Prevalence and Correlates of Sexual Aversion: A Canadian Community-Based Study.

BACKGROUND: Sexual aversion (SA) is a chronic difficulty impacting sexual, relational and psychological wellbeing. Yet, there is a dearth of studies exploring its prevalence and associated factors. AIM: To estimate the prevalence of SA and examine its correlates among a community sample of Canadian adults. METHODS: A large web-based sample of the Quebec (Canada) adult population (n = 1,935) completed an online survey on sexual wellbeing. Prevalence rates were estimated for SA and other sexual difficulties. Multivariate logistic regression analyses were used to identify correlates of SA. OUTCOMES: Demographics (eg, gender, employment status), self-reported experiences of sexual difficulties (low sexual desire and arousal, vaginal dryness, pain during sexual intercourse, erectile difficulties, premature or delayed ejaculation, and orgasm difficulties), and markers of psychosexual wellbeing (eg, psychological distress, performance anxiety) according to the presence or absence of SA were assessed. RESULTS: The prevalence of SA was 9.7% (95% CI: 8.5-11.2) in the present sample (6.9% [95% CI: 5.1-8.9] in men, 11.3% [95% CI: 9.4-13.4] in women and 17.1% [95% CI: 9.4-27.4] in nonbinary and/or trans individuals). The multivariate logistic regression model explained 31% of the likelihood of experiencing SA. SA was related to psychological distress (aOR: 1.77, 95% CI: 1.33-2.38), sexual satisfaction (aOR: .59, 95% CI:.49-0.70), sexual performance anxiety (aOR: 2.08, 95% CI: 1.45-2.98), and discomfort with sex-related information (aOR: 1.02, 95% CI: 1.01-1.04) CLINICAL IMPLICATIONS: Several psychosexual correlates of SA were documented and could be targeted by practitioners during the assessment and treatment of individuals living with SA. STRENGTHS AND LIMITATIONS: The study's strengths include its large, gender diverse sample and use of comprehensive diagnostic criteria for SA. Probability-based sampling methods and longitudinal studies should be conducted to address the current study's limitations. CONCLUSION: SA research is critical to document its prevalence in different sociodemographic groups, explore additional intrapersonal and interpersonal mechanisms involved in SA etiology, and ensure that the needs of people living with SA are met with tailored interventions. David Lafortune, Éliane Dussault, Mathieu Philibert, Natacha Godbout. Prevalence and Correlates of Sexual Aversion: A Canadian Community-Based Study. J Sex Med 2022;19:1269-1280.

Associations between neighborhood characteristics and dating violence: does spatial scale matter?

BACKGROUND: Dating violence (DV) is a public health problem that could have serious repercussions for the health and well-being of a large number of adolescents. Several neighborhood characteristics could influence these behaviors, but knowledge on such influences is still limited. This study aims at (1) evaluating the associations between neighborhood characteristics and DV, and (2) assessing how spatial scale influences the estimations of the latter associations. METHODS: The Québec Health Survey of High School Students (2016-2017) was used to describe DV. Neighborhoods were operationalized with polygon-based network buffers of varying sizes (ranging from 250 to 1000 m). Multiple data sources were used to describe neighborhood characteristics: crime rate, alcohol outlet density (on-premises and off-premises), walkability, greenness, green spaces density, and youth organizations density. Gendered-stratified logistic regressions were used for assessing the association between neighborhood characteristics and DV. RESULTS: For boys, off-premises alcohol outlet density (500 m) is associated with an increase in perpetrating psychological DV. Crime rate (500 m) is positively associated with physical or sexual DV perpetration, and crime rate (250 m) is positively associated with physical or sexual DV victimization. Greenness (1000 m) has a protective effect on psychological DV victimization. For girls, walkability (500 m to 1000 m) is associated with a decrease in perpetrating and experiencing psychological DV, and walkability (250 m) is negatively associated with physical or sexual DV victimization. CONCLUSIONS: Several neighborhood characteristics are likely to influence DV, and their effects depend on the form of DV, gender, and spatial scale. Public policies should develop neighborhood-level interventions by improving neighborhood living conditions.

Neighborhood Social Support and Social Participation as Predictors of Dating Violence.

Many adolescents experience violence in the context of dating and romantic relationships. Neighborhoods can influence dating violence by offering certain resources which can provide social support and opportunities for social participation, but knowledge about these effects is still limited. The purpose of the current study was to (a) assess the association between neighborhood social support, social participation, and dating violence, and (b) explore possible gender difference in these associations. This study was conducted on a subsample of 511 participants living in Montréal from the Québec Health Survey of High School Students (QHSHSS 2016-2017). QHSHSS data were used to measure psychological and physical/sexual violence (perpetration and victimization), neighborhood social support, and social participation, as well as individual and family covariates. Several neighborhood-level data from multiple sources were also used as covariates. Logistic regressions were performed to estimate associations between neighborhood social support and social participation, and Dating violence (DV). Analyses were conducted separately for girls and boys to explore possible gender differences. Findings suggest that girls who reported high neighborhood social support had a lower risk of perpetrating psychological DV. High social participation was associated with a lower risk of perpetrating physical/sexual DV for girls, whereas it was associated with a higher risk of perpetrating psychological DV for boys. Preventive strategies to foster social support in neighborhoods, such as mentoring programs, and the development of community organizations to increase the social participation of adolescents could help reduce DV. To address the perpetration of DV by boys, prevention programs in community and sports organizations targeting male peer groups should also be developed to prevent these behaviors.

Associations between small-area sociodemographic characteristics and intimate partner violence in Montréal, Québec.

Background: Intimate partner violence (IPV) affects many individuals and can have a significant impact on their health and well-being. In order to inform prevention strategies, several studies have focused on the determinants of IPV. However, knowledge on the association between neighbourhood characteristics and IPV remains scarce. The social disorganization theory posits that certain neighbourhood characteristics are associated with violent behaviours. This theory has been used to explain spatial variations in IPV, but most studies have been conducted in the United States. Little is known about the effect of neighbourhood factors in urban contexts outside of the United States. Design and methods: Using police data from 2016 and 2017, this study estimated the association between sociodemographic characteristics of neighbourhoods (socioeconomic status, single-parenthood, residential instability and ethnocultural heterogeneity) and IPV victimization in Montréal, Québec. Results: Results suggest a neighbourhood-level variation in IPV, and that neighbourhood-level characteristics are associated with IPV victimization. Specifically, the likelihood of IPV is higher in neighbourhoods with the lowest SES level (OR = 2.80, 95%CI: 2.47-3.17, p < 0.001) and the lowest level of residential instability (OR = 0.81, 95%CI: 0.70-0.93, p = 0.003) as well as the highest proportion of single-parent households (OR = 1.88, 95%CI: 1.65-2.15, p < 0.001). Conclusion: Although neighbourhood-level interventions to reduce IPV are rare, our results highlight the importance of developing such preventive strategies. Prevention programs targeting high-risk neighbourhoods may prove effective in reducing IPV.

Who seeks sex therapy? Sexual dysfunction prevalence and correlates, and help-seeking among clinical and community samples.

Sexual dysfunctions (SD; e.g., female sexual interest/arousal disorder, erectile disorder, female orgasmic disorder, delayed ejaculation, genito-pelvic pain/penetration disorder, etc.) affect up to a third of individuals, impairing sexuality, intimate relationships, and mental health. This study aimed to compare the prevalence of SDs and their sexual, relational, and psychological correlates between a sample of adults consulting in sex therapy (n = 963) and a community-based sample (n = 1,891), as well as examine barriers to sexual health services for SD and the characteristics of individuals seeking such services. Participants completed an online survey. Analyses showed that participants in the clinical sample reported lower levels of sexual functioning and sexual satisfaction and higher levels of psychological distress than participants in the community-based sample. Moreover, higher SD rates were related to lower relational satisfaction and higher psychological distress in the community sample, and to lower sexual satisfaction in both samples. Among participants in the community sample who sought professional services for SD, 39.6% reported that they were unable to access services, and 58.7% reported at least one barrier to receiving help. This study provides important data regarding the prevalence of SD and the link between SD and psychosexual health in clinical and nonclinical samples, as well as barriers to treatment access.

Social resource patterns and health outcomes among Canadian LGBTQ2+ adults: A latent class analysis.

BACKGROUND: Decades of research have shown a strong association between wellbeing, health, and social resources. LGBTQ2+ communities are among those who historically have been excluded from accessing quality social resources. However, little is known about how access to different types of resources influences mental health and wellbeing. METHOD: Data were drawn from an online sample of 3890 LGBTQ2+ people aged 18 years and older in Quebec, Canada. We identified key social resource patterns (from family of origin, friends, partner, neighbourhood, and LGBTQ2+ community) and investigated differences in socio-demographic and health outcomes across classes. RESULTS: A five-class solution best fitted the data, highlighting distinctive patterns in access to five key social resources: moderate friend support access (42.14%), overall high support access (23.51%), high friend support access (18.06%), only close ties support access (10.90%) and overall low support access (5.39%). Marginalized groups (trans and non-binary people, racialized or disabled people, immigrants) were less likely to access diverse, high-quality social resources. Accessing diverse social resources, particularly close ties (e.g., family of origin), was associated with better health outcomes. In the absence of close ties, having at least one other social resource was associated with better health outcomes compared to having limited access to all resources. CONCLUSIONS: We found a major imbalance in social resource access among LGBTQ2+ people. Creating safe spaces for LGBTQ2+ people and ensuring access to high-quality social resources is important in sustaining their health and wellbeing.

Predictors of Residential Mobility among Older Canadians and Impact on Analyses of Place and Health Relationships.

This study aimed to identify predictors of residential mobility in 55+ Canadians, to characterise neighbourhood changes following mobility, to assess whether such changes differ according to income, and to evaluate for cross-sectional estimations of place-health relationships the extent of bias associated with residential mobility. Using longitudinal data from the Canadian National Population Health Study (NPHS), residential mobility was operationalised by a change in postal code between two consecutive waves. Individuals' sociodemographic factors and neighbourhood characteristics were analysed in relation to mobility. Bias in cross-sectional estimations of place-health associations was assessed analysing neighbourhood-level deprivation and housing quality in relation to self-assessed health. Multiple age-related events were predictive of moving. Three out of 10 individuals moved at least once. Two thirds of movers experienced a change in neighbourhood type and such changes were not associated with income. No systematic biases in estimating place effects on health using cross-sectional data were observed. Given that individual-level socioeconomic status (SES) was neither a predictor of moving nor of its consequences in terms of neighbourhood type, controlling for SES could potentially lead to biased estimations of place-health associations. Results suggest that cross-sectional data can yield valid estimations of place-health associations among older adults.

Conceptual and operational considerations in identifying socioenvironmental factors associated with disability among community-dwelling adults.

Disability is conceived as a person-context interaction. Physical and social environments are identified as intervention targets for improving social participation and independence. In comparison to the body of research on place and health, relatively few reports have been published on residential environments and disability in the health sciences literature. We reviewed studies evaluating the socioenvironmental correlates of disability. Searches were conducted in Medline, Embase and CINAHL databases for peer-reviewed articles published between 1997 and 2014. We found many environmental factors to be associated with disability, particularly area-level socioeconomic status and rurality. However, diversity in conceptual and methodological approaches to such research yields a limited basis for comparing studies. Conceptual inconsistencies in operational measures of disability and conceptual disagreement between studies potentially affect understanding of socioenvironmental influences. Similarly, greater precision in socioenvironmental measures and in study designs are likely to improve inference. Consistent and generalisable support for socioenvironmental influences on disability in the general adult population is scarce.

Neighborhood characteristics associated with the availability of alcohol outlets in quebec, Canada.

Objectives. The objectives of this study were to examine the spatial accessibility to alcohol outlets in Quebec and to assess the association between neighborhood level characteristics and availability of alcohol outlets. Methods. The Tobit Model was used to assess the association between neighborhood level characteristics and the availability of alcohol outlets within 500, 1000, 2000, and 3000 metres, respectively. Results. Alcohol outlets were found to be most available in the two largest metropolitan areas of the province of Quebec (Montréal and Québec City). Within 1000 metres, alcohol outlets are more available in neighbourhoods with the following characteristics: highest concentration of men, least materially deprived highest concentration of persons aged 20 years or more, and location either in a metropolitan area or in a small town. Finally, the number of bars with video lottery terminals increases with the level of social and material deprivation. Conclusion. In Québec, there is no rule governing the location of alcohol outlets. Thus, there is an abundant literature indicating that the regulation of alcohol outlet density could be an effective means of controlling risk attributable to alcohol consumption.

Interactions between neighborhood characteristics and individual functional status in relation to disability among Québec urbanites.

BACKGROUND: Disability is conceived as a person-context interaction. Neighborhoods are among the contexts potentially influencing disability. It is thus expected that neighborhood characteristics will be associated with disability prevalence and that such associations will be moderated by individual-level functional status. Empirical research targeting the influences of features of urban environments is relatively rare. OBJECTIVES: To evaluate the presence of contextual differences in disability prevalence and to assess the moderating role of individual functional status on the association between neighborhood characteristics and disability prevalence. METHODS: Multi-level analyses of individual-level data obtained from the Canadian Community Health Survey and neighborhood-level data derived from the Canada census. RESULTS: A contextual component was observed in the variability of disability prevalence. Significant neighborhood-level differences in disability were found across levels of social deprivation. Evidence of person-place interaction was equivocal. CONCLUSIONS: The contextual component of the variability in disability prevalence offers potential for targeting interventions to neighborhoods. The pathway by which social structure is associated with disability prevalence requires further research. Analyses of particular functional limitations may enhance our understanding of the mechanisms by which socioenvironmental factors affect disability. Publicly available survey data on disability in the general Canadian population, while useful, has limitations with respect to estimating socioenvironmental correlates of disability and potential person-place interactions.

Geographic access to mammography screening centre and participation of women in the Quebec Breast Cancer Screening Programme.

BACKGROUND: This study evaluated the impact of distance between women's residences and designated screening centres (DSC) on participation in the Quebec Breast Cancer Screening Programme, whether this impact varied according to the rural-urban classification and the proportion of participants who used the DSC nearest to their home. METHODS: Travel distance between the residence of 833 856 women and the nearest DSC (n=85) was estimated. Data were obtained from administrative and screening programme databases. The analysis made use of a log-binomial regression model adjusting for age and material and social deprivation. The proportions of participants who used the DSC nearest to their residence were measured. RESULTS: Compared to women living <2.5 km from a DSC, absolute decreases of 6.3% and 9.8% in participation rate were observed for distances of 50.0 to <75.0 km (rate ratios (RR)=0.88, 95% CI 0.86 to 0.89) and ≥75.0 km (RR=0.81, 95% CI 0.79 to 0.83), respectively. The lowest participation (42%) was observed in Montreal Island. The distance at which participation started to decrease materially varied according to rural-urban classification. Participation rates decreased at distances of ≥25.0 km in the Montreal suburbs and midsize cities, at ≥12.5 km in small cities and at ≥50.0 km in rural areas (interaction p<0.0001). The proportion of participants who had their mammography at the nearest DSC decreased with increasing distance. CONCLUSIONS: Distance affects participation and this effect varies according to rural-urban classification. The lower participation in Montreal Island, where all women lived <12.5 km from a DSC, argues for a major impact of other characteristics or other dimensions of accessibility.

An area-based material and social deprivation index for public health in Québec and Canada.

OBJECTIVES: To overcome the absence of socio-economic information in administrative databases and to monitor social inequalities in health, a material and social deprivation index was developed for Québec and Canada. METHODS: The index is based on the smallest area unit used in Canadian censuses, with 400 to 700 persons on average. It includes six socio-economic indicators grouped along two dimensions - material and social - produced from principal component analyses. The index exists for 1991, 1996, 2001 and 2006 and in different versions, from local areas to the whole of Canada. Numerous products related to the index are available online free of charge. RESULTS: The index has been used extensively in the field of health and social services, mainly in the province of Québec but also elsewhere in Canada. It has had four main uses, all related to public health: describing geographic variations of deprivation, illustrating inequalities in population health status and in service use according to deprivation, supporting the development of health reports and policies, and guiding regional resource allocation. These applications are facilitated by a close partnership between the producers and users of the index. CONCLUSION: The deprivation index is a marker of social inequalities in health. It allows for monitoring of inequalities over time and space, and constitutes a useful tool for public health planning, intervention and service delivery.