Gender Differences in the Characterization of Child Sexual Abuse.

Research on child sexual abuse (CSA) has increased in recent decades. However, the study of gender differences in this field is still scarce. The aim of this study was to analyze the differences in the characterization of CSA between Spanish adult men and women. The Juvenile Victimization Questionnaire was administered to 162 cisgender victims of CSA aged 18-63. Most of the abuses involved physical contact and were committed by a known person. Twenty percent of the victims indicated that they had developed a mental health problem that they believed was due to the CSA experience. Women suffered more CSA with physical contact and penetration, more types of abuse and more abuse by men, and were abused more frequently by a family member. Compared to women, men suffered more sexual abuse by women. Exploring gender differences in CSA could help to improve preventive strategies and interventions aimed at reducing the occurrence of this type of abuse and sequelae resulting from it.

Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020.

Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.

RESUMEN: La autoeficacia parece ser uno de los recursos más importantes para las diferentes etapas que subyacen al uso del preservativo y la prevención de las ITS. Por ello, este estudio evalúa la tendencia de la autoeficacia por género, desde 2004 a 2008, 2013 y 2020 en España. A lo largo de estos años, 6.698 personas con edades comprendidas entre los 17 y los 40 años participaron cumplimentando la Escala Breve de autoeficacia en el uso del preservativo. Según nuestros hallazgos, a pesar de la ligera mejoría en los últimos años, la autoeficacia aún mantiene un perfil de riesgo para el sexo seguro, especialmente entre los más jóvenes. Además, la tradicional diferencia de género continúa a lo largo de los años: las mujeres informan puntuaciones más bajas en la compra de condones y los hombres en ponérselo. Sin embargo, estas diferencias no son relevantes en otras dimensiones como el uso del preservativo a pesar del consumo de drogas donde las mujeres muestran peores resultados a lo largo de los años. Por tanto, nuestros hallazgos reafirman la necesidad de intensificar los esfuerzos preventivos de género dirigidos a los españoles y, en particular, a los más jóvenes.

Poverty, social exclusion, and mental health: the role of the family context in children aged 7-11 years INMA mother-and-child cohort study.

Mental health problems are common in childhood and tend to be more frequent in populations at risk of poverty or social exclusion (AROPE). The family environment can play a role in reducing the impact of economic hardship on these problems. The aim of this study was to assess the effect of multidimensional poverty on the mental health of children aged 7-11 years and the role of the family environment in two areas of Spain. Participants were 395 and 382 children aged 7 and 11 from Gipuzkoa and Valencia, respectively. Internalizing and externalizing problem scales of the child behaviour checklist (CBCL) were used. AROPE indicators were obtained by questionnaire, and three dimensions of the family context (Organization of the Physical Environment and Social Context, Parental Stress and Conflict, and Parental Profile Fostering Development) were measured through subscales 3, 4 and 5 of the Haezi-Etxadi family assessment scale (7-11) (HEFAS 7-11), respectively. Data were analysed using negative binomial regression and Structural Equation Modelling. AROPE prevalence was 7.1 and 34.5% in Gipuzkoa and Valencia, respectively. In both cohorts, there was a significant increase in internalizing and externalizing problems among participants with a higher AROPE score. However, AROPE did not affect internalizing problems in children from families living in a better physical environment and with social support (Subscale 3). The AROPE effect was jointly mediated by subscales 4 and 5 in 42 and 62% of internalizing and externalizing problems, respectively. Preventing economic inequities by economic compensation policies, improving the neighbourhood and immediate environment around the school, and promoting positive parenting programmes can improve mental health in childhood.

Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?

The COVID-19 pandemic may have exacerbated the sexual health differences that already existed among women based on their sexual orientation. Therefore, a total of 971 Spanish women aged 18-60 years (84 % heterosexual and 16 % with a minority sexual orientation) answered an ad hoc online questionnaire about sexual behavior during April 2020. Compared to heterosexual women, sexual minority women showed a greater increase in sexual frequency, masturbated more, had more sex with a housemate, and engaged in more online sexual activities during lockdown. The emotional impact of the pandemic, having privacy, and age showed a relationship with the quality of sexual life, but not sexual orientation. Based on these results, women's sexual lives are not as closely related to their sexual orientation as they are to other variables. Therefore, it seems more necessary to address issues affecting women in general during lockdown than to focus on their specific sexual orientation.

A Trend Analysis of Condom use in Spanish Young People over the Two Past Decades, 1999-2020.

HIV exposure is one of the greatest sexual risks in young people, and condom use is the best protective measure. Despite the preventive efforts, trend in condom use is still unclear. This study examines the trend of condom use by gender in Spanish young people, in different sexual practices (vaginal, oral and anal), relationships (regular and casual) and having sex after drugs consumption during the two past decades (from 1999 to 2020). For this, 14,472 people who ranged from 17 to 40 years old (63.5% women) filled the AIDS Prevention Questionnaire in each year. In general, low condom use remains stable and even gets worse regardless of the type of sexual practice, relationship and the substance consumption. Regarding gender, this trend is worse in women who have been less likely to report condom use than men have. Moreover, older people have reported a minor frequency of condom use than the youngest people have done, except for anal sex. Therefore, it is necessary to analyze why, despite preventive efforts, condom use seems to decrease over time.

RESUMEN: El VIH es uno de los mayores riesgos en la sexualidad de la juventud, y el uso del preservativo la mejor medida de protección. A pesar de los esfuerzos preventivos, la tendencia en su uso es indeterminada. Este estudio examina la evolución del uso del preservativo según género en jóvenes españoles, en diferentes prácticas sexuales (vaginal, oral y anal), relaciones (estable y esporádica) y al practicar sexo tras consumir drogas, durante las dos últimas décadas (de 1999 a 2020). Para ello, 14.472 personas entre 17 y 40 años (63,5% mujeres) cumplimentaron el Cuestionario de Prevención del Sida cada año. En general, el bajo uso del preservativo se mantiene estable e incluso empeora con independencia del tipo de práctica sexual, relación y consumo de sustancias. Según el género, las mujeres muestran peor tendencia, al informar menor uso que los hombres. Además, las personas más mayores informan menor frecuencia de uso que los más jóvenes, excepto para el sexo anal. Por tanto, es necesario analizar por qué, a pesar de los esfuerzos preventivos, el uso del preservativo parece disminuir con el tiempo.

Development and Validation of a Scale for Assessing the Interference of Chronic Primary Pain Conditions in Sexual Functioning: The Sex-Pain Questionnaire.

Chronic pain represents one of the main health public problems worldwide and significantly affects the sexual life of patients. However, no specific instruments of evaluation have been found that address this population. This study presents the SEX-PAIN Questionnaire, developed for identifying chronic pain's interference with sexual functioning among people with chronic pain. Methods. The validation has been carried out with a sample of 303 Spanish non-hospitalized patients with chronic pain diagnosis aged between 20 and 71 years old (Mage = 49.49; SD = 10.7). Exploratory Factor Analysis (EFA) yielded 2-factor structure: Sexual and Relationship Dissatisfaction, and Chronic Pain Impact on Sexual Life. This structure was later verified through Confirmatory Factor Analysis (CFA). Internal consistency (Omega) of each factor was .72 and .96, respectively. This study presents the psychometric properties of a new measure addressed to patients with chronic pain. This 17-items self-administered instrument can be a useful measure of the chronic pain's interference with sexual functioning among chronic pain patients. It represents the first original questionnaire known in Spanish language to date. This measure could potentially help researchers and clinicians to obtain key information to design appropriate healthcare interventions.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2039336 .

Influence of beliefs about romantic love on the justification of abusive behaviors among early adolescents.

INTRODUCTION: Romantic experiences during adolescence have an important influence on functioning later in life. Romantic love has been associated with the acceptance of abusive behaviors. This study examined the relationship between myths of romantic love and the perceived severity of different types of abusive behaviors, as well as the influence of gender. METHODS: The sample comprised 448 Spanish adolescents (M = 12.92 years old; SD = 0.85), of which 50.3% were male and 49.7% were female. Participants were evaluated in the school setting. The Perception of Abuse Scale and the Myths, Fallacies, and Misconceptions about Romantic Love Scale were administered. RESULTS: Statistically significant negative associations between the myths of romantic love and the perceived severity of abusive behaviors were found. Myths regarding possession, dedication, and exclusivity were associated with a lower perceived severity of abusive behaviors in adolescent males. Myths regarding the omnipotence of love were associated with a lower perceived severity of abusive behaviors in adolescent females. Believing in jealousy as a demonstration of love (myth of jealousy) and in the need to establish a steady union when you love someone (marriage myth) explained a lower perceived severity of abusive behaviors in regression models. However, being female and having these beliefs explained a higher perceived severity of abusive behaviors. CONCLUSIONS: The myths of romantic love are already present during early adolescence. These beliefs are implicated in the construction of gender inequality and difficulties in the identification of dating abuse behavior severity. A gendered perspective is necessary to understand this issue. Early intervention strategies should address the cognitive and emotional components of intimate relationships.

The Role of Dispositional and Social Factors in Argentinian and Spanish Women's Sexuality.

This study examines the role of sociocultural and dispositional factors in the sexual expressions of young Argentinian and Spanish women. Three hundred young women self-evaluated their sexual practices, sexual orientation, and relationships. Results reveal differences in women's sexuality based on societal and dispositional variables. The latter seem to play a more important role in those sexual behaviors that are normative in Hispanic traditions, whereas gender dissimilarity is more relevant when these behaviors are socially censured. Therefore, women's sexuality in Hispanic traditions, such as in Argentina and Spain, seems to be more complex than past studies reported.

Structural Equation Modeling Test of an Integrated Model of Spanish Youth's Condom Use.

Heterosexual transmission represents 26 % of newly diagnosed infection in Spanish youth. Behavioral change models have emphasized the influence of multiple variables to predict condom use behavior. The aim of this study is to examine how those variables are organized and which theory explains the condom use behavior better. A sample of 424 young heterosexuals (M age  = 20.62; SD = 2.16) filled out a battery of self-report questionnaires for assessing AIDS-related variables, personality traits and clinical variables (general, sexuality-related and health-related). A structural model was specified that included perceived pleasure and condom use self-efficacy as predictive variables. Depression and sexual compulsivity indirectly influence behavior. The final model accounted for 65.9 % of the variance in behavior. These results highlight the importance of cognitive and emotional variables as predictors of behavior (ex. expectations of pleasure and self-efficacy beliefs). This is important information for designing effective psychological interventions.

Effectiveness of a Brief Multi-Component Intervention to HIV Prevention Among Spanish Youth.

The greater rate of HIV infection occurs before age 30 in Spain. Our aim was to evaluate the long-term impact of a brief HIV preventive intervention on key sexual risk behavior components in Spanish young population. Participants were 467 young people aged 18-25 years who participated in B-PAPY intervention. They were evaluated at four times: a week, a month, three months and one year after intervention. A self-administered instrument was used. It was found a significant increase from pre-test to follow-ups in HIV knowledge, HIV susceptibility perception, confidence in condom and use of condoms. There were decreases statistically significant in the perceived severity of AIDS. The HIV intervention showed effectiveness over time in the main risk variables for HIV infection. Brief multi-component HIV interventions would be a useful resource to generalize HIV prevention.

HIV Testing Among Spanish Youth: Analysis of the Mediating Role of the Big Five Personality and Other Psychological Factors.

Early diagnosis of HIV improves the effectiveness of treatments and stops the progression of the disease. The influence of personality and other psychological variables in testing for HIV is analyzed. The first part of the study is composed of 4,929 young people (M age = 20.45, SD = 2.16). For the second part, young heterosexuals who participated in a broader project on HIV prevention were selected (n = 240, M age = 20.78, SD = 2.29). Only 23.3 % of the total sample have ever been tested for HIV antibodies. The main reason for not testing was fear of positive result (25.4 %). Statistically significant differences in Agreeableness (p = .027), Trust (p = .022) and Straightforwardness (p = .024) were found between HIV-tested and not HIV-tested youth. Trust explained 3.3 % of variance of HIV-test. Knowing barriers to testing and individual differences could be useful in developing preventive campaigns.

Differences in the Sexual Life of Spanish Men During the COVID-19 Lockdown by Sexual Orientation.

BACKGROUND: The pandemic affected the psychological well-being and sexuality of the population, especially among vulnerable groups such as men from sexual minorities. METHOD: In Spain, a total of 320 heterosexual men and 151 sexual minority men, aged between 18 and 60, answered an ad hoc online questionnaire about sexual behavior during the lockdown. RESULTS: Compared to heterosexual men, during the lockdown, sexual minority men masturbated more, engaged in more sexual activities online, and had more sex with non-cohabitants. Heterosexual men had more sexual relations with their partners. Living with a partner during the lockdown predicted an improvement in sex life, especially for heterosexual men. Furthermore, the emotional impact of lockdown was a predictor of a worsening sex life regardless of sexual orientation. CONCLUSIONS: Future interventions should take into account that men's sex lives are mediated by the emotional impact of the moment, especially among sexual minority men, since the quality of their sex life shows a weaker relationship with some of the protective variables studied (living with a partner).

Experience sampling methods for the personalised prediction of mental health problems in Spanish university students: protocol for a survey-based observational study within the PROMES-U project.

INTRODUCTION: There is a high prevalence of mental health problems among university students. Better prediction and treatment access for this population is needed. In recent years, short-term dynamic factors, which can be assessed using experience sampling methods (ESM), have presented promising results for predicting mental health problems. METHODS AND ANALYSIS: Undergraduate students from five public universities in Spain are recruited to participate in two web-based surveys (at baseline and at 12-month follow-up). A subgroup of baseline participants is recruited through quota sampling to participate in a 15-day ESM study. The baseline survey collects information regarding distal risk factors, while the ESM study collects short-term dynamic factors such as affect, company or environment. Risk factors will be identified at an individual and population level using logistic regressions and population attributable risk proportions, respectively. Machine learning techniques will be used to develop predictive models for mental health problems. Dynamic structural equation modelling and multilevel mixed-effects models will be considered to develop a series of explanatory models for the occurrence of mental health problems. ETHICS AND DISSEMINATION: The project complies with national and international regulations, including the Declaration of Helsinki and the Code of Ethics, and has been approved by the IRB Parc de Salut Mar (2020/9198/I) and corresponding IRBs of all participating universities. All respondents are given information regarding access mental health services within their university and region. Individuals with positive responses on suicide items receive a specific alert with indications for consulting with a health professional. Participants are asked to provide informed consent separately for the web-based surveys and for the ESM study. Dissemination of results will include peer-reviewed scientific articles and participation in scientific congresses, reports with recommendations for universities' mental health policy makers, as well as a well-balanced communication strategy to the general public. STUDY REGISTRATION: osf.io/p7csq.

Factors associated with condom use in vaginal intercourse among Spanish adults with intellectual disability: Proposal for an explanatory model.

BACKGROUND: The prevention of HIV or other STIs in people with intellectual disabilities (ID) is a rarely studied subject even though this population group is at the same risk of infection as the general population. AIMS: The present study aims to conduct a descriptive analysis of sexual behaviours and condom use frequency in Spanish men and women with intellectual disabilities and identify the combination of variables that best explain condom use in vaginal intercourse. METHODS AND PROCEDURES: The sample consisted of 253 people (56.1 % male and 43.9 % female) aged between 20 and 64 years (M = 38.52; SD = 10.48). Participants completed the Sexuality Questionnaire for People with Intellectual Disabilities and the Sexual Abuse Risk Screening Scale. OUTCOMES AND RESULTS: The percentage of consistent condom use is 27.7 % for vaginal intercourse. Lack of knowledge about body boundaries constitutes a risk factor contributing to risky sexual behaviour. Knowledge of HIV-transmitting fluids and perceived self-efficacy are protective factors. The proposed model explains between 35.5 % and 46.6 % of the variance. CONCLUSIONS AND IMPLICATIONS: The results highlight the importance of considering the judgements people make about their ability to perform preventive behaviour and the provision of information on sexuality adapted to cognitive abilities to minimise the engagement in risky behaviours.

Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999-2020).

Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.

"INSIDE" Project on Sexual Health in Spain: Sexual Life During the Lockdown Caused by COVID-19.

INTRODUCTION: The COVID-19 pandemic is becoming a major hazard to public health worldwide. This is causing a significant impact on life and physical health, as well as on the psychological well-being of the general population. Since the emotional distress and the social restrictions caused by this epidemic, it must be expected that its impact will also extend to sexual health. The purpose of this study, the first including a large sample of the Spanish general population, was to analyze sexual behavior during the 99 days of confinement in Spain (INSIDE Project). METHOD: One thousand four hundred forty-eight Spanish people, between 18 and 60 years old, were evaluated through an online survey during April 2020. The variables analyzed were the physical and social environment during confinement, sexual desire, type of sexual activity, masturbation, sexual intercourse, online sexual activity, general sexual frequency, sexual fantasies, degree of self-control over sexual drive, sexual abuse, general impact of confinement on sexuality, and emotional mood. RESULTS: Confinement has affected the sexual life of half of the Spanish population (47.7%), especially women. Those who reported a worsening of their sexual life are almost three times more (37.9%) than those who reported an improvement (14.4%). CONCLUSIONS: Different factors have been significant predictors of the positive or negative evaluation about the impact of this confinement on sexual life, such as gender, couple life, privacy, stress level, and the perception of confinement as unbearable. POLICY IMPLICATIONS: These results have important implications for the public health and more especially sexual health of the Spanish population.

Explanatory Psychological Factors of Inconsistently Condom Use among Spanish University Students: Gender Differences.

More than 50% of Spanish youth does not use of condoms correctly and consistently. University students are a particular population at high risk of the HIV infection, other STIs and unwanted pregnancies. The influence of psychological variables in using of condom is analyzed by gender and type of sexual relationship. A total of 256 females and 168 males were assessed (Mage= 20.62; SD = 2.16). A regression logistic analysis showed that sexual sensation seeking appears as an explanatory variable of inconsistently condom use in both females and males in vaginal intercourse, steady relationship intercourse and sex under the alcohol and other drugs effects (adjusted odds ratio between 1.095 and 1.124). Moreover, self-esteem appears as a risk factor and extraversion as a protective factor of use of condom in females. On the other hand, neuroticism reveals itself as a protective factor and fear of negative evaluation as a risk factor of use of condom in males. It is necessary to know the psychological mechanisms that underlie sexual risk behaviors for adapting interventions to individual and contextual characteristics.

Health promotion in young people: Identifying the predisposing factors of self-care health habits.

Unhealthy behaviors are strongly associated with chronic diseases, disabilities, or mortality. Identifying the predisposing factors that influence on self-care healthy habits will improve an early detection of high-risk groups. Four hundred and sixty-six Spanish young people aged 18-25 years were assessed. Global perceived health self-care was predicted by Value of health and Conscientiousness, both in females (R2 = 0.185; F = 29.661; p < 0.001) and males (R2 = 0.154; F = 17.849; p < 0.001). The results have shown gender differences in health self-care habits. Health promotion policies should include specific health consciousness-based strategies.

"The COVID-19 outbreak"-An empirical phenomenological study on perceptions and psychosocial considerations surrounding the immediate incorporation of final-year Spanish nursing and medical students into the health system.

The COVID-19 pandemic has caused an unprecedented health crisis worldwide, with the numbers of infections and deaths worldwide multiplying alarmingly in a matter of weeks. Accordingly, governments have been forced to take drastic actions such as the confinement of the population and the suspension of face-to-face teaching. In Spain, due to the collapse of the health system the government has been forced to take a series of important measures such as requesting the voluntary incorporation of final-year nursing and medical students into the health system. The objective of the present work is to study, using a phenomenological qualitative approach, the perceptions of students in this exceptional actual situation. A total of 62 interviews were carried out with final-year nursing and medicine students from Jaime I University (Spain), with 85% reporting having voluntarily joined the health system for ethical and moral reasons. Results from the inductive analysis of the descriptions highlighted two main categories and a total of five sub-categories. The main feelings collected regarding mood were negative, represented by uncertainty, nervousness, and fear. This study provides a description of the perceptions of final-year nursing and medical students with respect to their immediate incorporation into a health system aggravated by a global crisis.

Factorial Structure and Psychometric Properties of a Brief Scale of the Condom Use Self-Efficacy for Spanish-Speaking People.

BACKGROUND: Studies have shown the role played by perceived self-efficacy in explaining condom negotiation and condom use. AIMS: The factorial structure and the psychometric properties of the Brief Condom Use Self-Efficacy Scale are presented. METHOD: The study included 368 men and 456 women aged 17 to 55 years ( Mage = 25.01, SD = 6.93). RESULTS: Exploratory factor analysis yielded three factors: fear of rejection, impulse control, and condom acquisition and negotiation, which together accounted for 68% of the total variance. That structure was confirmed through confirmatory factor analysis. Cronbach's alpha for the Brief Condom Use Self-Efficacy Scale was .71. The scale provided adequate convergent validity, and positive correlations were observed between self-reported condom use and self-efficacy for use of other barrier methods. DISCUSSION: This brief instrument could be a useful and appropriate measure to assess the types of condom use self-efficacy that occur at the different moments of a sexual relationship.