Students' awareness of the student health center's sexual health services at a southeast public university.

Objective: To determine whether university students are aware of the sexual health services offered by the student health center. Participants: 522 undergraduate students at a southeast public university. Methods: Students were given a list of 19 sexual health services and tests and were instructed that for each one to check "offered," "not offered," or "I'm not sure." Results: Students were generally unaware that the health center offered testing for a variety of sexually transmitted infections (13-27.4% aware), the Gardasil vaccine for human papillomavirus (HPV) (15.5% aware), the IUD (8.8% aware), emergency contraception (18.6% aware), and breast (24.9% aware) and pelvic examinations (16.5% aware). The only exceptions were for free male condoms (63% aware) and women's awareness of birth control pills (55.3% aware) and pregnancy testing (50.3% aware). Nearly half the students were not aware that parents/guardians could not obtain health center medical records without the student's permission. Conclusions: Student health centers cannot be effective in reducing unwanted pregnancies and the spread of STIs if students are unaware of the services provided. Health centers must do a better job of educating students.

Oral-Genital Contact and the Meaning of "Had Sex": The Role of Social Desirability.

Previous studies have found that a large proportion of college students do not consider oral-genital contact as having "had sex." In all studies, the questions posed were hypothetical. In the present study, university students were asked about their own personal sexual experiences. From a large pool of participants, two subgroups were identified: those who responded "No" to having "had sex" but responded "Yes" to having had oral-genital contact (No-Yes), and those who responded "Yes" to having had both sex and oral-genital contact (Yes-Yes). None of the participants in these two subgroups self-reported vaginal or anal intercourse. The No-Yes group was significantly higher in social desirability (p < .0005) as measured by the Marlowe-Crowne scale and was also significantly higher in religiosity (p < .01) as measured on a 7-point Likert scale. There was a modest correlation between level of religiosity and social desirability (r = .25, p < .01). It was concluded that many students who have had oral-genital contact but deny having had sex do so because of impression management, i.e., a desire to present themselves more positively. These results provide further evidence that social desirability responding is a serious problem for sex researchers, one that affects even the most basic questions about having had sex.

The Influence of Social Desirability on Sexual Behavior Surveys: A Review.

Research in fields for which self-reported behaviors can be compared with factual data reveals that misreporting is pervasive and often extreme. The degree of misreporting is correlated with the level of social desirability, i.e., the need to respond in a culturally appropriate manner. People who are influenced by social desirability tend to over-report culturally desired behaviors and under-report undesired behaviors. This paper reviews socially desirable responding in sexual behavior research. Given the very private nature of the sexual activity, sex researchers generally lack a gold standard by which to compare self-reported sexual behaviors and have relied on the anonymity of participants as the methodology to assure honest answers on sexual behavior surveys. However, indirect evidence indicates that under-reporting (e.g., of a number of sexual partners, receptive anal intercourse, condom use) is common. Among the general population, several studies have now reported that even with anonymous responding, there are significant correlations between a variety of self-reported sexual behaviors (e.g., use of condoms, sexual fantasies, exposure to pornography, penis size) and social desirability, with evidence that extreme under- or over-reporting is as common as is found in other fields. When asking highly sensitive questions, sex researchers should always include a measure of social desirability and take that into account when analyzing their results.

College Students' Perceptions of Concurrent/Successive Nonverbal Behaviors as Sexual Consent.

In previous studies, researchers had students rate single nonverbal behaviors as signals conveying and inferring sexual consent. In real-life interactions, young people use an array of behaviors occurring concurrently or successively to interpret sexual consent. With use of a 7-point scale (0 = Definitely No, 6 = Definitely Yes), students at a southeast public university were asked to rate their perceptions of nine nonverbal behaviors as signals of sexual consent, nine combinations of two of those behaviors, and eight combinations of three behaviors. There were significant effects for both gender and number of behaviors (p < .001). Over 43% of women answered "0" to all behaviors and combinations of behaviors, whereas only 20.3% of men answered "0" to all. The mean ratings for men were greater than those for women under all three conditions and increased with the number of behaviors. At least one third of men responded with "3" (the midpoint of the scale) or greater to seven of the eight combinations of three behaviors, whereas the percentage of women responding "3" or greater never exceeded 18% for any of the individual behaviors or combinations. It is concluded that as the number of nonverbal behaviors increases the subjective interpretation of sexual consent also increases, thus also increasing the chances of unwanted sexual advances.

Average-Size Erect Penis: Fiction, Fact, and the Need for Counseling.

Most men believe that the average length of an erect penis is greater than 6 inches (15.24 cm). This belief is due, in part, to several often-cited studies that relied on self-reported measurements, with means of about 6.2 inches (15.75 cm) for heterosexual men and even greater for gay men. These studies suffered from both volunteer bias and social desirability bias. In this review, the combined mean for 10 studies in which researchers took measurements of erect penises was 5.36 inches (13.61 cm; n = 1,629). For 21 studies in which researchers measured stretched penises, the mean was approximately 5.11 inches (12.98 cm; n = 13,719). Based on these studies, the average length of an erect penis is between 5.1 and 5.5 inches (12.95-13.97 cm), but after taking volunteer bias into account, it is probably toward the lower end of this range. Studies show that a majority of men wish they were larger, with some choosing penile lengthening surgery. These surgeries are considered by the American Urological Association to be risky. Most men seeking surgery have normal sized penises. Counseling with factual information about penis size might be effective in alleviating concerns for the majority of men who worry about having a small penis.

Social Desirability and Young Men's Self-Reports of Penis Size.

Previous studies demonstrate that many men have insecurities about the size of their penises, often resulting in low sexual self-esteem and sexual problems. In the present study, mean self-reported erect penis length by 130 sexually experienced college men (6.62 inches) was greater than found in previous studies in which researchers took measurements. This suggests that many of the men embellished their responses. Only 26.9% of the sexually experienced men self-reported penis lengths of less than 6 inches, while 30.8% self-reported lengths of 7 inches or more (with 10% self-reporting 8 inches or more). The correlation with Marlowe-Crowne social desirability scores was +.257 (p < .01), indicating that men with a high level of social desirability were more likely than others to self-report having a large penis.

The modern obesity epidemic, ancestral hunter-gatherers, and the sensory/reward control of food intake.

Obesity has become a true pandemic. In the United States, over two thirds of adults are obese or overweight. The prevalence of obesity has doubled since 1980. The increase in the prevalence of obese and overweight individuals has happened too rapidly for it to be due to an alteration in the genome. The gastrointestinal, sensory (taste and olfaction), and brain feeding mechanisms that developed during the past 2 million years were highly adaptive for ancestral hunter-gatherers living in an environment with limited high-density foods and periods of food deprivation. Today, however, humans in industrialized countries live in what has been called an "obesogenic environment." The nonhomeostatic brain reward circuitry that was acquired during evolution to seek out and eat as many nutritionally high-dense foods as possible is able to overrule the physiological inhibitory mechanisms that were designed to limit meal size and weight gain.

Olfactory bulbectomy impairs the feeding response to 2-deoxy-D-glucose in rats.

An early study reported that, unlike sham-operated rats, rats made anosmic by olfactory bulbectomy (OBX) failed to compensate for the dilution of their diet with nonnutritive bulk by increasing their food intake. In the present study, the effects of a glucoprivic challenge, intraperitoneal-administered 350 mg/kg 2-deoxy-D-glucose (2-DG), on food intake were measured in OBX and sham-operated female rats. Sham-operated rats significantly increased their food intake, but in two separate experiments OBX rats displayed no increase in food intake during the first 2 h following administration. Blood glucose levels were nearly identical in both groups. Body weights and daily food intakes of OBX rats did not differ from the sham-operated controls throughout the studies. Bulbectomized rats also displayed a normal drinking response after an intraperitoneal injection of 1M hypertonic saline. Hypothalamic nuclei and the neural pathways mediating taste have been implicated in the feeding response to 2-DG. The present results suggest that olfactory input and olfactory neural pathways also mediate, at least in part, the feeding response to a glucoprivic challenge induced by intraperitoneal injection of 2-DG.

A re-examination of septal lesion-induced weight gain in female rats.

Previous studies that examined the effects of knife cuts ventral to the septal area, or the pattern of anterograde degeneration after other obesity-inducing lesions or cuts, have implicated the septal area in feeding behavior. However, lesion studies have been inconsistent. In the present study, large electrolytic lesions that destroyed all or nearly all of the septal area resulted in excessive weight gain in female rats (25 g/20 days compared to 1 g/20 days for controls). Lesions confined to the ventral septum produced equal weight gains, but rats with lesions confined to the dorsal septum did not differ from controls. The excessive weight gains were accompanied by modest hyperphagia. The weight gains were not the result of incidental damage to adjacent structures such as the stria terminalis or the shell of the nucleus accumbens. It is concluded that the ventral portion of the septum is part of a limbic-hypothalamic circuitry regulating food intake in female rats.

Role of the stria terminalis in food intake and body weight in rats.

Previous studies have shown that lesions of the posterodorsal amygdala result in hyperphagia and obesity in female rats. In the present study, lesions of the stria terminalis at its most dorsal point (before it separates into dorsal and ventral components) also resulted in hyperphagia and excessive weight gains in female rats compared to female rats with sham lesions, as did coronal knife cuts anterior to the ventromedial hypothalamus. Identical lesions and knife cuts did not elevate food intake or weight gains in male rats compared to male control animals. Examination of the anterograde degeneration with the amino-cupric-silver method in the brains of two female rats with hypothalamic knife cuts revealed degenerating terminals in the capsule of the ventromedial hypothalamus and in the premammillary nuclei, two classic indicators of damage to the dorsal component of the stria terminalis. No degenerating axon terminals were observed in the paraventricular nucleus. Differences from previous studies that used male rats were attributed to a sex difference for the effects of amygdaloid and ventromedial hypothalamic lesions. It is proposed that the posterodorsal amygdala, dorsal component of the stria terminalis, and ventromedial hypothalamus are part of an inhibitory pathway in the regulation of feeding behavior.

Amygdaloid lesion-induced obesity: relation to sexual behavior, olfaction, and the ventromedial hypothalamus.

Lesions of the amygdala have long been known to produce hyperphagia and obesity in cats, dogs, and monkeys, but only recently have studies with rats determined that the effective site is the posterodorsal amygdala (PDA)-the posterodorsal medial amygdaloid nucleus and the intra-amygdaloid bed nucleus of the stria terminalis. There is a sex difference; female rats with PDA lesions display greater weight gain than male rats. In the brains of female rats with obesity-inducing PDA lesions, there is a dense pattern of axonal degeneration in the capsule of the ventromedial hypothalamus (VMH) and other targets of the stria terminalis. Transections of the dorsal component of the stria terminalis also result in hyperphagia and obesity in female rats. Similar to rats with VMH lesions, rats with PDA lesions are hyperinsulinemic during food restriction and greatly prefer high-carbohydrate diets. The PDA is also a critical site for some aspects of rodent sexual behavior, particularly those that depend on olfaction, and the pattern of degeneration observed after obesity-inducing PDA lesions is remarkably parallel to the circuit that has been proposed to mediate sexual behavior. Medial amygdaloid lesions disrupt the normal feeding pattern and result in impaired responses to caloric challenges, and there is evidence that these behavioral changes are also due to a disruption of olfactory input. With its input from the olfactory bulbs and connections to the VMH, the PDA may be a nodal point at which olfactory and neuroendocrine stimuli are integrated to affect feeding behavior.

The rise, fall, and resurrection of the ventromedial hypothalamus in the regulation of feeding behavior and body weight.

Early researchers found that lesions of the ventromedial hypothalamus (VMH) resulted in hyperphagia and obesity in a variety of species including humans, which led them to designate the VMH as the brain's "satiety center." Many researchers later dismissed a role for the VMH in feeding behavior when Gold claimed that lesions restricted to the VMH did not result in overeating and that obesity was observed only with lesions or knife cuts that extended beyond the borders of the VMH and damaged or severed the ventral noradrenergic bundle (VNAB) or paraventricular nucleus (PVN). However, anatomical studies done both before and after Gold's study did not replicate his results with lesions, and in nearly every published direct comparison of VMH lesions vs. PVN or VNAB lesions, the group with VMH lesions ate substantially more food and gained twice as much weight. Several other important differences have also been found between VMH and both PVN and VNAB lesion-induced obesity. Concerns regarding (a) motivation to work for food and (b) the effects of nonirritative lesions have also been addressed and answered in many studies. Lesion studies with weanling rats and adult pair-tube-fed rats, as well as recent studies of knockout mice deficient in the orphan nuclear receptor steroidogenic factor 1, indicate that VMH lesion-induced obesity is in large part a metabolic obesity (due to autonomic nervous system disorders) independent of hyperphagia. However, there is ample evidence that the VMH also plays a primary role in feeding behavior. Neuroimaging studies in humans have shown a marked increase in activity in the area of the VMH during feeding. The VMH has a large population of glucoresponsive neurons that dynamically respond to blood glucose levels and numerous histamine, dopamine, serotonin, and GABA neurons that respond to feeding-related stimuli. Recent studies have implicated melanocortins in the VMH regulation of feeding behavior: food intake decreases when arcuate nucleus pro-opiomelanocortin (POMC) neurons activate VMH brain-derived neurotrophic factor (BDNF) neurons. Moderate hyperphagia and obesity have also been observed in female rats with damage to the efferent projections from the posterodorsal amygdala to the VMH. Hypothalamic obesity can result from damage to either the POMC or BDNF neurons. The concept of hypothalamic feeding and satiety centers is outdated and unnecessary, and progress in understanding hypothalamic mechanisms of feeding behavior will be achieved only by appreciating the different types of neural and blood-borne information received by the various nuclei, and then attempting to determine how this information is integrated to obtain a balance between energy intake and energy output.

Factors affecting individuals dissuading sexual partners from using condoms: a comment on McDermott and Noland.

Undergraduate students at an urban, public university were asked if they had ever attempted to dissuade a sexual partner from using condoms. Over 17% of the men and nearly 15% of the women admitted to having done so, and twice as many said that a sexual partner had attempted to dissuade them. Responses to a questionnaire indicated that individuals who had attempted to dissuade use of condoms did not show a greater tendency to engage in nonsexual risk-taking behaviors. Despite their claims that attempts to dissuade partners from using condoms occurred in committed relationships, condom dissuaders did show evidence of engaging in other high-risk sexual behaviors, e.g., greater number of sexual partners, greater number of sexually transmitted diseases.

Combination unilateral amygdaloid and ventromedial hypothalamic lesions: evidence for a feeding pathway.

Previous studies have reported hyperphagia and obesity in female rats with bilateral lesions of the most posterodorsal part of the amygdala. In rats with unilateral posterodorsal amygdaloid lesions, a dense pattern of anterograde degeneration appears in the ipsilateral ventromedial hypothalamus, but not the contralateral nucleus. In the present study, female rats with unilateral ventromedial hypothalamic lesions or sham lesions were given either sham lesions or unilateral lesions of the posterodorsal amygdala (PDA) 20 days later. Unilateral lesions of the ventromedial hypothalamus resulted in hyperphagia and excessive weight gain. Subsequent amygdaloid lesions that were contralateral to the initial hypothalamic lesions resulted in hyperphagia and additional excessive weight gains, but amygdaloid lesions ipsilateral to the initial hypothalamic lesions did not. It is concluded that the effects of the two lesions on body weight are not additive and that the PDA and ventromedial hypothalamus are part of the same ipsilateral pathway regulating feeding behavior and body weight regulation.

Excessive weight gains in female rats with transections of the stria terminalis.

Recent studies have demonstrated hyperphagia and excessive weight gains in female rats with small lesions in the most posterodorsal aspects of the medial amygdala. In the present study, similar results were observed in female rats with bilateral transections of the stria terminalis just as it exits the amygdala to begin its dorsal ascent (mean weight gain of 35.9 g/20 days compared to 0.1 g/20 days for operated control animals). Cellular damage caused by the retractable wire knife was limited to the caudal globus pallidus. The results of previous studies that failed to observe weight gains after stria terminalis transections were attributed to the use of male animals. The present results, along with the pattern of anterograde degeneration that is observed after obesity-inducing amygdaloid lesions, suggest a medial amygdala-stria terminalis-medial hypothalamic pathway in the regulation of food intake and body weight, but other possibilities are considered.

Obesity-inducing amygdala lesions: examination of anterograde degeneration and retrograde transport.

Small lesions centered in the posterodorsal region of the medial amygdala resulted in excessive weight gains in female rats. Unilateral lesions were nearly as effective as bilateral lesions in the first 48 h after surgery (+21 to +32 g). Assessment of lesion damage was done by both qualitative evaluation and by a quantitative grid-point counting method. The critical sites for weight gain were the intra-amygdaloid bed nucleus of the stria terminalis and the posterodorsal medial amygdaloid nucleus. Incidental damage to the overlying globus pallidus was negatively related to weight gain. The cupric silver method for demonstrating axonal degeneration was applied to brains with obesity-inducing lesions. A dense pattern of degenerating terminals was found in the lateral septum, amygdala, ventral striatum, and ventromedial hypothalamus. Degeneration in the paraventricular nucleus of the hypothalamus was scarce or absent. Small retrograde tracer injections made in either the intra-amygdaloid bed nucleus of the stria terminalis or in the posterodorsal medial amygdaloid nucleus labeled cells in the amygdala, lateral septum, and hypothalamus, reciprocating the anterograde projections from the amygdala to these areas. The data suggest that subdivisions of the posterodorsal amygdala participate in the regulation of feeding in a manner that is similar to the better-known role of this part of the brain in mediating reproductive behavior. Although topographical differences may exist within the amygdaloid and hypothalamic subdivisions regulating these two sexually dimorphic behaviors, the relays engaged by feeding-related connections and those related to reproduction are remarkably parallel.