Analysis of the Effectiveness of an Affective-Sexual Education Program for Adults with Intellectual Disabilities.

In recent years, the number of programs to improve sex education for people with intellectual disabilities has increased. However, in most cases, these programs do not provide any evidence of their impact. In the present study we analyzed the effectiveness of the SALUDIVERSEX affective-sexual education program for people with intellectual disabilities using a controlled trial design. 246 individuals from eastern Spain completed a battery of questionnaires before and after the intervention. Multilevel statistical analyses showed that the risk of experiencing sexual abuse had significantly decreased and knowledge about sexuality significantly increased among those who received the intervention compared to those who did not. The evaluation of the professionals who worked daily with the participants agreed on how knowledge about sexuality and intimacy increased and concerns about sexuality decreased among those in the intervention group. The SALUDIVERSEX program is a powerful educational strategy to promote better sexual health and quality of life for people with intellectual disabilities.

Sexual Victimization of Adolescents in Residential Care: Self-Reported and Other-Reported Prevalence.

Adolescents in the child welfare system have been exposed to multiple forms of victimization, most notably sexual victimization, many times underreported and misreported. The main aim of this study was to explore the lifetime prevalence of sexual victimization among adolescents in residential care in Eastern Spain, contrasting self-reported information compared to the information reported by the professionals. Sexual abuse/assault characteristics and effects of gender and age were analyzed. Additionally, the association between sexual revictimization and the relationship with the aggressor as well as the age of the first episode of sexual abuse/assault was analyzed. The sample comprised 346 adolescents (34.1% females, 65.9% males) aged between 11 and 19 years old. The prevalence of sexual victimization reported by adolescents was 35.3%, more than double compared to the information reported by professionals (16.9%). Females experienced significantly more sexual victimization than males (OR = 0.23, 95% CI [0.14, 0.37]). The age of the victim at the first episode of sexual abuse/assault and the relationship with the aggressor were explanatory variables of revictimization. Research such as this is crucial to ascertain that these adolescents have very different needs that will influence the design of affective-sexual education initiatives, which are essential to ensure healthy sexual development.

Mental Health of People with Intellectual Disabilities Living in Residential Care before, during, and after Lockdown.

BACKGROUND: The impact of the COVID-19 on the well-being of people with intellectual disabilities (PID) has been little studied. METHODS: We analyzed its impact with a cohort study quantitatively analyzing anxiety, depression, organic symptoms, quality of life, and support needs in 24 PID, aged 19-74 years (x¯ 40, σ = 13.09), living in a residential center, before, during, and after the pandemic. RESULTS: Their mental health improved unexpectedly at the onset of the lockdown although there was an increase in organic symptoms. But, with the progress of the lockdown, their mental health deteriorated drastically. On the contrary, as expected, their quality of life and support needs worsened from the beginning of the lockdown until the country returned to normality, a time when there was a general recovery, without reaching pre-pandemic levels. These results show that the mental health of PID was affected differently to that of people without intellectual disabilities.

SALUDIVERSEX: A quality of life and sexual health intervention for adults with mild intellectual disabilities.

Individuals with intellectual disabilities need an affective and sexual education adapted to their characteristics. There are few interventions that meet these objectives and offer empirical evidence of their efficacy. To respond to the limitations of existing interventions, an evidence-based affective-sexual educational intervention for adults with a mild degree of intellectual disability is proposed: SALUDIVERSEX. Participants will be randomly assigned to an intervention group that will receive the SALUDIVERSEX program or to a waiting list group. The intervention will be implemented by educators of occupational centers after a thorough training phase. Our main hypothesis is that the SALUDIVERSEX program will improve the sexual health and quality of life, through the joint action built into three components: the acquisition of basic information, the development of skills and strategies and the achievement of healthy attitudes towards the experience and expression of sexuality. The results of this approach could have important implications for optimizing the quality of life and self-determination of individuals with Intellectual disability by contributing to the development of healthy sexuality.

Salivary testosterone levels are associated with Compulsive Sexual Behavior (CSB) in men but not in women in a community sample.

Background and aims: Despite the inclusion of Compulsive Sexual Behavior (CSB) as a diagnostic entity in the ICD-11 and the increasing number of studies addressing psychological factors leading to its onset and maintenance, little is known about the role of hormonal factors when accounting for this clinical condition (especially in women). This study aimed to provide insights into the association between testosterone levels (i.e., the androgen more intimately linked to sexual desire and arousability) and CSB in both men and women. Methods: A total of 80 participants (40 men [Mage = 22.31; SD = 2.93] and 40 women [Mage = 21.79; SD = 2.06]) provided a saliva sample for the estimation of the level of free testosterone and completed a battery of measures assessing CSB and other related sexual domains (sexual sensation seeking and online/offline sexual behavior). Results: In men, salivary testosterone had a positive and significant correlation with three scales assessing CSB (r between 0.316 and 0.334). In women, these correlations were small and non-significant (r between 0.011 and 0.079). In both men and women, the level of salivary testosterone had small non-significant correlations with the other domains of sexual behavior assessed. Discussion and conclusions: Individuals' level of testosterone may contribute to the etiopathogenesis of CSB, but only in men. In women, alternative psychological -i.e., motivational, behavioral, or cognitive- processes may be playing a more central role in the expression of this condition.

People with intellectual disabilities' sexuality from three different perspectives: Parents, professionals, and themselves.

BACKGROUND: A positive conception of sexuality among people with intellectual disabilities is crucial and relies on several social and interpersonal contexts. The goal of this study is to analyse the interaction and impact of three different contextual groups: individuals with intellectual disabilities, their parents, and professionals working with them. METHODS: Survey data were collected from 330 people with intellectual disabilities attending occupational centres in eastern Spain, 330 parents, and 100 professionals. RESULTS: Correlation and variance analyses of dyad-level data show significant differences among the three groups in all variables. Professionals perceived people with intellectual disabilities to have higher knowledge of socio-sexual norms than people with intellectual disabilities actually appear to be, but they are also more concerned about aspects related to this area of people with intellectual disabilities. Compared to people with intellectual disabilities and professionals, parents perceived people with intellectual disabilities to have lower sexual knowledge. CONCLUSIONS: Our study demonstrates inconsistent perceived knowledge of people with intellectual disabilities' socio-sexual norms and sexual knowledge among the three groups, leading to disparate levels of concern regarding people with intellectual disabilities sexuality. Thus, the need to collect information from different perspectives for more accurate reporting and the critical need for sex education programs that involve the target population, but also parents and professionals who frequently interact with people with intellectual disabilities are highlighted.

Construction of a Form for Users of the Child Welfare System Based on the Delphi Method.

Professionals in charge of designing individualized plans for children and adolescents in the child welfare system often lack the necessary information, either because it has not been systematically collected or because there are doubts about the reliability of the data obtained. The lack of consensual and validated instruments that gather the necessary information has led to the development of a rigorous and effective form, based on the Delphi methodology, aimed at obtaining an exhaustive knowledge of the characteristics of children and adolescents under the child welfare system. Once a consensus of different specialists approved the hetero-informed form, it was completed by 41 professionals working in residential care facilities for 307 children and adolescents. It consists of 66 items grouped into six dimensions: general information, school/work situation, child welfare system history, family visitation history, biological family information, and experiences of sexual abuse. During its construction and validation, a panel of experts analyzed its format and content during the different phases. Most of the items showed good performance, and professionals highlighted their ease of use and relevance. The method used ensured the content validity of this form. This instrument has proven to be a useful and effective tool for collecting sociodemographic information on children and adolescents in the child welfare system, which may improve their conditions.

Sexual life of Spanish women during the lockdown by COVID-19: Differences according to sexual orientation?

The COVID-19 pandemic may have exacerbated the sexual health differences that already existed among women based on their sexual orientation. Therefore, a total of 971 Spanish women aged 18-60 years (84 % heterosexual and 16 % with a minority sexual orientation) answered an ad hoc online questionnaire about sexual behavior during April 2020. Compared to heterosexual women, sexual minority women showed a greater increase in sexual frequency, masturbated more, had more sex with a housemate, and engaged in more online sexual activities during lockdown. The emotional impact of the pandemic, having privacy, and age showed a relationship with the quality of sexual life, but not sexual orientation. Based on these results, women's sexual lives are not as closely related to their sexual orientation as they are to other variables. Therefore, it seems more necessary to address issues affecting women in general during lockdown than to focus on their specific sexual orientation.

Atypical Sexual Interests in Compulsive Sexual Behavior: Results From a Phallometric Study.

The link between Compulsive Sexual Behavior (CSB) and atypical sexual interests is elusive. This study aimed to provide preliminary insights into the relationship between both aspects. The study sample comprised 61 self-identified straight men. CSB was measured through a composite self-report index assessing symptoms of CSB, whereas sexual interests -atypical and normophilic- were assessed objectively through penile plethysmography. The CSB index had small, non-significant correlation with greater sexual response to different sexual stimuli (rgeneral sexual responsiveness=.127 [95% CI: -.137, .384]). In terms of overall sexual interest, increased scores on the CSB index had small, non-significant correlation with a higher preference for younger sexual stimuli (r = -.098 [95% CI: -.499, .215]) and persuasive sex (r = .10 [95% CI: -.168, .316]). Finally, CSB had a moderate correlation with sexual response when presented with stimuli depicting "female toddler coercive" (r = .27 [95% CI: -.083, .544]). We conclude that our findings do not support the hypotheses that CSB is significantly related to an increased arousability across sexual stimuli. The study findings also suggest that CSB may be, to a small degree, predisposed to experience sexual attraction toward children. Given the preliminary nature of the study, these conclusions warrant further research. Alternative explanations for the study findings related to the particular components of CSB that may be related to typical and atypical sexual interests are also considered.

HIV and STI Prevention Among Spanish Women Who have Sex with Women: Factors Associated with Dental Dam and Condom Use.

The scientific community has systematically ignored the needs of women who have sex with women (WSW). The invisibilization of romantic and sexual relationships between women has caused a profound lack of knowledge about the impact of HIV and other STIs on this population subgroup. This study aims to analyze the frequency of dental dam and condom use in WSW and identify the variables that explain the use of these two preventive methods. The sample is composed of 327 women aged between 18 and 60 years (M = 27.82; SD = 8.10). The results indicate that only 4.7% of those who practice cunnilingus and 5.2% of those who practice anilingus report "always" using dental dam (systematic use). Condoms are used systematically by 37.1% of those who practice vaginal penetration and 37.8% of those who practice anal penetration. Age, high perceived self-efficacy, and adequate assertive communication skills are variables significantly related to preventive behavior. The severity attributed to HIV and the perceived risk of infection are protective factors regarding dental dam use. For condom use, high levels of internalized homophobia and drug use are risk factors. Future preventive strategies should provide information on preventive strategies to WSW who, for different reasons, are not involved in LGBT contexts or associations and, therefore, do not have access to training activities and mistakenly believe that they are invulnerable as they do not have sexual relations with men.

Analysis of the Differential Efficacy of the Reduced Version Over the Extended Version of an Affective-Sexual Education Program for Adults with Intellectual Disabilities.

Recently, with the increase in demand, multiple intervention proposals aimed at improving the sexual health of people with intellectual disabilities have emerged. Among them is the SALUDIVERSEX program, which takes a positive approach to sexuality. It has an extended version, consisting of 16 sessions and whose efficacy has already been proven, and a reduced version of 10 sessions. Thus, the present study aimed to test the differential efficacy of the two versions. A total of 208 participants (103 women and 105 men) aged between 19 and 67 years (M = 37.23, SD = 10.66) completed a battery of instruments before and after the intervention. Statistical analyses showed that users who participated in the reduced version of the program presented a significantly higher rate of improvement in their sexual behaviors compared to those who participated in the extended version (Sexual response: ß10 = - 0.46 ± 0.19, p = .034; Sex practices: ß10 = - 0.52 ± 0.23, p = .037; Use condoms: ß10 = - 1.56 ± 0.59, p = .017), as well as a significantly higher decrease in the risk of suffering sexual abuse (ß10 = 3.95 ± 0.64, p < .001). However, no statistically significant differences in sexuality knowledge were obtained with respect to the improvement between the two versions (ß10 = - 0.09 ± 1.21, p = .94). Meanwhile, the professionals who applied the program found that those who participated in the reduced version, although they presented a significantly greater increase in their knowledge about privacy (ß10 = - 0.48 ± 0.08, p < .001), did not improve their concerns about their inappropriate sexual behaviors as much as the users of the extended version (ß10 = - 1.35 ± 0.21, p < .001). Thus, although both versions were effective, the reduced version seems to do so to a greater extent and in a shorter time, which makes it the more recommendable option.

Exploring Self-efficacy for Condom Use in Spanish People: A Trend Analyses by Gender from 2004 to 2020.

Self-efficacy seems to be one of the most important resources for the different stages underlying condom use and STI prevention. For this reason, this study evaluates trends in self-efficacy by gender, from 2004 to 2008, 2013 and 2020 in Spain. Throughout these years, 6,698 people ranging from 17 to 40 years old, participated filling the Brief scale of condom use self-efficacy. According to our findings, despite the slight improvement in the recent years, self-efficacy still maintains a risky profile for safe sex, especially among the youngest people. Moreover, most of the traditional gender differences continue over the years with women reporting lower scores for condom purchase and men for putting them. However, these differences are not relevant in other dimensions such as using condoms despite drug consumption where women reveal worse results over the years. Therefore, our findings reaffirm the need of intensifying gendered preventive efforts aimed at Spanish people and, particularly, among the youngest.

RESUMEN: La autoeficacia parece ser uno de los recursos más importantes para las diferentes etapas que subyacen al uso del preservativo y la prevención de las ITS. Por ello, este estudio evalúa la tendencia de la autoeficacia por género, desde 2004 a 2008, 2013 y 2020 en España. A lo largo de estos años, 6.698 personas con edades comprendidas entre los 17 y los 40 años participaron cumplimentando la Escala Breve de autoeficacia en el uso del preservativo. Según nuestros hallazgos, a pesar de la ligera mejoría en los últimos años, la autoeficacia aún mantiene un perfil de riesgo para el sexo seguro, especialmente entre los más jóvenes. Además, la tradicional diferencia de género continúa a lo largo de los años: las mujeres informan puntuaciones más bajas en la compra de condones y los hombres en ponérselo. Sin embargo, estas diferencias no son relevantes en otras dimensiones como el uso del preservativo a pesar del consumo de drogas donde las mujeres muestran peores resultados a lo largo de los años. Por tanto, nuestros hallazgos reafirman la necesidad de intensificar los esfuerzos preventivos de género dirigidos a los españoles y, en particular, a los más jóvenes.

Differences in the Sexual Life of Spanish Men During the COVID-19 Lockdown by Sexual Orientation / Diferencias en la Vida Sexual de los Hombres Españoles Durante el Confinamiento por la COVID-19 por Orientación Sexual

Background: The pandemic affected the psychological well-being and sexuality of the population, especially among vulnerable groups such as men from sexual minorities. Method: In Spain, a total of 320 heterosexual men and 151 sexual minority men, aged between 18 and 60, answered an ad hoc online questionnaire about sexual behavior during the lockdown. Results: Compared to heterosexual men, during the lockdown, sexual minority men masturbated more, engaged in more sexual activities online, and had more sex with non-cohabitants. Heterosexual men had more sexual relations with their partners. Living with a partner during the lockdown predicted an improvement in sex life, especially for heterosexual men. Furthermore, the emotional impact of lockdown was a predictor of a worsening sex life regardless of sexual orientation. Conclusions: Future interventions should take into account that men’s sex lives are mediated by the emotional impact of the moment, especially among sexual minority men, since the quality of their sex life shows a weaker relationship with some of the protective variables studied (living with a partner).(AU)

Antecedentes: La pandemia ha afectado al bienestar psicológico y a la sexualidad de la población, especialmente entre grupos vulnerables como los hombres de una minoría sexual. Método: En España, un total de 320 hombres heterosexuales y 151 hombres de minorías sexuales, de entre 18 y 60 años, respondieron un cuestionario online ad hoc sobre comportamiento sexual durante el confinamiento. Resultados: Durante el confinamiento, respecto a los hombres heterosexuales, los hombres de minorías sexuales se masturbaron más, realizaron más actividades sexuales en línea y tuvieron más sexo con no convivientes. En cambio, los hombres heterosexuales tuvieron más relaciones sexuales con su pareja. El hecho de vivir en pareja durante el confinamiento fue predictor de una mejoría de la vida sexual, sobre todo para los hombres heterosexuales. Además, el impacto emocional del confinamiento fue predictor de un empeoramiento de la vida sexual sin distinción por orientación sexual. Conclusiones: En futuras intervenciones habría que tener en cuenta que la vida sexual de los hombres está mediada por el impacto emocional del momento, especialmente entre los hombres de minorías sexuales, ya que su calidad de vida sexual muestra menor relación con algunas de las variables protectoras estudiadas (vivir en pareja).(AU)

Sexual Health among Youth in Residential Care in Spain: Knowledge, Attitudes and Behaviors.

Adolescents in the child welfare system often face multiple maladaptive experiences that predispose them to worse sexual health outcomes. This study aims to (1) describe the sexual health of adolescents in Spanish residential care by exploring their sexual knowledge, attitudes toward sexuality, and sexual behaviors and (2) to find out whether there are certain characteristics that make a subgroup particularly vulnerable to engaging in risky sexual behaviors. A total of 346 adolescents recruited from 47 Spanish residential care facilities (34.1% girls, 65.9% boys) aged between 11 and 19 years old completed some self-report instruments. Descriptive analyses and tests to prove gender and age differences were conducted. Their knowledge of sexuality was lower than observed in the general adolescent population, their attitudes more negative, and their tendency to engage in risky sexual behaviors higher. Girls made very infrequent use of condoms, while boys had more sexist attitudes and made habitual use of withdrawal. Although more than 20% of them had experienced sexual exchange activities before the age of 13 until 17, they did not use condoms systematically. The low level of knowledge, the early initiation of sexual exchange activities, and the scarce use of protection methods, together with sexist attitudes, place this group in a situation of great vulnerability, increasing the risk of unwanted pregnancies, sexually transmitted infections, and even teen dating violence.

What Does Heterosexuality Mean? Same-Sex Attraction, Behaviors, and Discomfort Among Self-identified Heterosexual Young Adults from Spain.

Sexuality has been censored by Spanish culture, where legal progress in the form of new policies about sexual diversity rights has not been followed by lower levels of social discrimination. This has affected sexual development across the lifespan for both sexual minorities and heterosexual people who experience their sexuality outside of heteronormativity. However, the literature has regularly excluded the possible consequences of the experience of sexuality within prescriptive categories, particularly in heterosexual people. This study delves deeper into the same-sex experiences of heterosexual women and men and the discomfort they may feel toward such experiences in Spain. A total of 2900 young Spanish people who self-identified as heterosexual completed a questionnaire on sexual diversity and experiences related to sexual orientation. The mean age was 24.22 years (SD = 5.71), 71.1% were women, and 28.9% were men. More heterosexual women than heterosexual men reported having had same-sex attraction, fantasies, desires, and behavioral intentions. However, these men and women reported having similar levels of same-sex sexual intercourse. The discomfort level experienced was higher among heterosexual men and younger people, suggesting the possibility that traditional norms restrict behavioral expression of sexuality among these individuals. At least in the Spanish context, these gender differences should be taken into account to adjust all psychological and educational interventions in the future to improve inclusive sexual attitudes and the treatment of discomfort with sexual orientation. Following these results, research on sexual diversity should focus on young heterosexual people who have different same-sex experiences according to gender differences.

Development and Validation of a Scale for Assessing the Interference of Chronic Primary Pain Conditions in Sexual Functioning: The Sex-Pain Questionnaire.

Chronic pain represents one of the main health public problems worldwide and significantly affects the sexual life of patients. However, no specific instruments of evaluation have been found that address this population. This study presents the SEX-PAIN Questionnaire, developed for identifying chronic pain's interference with sexual functioning among people with chronic pain. Methods. The validation has been carried out with a sample of 303 Spanish non-hospitalized patients with chronic pain diagnosis aged between 20 and 71 years old (Mage = 49.49; SD = 10.7). Exploratory Factor Analysis (EFA) yielded 2-factor structure: Sexual and Relationship Dissatisfaction, and Chronic Pain Impact on Sexual Life. This structure was later verified through Confirmatory Factor Analysis (CFA). Internal consistency (Omega) of each factor was .72 and .96, respectively. This study presents the psychometric properties of a new measure addressed to patients with chronic pain. This 17-items self-administered instrument can be a useful measure of the chronic pain's interference with sexual functioning among chronic pain patients. It represents the first original questionnaire known in Spanish language to date. This measure could potentially help researchers and clinicians to obtain key information to design appropriate healthcare interventions.Supplemental data for this article is available online at https://doi.org/10.1080/0092623X.2022.2039336 .

A Trend Analysis of Condom use in Spanish Young People over the Two Past Decades, 1999-2020.

HIV exposure is one of the greatest sexual risks in young people, and condom use is the best protective measure. Despite the preventive efforts, trend in condom use is still unclear. This study examines the trend of condom use by gender in Spanish young people, in different sexual practices (vaginal, oral and anal), relationships (regular and casual) and having sex after drugs consumption during the two past decades (from 1999 to 2020). For this, 14,472 people who ranged from 17 to 40 years old (63.5% women) filled the AIDS Prevention Questionnaire in each year. In general, low condom use remains stable and even gets worse regardless of the type of sexual practice, relationship and the substance consumption. Regarding gender, this trend is worse in women who have been less likely to report condom use than men have. Moreover, older people have reported a minor frequency of condom use than the youngest people have done, except for anal sex. Therefore, it is necessary to analyze why, despite preventive efforts, condom use seems to decrease over time.

RESUMEN: El VIH es uno de los mayores riesgos en la sexualidad de la juventud, y el uso del preservativo la mejor medida de protección. A pesar de los esfuerzos preventivos, la tendencia en su uso es indeterminada. Este estudio examina la evolución del uso del preservativo según género en jóvenes españoles, en diferentes prácticas sexuales (vaginal, oral y anal), relaciones (estable y esporádica) y al practicar sexo tras consumir drogas, durante las dos últimas décadas (de 1999 a 2020). Para ello, 14.472 personas entre 17 y 40 años (63,5% mujeres) cumplimentaron el Cuestionario de Prevención del Sida cada año. En general, el bajo uso del preservativo se mantiene estable e incluso empeora con independencia del tipo de práctica sexual, relación y consumo de sustancias. Según el género, las mujeres muestran peor tendencia, al informar menor uso que los hombres. Además, las personas más mayores informan menor frecuencia de uso que los más jóvenes, excepto para el sexo anal. Por tanto, es necesario analizar por qué, a pesar de los esfuerzos preventivos, el uso del preservativo parece disminuir con el tiempo.

Academic Perfectionism, Psychological Well-Being, and Suicidal Ideation in College Students.

High levels of perfectionism in college students can compromise their academic performance and psychological well-being. This study aims to analyze the implication of perfectionism in psychological well-being and suicidal ideation in the last year. A total of 1.287 students from different degrees reported their academic performance in the previous academic year and completed questionnaires on academic perfectionism, psychological well-being, and suicidal thoughts in the last year. In both men and women, academic perfectionism correlates positively with academic performance and negatively with the different dimensions of psychological well-being. Likewise, both the average grade in the previous year (ß = 0.364) and the level of demand of the degree (ß = -0.461) are mediating variables between perfectionism and psychological well-being. Furthermore, the interaction between perfectionism and academic performance is related positively to psychological well-being, but not to with suicidal ideation. So, the relation between suicidal ideation and perfectionism is positive (OR = 1.075), but this is negative with academic performance (OR = 0.900), although both variables show a mild predictive capacity. These findings suggest that the levels of perfectionism are associated differently with the mental health of students, since if perfectionism is effective (high academic performance), psychological well-being is high, although in our results, this interaction is not as important for suicidal thoughts.

Trends in HIV sexual prevention: Attitudinal beliefs and behavioral intention in Spanish young people over the past two decades (1999-2020).

Despite preventive efforts, HIV exposure is still a concern for public health. The current prevalence is related to unsafe sex, which is based on socio-cognitive variables. Therefore, information about these variables is required to verify whether the past preventive strategies have been effective and improve the future ones. However, there is not updated information to adjust future preventive interventions. For this reason, this study analyzes trends by gender in Spanish young people over the past two decades in perceived susceptibility to HIV, severity perceived to HIV, condom confidence and the intention of condom use, from 1999 to 2020. For this purpose, 11,665 Spanish young people (from 17 to 40 years old) completed the AIDS Prevention Questionnaire in each year. Following our results, in general, the socio-cognitive variables have revealed an unsatisfactory trend: a low perceived susceptibility to HIV and a behavioral intention that have remained stable or even declined slightly over the past years. Particularly, men are more likely to report a riskier level in socio-cognitive variables although, in the latest evaluations, women would decrease condom use intention largely than men. In general, regarding age, young adult would report better levels of condom confidence, but early youth would get higher results in perceived severity, as well as better scores in the latest evaluations of condom use intention. Considering these results, policies should make an effort in HIV prevention programs, and emphasize the attention to attitudinal beliefs and behavioral intention to improve their effectiveness.

Factors associated with condom use in vaginal intercourse among Spanish adults with intellectual disability: Proposal for an explanatory model.

BACKGROUND: The prevention of HIV or other STIs in people with intellectual disabilities (ID) is a rarely studied subject even though this population group is at the same risk of infection as the general population. AIMS: The present study aims to conduct a descriptive analysis of sexual behaviours and condom use frequency in Spanish men and women with intellectual disabilities and identify the combination of variables that best explain condom use in vaginal intercourse. METHODS AND PROCEDURES: The sample consisted of 253 people (56.1 % male and 43.9 % female) aged between 20 and 64 years (M = 38.52; SD = 10.48). Participants completed the Sexuality Questionnaire for People with Intellectual Disabilities and the Sexual Abuse Risk Screening Scale. OUTCOMES AND RESULTS: The percentage of consistent condom use is 27.7 % for vaginal intercourse. Lack of knowledge about body boundaries constitutes a risk factor contributing to risky sexual behaviour. Knowledge of HIV-transmitting fluids and perceived self-efficacy are protective factors. The proposed model explains between 35.5 % and 46.6 % of the variance. CONCLUSIONS AND IMPLICATIONS: The results highlight the importance of considering the judgements people make about their ability to perform preventive behaviour and the provision of information on sexuality adapted to cognitive abilities to minimise the engagement in risky behaviours.