Unwanted Sex Due to Intoxication among Australians Aged 16-69 Years.

Intoxication can be a factor in unwanted sex, but research on the extent of the issue in both women and men is limited. We assessed the prevalence, correlates, and 10-year time-trends of unwanted sex due to intoxication among a representative sample of 4,279 women and 3,875 men aged 16-69 years in Australia and considered how these vary by gender. In 2012-13, 16% of women and 10% of men reported ever having had a sexual experience when they "did not want to because they were too drunk or high at the time." For both women and men, this was associated with younger age, bisexual activity, and reports of lifetime injection drug use, sexually transmitted infections, and forced sex. Among women only, it was associated with drinking above guideline levels and ever having terminated a pregnancy. Among men only, it was associated with current tobacco smoking, elevated psychosocial distress, and poor general health. Compared with 2001-02 data, fewer men reported unwanted intoxicated sex, while there were no changes for women as a whole. Interpreting these findings through an intersectional assemblage framework supports stronger understanding of the multiple factors influencing sexuality and substance use with implications for promoting equity, safety, and sexual health.

Tobacco smoking and sexual difficulties among Australian adults: a cross-sectional study.

Background Few studies have examined smoking and female sexual difficulties. The aim of this study was to investigate the association between current tobacco smoking and sexual difficulties in Australian men and women. METHODS: Data for this study came from the Second Australian Study of Health and Relationships (2012-13), which includes a representative sample of 18427 sexually active Australian adults (aged 16-69 years). The main study and outcome measures were tobacco smoking and sexual difficulties. A multiple logistic regression analysis was conducted to adjust for potential confounders. RESULTS: Male heavy smokers (>20 cigarettes per day) were significantly more likely than non-smokers to have trouble keeping an erection [adjusted odds ratio (AOR) 4.14, 95% confidence interval (CI) 1.87-9.20; P<0.0001], lack interest in having sex (AOR 2.18, 95% CI 1.20-3.97; P=0.011), have anxiety about performance (AOR 2.46, 95% CI 1.24-4.86; P=0.010) and be unable to come to orgasm (AOR=2.81, 95% CI 1.23-6.42; P=0.015). Female smokers were also significantly more likely than non-smokers to not find sex pleasurable (AOR 1.48, 95% CI 1.05-2.07; P=0.025); and light female smokers were significantly more likely than non-smokers to be unable to come to orgasm (AOR=1.44, 95% CI 1.05-1.98; P=0.025). CONCLUSIONS: Current tobacco smoking was associated with sexual difficulties in both men and women. For women, even light smoking was associated with not finding sex pleasurable and being unable to come to orgasm.

Incidence and persistence/recurrence of women's sexual difficulties: findings from the Australian Longitudinal Study of Health and Relationships.

This study presents data on the prevalence, incidence, and persistence/recurrence of 8 sexual difficulties among women. Australian women participated in 2 computer-assisted interviews approximately 12 months apart. Analyses were based on a weighted sample of 2,252 women who were 20-64 years of age, sexually active in the past 12 months, and in the same heterosexual relationship at both interviews. Upon recruitment, two-thirds of women (66%) reported having one or more sexual difficulties. At follow-up, 36% reported a new sexual difficulty. The two highest incident difficulties were "lacking interest in having sex" (26%) and "taking too long to orgasm" (11%). In addition, 68% of women with 1 or more sexual difficulties at recruitment reported having at least 1 of these again at follow-up. Lacking interest in having sex had the highest persistence/recurrence (65%). Logistic regression modeling revealed a lower incidence of sexual difficulties among women in their 40s. Age was also a predictor of the persistence/recurrence, with persistence/recurrence most likely among older women. Tobacco and alcohol use predicted the incidence, but not persistence/recurrence, of lacking interest in sex. Health professionals need to take note of the sociodemographic groups most prone to developing and having persistent/recurrent sexual difficulties.

Who gets tattoos? Demographic and behavioral correlates of ever being tattooed in a representative sample of men and women.

PURPOSE: Despite recent increases in the popularity of tattooing, little is known about the prevalence and characteristics of adults who have ever been tattooed. We investigated demographic and behavioral correlates of ever getting tattooed in an adult population. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 8656 men and women ages 16-64 years in Australia. RESULTS: A total of 14.5% of respondents had ever been tattooed, and 2.4% of respondents had been tattooed in the year before the interview. Men were more likely than women to report a tattoo, but the highest rates of tattooing were found among women in their 20s (29.4%). Men and women ages 20-39 were most likely to have been tattooed, as were men with lower levels of education, tradesmen, and women with live-out partners. Tattooing was also associated with risk-taking behaviours, including smoking, greater numbers of lifetime sexual partners, cannabis use (women only) and ever having depression (men only). CONCLUSIONS: Tattooing has increased in popularity during the past decade. Yet tattoos still appear to be a marker for risk-taking behavior in adults.

Association between sexual behavior and cervical cancer screening.

BACKGROUND: Not much is known about whether women who follow Pap testing recommendations report the same pattern of sexual behavior as women who do not. METHODS: Data come from part of a larger population-based computer-assisted telephone survey of 8656 Australians aged 16-64 years resident in Australian households with a fixed telephone line (Australian Longitudinal Study of Health and Relationships [ALSHR]). The main outcome measure in the current study was having had a Pap test in the past 2 years. RESULTS: Data on a weighted sample of 4052 women who reported sexual experience (ever had vaginal intercourse) were analyzed. Overall, 73% of women in the sample reported having a Pap test in the past 2 years. Variables individually associated with Pap testing behavior included age, education, occupation, cohabitation status, residential location, tobacco and alcohol use, body mass index (BMI), lifetime and recent number of opposite sex partners, sexually transmitted infection (STI) history, and condom reliance for contraception. In adjusted analyses, women in their 30s, those who lived with their partner, and nonsmokers were more likely to have had a recent Pap test. Those who drank alcohol at least weekly were more likely to have had a recent test than irregular drinkers or nondrinkers. Women with no sexual partners in the last year were less likely to have had a Pap test, and women who reported a previous STI diagnosis were more likely to have had a Pap test in the past 2 years. CONCLUSIONS: There are differences in Pap testing behavior among Australian women related to factors that may affect their risk of developing cervical abnormalities. Younger women and regular smokers were less likely to report a recent test. Screening programs should consider the need to focus recruitment strategies for these women.

High prevalence of symptoms associated with ovarian cancer among Australian women.

BACKGROUND: Symptoms associated with ovarian cancer are often vague and non-specific, such as abdominal bloating and pain. Presently, nothing is known about the prevalence of these symptoms among women in the community. AIMS: To identify the prevalence and correlates of symptoms associated with ovarian cancer in a nationally representative sample of Australian women. METHODS: Women answered questions about symptoms associated with ovarian cancer via computer-assisted telephone interviews. Binomial regression was used to assess the association between reporting symptoms, demographic characteristics and sexual problems. RESULTS: Data on 2235 women aged 18-70 who had not had an oophorectomy or hysterectomy were analysed. Prevalences of symptoms were abdominal bloating 52%, abdominal pain 37%, increased abdominal size 30%, pelvic pain 29%, feeling full quickly 18% and unable to eat normally 15%. One-third of women (32%) reported three or more symptoms, 2% reported all six and 32% of women reported none. Severe symptoms were generally reported by <10% of women reporting symptoms, and symptoms usually persisted for 5 days or less a month. Older women were less likely to report symptoms, as were women who had been pregnant. There was an association between symptoms and sexual difficulties whereby women who reported multiple ovarian cancer symptoms were more likely to report sexual problems. CONCLUSIONS: There is a high prevalence of ovarian cancer symptoms in the Australian community. Because of this, awareness campaigns will likely impact a large number of women who do not have ovarian cancer.

Knowledge of human papillomavirus (HPV) and the HPV vaccine in a national sample of Australian men and women.

BACKGROUND: Human papillomavirus (HPV) knowledge has rarely been investigated in the context of a national vaccination program. The present study investigated HPV knowledge after the introduction of a national HPV vaccination program in Australia using a national sample of men and women. METHODS: Questions assessing HPV knowledge were part of a broader national study of health and relationships administered via a computer-assisted telephone interview. These findings are from wave four of the study, conducted between 2007 and 2008. Knowledge questions about HPV included its association with cervical cancer, genital warts and abnormal Pap tests. RESULTS: A total of 2634 women and 2556 men between the ages of 18 and 70 were interviewed. Overall, 62.8% (95% confidence interval (CI): 60.8-64.7%) of women and 38.3% (95% CI: 36.3-40.4%) of men had heard of HPV. Of these, 66.0% (95% CI: 64.1-67.9%) correctly answered that HPV is associated with cervical cancer, 50.2% (95% CI: 48.2-52.1%) answered that HPV is associated with abnormal Pap tests and 44.5% (95% CI: 42.5-46.5%) answered that HPV causes warts. Predictors of good knowledge included being female, aged between 26 and 45, holding higher education levels and older age at first sex. Ever having a Pap test was also associated with awareness about HPV. CONCLUSION: One of the highest levels of knowledge about HPV in Australia to date is reported in the present study. Knowledge about the association between HPV and cervical cancer was particularly high, especially when compared with knowledge of the association with genital warts. This appears to be a consequence of the marketing of the HPV vaccine as a vaccination against cervical cancer.

Sociodemographic correlates of selected health risk behaviors in a representative sample of Australian young people.

To facilitate the development of interventions to reduce health risk behavior among young people, we designed this study to compare risk behavior among young people and older people, to compare risk behavior profiles between young men and women, and to identify sociodemographic correlates of risk behavior among young people. Computer-assisted telephone interviews with a representative sample of 19,307 Australian men and women (response rate 73.1%) assessed alcohol consumption, cigarette smoking, injection drug use, and unprotected intercourse. Respondents aged 16 to 24 reported less healthy behavior than older people. Although men and women aged 16 to 24 had similar profiles of health risk behavior, correlates of these behaviors differed for men and women. There were few consistent sociodemographic correlates of different risk behaviors. The results suggest that young women are now as important a priority as young men for interventions. Young people remain an important target group for health promotion, with nonheterosexual young people a particular high-risk group.

Sex in Australia: attitudes towards sex in a representative sample of adults.

OBJECTIVE: To describe social attitudes towards sex of Australian adults and correlates of a scale of sexual liberalism. METHODS: Computer-assisted telephone interviews were completed by a representative sample of 10,173 men and 9,134 women aged 16-59 years. The overall response rate was 73.1% (69.4% men, 77.6% women). Respondents were asked about their agreement with nine attitude statements. Factor analysis and examination of internal consistency resulted in a six-item scale of liberalism. Correlates of attitude statements and the liberalism scale were examined. RESULTS: Most people agreed that premarital sex was acceptable, that oral sex was considered 'sex', that sex was important for a sense of well-being and that extramarital sex was unacceptable. Men were more likely (36.9%) to disapprove of sex between two men than women were to disapprove of sex between two women (25.1%). Higher levels of education were associated with increased liberalism for men and women, as was speaking English at home, identifying as homosexual or bisexual, vaginal intercourse before age 16, having had more than one sexual partner in the year before interview, having had heterosexual anal intercourse, having no religion or faith, smoking tobacco, and drinking more alcohol. CONCLUSION: Sexual attitudes of Australians largely support a heterosexual paradigm with no sex outside the relationship. High levels of approval of premarital sex are consistent with decreasing age of first intercourse in Australia. Higher levels of liberalism were associated with greater sexual adventurism and health risk taking.