Experiences of Successful PrEP Uptake Among Adolescent Sexual Minority Men in the United States: A Qualitative Exploration.

Male adolescent sexual minorities are at elevated risk of HIV acquisition yet demonstrate low rates of PrEP uptake. Understanding the experiences of adolescents who have successfully accessed PrEP may inform ways to best support adolescents seeking PrEP. Adolescent sexual minorities (N = 100) who reported utilizing PrEP responded to open-ended items asking about their initial PrEP experiences and advice for others. Qualitative analysis suggested that adolescents' ability to access PrEP is influenced by managing parental involvement and seeking culturally competent health care providers. Additionally, they reported how the benefits and drawbacks of taking PrEP played a role in their PrEP use. Findings suggest that educational PrEP interventions targeted at this population could improve uptake by incorporating discussions on side effects and mental health benefits associated with PrEP use. Structural interventions are warranted that improve adolescents' ability to seek sexual health care independently and make room for parental involvement when adolescents could benefit from their support.

Acceptability of 'Humpr': An Online Tool to Educate Adolescent Sexual Minority Males About Sexual Networking Applications.

We examined the acceptability of Humpr - an interactive, online tool developed to educate adolescent sexual minority males (ASMM) about how to safely navigate sexual networking applications (SNA). We developed Humpr as part of a larger HIV intervention trial in the U.S. In Humpr, 218 ASMM aged 14-20 (Mage = 17.18) created a mock dating profile, explored simulated user profiles, learned health-related information (e.g. slang indicating HIV/STI risks and/or drug use intentions), and then gave feedback regarding acceptability of the tool. Results showed that Humpr was very well-received, with 94% overall approval rates. Reasons for liking Humpr were evenly split between liking it for educational and entertaining reasons. Participants praised Humpr for its realistic design and interactive interface that allowed them to engage and connect with the tool. The majority (61%) had used SNAs in the past, but many still reported learning something new from Humpr. Participants also appreciated the acknowledgment of SNA use in ASMM and how the education was implemented in an open and judgment-free way. Topics learned from Humpr included how to be safe on SNAs and warning signs for HIV/STI risks. Suggested areas of improvement included having an opt-out option for those who do not wish to participate for any reason (e.g. discomfort) and additional educational content (e.g. consequences of being a minor on SNAs). Taken together, the findings offer preliminary evidence for the potential educational benefits of digital tools like Humpr for ASMM with and without prior SNA exposure.

Sexual Arousal-Delay Discounting: When Condoms Delay Arousal.

Sexual arousal plays an important role in condom use decisions. However, combined effects of reduced sexual arousal and delay to achieving arousal on condom use decisions remain understudied. This study used a novel sexual arousal-delay discounting (SADD) task to measure individuals' willingness to use a condom in situations where condom use would (1) delay time to arousal and (2) reduce the level of arousal one could achieve even after the delay (e.g., 5 minutes to reach 50% arousal). In Study 1, U.S. college students (N = 115; Mage = 18.6) reported their willingness to have sex with a condom in hypothetical scenarios where the condom delayed and reduced their partner's sexual arousal. In Study 2, U.S. college students (N = 208; Mage = 19.6; 99% ≤ 24 years old) completed the same task for two partners-partner perceived as most desirable and partner perceived as least likely to have an STI. In this study, a condom would affect either participants' own or partner's arousal. Study 3 replicated Study 2 using a non-college sample in the U.S. (N = 227; Mage = 30.5; 84% ≥ 25 years old). Across studies, willingness to use a condom decreased as the delay to reduced arousal increased. This effect of SADD was stronger when condoms reduced participants' own (vs. partner's) arousal, whereas comparisons between most desirable and least likely-to-have-STI partners provided mixed findings. Men had higher discounting rates than women across conditions. Greater SADD was associated with lower condom use self-efficacy, providing initial evidence for the task's validity. The role of delayed arousal in condom use and implications are discussed.

Delay Discounting for HIV/STI Testing.

Introduction: Wait time in healthcare is an important barrier to HIV/STI testing. Using a delay discounting approach, the current study examined a systematic reduction in testing likelihood as a function of delay (wait time) until testing. Methods: In Study 1 (N = 421; data collected in 2019), participants were randomly assigned to either a chlamydia/gonorrhea group or HIV group. A delay discounting task asked them to report how likely they would get tested for the assigned STI if they had to wait for the test (the delay durations varied within persons). In Study 2 (N = 392; data collected in 2020), we added a smaller, sooner outcome (consultation without testing) and tested whether the effect of delay was mediated by perceived severity of the STIs. Results: In both studies, the subjective value of a delayed STI test was discounted. That is, people were less likely to undergo STI testing as the delay to STI testing increased. The chlamydia/gonorrhea group discounted delayed testing more than the HIV group (i.e., the effect of delay on testing decisions was stronger for the former). This effect was statistically mediated by perceived severity. Conclusions: We found evidence for delay discounting for HIV/STI testing and that testing decisions were more susceptible to delay when the test was for relatively mild STIs. Policy Implications: Even mild STIs can cause serious health damage if left untreated. The findings provide strong argument for policies aimed to reduce wait times in healthcare, especially for relatively mild STIs.

Occurrence, Frequency, and Correlates of Faking Orgasm and Satisfaction in Sexual Minority Men.

Existing literature on "faking" orgasm focuses almost exclusively on women. Limited research exists among men, and none focuses on sexual minority (e.g., gay, bisexual, queer) men. Additionally, faking satisfaction (pretending to be sexually satisfied) remains an unknown concept. This study examined the occurrence, frequency, and correlates of faking orgasm and satisfaction in sexual minority men. Participants (N = 211, age = 18-53, 59% identified as gay) responded to an online survey assessing frequencies of faking orgasm and satisfaction as well as potential correlates of faking (age, relationship status, sexual frequency, orgasm frequency, internalized sexual stigma). Results showed that faking orgasm and faking satisfaction were highly prevalent among sexual minority men in this sample (83% had faked orgasm and 88% had faked satisfaction in the past two years). The frequency of faking was also high; 62% and 68% faked orgasm and satisfaction at least "sometimes." Higher internalized sexual stigma and lower orgasm frequency were associated with higher frequencies of faking orgasm and satisfaction. For faking orgasm, however, the relationship between internalized sexual stigma and faking only existed in gay men. The findings suggest that faking pleasure in sexual minority men is common and deserves more empirical attention.

Waiting for medical test results: A delay discounting approach.

RATIONALE AND OBJECTIVE: Delay discounting is the devaluation of an outcome as a function of delay until receiving that outcome. In two studies, we used a delay discounting approach to examine how wait times for a medical diagnosis can affect people's decision to undergo medical testing. METHODS: In Study 1 (N = 151), participants rated the likelihood they would get tested for a severe and a mild disease with wait times ranging from 0 to 180 days (within persons). Study 2 (N = 400) randomized disease severity (severe vs. mild) between persons and manipulated disease curability (curable vs. incurable). RESULTS: Likelihood of testing decreased as delay until receiving test results increased. This effect of delay on testing was stronger for the mild than for the severe disease, and for the curable than for the incurable disease. CONCLUSIONS: We found strong evidence for a delay discounting effect, an effect that varied depending on aspects of diseases. The findings illustrate how delay discounting can affect screening uptake and how it is moderated by disease characteristics.

"We have to figure it out ourselves": Transfeminine adolescents' online sexual experiences and recommendations for supporting their sexual health and wellbeing.

The internet plays a significant role in adolescent sexual development. Sexual and gender minority (SGM) adolescents are more likely than their cisgender, heterosexual peers to use online spaces for sexual and romantic purposes, as they may have a smaller pool of potential partners and more concerns about the risks of in-person partner seeking. Among SGM adolescents, gender identity may shape how youth navigate online spaces for sexual purposes but there is limited research focused on transgender and gender diverse (TGD) adolescents' online partner seeking. Previous research has focused on cisgender gay and bisexual boys' experiences with sexual networking applications designed for adult men who have sex with men. This perspective article integrates clinical expertise and survey data from transfeminine adolescents (N = 21) in the United States reporting their online sexual behavior and experiences. We use qualitative data to describe the sexual health, safety, and wellbeing of transfeminine adolescents and offer suggestions for clinical assessment of online versus offline sexual activity and call for inclusive sexual health resources for transfeminine adolescents.

It's The "Why": Links between (Non)autonomous Sexual Motives, Sexual Assertiveness, and Women's Orgasm in Casual Sex.

Existing literature shows conflicting and inconclusive evidence regarding women's sexual experiences in casual sex. Some studies have found negative sexual outcomes (e.g., fewer orgasms), while others have found positive sexual outcomes (e.g., more orgasms, higher sexual satisfaction) when women had casual sex. According to self-determination theory (Deci & Ryan, 1985), people's needs are fulfilled when their choice and behavior are self-motivated and reflect their intrinsic values. We hypothesized that women's autonomous motivation to have casual sex would be associated with higher orgasmic function, whereas nonautonomous motivation would be associated with lower orgasmic function in casual sex. We also hypothesized that sexual assertiveness would mediate the relationship between sexual motives and orgasmic function in casual sex. Participants in this study were women (N = 401) aged 18-59 years who reported having had casual sex in the past 12 months. Participants completed an online survey reporting their motives to have casual sex, sexual assertiveness, and orgasmic function (e.g., orgasm frequency, satisfaction with orgasm) in casual sex. We focused on two motives: (a) pleasure motive and (b) insecurity (i.e., self-esteem boost and pressure) motive. Results showed that greater pleasure (autonomous) motives related to higher sexual assertiveness, which in turn related to higher orgasmic function in casual sex. In contrast, greater insecurity (nonautonomous) motives related to lower sexual assertiveness, which in turn related to lower orgasmic function in casual sex. The findings support self-determination theory, suggesting that autonomous motives are important for women's sexual experience in casual sex.

Predictors of Face and Body Visibility in Online Dating Applications Among Young Men Who Have Sex with Men.

In this study, we explored the factors relating to face and body visibility in young men who have sex with men (YMSM) from online dating applications. Research on visual self-presentation in online dating applications, especially in YMSM, remains scarce. The sample consisted of 339 young men (ages 18-24 years) who had casual sex with one or more male partners from online dating applications. Participants completed an online survey asking how visible their face and body were on their profile pictures. For body visibility, participants rated the visibility of their upper and lower body separately. We also computed difference scores between face and body visibility to measure face visibility in relation to body visibility (e.g., showing more-visible face compared to body). Predictors included self-rated attractiveness, fear of being identified on the applications, and motives for application use. Participant age and duration of application use were statistically controlled in all analyses. Results showed that higher perceived attractiveness related to higher upper- and lower-body visibility on profile pictures. Greater fear of being identified related to lower face visibility and less-visible face relative to upper- and lower-body visibility. Having a relationship motive was associated with higher face visibility. Older age and longer duration of application use were associated with more-visible face relative to lower body. The findings contribute to the literature on visual self-presentation in online dating applications in young and vulnerable sexual minorities.

The Rise, Demise, and Reprise of the Increasingly Protracted APA Journal Article?

Are APA journal articles getting longer or shorter over time? Earlier work that examined changes over time in article length in 24 APA journals (1986-2005) found that pages per article increased over time for the average journal, peaking around 2001, and then plateaued thereafter. But have these trends continued during the past 14 years? The current research extends prior work by adding additional years (1986-2019) and four additional journals (28 journals, 34 years, and 865 total observations). Multilevel growth curve analyses revealed a cubic effect of time on average article length, showing an increase in the 1980s and 1990s, a plateau or slight decline in the 2000s, and a slight increase again in the 2010s. Journal impact factors (JIFs) moderated linear growth over time; journals with higher JIFs had larger linear increases in article length. Exploratory multilevel interrupted time-series analyses suggested that the average linear increase in pages per article over time was greater after the start of psychology's credibility crisis (2012-2019) than before it (1986-2011), which may relate to an increased emphasis on reporting details and transparency. We discuss implications for article length in the contexts of publishing and psychology's ongoing credibility crisis.

American psychology is becoming more international, but too slowly: Comment on Thalmayer et al. (2020).

Commenting on Thalmayer, Toscanelli, and Arnett (2020), we provide broader analysis of the national institutional affiliations of authors (2,978), editors (286), and consulting editors (2,652) from seven (vs. six) American Psychological Association (APA) journals that span over 40 (vs. 30) years. Using multilevel models, results showed that percentages of lead authors at American institutions decreased linearly and significantly and over time. Predicted mean percentages of American authors were 86% in 1978 versus 54% in 2018, a decrease of 37%. Percentages of editors and consulting editors at American institutions also decreased significantly; however, the effect for consulting editors was also quadratic-the linear decline accelerated over time. Predicted mean percentages of American consulting editors at 10-year intervals (1980-2020) were 94%, 92%, 89%, 80%, and 69%. Our 2020 predicted mean of 69% American consulting editors was notably lower than Thalmayer et al.'s (2020) 2018 mean of 82%. In addition, higher-impact journals had more pronounced quadratic declines in the percentages of American consulting editors over time. American psychology continues to become more international, but not quickly enough. We concur with Thalmayer et al.'s (2020) policy proposals, especially that APA journals and their editors should actively pursue non-American associate and consulting editors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Attractiveness, profile-picture face visibility and unprotected receptive anal intercourse in young men who have sex with men using online dating applications.

Background We examined links among face visibility on dating-profile pictures, self-perceived attractiveness, condom use self-efficacy, and unprotected receptive anal intercourse (URAI) in 223 young men who have sex with men (YMSM; ages 18-24 years) using online dating applications (e.g. Grindr). METHODS: Participants reported their face visibility on their main dating-profile picture, attractiveness, condom use self-efficacy, and frequency of URAI in the past 3 months. Number of casual sex partners and pre-exposure prophylaxis (PrEP) use were statistically controlled in all analyses. RESULTS: Using a mediated moderation model, we found that a significant attractiveness-by-face-visibility interaction for URAI was fully mediated by condom use self-efficacy. Specifically, lower face visibility on profile pictures related to lower condom use self-efficacy, which in turn related to higher URAI, but only among highly attractive YMSM. CONCLUSIONS: Our findings suggest that attractive YMSM who show less-visible faces on their dating profiles could be at particularly high risk for sexually transmissible infections. This study has potentially important clinical implications because dating applications have become one of the most common ways for YMSM to find sexual partners.

Sexual Arousal Discounting: Devaluing Condom-Protected Sex as a Function of Reduced Arousal.

Sexual discounting is a growing area of research aimed at identifying factors that reduce people's reported willingness to have safe sex. One commonly reported reason for condom non-use is that a condom reduces sexual arousal. However, researchers have yet to isolate the specific role of sexual arousal using a sexual discounting framework. We extended past research by measuring how sexual arousal reduced people's willingness to have condom-protected sex ("sexual arousal discounting": SAD). College students (n = 379; 67.5% females) selected partners they most wanted and least wanted to have sex with and were randomized to one of two groups. In one group, participants rated their willingness to have sex with a condom if their own arousal decreased (from 100 to 10%) from condom use. The other group completed the same task except their partner's arousal decreased from condom use instead of their own. We observed a three-way interaction between arousal levels, most versus least desirable partners, and self versus partner groups. Participants' willingness to have condom-protected sex systematically reduced as a function of sexual arousal. This was observed more with the most (vs. least) desirable partner and in the self-arousal (vs. partner-arousal) group but only when the partner was their least desirable. Men (vs. women) displayed more arousal discounting but only with the most desirable partner. Finally, higher arousal discounting was associated with lower safe-sex self-efficacy and higher reported frequency of unprotected sex in the past 3 months. This study demonstrates how reduced sexual arousal from condom use can be measured as a factor influencing sexual risk-taking.

Culture, COVID-19, and collectivism: A paradox of American exceptionalism?

Do geographic differences in collectivism relate to COVID-19 case and death rates? And if so, would they also replicate across states within arguably the most individualistic country in the world-the United States? Further still, what role might the U.S.'s history of ethnic strife and race-based health disparities play in either reinforcing or undermining state-level relations between collectivism and COVID-19 rates? To answer these questions, we examined archival data from 98 countries (Study 1) and the 48 contiguous United States (Study 2) on country/state-level collectivism, COVID-19 case/death rates, relevant covariates (per-capita GDP, population density, spatial dependence), and in the U.S., percent of non-Whites. In Study 1, country-level collectivism negatively related to both cases (r = -0.28) and deaths (r = -0.40) in simple regressions; however, after controlling for covariates, the former became non-significant (r p = -0.07), but the latter remained significant (r p = -0.20). In Study 2, state-level collectivism positively related to both cases (r = 0.56) and deaths (r = 0.41) in simple regressions, and these relationships persisted after controlling for all covariates except race, where a state's non-White population dominated all other predictors of COVID-19 cases (r p = 0.35) and deaths (r p = 0.31). We discuss the strong link between race and collectivism in U.S. culture, and its implications for understanding COVID-19 responses.

Women's Orgasm and Sexual Satisfaction in Committed Sex and Casual Sex: Relationship Between Sociosexuality and Sexual Outcomes in Different Sexual Contexts.

Previous studies have found that women report more orgasm and sexual satisfaction from sex in committed relationships than from casual sex. We examined whether sociosexual orientation was associated with these differences, and explored the links between sociosexuality and sexual outcomes in these two sexual relationship contexts. Sexually active women (n = 1,084) completed an online survey measuring sociosexual orientation, orgasmic function, and sexual satisfaction. Participants reported sexual outcomes (orgasmic function and sexual satisfaction) with respect to their sexual activity over the past 12 months in a casual context (if applicable), and separately in a committed context (if applicable). Among women who had both casual and committed sex in the past year, orgasmic function and sexual satisfaction differed between these two relationship contexts only for more sexually restricted women (lower sociosexuality). In the full sample, higher sociosexuality was associated with higher orgasmic function in casual sex and with lower sexual satisfaction in committed sex. These findings underscore the importance of examining interactions between individual differences and contextual factors when studying women's sexual outcomes.

Devaluation of Safe Sex by Delay or Uncertainty: A Within-Subjects Study of Mechanisms Underlying Sexual Risk Behavior.

The value of safe sex may be discounted based on contextual factors associated with an opportunity for sex. College students in a within-subjects study selected hypothetical sexual partners from a set of pictures and classified them based on attractiveness and estimated chance of having an sexually transmitted infection (STI). In the Sexual Delay Discounting (SDD) task, participants rated their likelihood (0-100 %) of waiting for some period of time (e.g., 3 h) to have protected sex with their selected partners, when they could have immediate sex without protection. In the Sexual Probability Discounting (SPD) task, participants rated their likelihood of having protected sex if the opportunity was uncertain (e.g., 50 %), when they could have unprotected sex for sure (100 %). All participants included in the final analyses were aware of and had a positive attitude towards protection against STIs as they were likely to have immediate (or certain) protected sex. Results from 432 delay data in the SDD task and 488 probability data in the SPD task showed that participants' preference for safe sex systematically decreased as the delay to and odds against having safe sex increased. However, this preference was altered by the participants' perception of their partner's attractiveness and STI risk.