Evaluation of Indicators of Female Sexual Dysfunction in Adult Entertainers.

INTRODUCTION: Female sexual dysfunction (FSD) incorporates a wide range of sexual issues within the female population; however, it has not been evaluated among female adult entertainers. AIM: To evaluate the prevalence of FSD in women working in the adult entertainment industry. METHODS: A 53-question online survey was distributed to female adult entertainers via e-mail through collaboration with the Free Speech Coalition, the North American Trade Association of the Adult Industry. Surveys were sent by the Free Speech Coalition to those within the Performer Availability Screening Services database who met the criteria of having biological vaginas and having experience as adult entertainers. The surveys were answered anonymously. Statistical analysis was performed with Stata/IC 15.1. MAIN OUTCOME MEASURES: The survey acquired baseline characteristics, use of contraceptives, sexual activity, work vs home sexual satisfaction, and orgasm, in addition to evaluation of female sexual function using the Female Sexual Function Index survey, with a total score <26.55 indicative of FSD. RESULTS: Of the 147 respondents, 96 (65%) met inclusion criteria of adequately completing the survey, having a biological vagina, and working in the adult entertainment industry. The mean age was 34.1 ± 10.3 years (range 20-66). The average Female Sexual Function Index score was 28.7 ± 5.6, and 24.0% (23 of 96) of entertainers had scores indicative of FSD. Overall, women found their personal sex lives more satisfying when compared with their professional sex lives (3.99 ± 1.40 vs 3.08 ± 1.52, P < .01). When comparing women with FSD to those without FSD, women with FSD had less sexual satisfaction at home (2.8 ± 1.7 vs 4.4 ± 1.0, P < .01), fewer overall sexual events (7.0 ± 6.7 FSD vs 12.9 ± 10.0 non-FSD, P < .01), and fewer satisfying sexual events overall (3.3 ± 4.2 vs 10.7 ± 8.7, P < .01). CLINICAL IMPLICATIONS: FSD is prevalent among all women, including those within the adult entertainment industry, and must be addressed during patient interactions. STRENGTH & LIMITATION: This is the first study to evaluate the novel group of female adult entertainers. Despite this novel population, the study size is rather small and is susceptible to response bias. CONCLUSION: FSD appeared to be less prevalent among female adult entertainers than rates commonly quoted for the general population and was more often seen in the women with less satisfying personal sex lives. Dubin JM, Greer AB, Valentine C, et al. Evaluation of Indicators of Female Sexual Dysfunction in Adult Entertainers. J Sex Med 2019;16:621-623.

Clinic-level complexities prevent effective engagement of people living with HIV who are out-of-care.

Approximately half of people living with HIV (PLWH) in the United States are not retained in HIV care. Although numerous studies have identified individual-level barriers to care (i.e., substance abuse, mental health, housing, transportation challenges), less is known about institutional-level barriers. We aimed to identify clinic-level barriers to HIV care and strategies to address them to better engage PLWH who have been out of care (PLWH-OOC). As part of a larger qualitative study in a Ryan White-funded HIV Clinic in Atlanta, which aimed to understand the acceptance and feasibility of community-based HIV care models to better reach PLWH-OOC, we explored barriers and facilitators of HIV care engagement. From October 2022-March 2023, 18 in-depth-interviews were conducted with HIV-care providers, administrators, social workers, and members of a Community Advisory Board (CAB) comprised of PLWH-OOC. Transcripts were coded by trained team members using a consensus approach. Several clinic-level barriers emerged: 1) the large burden placed on patients to provide proof of eligibility to receive Ryan White Program services, 2) inflexibility of provider clinic schedules, 3) inadequate processes to identify patients at risk of disengaging from care, 4) poorly-resourced hospital-to-clinic transitions, 5) inadequate systems to address primary care needs outside of HIV care, and 6) HIV stigma among medical professionals. Strategies to address these barriers included: 1) colocation of HIV and non-HIV services, 2) community-based care options that do not require patients to navigate complex transportation systems, 3) hospital and community-based peer navigation services, 4) dedicated staffing to identify and support PLWH-OOC, and 5) enhanced systems support to help patients collect the high burden of documentation required to receive subsidized HIV care. Several systems-level HIV care barriers exist and intersect with individual and community-level barriers to disproportionately affect HIV care engagement among PLWH-OOC. Findings suggest several strategies that should be considered to reach the remaining 50% of PLWH who remain out-of-care.

Erectile dysfunction among male adult entertainers: a survey.

BACKGROUND: Erectile dysfunction (ED) has not been evaluated among male adult entertainers. Our goal was to evaluate the prevalence of ED and use of erectile aids among men working in the adult entertainment industry. METHODS: An online survey was distributed to male adult entertainers through collaboration with the Free Speech Coalition (FSC), the North American Trade Association of the Adult Industry. Surveys were sent via email to those who met the criteria of being non-transgender men with biological penises and have experience as adult entertainers. The survey acquired baseline characteristics, use and frequency of erectile aids, and assessed erectile function using the International Index of Erectile Function (IIEF) survey. Statistical analysis was performed in Microsoft Excel. RESULTS: Of the 98 respondents, 62 met inclusion criteria. The median age was 36 (IQR 28.25-45) years. Of those included, 69.4% (43/62) used erectile aids. In men who used erectile aids, 58.1% (25/43) used for both work and personal reasons. Erectile aids were used most among young men aged 20-29 (84.2%). Overall, 38.7% (24/62) of men had ED as defined by the IIEF survey. Of note, 26.3% (5/19) of men aged 20-29 had moderate to severe ED. CONCLUSIONS: This is the first study to evaluate ED among adult male entertainers. Male entertainers between the ages of 20-29 had both the highest prevalence of moderate to severe ED and the highest erectile aid usage among all male adult entertainers.