. Greater levels of alcohol consumption were descriptively associated with lower ratings of internal sexual consent. CONCLUSIONS: We found that combined use of alcohol and cannabis may lead to lower internal sexual consent than using either substance alone - potentially due to greater levels of impairment associated with polysubstance use. Sexual health education programs should consider more nuanced approaches to teaching people how to navigate substance use and sexual consent.

Alcohol's Effects on Bystander Intervention Strategies to Prevent Sexual Assault.

Alcohol's effects on bystander responses to potential sexual assault situations are understudied. In this mixed-methods study, we examined quality of bystander responses in intoxicated versus sober people. Participants were 121 young adults (ages 21-29, 50% female) randomly assigned to consume alcoholic beverages or soda water. After drinking, participants listened to a sexual assault vignette and completed a semistructured interview assessing how they would respond if they had witnessed the situation. Nearly all participants reported they would directly intervene if faced with the situation. Intoxicated participants and men were significantly less likely to use high-quality bystander intervention strategies than were sober participants and women. Results suggest that alcohol intoxication may negatively impact the likelihood that bystander intervention efforts will be helpful.

Validation of the Sexual Experience Survey-Short Form Revised Using Lesbian, Bisexual, and Heterosexual Women's Narratives of Sexual Violence.

Lesbian and bisexual women have high rates of sexual violence compared to heterosexual women, yet prevalence rates vary widely across studies. The Sexual Experience Survey-Short Form Revised (SES-SFV) is the most commonly used method of measuring sexual assault and rape prevalence, but it has not been validated in this high-risk population of lesbian and bisexual women. The current study assessed a modified form of the SES-SFV utilizing a five-step, mixed-methods approach. Women (N = 1382) who identified as lesbian (31%), bisexual (32%), and heterosexual (31%) completed an online survey disseminated through Qualtrics Online Survey Company to a national audience. All types of non-consensual behaviors (non-penetrative, oral, vaginal, and anal) and nearly all perpetration tactics in the original SES-SFV emerged inductively in our qualitative data. Using quantitative data, lesbian and bisexual victims endorsed each perpetration tactic in the SES-SFV at comparable rates to heterosexual victims. SES-SFV's false-positive categorization was minimal. However, the original SES-SFV did not capture some common experiences that participants described in their open-ended narratives. The SES-SFV satisfactorily assesses sexual assault and rape experiences in lesbian, bisexual, and heterosexual women. Possible additions and deletions to the SES-SFV are presented alongside discussion of managing comprehensiveness and participant fatigue.

Show or Tell? Does Verbal and/or Nonverbal Sexual Communication Matter for Sexual Satisfaction?

Communication is linked to sexual satisfaction. This includes verbal and nonverbal communication. Much of the extant research focuses on verbal communication within a relationship as a predictor of sexual satisfaction, yet some people feel more comfortable communicating nonverbally, perhaps especially during sex. Regardless of the communication style (verbal or nonverbal), satisfaction with one's communication style with a partner also seems to be linked to sexual satisfaction. However, the relationship between (a) communication style (verbal and nonverbal) and (b) satisfaction with communication style regarding communication during sex with sexual satisfaction is not well established. Given this gap in the research, we explored (a) how one's own and one's partner's use of verbal and nonverbal communication during sex is associated with sexual satisfaction, and (b) how satisfaction with sexual communication is associated with sexual satisfaction among a convenience sample (N = 398; ages 18-55+). Sexual communication satisfaction mediated the association between self and partner communication during sex and sexual satisfaction. This study has implications for education and counseling-specifically we argue that couples may benefit more from finding consistency and satisfaction with their communication style than from focusing on trying to ascribe to a particular style.

Sexual Precedent's Effect on Sexual Consent Communication.

Sexual consent is one's voluntary, sober, and conscious willingness to engage in a particular sexual behavior with a particular person within a particular context. Sexual precedent theory posits that people believe that engaging in consensual sex at one point in time implies consent to later sexual encounters with that person. By assuming consent once a sexual precedent is set, people may rely less on communication cues. We sought to provide quantitative support for the claim that sexual precedent influences sexual consent in people's sexual relationships. To capture variability across sexual experiences, we collected daily sexual behavior data from each participant (n = 84) over a period of 30 days. We found a curvilinear relationship between sexual history with a partner and how people perceived consent during sexual activity with that partner (p = .003, ∆R2 = .089). A piecewise regression revealed that participants were less likely to report consent communication cues as sexual precedent increased until about 575 previous sexual behaviors (p = .003, R2 = .122); after this point, participants were more likely to report consent communication cues as sexual precedent increased (p = .028, R2 = .179). Overall, we provide the first quantitative evidence that consent conceptualization varies both within the person and across relationships regarding sexual precedent. In our discussion, we emphasize that sexual consent is contextual and cannot be assumed even after previous sexual encounters.

Students' Alcohol Use, Sexual Behaviors, and Contraceptive Use While Studying Abroad.

College study abroad students may represent a subgroup at risk for increased alcohol use and sexual activity while traveling. The present study explored student's alcohol use, sexual activity, and the interrelationship between the two while abroad. A sample of 372 students (Mage abroad = 20, SD = 3.3, 68% women) who had traveled abroad in the past 3 years were recruited from a large, southern university. Students completed an online survey of demographics, alcohol use, sexual behaviors, and contraceptive use. Students reported consuming an average of six drinks in one sitting, and 76% of women and men met criteria for 'hazardous drinking' while abroad. Students who met criteria for 'hazardous drinking' were more likely to engage in sexual activity; however, they also had a greater likelihood of wearing a condom. Our findings show students engage in problematic drinking and this is related to their engagement in sexual activity while abroad. Findings extend previous research and suggest study abroad programs should address norms around drinking and sexual activity prior to travel to ensure students' safety while abroad.

The Influence of Partner Status and Sexual Behavior on College Women's Consent Communication and Feelings.

The topic of sexual consent has permeated mainstream discourse as a mechanism used to decrease rates of sexual assault and increase sex-positive communication. Women's external consent behaviors are frequently examined; however, research exploring their internal consent and feelings associated with sexual activity is understudied. The purpose of this study was to understand how partner status and sexual behavior at most recent sexual activity influence women's external/internal consent and feelings during sexual activity. Three hundred and ninety women completed a survey on consent, partner status, and most recent sexual behavior. Internal and external consent differed by partner status for women who engaged in vaginal-penile sex, but not genital and oral sex. Feelings associated with the sexual act were different within each behavior group and partner status. Women with a serious dating partner reported stronger feelings related to sexual activity, higher internal consent feelings, and increased use of nonverbal external consent cues. Partner status appears to influence factors of interest for vaginal-penile sex, but not genital and oral sex. Findings from this study can inform prevention efforts to increase sex-positive communication around consent.

Beyond "Just Saying No": A Preliminary Evaluation of Strategies College Students Use to Refuse Sexual Activity.

Preventing sexual assault is a core goal for universities as prevalence rates of sexual assault remain high, particularly among college students. A key mechanism thought to decrease rates of sexual assault is teaching college students how to give clear, explicit, verbal refusals. However, there is a paucity of research regarding how college students refuse sex. Thus, the purpose of this study was to understand different behavioral strategies college students would use to refuse sex. A sample of 773 heterosexual college students (523 women, 250 men) were recruited from two large southern universities in the USA to complete a survey on sexual communication. Thirty-eight items assessing verbal and behavioral cues that college students would use to refuse vaginal-penile sex were written based on previous, formative research. Items were assessed by the research team through an exploratory factor analyses, followed by a confirmatory factor analysis (CFA). The results yielded a three-factor structure: direct nonverbal refusals, direct verbal refusals, and indirect nonverbal refusals; CFA results suggested a good fit index for the model. Two independent sample t tests were conducted to examine differences in refusal cues across gender and relationship status; significant differences in refusals emerged for both. The three-factor structure depicting refusal cues was similar to previous work depicting cues college students use to communicate sexual consent; such information could inform sexual assault prevention programming.

Are Women's Orgasms Hindered by Phallocentric Imperatives?

Women who have sex with women (WSW) are more likely to report experiencing an orgasm during partnered sex, compared to women who have sex with men (WSM). We investigated whether this difference can be partially accounted for by phallocentric imperatives-gendered sexual scripts that prioritize men's sexual experience. For example, these imperatives emphasize vaginal-penile intercourse (i.e., the coital imperative) and men's physical pleasure (i.e., the male orgasm imperative). We reasoned that a larger variety of sexual behaviors indicates less adherence to the coital imperative and that more self-oriented orgasm goals for women indicate less adherence to the male orgasm imperative. Consistent with previous work, we expected WSW to report higher rates of orgasm than WSM when taking frequency of sex into account. We also hypothesized that this difference in orgasm rates would dissipate when controlling for variety of sexual behavior and women's self-oriented orgasm goals. In a sample of 1988 WSM and 308 WSW, we found that WSW were 1.33 times (p < .001) more likely to report experiencing an orgasm than WSM, controlling for frequency of sex. This incidence rate ratio was reduced to 1.16 (p < .001) after taking into account variety of sexual behavior and self-oriented orgasm goals. Our findings indicate that certain sexual scripts (e.g., phallocentric imperatives) help explain the orgasm discrepancy between WSW and WSM. We discuss masturbation as another male-centered practice that may be relevant to this gap, as well as implications for intervention and future research.

Female sexual subjectivity and verbal consent to receiving oral sex.

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

Hormonal contraception and female pain, orgasm and sexual pleasure.

INTRODUCTION: Almost half of all pregnancies in the United States are unintentional, unplanned, or mistimed. Most unplanned pregnancies result from inconsistent, incorrect, or nonuse of a contraceptive method. Diminished sexual function and pleasure may be a barrier to using hormonal contraception. AIM: This study explores sexual function and behaviors of women in relation to the use of hormonal vs. nonhormonal methods of contraception. METHODS: Data were collected as part of an online health and sexuality study of women. MAIN OUTCOME MEASURES: Main outcomes variables assess frequencies in two domains: (i) sexual function (proportion of sexual events with experiences of pain or discomfort, arousal, contentment and satisfaction, pleasure and enjoyment, lubrication difficulty, and orgasm) and (ii) sexual behavior (number of times engaged in sexual activity, proportion of sexual events initiated by the woman, and proportion of sexual events for which a lubricant was used). Sociodemographic variables and contraceptive use were used as sample descriptors and correlates. The recall period was the past 4 weeks. RESULTS: The sample included 1,101 women with approximately half (n = 535) using a hormonal contraceptive method exclusively or a combination of a hormonal and nonhormonal method, and about half (n = 566) using a nonhormonal method of contraception exclusively. Hierarchical regression analyses were conducted to examine the relation of hormonal contraceptive use to each of the dependent variables. Women using a hormonal contraceptive method experienced less frequent sexual activity, arousal, pleasure, and orgasm and more difficulty with lubrication even when controlling for sociodemographic variables. CONCLUSIONS: This study adds to the literature on the potential negative sexual side effects experienced by many women using hormonal contraception. Prospective research with diverse women is needed to enhance the understanding of potential negative sexual side effects of hormonal contraceptives, their prevalence, and possible mechanisms. Clinical and counseling implications are discussed.

Consenting to sexual activity: the development and psychometric assessment of dual measures of consent.

Sexual assault prevention efforts have focused on educating students to obtain consent as a mechanism to reduce sexual assault, yet little is known about how college students consent to sex. Additionally, there are currently no measures available to assess students' consent to sex. The current study aimed to better understand college students consent by using a systematic approach to develop validated measures of sexual consent. This study integrated mixed methods via three phases and two waves of data collection to develop two measures of consent. In Phase 1, qualitative data were collected from college students (n = 185) to inform the design of quantitative measures aimed at assessing sexual consent at last sexual intercourse. In Phase 2, items were written for the closed-ended quantitative instrument and reviewed by a team of experts, educators, and clinicians. In Phase 3, a quantitative survey was administered to college students (n = 660) which included the measures of consent developed from the Phase 1 data; the measures were assessed for their psychometric properties. Exploratory factor analyses were utilized to assess the measures and resulted in five factors each for both consent scales. Both scales had high internal consistency reliability, showed gender differences, and showed differences across relationship status (single vs. in a relationship). The two newly developed measures assess unique constructs of consent and demonstrate assessments of specific concepts. Our findings provide an important contribution to the field of sexuality as these measures can be used in future research to better understand sexual consent.

How Do College Students Perceive Their Partner Responds to Them When They Refuse Sexual Activity?

Refusal communication is a dyadic process, with one person communicating a refusal and another person responding. To enhance our understanding of this process, we surveyed college students to assess their interpretation of their partners' responses when they declined vaginal-penile sexual activity. In an online survey, participants were prompted to describe their partners' reactions when participants refused their partner's vaginal-penile sex initiation. Through content analysis, three themes were present: (1) partner accepted the refusal, (2) partner experienced negative emotions, (3) partner ignored their refusals. Participants frequently reported their refusals were accepted. Sexual assault prevention initiatives should work to normalize refusal communication.