Does a one-session sexual health education program improve sexual confidence in patients with cervical cancer? A transtheoretical model-based clinical study.

PURPOSE: This study aimed to evaluate the effects of a one-session sexual health education program using a transtheoretical model to enhance sexual self-efficacy in patients with cervical cancer. METHODS: This study recruited patients with cervical cancer from the gynecological wards of a medical center in northern Taiwan. A total of 63 participants were divided into 2 groups: the control group (n = 30) received traditional sexual health education. The intervention group (n = 33) participated in a transtheoretical model (TTM)-based sexual health education program. Scores from self-report questionnaires for variables of knowledge, attitudes, and self-efficacy regarding sexual health collected 1 and 6 weeks after the intervention were compared with baseline scores. RESULTS: Patients who received transtheoretical model (TTM)-based sexual health education had significantly greater sexual knowledge (ß = 3.794, p < 0.01), sexual attitudes (ß = 9.226, p < 0.01), and sexual self-efficacy (ß = 17.053, p < 0.01) than those who received traditional sexual health education at 1 and 6 weeks. CONCLUSION: Our findings suggest that a one-session sexual health education using a TTM-based model can enhance sexual knowledge, attitudes, and sexual self-efficacy among patients with cervical cancer. This educational program can be translated into routine clinical practice to help patients with cervical cancer enhance their sexual health and improve confidence in their sexual well-being.

Sexuality during pregnancy: attitudes, self-efficacy and self-consciousness.

The study aimed to determine the relationship between sexual self-efficacy and sexual self-consciousness levels and pregnant women's attitudes toward sexuality. The data of this descriptive, cross-sectional, and correlational study were collected from 318 pregnant women between September 2020 and May 2021. A personal information form and the Sexual Self-Efficacy (SSES), Sexual Self-Consciousness (SSCS) Scale, and Attitude toward Sexuality in Pregnancy Scale (AStSdP) were used to collect the data. Six out of ten pregnant women had a positive attitude toward sexuality during pregnancy, and their sexual self-efficacy (26.35 ± 6.71) and sexual self-consciousness (24.75 ± 9.10) levels were moderate. Participants' AStSdP mean score had a moderate positive correlation with the SSES mean score, a low negative low level relationship with the SSCS mean score, and a moderate negative relationship with sexual shyness (p < .05). Risk factors for attitude toward sexuality during pregnancy were SSES total score (Odds Ratio [OR] = .90, 95 percent Confidence Interval [CI] = .86-.95), sexual shyness score (OR = 1.23, 95 percent CI = .901-1.02), and partner training (OR = 3.93, 95 percent CI = 1.58-9.77). Sexual self-consciousness, sexual shyness, and education level of the partner influenced pregnant women's attitudes toward sexuality during pregnancy. Attitudes toward sexuality, sexual self-efficacy, and sexual self-consciousness levels of pregnant women should be determined in prenatal follow-ups.

Developing Sexual Self-Efficacy Beliefs During Adolescence: Do Health Teachers Really Matter?

Teacher attitudes and instructional strategies impact success of human sexuality programs. Limited prior research has examined the relations of teachers' attitudes and instruction to the development of adolescents' sexual self-efficacy beliefs. This study examined how adolescents' perceptions of their health teachers (i.e., teacher value of content, teacher affinity, teacher caring for students) predict changes in efficacy beliefs related to HIV/STD and pregnancy prevention, and if perceptions of mastery goal structure predicted adaptive efficacy beliefs. Data were collected in 4 Midwestern/Appalachian high schools in health class where the delivery of a 14-lesson sexual health curriculum occurred. Participants included 561 students (50.4% 9th graders, 43.5% female, 56.3% White, 53.7% did not have a current romantic partner, and 59.7% had previously not engaged in sexual activity). The findings indicate students' perceptions of teachers valuing the content predicted perceptions of mastery goal structure for all sexual self-efficacy beliefs: learning efficacy, condom negotiation efficacy, refusal self-efficacy, and situational self-efficacy. Students who perceive a mastery goal structure in health class, and who feel their teachers value learning about HIV/STD and pregnancy prevention, are likely to experience positive adaptive self-efficacy beliefs related to sexual health, ultimately leading to behaviors indicative of decreased STDs among teenagers and safe sexual practices, such as abstinence, the use of a condom, and saying "no" to having sex.

The effect of counseling based on Bandura's self-efficacy theory on sexual self-efficacy and quality of sexual life.

This study aimed to determine the effect of counseling, based on Bandura's self-efficacy theory, on sexual self-efficacy and quality of sexual life. This randomized controlled trial was conducted on 96 newlywed women in Zanjan, Iran during 2015-2016. The participants were assigned to the control and intervention groups through block randomization. Six 90-minute counseling sessions were held weekly for participants in the intervention group. Questionnaires of sexual self-efficacy and quality of sexual life were completed before and 8 weeks after the end of intervention. No significant difference was observed between groups in sexual self-efficacy and quality of sexual life at baseline (p > .05). Using ANCOVA, the mean score for sexual self-efficacy in the intervention group was significantly higher than the control group 8 weeks after the intervention ended (mean difference in scores = 9.4; 95% confidence interval [CI] 2.6 to 16.2; p = .007). However, no significant difference was observed in the quality of sexual life between the two groups (mean difference in mean score = 2.1; 95% CI -2.5 to 6.7; p = .365). Thus, counseling had a positive impact on sexual self-efficacy. However, the intervention had no significant impact on the quality of sexual life, which may be attributed to the short duration of follow-up.

Longitudinal Associations Between Childhood Sexual Abuse, Silencing the Self, and Sexual Self-Efficacy in Adolescents.

Sexual self-efficacy-the belief in one's ability to engage in desired and to refuse unwanted, sexual activities and behaviors-is an important feature in promoting adolescent sexual health and well-being. One factor that may affect the development of sexual self-efficacy is child sexual abuse. However, little is known about the processes underlying the relation between child sexual abuse and sexual self-efficacy. Using longitudinal data from a sample of 739 adolescent girls and boys aged between 14 and 18 years, we examined the mediational role of two "silencing the self" attitudes and behaviors in romantic relationships-self-silencing, i.e., inhibiting fulfilling one's own needs, and divided self, i.e., presenting an outer compliant self-in the associations between child sexual abuse severity and two dimensions of sexual self-efficacy: the ability to set clear sexual limits and the ability to use sexual protection. Results of path analysis showed that child sexual abuse severity was associated with more self-silencing and more divided self. In turn, self-silencing was associated with lower protection use self-efficacy, whereas divided self was associated with lower limit-setting and protection use self-efficacy. Thus, self-silencing strategies in romantic relationships mediated the associations between child sexual abuse severity and lower sexual self-efficacy. The overall findings may inform the development of prevention/intervention programs that target the enhancement of an integrated sense of self in intimate relationships to promote assertive strategies in sexual situations.

Associations of Sexual Subjectivity with Global and Sexual Well-Being: A New Measure for Young Males and Comparison to Females.

Sexual subjectivity refers to multiple aspects of sexual self-perceptions, including sexual body-esteem, perceptions of efficacy and entitlement to sexual desire and pleasure, and sexual self-reflection (Horne & Zimmer-Gembeck, 2006). Previous research on sexual subjectivity has shown that it is elevated in young women who report better global well-being and have more sexual experience. However, research has not focused on young men. Thus, two studies were conducted to develop a new measure to assess young men's sexual subjectivity (Study 1, N = 304 men) and to examine associations of sexual subjectivity with general and sexual well-being among young men and women (Study 2, N = 208 men and 214 women). In Study 1, five elements of men's sexual subjectivity were found, which paralleled the elements found in previous research with young women. In Study 2, sexual subjectivity, especially two elements of sexual body-esteem and self-efficacy in achieving pleasure, was significantly associated with enhanced global and sexual well-being in both men and women. Gender did not moderate these associations, supporting sexual subjectivity as an aspect of sexual health in all young adults. As anticipated, men reported greater entitlement to self-pleasure and self-efficacy in achieving pleasure, but women reported greater entitlement to pleasure with partners. Women's feelings of less efficacy but more entitlement to pleasure with partners suggest that feelings of entitlement may not be consistent with their experiences. Future research with young men and women will be important for understanding sexual health and development during late adolescence and early adulthood.

Masculine Ideology, Sexual Communication, and Sexual Self-Efficacy Among Parenting Adolescent Couples.

This study examined the relationship between traditional masculine role norms (status, toughness, anti-femininity) and psychosocial mechanisms of sexual risk (sexual communication, sexual self-efficacy) among young, low-income, and minority parenting couples. Between 2007 and 2011, 296 pregnant adolescent females and their male partners were recruited from urban obstetrics clinics in Connecticut. Data regarding participants' beliefs in masculine role norms, frequency of general sex communication and sexual risk communication, and sexual self-efficacy were collected via computer-assisted self-interviews. Generalized estimating equation (GEE) models were used to test for actor effects (whether a person's masculine role norms at baseline influence the person's own psychosocial variables at 6-month follow-up) and partner effects (whether a partner's masculine role norms at baseline influence an actor's psychosocial variables at 6-month follow-up). Results revealed that higher actor status norms were significantly associated with more sexual self-efficacy, higher actor toughness norms were associated with less sexual self-efficacy, and higher actor anti-femininity norms were significantly associated with less general sex communication, sexual risk communication, and sexual self-efficacy. No partner effects were found. These results indicate a need for redefining masculine role norms through family centered approaches in pregnant or parenting adolescent couples to increase sexual communication and sexual self-efficacy. Further research is needed to understand partner effects in the context of a relationship and on subsequent sexual risk behavior.

The effect of 8-week mindfulness counseling on sexual self-efficacy of women suffering from human immunodeficiency syndrome: A randomized controlled trial in Iran.

Background and Aims: Sexual self-efficacy refers to a woman's belief that she can be sexually active and attractive for her sexual partner and has acceptable sexual function. One of the issues that may negatively affect sexual self-efficacy is HIV infection. The present study aimed to evaluate the effect of 8 weeks of counseling based on mindfulness on sexual self-efficacy of women affected with HIV. Methods: This was a randomized controlled trial involving 62 HIV-positive women in their reproductive age. Women in the intervention group were further divided into four groups. Each group received eight sessions of counseling based on mindfulness, while the control group received no intervention. A demographic questionnaire and sexual self-efficacy questionnaire were used to collect the data. The independent t test, χ 2, and repeated measure tests were used to analyze the data. Results: The mean change of total score of sexual self-efficacy in Week 8 compared with before intervention was 37.04 (95% CI: 31.38-42.70, p < 0001) and in Week 12 compared with before intervention was 36.97 (95% CI: 31.59-42.34, p < 0.0001), while in the control group, it almost remained unchanged. The score of readiness for sexual relationship, sexual self-stimulation, intimacy without sexual intercourse, and orgasm improved significantly 8 and 12 weeks after intervention (p < 0.0001), whereas no significant differences were observed in these dimensions in the control group. Conclusion: The results of this study showed that 8 weeks of counseling based on mindfulness could significantly improve all dimensions of sexual self-efficacy and its total score in women affected with HIV. Thus, this method of counseling is recommended for HIV-positive women.

Cracking the code to female sexual satisfaction: the serial mediation of sexual behavior and the perceived importance of healthy sexuality from sexual self-efficacy.

Introduction: Sexual satisfaction has been shown to have a strong association with many aspects of sexual health and wellbeing. It is further considered a robust indicator of an individual's health status and general wellbeing, revealing that a person can enjoy pleasurable and healthy sexual experiences, beyond the mere absence of sexual and reproductive health issues. Objectives: This study aimed to analyze the relationship between sexual satisfaction, sexual behaviors, sexual self-efficacy, and the importance personally attributed to maintaining an active and satisfying sexual life among young and middle-aged women aged 18-50. Design: A descriptive correlational study with a cross-sectional design was conducted. Methods: Participants (N = 1,076 women) completed self-reports on sexual self-efficacy beliefs, frequency of sexual behaviors, the importance attributed to active and healthy sexuality, and multidimensional sexual satisfaction. Results: The supported mediation model indicated that sexual self-efficacy was related to sexual satisfaction directly and indirectly through sexual behavior and a serial path through sexual behavior and the perceived importance of healthy sexuality. The total effect was significant, and the full model explained 7.3% of the global sexual satisfaction variance (F = 17.218, p = 0.000), with the mediated effect accounting for 44.3%. Conclusion: This study confirms a partial serial mediation model by which sexual self-efficacy significantly predicts sexual satisfaction through sexual behaviors and the importance attributed to a healthy sexuality. Due to its significant contribution, the perceived importance of sexuality should be considered when studying correlates of sexual satisfaction. These findings have interesting implications for the development of strategies aimed at sexual health promotion and sexual education among women in early and middle adulthood.

Effect of mindfulness on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women: a quasi-experimental study.

Background: Menopause with anatomical, physiological, and psychological changes can affect sexual satisfaction and consequently the quality of life. Aims: The study sought to evaluate the effects of mindfulness-based counseling on sexual self-efficacy and sexual satisfaction among Iranian postmenopausal women. Methods: This quasi-experimental study was conducted on 110 women who were assigned to an intervention group (n = 55) and a control group (n = 55). The intervention group received 8 sessions of mindfulness-based training and daily mindfulness exercises. Data collection tools included questionnaires of demographics and midwifery, sexual self-efficacy, and sexual satisfaction. They were completed before and 8 weeks after the intervention. The collected data were analyzed through a t test, a chi-square test, and repeated-measures analysis of variance. Outcomes: Changes in sexual self-efficacy and sexual satisfaction scores were evaluated. Results: The mindfulness-based intervention significantly improved sexual self-efficacy (F = 146.98, P = .000, ƞ2 = 0.576) and sexual satisfaction (F = 129.47, P = .000, ƞ2 = 0.545) over time. The mean scores of sexual self-efficacy (17.03 ± 2.08) and sexual satisfaction (87.94 ± 8.26) in the intervention group increased after the intervention as opposed to the mean scores of sexual self-efficacy (12.65 ± 1.70) and sexual satisfaction (76.61 ± 6.45) in the control group. Clinical Implications: Mindfulness training can improve sexual self-efficacy and sexual satisfaction in postmenopausal women. Strengths and Limitations: The intervention was implemented on a population of menopausal women in a culture in which the expression of sexual issues is taboo and has not been noticed in the past. The main limitation of this study was self-reporting, which may have affected the responses. The next limitation was the nonrandomized controlled design. Finally, the research sample included menopausal women who were heterosexual and married. Hence, the findings may not be generalizable to more diverse samples. In this study, psychological maladjustment or psychological distress was not analyzed. They should also be considered in future research. Conclusion: According to the results, it is advisable to employ mindfulness-based intervention in routine care, because it can improve different aspects of menopausal women's life.

Sexual self-efficacy and sexual communication among adolescent girls: moderated mediation results from a randomized controlled trial.

OBJECTIVE: Guided by the Operating Conditions Framework, the goal of this study was to identify how and for whom an online sexual health program called Health Education and Relationship Training (HEART) worked. DESIGN: Data come from a randomized controlled trial among 198 U.S. high school girls who completed HEART or an attention-matched control. We conducted mediation and moderated mediation models to determine if sexual self-efficacy was a mediator and if program acceptability and sexual activity status were moderators of HEART efficacy. MAIN OUTCOME MEASURE: Sexual communication skills were assessed with a behavioral role-play task. RESULTS: HEART significantly improved sexual communication skills. These effects were fully mediated through sexual self-efficacy. Specifically, HEART improved sexual self-efficacy which in turn increased sexual communication skills. Also, when participants liked the program more, the effect of HEART on sexual self-efficacy was stronger. Further, among girls who had engaged in sexual activity, sexual self-efficacy was significantly associated with sexual communication skills. CONCLUSION: This study provides insights into the mechanisms of behavior change underlying HEART. Results highlight the need to further 'unpack' the effects of other sexual health programs, as we showed that programs may work better under certain conditions.

The mediation effects of sexual self-efficacy in the relationship between psychosocial wellbeing and depressive symptoms among female migrant workers in Vietnam.

BACKGROUND: Depression is a common mental disorder that significantly contributes to the global burden of disease. Studies have consistently reported that migrant workers experience higher levels of depressive symptoms, especially women. AIMS: This study aimed to examine the mediation role of sexual self-efficacy on the relationship between psychological wellbeing, and depressive symptoms among young female migrant workers in Vietnam's industrial zones. METHODS: A cross-sectional study was conducted among 1061 female migrant workers aged 18 to 29 from January to November 2020 in Hanoi, Vietnam. Anonymous interview questionnaires were used to collect data on demographic characteristics, psychosocial wellbeing (PWB), sexual self-efficacy, and depressive symptoms. Mediation analysis was conducted to explore the mediation effect of sexual self-efficacy on the relationship between PWB and depressive symptoms. RESULTS: Nearly 8% of the female migrant workers reported experiencing depressive symptoms. The final mediation model showed that the effect of overall psychological wellbeing on depressive symptoms was partially mediated by sexual self-efficacy. Specifically, 4.1% of the effect of overall PWB on depressive symptoms was mediated through sexual self-efficacy. In the PWB subdimension analyses, sexual self-efficacy mediated 14.3% of the effect of personal growth, 8.8% of the effect of purpose in life, 8.0% of the effect of autonomy, and 7.8% of the effect of environmental mastery on depressive symptoms, respectively. CONCLUSION: The study findings demonstrate that sexual self-efficacy plays an important role in the relationship between psychosocial wellbeing and depressive symptoms among female migrant workers in industrial zones in Vietnam. Improving psychosocial wellbeing and promoting sexual health including sexual self-efficacy should be prioritized when addressing depressive symptoms and mental health concerns among industrial zone female migrant workers in Vietnam, which may also be applicable in other low- and middle-income countries with similar socio-cultural settings.

The effectiveness of cognitive-behavioural consultation on sexual function and sexual self-efficacy of women after childbirth.

Objective: The purpose of this study was to investigate the effect of the cognitive-behavioral therapy program (CBT) on the sexual function and sexual self-efficacy of 100 women after childbearing. Methods: In this experimental pretest-posttest and control group design study, women who passed eight weeks of their delivery and were referred to three health centers, in Shadegan, Iran, from January to April 2019 registered using the simple sampling method and randomly allocated into two groups of case and control. For the CBT group eight weeks of counseling (one session/week), and for the control group, routine educations were provided by health care providers. Both groups filled out the female sexual function index and sexual self-efficacy questionnaires before intervention and eight weeks after the last session. Results: There was no significant difference between the CBT and control groups before the intervention in terms of sexual function and sexual self-efficacy, but eight weeks after the intervention, there was a statistically significant difference between the two groups (P = 0.001). Conclusion: Proper implementation of counseling based on the CBT model improved sexual function and self-efficacy of nulliparous women after childbirth.

Past, present, and future dimensions of socioeconomic status and sexual self-efficacy of young women during the transition into adulthood.

Socioeconomic disadvantages can undermine a person's ability to control their sexual lives (sexual self-efficacy) during the transition to adulthood. Most scholarship focuses on proximate circumstances, specifically how sexual self-efficacy is a result of current socioeconomic status. Yet, this sexual agency is embedded within much longer behavioral and psychological trajectories shaped by socioeconomic contexts. Therefore, I identify a novel explanation for sexual self-efficacy by connecting it to past, present, and anticipatory future conceptualizations of young adults' socioeconomic circumstances. Drawing from 2.5 years of quarterly data from the Relationship Dynamics and Social Life Study, I found significant associations between more advantaged past, present, and anticipatory future socioeconomic circumstances and greater sexual self-efficacy during the transition to adulthood. Stage-specific dimensions of socioeconomic status (SES) followed two life course patterns (pathways and accumulation). In addition, prospective SES was found to be a more powerful predictor than childhood and current SES. As such, I encourage researchers to conceptualize socioeconomic status in life course terms to illuminate the underlying causes and consequences of varying young adulthoods.

The Mediating Role of Sexual Self-Efficacy on Protected Sex.

BACKGROUND: Ascribed traditional gender role has rarely been examined in the topical area of protected sex. OBJECTIVE: The purpose of this study was to examine the relationship between HIV knowledge, ascribed cultural gender roles of machismo and marianismo, acculturation, attitudes toward risky sexual behaviors and sexual self-efficacy on protected sex, and the mediating effect of sexual self-efficacy between these predictors and protected sex. METHODS: Part of a larger study, Hispanic college students from a Hispanic-serving institution in a U.S. southern border city were recruited. RESULTS AND CONCLUSION: Sexual self-efficacy was found a significant mitigating factor against sexual risks associated with machismo as well as a positive reinforcing element on attitudes toward protected sex. Study findings have implications toward the development of culturally sensitive evidence-based interventions that promote sexual self-efficacy skills among Hispanic males who strongly identify with culturally ascribed gender roles.

Personality traits and sexual self-efficacy in diabetic women: The mediating role of marital satisfaction and sexual function.

INTRODUCTION: Although the relationship between personality traits and sexual self-efficacy has received theoretical and empirical support, there is little information on how personality affects the sexual self-efficacy of diabetic women. This study aimed to investigate the mediating role of marital satisfaction and sexual function in the relationship between personality traits and sexual self-efficacy in diabetic women. METHODS: Using a two-stage sampling method, 410 reproductive-aged Iranian women with type 2 diabetes were recruited in this descriptive-analytical study. The participants completed self-administered questionnaires, including the Vaziri Sexual Self-Efficacy Questionnaire, the Female Sexual Function Index, ENRICH Marital Satisfaction Scale, and the Goldberg's Big Five Questionnaire. To analyze the data, structural equation modeling was employed in Amos software version 24. RESULTS: Results indicated an acceptable fit of the model to the data. Personality trait of openness to experience was associated with sexual self-efficacy directly (ß = .02, p = .030) and indirectly through the mediators of marital satisfaction (ß = .06, p = .009) and sexual function (ß = .18, p = .014). Furthermore, sexual function was associated with sexual self-efficacy directly (ß = .50, p = .025) and indirectly through the mediator of marital satisfaction (ß = .36, p = .012). CONCLUSION: Due to the mediating role of marital satisfaction and sexual function, this study has some practical implications for improving the sexual self-efficacy of diabetic women with different personality traits.

Associations Between Sexual Violence and Women's Sexual Attitudes, Sexual Self-Consciousness, and Sexual Self-Efficacy.

Sexual violence, a public health problem, can be seen in all societies and among individuals from all levels of educational background. It is important to be aware of the social and individual factors associated with sexual violence to prevent and fight sexual violence. In this study, it was aimed to determine the associations between sexual violence and women's sexual attitudes, sexual self-consciousness, and sexual self-efficacy. This is a descriptive study. The data were collected from 469 women admitted to three family health centers in Turkey between May and September 2018. Data were collected using a data collection form and three scales (the Sexual Self-Consciousness Scale, the Sexual Self-efficacy Scale, and the Hendrick Brief Sexual Attitudes Scale). The data were analyzed using descriptive statistics as well as the independent-sample t test and logistic regression analysis. It was found that 37.7% of the women were exposed to sexual violence. The most frequent response of the women against sexual violence was "crying" with 61%. The first reason why the women maintained the marriage despite sexual violence was to avoid their children growing up without a father (43.3%). There was a statistically significant difference between sexual violence and sexual embarrassment, sexual self-focus, sexual self-consciousness, and sexual self-efficacy scores of the women (p < .001). No significant difference between the means of the women's sexual attitude scores and their sexual violence experiences was observed (p = .526). There was an association between sexual violence and sexual self-efficacy (p = .036; odds ratio [OR] = 1.030, 95% confidence interval [CI] = [1.002, 1.059]). Health professionals may provide sexuality education programs at family health centers, especially for couples preparing for marriage to increase sexual efficacy. Moreover, education may be provided identifying sexual violence acts in marriage and informative awareness programs may be offered regarding sexual violence.

Adolescent Women's Sexual Self-Efficacy: Associations with Personal and Perceived Partner Beliefs that Condoms Interfere with Pleasure.

Sexual self-efficacy, an individual's confidence in the domain of sexual health behaviors, was studied among an ethnically diverse sample of 128 sexually active adolescent women between the ages of 14 and 18 years. A hypothesized interaction between women's belief that condoms interfere with sexual pleasure and her perception of a partner's belief that condoms interfere with sexual pleasure was not supported. Both adolescent women's belief that condoms interfere with pleasure and their perception that their partner believed condoms interfere with pleasure were separately associated with lower self-efficacy to refuse sex without condoms and use condoms. Both a partner's and one's own sexual pleasure may be important determinants of adolescent women's confidence to engage in health protective sexual behaviors. Adolescents' self-efficacy to experience pleasure when using condoms should be enhanced.

Effectiveness of cognitive-behavioral therapy on sexual function and sexual self-efficacy in pregnant women: An RCT.

BACKGROUND: Cognitive-behavioral therapy (CBT) is one of the ways to improve an undesirable sexual function. OBJECTIVE: The purpose of this study was to investigate the effect of CBT on the sexual function and sexual self-efficacy of pregnant women. MATERIALS AND METHODS: In this randomized clinical trial, 36 pregnant women referred to five healthcare centers in Ahvaz, Iran, from December 2016 to January 2017 were enrolled through stratified random sampling in two groups. The case group received counseling based on cognitive behavioral therapy for eight consecutive weeks and the control group received the routine training provided by healthcare staff. Two and four weeks after the end of sessions, both groups completed the Female Sexual Function Index and self-efficacy questionnaires again. RESULTS: The mean of sexual function and self-efficacy scores in pregnant women in the case and control groups before the intervention did not show a significant difference (p = 0.56). The mean of sexual function and self-efficacy scores of pregnant women in the case and control groups was statistically significant two and four weeks, respectively, after the intervention (p ≤ 0.0001). CONCLUSION: The results of this study showed that counseling based on CBT in comparison with the routine training during pregnancy improves the sexual performance and self-efficacy of pregnant women.

[DIFFERENCES IN SEXUAL NEGOTIATION STYLES AND SEXUAL SELF-EFFICACY IN USE OF CONDOM IN UNIVERSITY MEN AND WOMAN OF QUERETARO, MEXICO, 2018].

OBJECTIVE: To compare sexual negotiation levels and self-efficacy in male condom use in men and women. METHODS: Comparative crosssectional study of undergraduate students carried out during the year 2018 in a private university in the city of Querétaro, Mexico. Non-probabilistic sampling was used. Measured variables included sociodemographic characteristics, risky sexual behaviors, negotiation skills and sexual self-efficacy for condom use. The Mann Whitney U test and non-parametric variance analysis (Kruskal - Wallis) were used. RESULTS: Overall, 270 students were enrolled; 89.6% of university students were sexually active; the mean age of sexual activity initiation was 15.41 years. The average reported number of sexual partners was 4.2. In each sexual relation, 27.8% had used a condom. Differences were found between men and women in terms of sexual negotiation styles in the avoidance (p=0.04) and accommodation (p<0.00) domains, with higher scores for men compared to women. Women scored higher for self-efficacy in condom use (p<0.001). CONCLUSIONS: The young university students interviewed engage in risky sexual activities. Women exhibit greater sexual self-efficacy as well as better skills at negotiating condom use. Strengthening public policies targeted to the student population for the prevention of risky sexual behavior is needed. Further studies on interventions aimed at building strong sexual negotiation and self-efficacy among adolescents are required.

TITULO: DIFERENCIAS EN LOS ESTILOS DE NEGOCIACIÓN SEXUAL Y AUTOEFICACIA EN EL USO DEL CONDÓN EN HOMBRES Y MUJERES UNIVERSITARIOS DE QUERÉTARO, MÉXICO, 2018. OBJETIVO: comparar los niveles de negociación sexual y autoeficacia en el uso del condón masculino en hombres y mujeres. METODOS: estudio transversal de tipo comparativo en el que se incluyeron estudiantes de licenciatura de una universidad privada de la ciudad de Querétaro, México, durante el año 2018. Muestreo no probabilístico. Se midieron: características sociodemográficas, conductas sexuales de riesgo, habilidades de negociación y autoeficacia sexual para uso de condón. Se compararon los grupos mediante la prueba U de Mann Whitney y el análisis de varianza no paramétrico (Kruskal-Wallis). RESULTADOS: ingresaron 270 estudiantes, el 89,6 % de los universitarios tiene vida sexual activa, la edad promedio de inicio de vida sexual es a los 15,41 años; el promedio de parejas sexuales reportado es de 4,2. El 27,8 % ha usado condón en cada relación sexual. Se encontraron diferencias entre hombres y mujeres en los estilos de negociación sexual en los dominios de evitación (p = 0,04) y acomodación (p < 0,00), con puntajes más altos para los hombres en comparación con las mujeres. Respecto a la autoeficacia en el uso del condón, las mujeres son quienes puntúan más alto (p < 0,001). CONCLUSIONES: los jóvenes universitarios entrevistados tienen conductas sexuales de riesgo. Se requiere fortalecer las políticas públicas que faciliten la prevención de la conducta sexual de riesgo dirigidas a la población estudiantil. Es necesario realizar más estudios sobre intervenciones que fortalezcan las habilidades de negociación y la autoeficacia sexual en adolescentes.