Author Interviews, Breast Cancer, Journal Clinical Oncology, Sexual Health / 29.07.2015

Martha F. Goetsch, MD, MPH Oregon Health & Science University Portland, OR 97239MedicalResearch.com Interview with: Martha F. Goetsch, MD, MPH Oregon Health & Science University Portland, OR 97239 MedicalResearch: What is the background for this study? Dr. Goetsch: Women who are survivors of breast cancer now number about 3 million in the US.  Therapy for breast cancer is anchored in creating a state of postmenopause in which estrogen is eliminated from the system. One of the most difficult symptoms of lack of estrogen is dyspareunia, the term for pain with intercourse. The old term “vulvovaginal atrophy” has been changed to “genitourinary syndrome of menopause” by agreement of two specialty societies. Because of my focus in the gynecologic specialty of vulvar pain, I have felt that this menopausal symptom is more than a condition of atrophy.  Additionally, my clinical experience has led me to believe that the exquisite tenderness is located in the vulvar vestibule rather than in the vagina. The vestibule is the inner vulva or entryway before the vagina. This study was devised to answer these hypotheses. I predicted that the population most likely to represent the worst examples of postmenopausal dyspareunia was the population of women who cannot use estrogen due to being survivors of breast cancer. I treated the problem as a pain problem rather than solely a problem of dryness. (more…)
Aging, Author Interviews, Sexual Health / 20.07.2015

Dr. Alan J. Gow PhD, CPsychol, CSci, AFBPsS, FHEA Associate Professor in Psychology School of Life Sciences Heriot-Watt University EdinburghMedicalResearch.com Interview with: Dr. Alan J. Gow PhD, CPsychol, CSci, AFBPsS, FHEA Associate Professor in Psychology School of Life Sciences Heriot-Watt University Edinburgh Taylor-Jane Flynn, who conducted the research is a recent graduate in psychology from Heriot-Watt, and is about to commence postgraduate training in Counseling Psychology at Glasgow Caledonian University Medical Research: What is the background for this study? What are the main findings? Dr. Gow: We were interested in exploring how sexual behaviours might be associated with quality of life in older adults. Ms. Taylor-Jane Flynn, who led on the research, noted "There is an abundance of research identifying factors that predict better health and well-being in later life, but sex is one that is under researched." We asked our participants to report the frequency with which they engaged in six sexual behaviours from touching or holding hands to sexual intercourse, and then to also rate how important the behaviours were to them. Our results suggested that how often older adults engaged in sexual behaviours was positively associated with the quality of their social relationships. Interestingly, the importance of these sexual behaviours was found to be positively associated with their psychological quality of life. Our recently published research on how sexual behaviours are associated with quality of life in older adults grew from Taylor-Jane’s work with older adults. She reflected "I found my inspiration for this study while working as a Health Care Assistant caring for older adults. In recent years, many of those who opened up to me on a personal level expressed their need and want to have intimacy and companionship in their lives. However, sex has generally been seen as a taboo subject, especially among older adults. Despite this, older adults shared in our conversations that they miss and want to engage in sexual behaviours, whether that be a kiss to intercourse, and for many these behaviours remained an important element in their life." We were therefore keen to use these anecdotal accounts as a foundation for studying sexual behaviours as one of the many and varied determinants of wellbeing. (more…)
Author Interviews, JCEM, Sexual Health, Testosterone / 11.07.2015

Darius A. Paduch, MD, PhDAssociate  Professor of Urology and Reproductive Medicine Director Sexual Health and Medicine Research Director of Male Infertility Fellowship Co-Director Male Infertility Genetics Laboratory Weill Cornell Medical College Dept of Urology New York, NY 10065MedicalResearch.com Interview with: Darius A. Paduch, MD, PhD Associate  Professor of Urology and Reproductive Medicine Director Sexual Health and Medicine Research Director of Male Infertility Fellowship Co-Director Male Infertility Genetics Laboratory Weill Cornell Medical College Dept of Urology New York, NY 10065 Medical Research: What is the background for this study? What are the main findings? Dr. Paduch: Ejaculatory dysfunction, inability to ejaculate or delayed ejaculation affects 10-8% of men. Inability to ejaculate either intravaginally or at all is independent of erectile function. Men with normal erection may take very long time to ejaculate (>30 min) or not able to ejaculate at all. The men in our study had either normal erections or minimal erectile dysfunction. Men of all ages have spontaneous erections but don't ejaculate just from erection, it is progression of arousal and activation of spinal cord motor generator for ejaculation which is necessary for ejaculation. One of important factors in our ability to ejaculate is testosterone (T), testosterone allows for normal function of CNS centers for ejaculation, it is a modulator and is necessary; preadolescent boys don't ejaculate because their spinal cord centers for ejaculations are not mature – process dependent on testosterone. However testosterone is just one of many neurotransmitters and hormones needed of normal ejaculation. Actually our study showed that in men who achieved normal levels of testostosterone the ejaculatory function have improved. As this was first double blinded and randomized clinical trial we had to report our results based on radomization to testosterone treatment or placebo. Unfortunately only 70-80% of men treated with topical testosterone preparation will achieve normal testosterone level , we simply didn’t reach statistical significance based on randomization and  considering relatively low number of patients in each group. But in men who achieved normal testosterone levels the difference was statistically significant. Testosterone should not be used to treat any conditions, including ejaculatory dysfunction, in absence of low testosterone  level. EjD is very common but it bares significant embarrassment stigma, it is difficult for the couple to bear fact that male partner can’t ejaculate, it also creates issues within couple and question about attraction and fidelity. We have previously showed that treatment with tadalafil improves ejaculatory and orgasmic dysfunction and these data has been published. This study was focused on effect of testosterone, but its main significance was it’s design: we developed new tools to assess ejaculatory function and learned a lot about when patients or their partners start to be bothered by EjD. If time to ejaclate takes > 30 min We are now looking into novel and available pharmacotherapy modulating dopaminergic and canabioid signaling and reward mechanisms. I am also very excited about our potential work in direct spinal cord motor generator nano stimulator, this could be very useful for men with spinal cord injuries and diabetic patients. We paved the road for others and I am sure new treatments are just a matter of time. (more…)
Author Interviews, Heart Disease, Psychological Science, Sexual Health, University Texas / 11.07.2015

Amelia Stanton, Graduate Student Department of Psychology The University of Texas at Austin Austin, TXMedicalResearch.com Interview with: Amelia Stanton, Graduate Student Department of Psychology The University of Texas at Austin Austin, TX Medical Research: What is the background for this study? What are the main findings? Response: Heart rate variability (HRV) has emerged as a valuable non-invasive test to assess autonomic nervous system (ANS) activity. Several studies have linked low resting Heart rate variability to mental health conditions including depression, anxiety, and alcohol dependence, indicating these disorders may be related to an imbalance in autonomic activity. As Heart rate variability is an index of the balance of sympathetic nervous system (SNS) and parasympathetic nervous system activity (PNS), it has proven a useful tool for examining the relative role of SNS activity in female sexual arousal. Moderate SNS dominance (relative to PNS activity) has been shown to predict women’s genital arousal in the laboratory, while high levels of SNS activation have been shown to inhibit genital arousal. Based on this background evidence and on a growing clinical literature indicating that low HRV (generally indicative of high SNS) is associated with negative health outcomes, we predicted a positive linear relationship between Heart rate variability and sexual arousal function. That is, we predicted that women with autonomic balance indicating moderate or low resting SNS activity (relative to PNS activity) would be less likely than women with autonomic balance indicating high resting SNS to report clinically relevant sexual arousal dysfunction. We also predicted that this relationship would hold for overall sexual function. To test this hypothesis, sexual arousal function, overall sexual function, and resting HRV were assessed in 72 women, aged 18-39. The main finding of the study is that women with below average Heart rate variability were significantly more likely to report sexual arousal dysfunction (p < .001) and overall sexual dysfunction (p < .001) than both women with average HRV and women with above average HRV. Based on these results, we concluded that low HRV may be a risk factor for female sexual arousal dysfunction and overall sexual dysfunction. (more…)
Author Interviews, Depression, Sexual Health, Testosterone / 03.07.2015

Michael S. Irwig MD Division of Endocrinology Medical Faculty Associates George Washington UniversityMedicalResearch.com Interview with: Michael S. Irwig MD Division of Endocrinology Medical Faculty Associates George Washington University Medical Research: What is the background for this study? What are the main findings? Response: Many factors are associated with lower testosterone levels and many men who have their testosterone levels checked have non-specific depressive symptoms. The main finding is a remarkably high rate of depression and depressive symptoms (56%) in men who are referred for borderline testosterone levels. Other significant findings include a prevalence of overweight and obesity higher than the general population. (more…)
Author Interviews, Psychological Science, Sexual Health / 13.06.2015

MedicalResearch.com Interview with: Fiona Dyshniku, M.A. Ph.D. Candidate, Clinical Psychology - Adult Clinical track Department of Psychology University of Windsor MedicalResearch: What is the background for this study? Response: This study was conducted in the context of previous research that has found other evidence that pedophilia has biological roots that start before birth, such as shorter stature and left-handedness. Both of these correlates have prenatal origins, meaning that their development necessarily precedes the onset of more socially oriented correlates, such as parenting styles, sexual abuse during childhood, etc. Moreover, these neurodevelopmental correlates appear permanent and immune to later psychosocial influences. Much like handedness and stature, minor physical anomalies (MPA) develop prenatally, are permanent, and remain immune to psychosocial influences. There are additional benefits to examining minor physical anomalies, including the fact that they tend to develop in a set sequence, are actually formed from the same tissue that gives rise to the central nervous system, and have been widely studied in other well-established neurodevelopmental disorders, such as schizophrenia. MedicalResearch: What are the main findings? Response: We found that individuals simultaneously possessing more craniofacial anomalies and fewer peripheral anomalies scored higher on several well-established pedophilia indices, including phallometric testing, possession of child pornography, and number of child victims. We also found that craniofacial anomalies on their own were more prevalent among individuals classified as pedophiles through phallometric testing. Taken together, these results suggest that there is further evidence for a biological cause of pedophilia. Moreover, since craniofacial anomalies develop around week 5 of gestation, it would appear that biological differences occur quite early on during foetal developmental. (more…)
Author Interviews, HIV, Sexual Health, UCSD / 05.06.2015

MedicalResearch.com Interview with: Dr. Martin Hoenigl Center for AIDS Research University of California, San Diego Medical Research: What is the background for this study? What are the main findings? Dr. Hoenigl: Although men who have sex with men (MSM) represent a dominant risk group for human immunodeficiency Virus, the risk of HIV infection within this population is not uniform. Characterizing and identifying the MSM at greatest risk for incident HIV infection might permit more focused delivery of both prevention resources and selection of appropriate interventions, such as intensive counseling, regular HIV screening with methods that detect acute infection (ie, nucleic acid amplification test), and antiretroviral preexposure prophylaxis (PrEP). By using data collected at a single HIV testing encounter from 8326 unique MSM were analyzed, including 200 with AEH (2.4%), we were able to create the San Diego Early Test (SDET) risk score. The SDET score consist of four risk behavior variables which were significantly associated with an AEH diagnosis (ie, incident infection) in multivariable: condomless receptive anal intercourse (CRAI) with an HIV-positive MSM (3 points), the combination of CRAI plus 5 or more male partners (3 points), 10 or more male partners (2 points), and diagnosis of bacterial sexually transmitted infection (2 points), all as reported for the prior 12 months. The SDET risk score is deployed as a freely available tool at http://sdet.ucsd.edu. (more…)
Author Interviews, HIV, NYU, Race/Ethnic Diversity, Sexual Health / 22.05.2015

Perry N Halkitis, Ph.D., M.S., MPH Professor of Applied Psychology Global Public Health, and Population Health/Medicine New York University.MedicalResearch.com Interview with: Perry N Halkitis, Ph.D., M.S., MPH Professor of Applied Psychology Global Public Health, and Population Health/Medicine New York University. Medical Research: What is the background for this study? Dr. Halkitis: The P18 Cohort Study is a prospective cohort study of gay, bisexual and other young men who have sex with men (YMSM) which seeks to examine the development of health behaviors as these young men transition from adolescent to adulthood. Officially named “Syndemic Production among Emergent Adult Men”, this study was funded by the National Institute on Drug Abuse from 2009-2014 and renewed on March 1, 2014 for an additional five years. The original aims of the study were as follows:
  • 1) to develop and test theoretically informed measurement models of the covariance of illicit drug use, unprotected sexual behavior and mental health burden (multiple overlapping epidemics known as a syndemic) among emergent adult HIV-negative YMSM within and across time;
  • 2) to delineate the risk and protective bases- physical factors (e.g., pubertal onset, HIV status, etc.), relational and structural factors (e.g., family history of psychopathology, current romantic relationships, peer support, neighborhood factors, etc.), and psychosocial factors (e.g., sexual identity, internalized homophobia, hyper-masculine conceptions, etc.) that predict the development of syndemics; and
  • 3) to determine the extent to which the development of a syndemic varies by race/ethnicity, social class, and homelessness/housing instability.
  • In this current five year continuation we also seek
    • 1) to describe the social and sexual networks of YMSM, and to examine the relationship between social and sexual network-level structural characteristics, social support and normative influences on syndemic production (illicit drug use, unprotected sexual behaviors, and mental health burden) in YMSM, singly and in combination with the physical, psychosocial, and relational predictors, both within and across time;
    • 2) to describe the acquisition of sexually transmitted infections (STIs) in YMSM, specifically, urethral and rectal gonorrhea and chlamydia, pharyngeal gonorrhea as well as syphilis serology; and to determine the extent to which physical, relational, and psychosocial factors explain STI acquisition as part of the syndemic model within and across time.
    • A third exploratory aim was also added: 3) to describe HIV clinical treatment markers (i.e., HIV viral load, ART uptake and adherence, HIV care) among HIV+ YMSM, and to assess the extent to which physical, relational, and psychosocial factors are associated with differences in these clinical markers among HIV+ YMSM, both within and across time. The study is led by Drs. Perry N Halkitis and Farzana Kapadia at New York University’s Center for Health, Identity, Behavior & Prevention Studies.
Potential participants were recruited through both active (e.g., approaching individuals to solicit study participation) and passive (e.g., flyer posting, website advertisements) methods from June 2009 to May 2011. Eligibility criteria included being 18-19 years old, biologically male, residing in the NYC metropolitan area, having sex (any physical contact that could lead to orgasm) with a man in the last 6 months, and reporting a seronegative or unknown HIV status at baseline. We ensured the diversity of our sample by setting a fixed recruitment quota for participants in each targeted racial/ethnic group, such that African Americans, Latino (across race), Asian-Pacific Islander (API), and mixed race men comprised the majority of the sample. All participants provided written, informed consent before data was collected and were compensated for their time and effort upon completing the baseline assessment. The New York University’s Institutional Review Board (IRB) approved all study protocols and a federal Certificate of Confidentiality protects these data. A total of 2,068 participants were screened for eligibility to participate in the study, and 600 participants completed the baseline assessment in the first wave of the study. In 2014, we began the second wave and opened to cohort to recruit a baseline sample of 650 YMSM who will now be between the ages of 22-23; recruitment of participants is still underway. Medical Research: What are the main findings? Dr. Halkitis: Numerous publications have been generated from the P18 Cohort Study and can be accessed at www.chibps.org.  A recent publication, “Incidence of HIV infection in Young Gay, Bisexual, and other YMSM: The P18 Cohort Study” became available in the May 2015 of JAIDS, the Journal of Acquired Immune Deficiency Syndromes. This paper reports that over a 36 month follow-up period, during the first wave of the study, 7.2% of study participants seroconverted, with Black and Hispanic men much more likely to seroconvert over this time frame than White men. This finding aligns with epidemiological trends for HIV infection at the national and local, NYC, levels. Also, men reporting a lower familial socioeconomic status were more likely to seroconvert than men reporting high familial socioeconomic status, and Black men were more likely to report a lower socioeconomic status.  Moreover, the Black young men who seroconverted were more likely to reside in neighborhoods with higher area-level poverty and higher area-level HIV prevalence. Additionally we found that men who reported anal sex without a condom in the 30 days prior to assessment were no more likely to seroconvert than those who reported sex with a condom.  However, an earlier age of sexual debut was a predictor of HIV seroconversion. (more…)
Author Interviews, Baylor University Medical Center Dallas, Dermatology, Sexual Health / 03.04.2015

MedicalResearch.com Interview with: Caitriona Ryan, MD Baylor University Medical Center, DallasMedicalResearch.com Interview with: Caitriona Ryan, MD Baylor University Medical Center, Dallas MedicalResearch: What is the background for this study? What are the main findings? Dr. Ryan: Psoriasis is a common, chronic, inflammatory disorder of the skin which has a considerable impact on social functioning and personal relationships. Genital involvement can have devastating psychosexual implications for psoriasis patients. In a study examining the stigmatization experience in psoriasis patients, involvement of the genitalia was found to be the most relevant, regardless of the overall psoriasis severity. Although sexual function is an integral component of quality of life, dermatology-specific and psoriasis-specific scales largely neglect the impact of disease on sexual health. Despite major advances in other aspects of psoriasis research, there has been little emphasis in recent times on the identification and treatment of genital psoriasis and few studies have examined predisposing risk factors, phenotypical associations or its impact on quality of life and sexual functioning. This study was designed to examine the prevalence and nature of genital involvement in patients with psoriasis, to ascertain risk factors for the development of genital psoriasis, to determine the impact of genital disease on quality of life and sexual functioning, and to assess patient satisfaction with current topical treatments for genital psoriasis. (more…)
Author Interviews, Sexual Health, Sleep Disorders, University of Michigan / 24.03.2015

David A Kalmbach, PhD Sleep and Circadian Research Laboratory Department of Psychiatry University of Michigan Medical School MedicalResearch.com Interview with: David A Kalmbach, PhD Sleep and Circadian Research Laboratory Department of Psychiatry University of Michigan Medical School Medical Research: What is the background for this study? What are the main findings? Dr. Kalmbach: As it happens, my research background is in sexual health, and my clinical work is in behavioral sleep medicine. Therefore, I've long been interested in the intersection between sleep and sexual response, though there has been little research in this area. With the growing recognition of a wide range of morbidities associated with poor sleep, coupled with the multifactorial etiology of sexual dysfunctions, I wanted to investigate whether sleep disturbance was associated with poorer sexual response. Using a 2-week daily diary approach in a sample of 171 young women, we found that longer reported sleep duration led to greater sexual desire the next day. This relationship was mirrored by finding that the likelihood of partnered sexual activity was increased following nights during which women slept longer. We also found an association between genital arousal and sleep length, though this relationship was more complex. Women reported greater vaginal arousal during sexual activity following nights of shorter sleep. However, women who slept longer on average reported better vaginal arousal than women who obtained less sleep on average. This dual relationship may reflect differential effects of a single night of sleep deprivations versus chronic sleep deprivation. However, I think more research is needed to delineate the underlying mechanisms of these relationships. Even so, I think it is notable that daytime sequelae of poor sleep (e.g., mood changes, fatigue) did not account for the relationships between sleep and sexual response. (more…)
Author Interviews, Occupational Health, Sexual Health, Stanford / 09.03.2015

Michael L. Eisenberg, M.D. Director, Male Reproductive Medicine and Surgery Assistant Professor Department of Urology Stanford University School of MedicineMedicalResearch.com Interview with: Michael L. Eisenberg, M.D. Director, Male Reproductive Medicine and Surgery Assistant Professor Department of Urology Stanford University School of Medicine Medical Research: What is the background for this study? What are the main findings? Dr. Eisenberg: There has been growing data that a man's overall health may impact his fertility. As such, we wanted to explore this link using the NICHD LIFE Study which has the unique ability to account for both health and work exposure in men with both normal and abnormal fertility. We found that certain aspects of a man's work and health can impact his semen parameters. (more…)
Author Interviews, Genetic Research, Sexual Health / 08.03.2015

Dr. David M.G. Lewis, PhD Assistant Professor Department of Psychology Bilkent Üniversitesi Ankara, Turkey Research Affiliate, Individual Differences and Evolutionary Psychology Area Department of Psychology The University of Texas at Austin MedicalResearch.com Interview with: Dr. David M.G. Lewis, PhD Assistant Professor Department of Psychology Bilkent Üniversitesi Ankara, Turkey Research Affiliate, Individual Differences and Evolutionary Psychology Area Department of Psychology The University of Texas at Austin MedicalResearch: What is the background for this study? Dr. Lewis: My motivations to conduct this study were a combination of several things. Men would often mention to me the features that they found attractive in women. They would often mention the butt, but not the *size* of the butt...it was something else, but they couldn't seem to put their finger on exactly what... I then began reading more deeply into the different muscular, ligamentous, skeletal, etc. structures that could influence the appearance of the buttocks. I moved beyond just buttock tissue and buttock size. What I began to discover is that while the size of the buttocks does indeed influence the buttocks' appearance, so too does other morphology that is not part of the buttocks themselves. These readings indicated that certain spinal structures can help women shift their center of mass back over the hips during pregnancy and reduce hip torque by roughly 700%. To the extent that women who possess these spinal structures would thereby be better able to carry a pregnancy (or multiple pregnancies) to term without suffering spinal injuries, selection would have favored the evolution of psychological mechanisms in men to prefer women exhibiting cues to these spinal structures. Men could not directly observed women's vertebrae, but lumbar curvature is an externally visible cue to the relevant spinal structures. At this point, we had a hypothesis that was both anchored in evolutionary theory and grounded in medical orthopedic literature. It was time we tested our idea that men possess a previously undiscovered, evolved preference for a beneficial intermediate angles of lumbar curvature in women. (more…)
Author Interviews, CDC, HIV, Race/Ethnic Diversity, Sexual Health / 05.03.2015

MedicalResearch.com Interview with: Cyprian Wejnert Center For Disease Control MedicalResearch: What is the background for this study? What are the main findings? Cyprian Wejnert: Men who have sex with men (MSM) remain the risk group most severely affected by HIV in the United States, accounting for approximately two-thirds of new infections each year.  Understanding racial and age disparities among MSM is critical to tailor effective prevention efforts. Our study examined data from CDC’s National HIV Behavioral Surveillance system (NHBS) from 20 U.S. cities. We assessed changes in HIV prevalence, awareness of infection, and risk behavior among MSM, by age and race, from 2008 to 2011, finding that: o   Among black Men who have sex with men, 30 percent were HIV-infected overall, and 1 in 5 black MSM aged 18-24 were infected with HIV. Compared to 14 percent and 4 percent among white MSM. o   In all age groups younger than 40 years, black Men who have sex with men were significantly more likely to be HIV-positive compared to all other racial/ethnic groups. o   Disparities in HIV prevalence between black and white MSM were greatest among the youngest MSM, and increased between 2008 and 2011. o   Black MSM were less likely to be aware of their infection than their white counterparts (54 vs. 86 percent). o   Black Men who have sex with men did not report higher levels of condomless sex overall or condomless sex with partners of discordant or unknown HIV status. (more…)
Author Interviews, CDC, OBGYNE, Sexual Health / 03.03.2015

MedicalResearch.com Interview with: Amy Branum M.S.P.H., Ph.D and Jo Jones Ph.D Center for Health Statistics Division of Vital Statistics, Reproductive Statistics Branch Medical Research: What is the background for this study? Response: This data brief was based on multiple years of the National Survey of Family Growth (NSFG).  The NSFG, first conducted in 1973, is administered by NCHS in response to a legal mandate that says that NCHS “shall collect statistics on …family formation, growth, and dissolution.” (PHS Act, Sec 306). Up through the 2002 NSFG, the survey was conducted periodically; with the 2006-2010 data collection, the NSFG is a continuous survey with interviews conducted over multiple years.  We felt it was important to examine long-term trends in  Long-acting Reversible Contraception use due to fluctuations over time in IUD and implant acceptability and availability as contraception methods, especially in light of recent efforts to promote LARC use to prevent unintended pregnancies and for birth spacing. Medical Research: What are the main findings? Response: We found that Long-acting Reversible Contraception use declined between 1982 and 1988, remained stable through 2002 and then increased almost five-fold between 2002 and 2011-2013 (from 1.5% to 7.2).  Long-acting Reversible Contraception use has, and continues to be, generally highest among women aged 25-34 but has increased the most among women 15-24 since 2002.  Hispanic women used Long-acting Reversible Contraception at higher rates in 1982 compared to non-Hispanic white and non-Hispanic black women but patterns of use diverged after 1995 so that by 2011-2013, patterns of use were more similar by race and Hispanic origin.  Women who have at least one previous live birth have used, and continue to use, LARCs at a higher rate compared to women with no previous births. (more…)
Author Interviews, Endocrinology, Sexual Health / 15.02.2015

Joshua D. Safer MD, FACP Director, Endocrinology Fellowship Training and Endocrinology Education Boston University Medical Center Associate Professor of Medicine and Molecular Medicine Boston University School of Medicine MedicalResearch.com Interview with: Joshua D. Safer MD, FACP Director, Endocrinology Fellowship Training and Endocrinology Education Boston University Medical Center Associate Professor of Medicine and Molecular Medicine Boston University School of Medicine   Medical Research: What is the background for this study? What are the main findings? Dr. Safer: This is a review of the current medical literature in favor of the biologic nature of gender identity.  The main barrier to medical care for transgender patients is lack of physicians with the knowledge and willingness to provide that care. A major concern of physicians is that this is a mental health issue, meaning that transgender hormone therapy and surgery may be too drastic a response to an individual who should be counseled instead.  The review lays out the evidence to make it clear that a major component of gender identity is biologic even if we don’t have the exact details worked out.  Therefore, counseling alone cannot address the disconnect between transgender individuals’ gender identity and their physical bodies. (more…)
Author Interviews, CDC, HIV, Sexual Health / 14.02.2015

MedicalResearch.com Interview with: Kristen Hess  ORISE Fellow Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD and TB Prevention Centers for Disease Control and Prevention Atlanta, GA MedicalResearch: What is the background for this study? Response: Men who have sex with men (MSM) of all races continue to be the risk group most severely affected by HIV in the United States. CDC’s most recent HIV incidence data show that the number of new infections among MSM increased 12 percent between 2008 and 2010, with an even steeper increase among the youngest MSM. These data clearly show the urgent need to better understand the factors that affect their risk and to develop effective prevention interventions. One specific factor is excessive alcohol use, which is responsible for 88,000 deaths in this nation each year, and cost the U.S. about $224 billion in 2006. Binge drinking (consuming ≥5 drinks for men on an occasion; ≥4 drinks for women) is the most common form of excessive alcohol consumption. The association between excessive alcohol consumption, including binge drinking, and risky sexual behaviors among MSM has had mixed results in the literature with some studies finding an association and others not. One limitation of previous work is that the definition of excessive alcohol consumption varies between studies, so results are not easily compared between studies and populations. Our study examines the relationship between binge drinking and sexual risk behaviors among MSM who are current drinkers and who were either HIV-negative or unaware of their HIV status. MedicalResearch: What are the main findings? Response: We assessed the prevalence of binge drinking, using a standard definition, among a sample of MSM recruited from 20 cities across the U.S. We also examined the association between binge drinking and several risky sexual behaviors. The findings show that 6 in 10 MSM reported binge drinking. Those who binge drank, in comparison to non-binge drinkers, were more likely to engage in risky sexual behaviors such as sex with an HIV-positive or unknown status partner and exchange sex for money or drugs at last sex, as well as more likely to have concurrent partners and more condomless sex partners in the past year. We also found that the likelihood of risky sexual behaviors went up with increased frequency of binge drinking. In fact, MSM who reported 10 or more binge-drinking episodes in the past month were more likely to report risky behaviors. This is a critical point, especially given that, among those who binged, 22 percent reported 10 or more binge drinking episodes in the past month. (more…)
Author Interviews, Geriatrics, Sexual Health / 01.02.2015

MedicalResearch.com Interview with: David M. Lee PhD MPH Cathie Marsh Institute for Social Research The University of Manchester Manchester UK Medical Research: What is the background for this study? What are the main findings? Response: These data on sexual health and wellbeing were collected in the latest phase of the English Longitudinal Study of Ageing (ELSA). ELSA is a representative survey of a cohort aged 50 to >90 years, and has gathered detailed longitudinal data since 2002 on changes in health, economic and social circumstances as people prepare for and move into retirement and old age. Our research asked over 7000 men and women taking part in ELSA a wide range of questions about their sexual lives; including their attitudes to sex, how sexually active they were and what problems and concerns they experienced with their sexual health. Around two-thirds of men and over half of women in this survey thought ‘good sexual relations were essential to the maintenance of a long-term relationship’ or ‘being sexually active was physically and psychologically beneficial to older people’. We found that half of men and almost a third of women aged 70 and over were still sexually active, with around a third of these sexually active older people having sexual intercourse twice a month or more. Sexual problems were relatively common, however, with a third of sexually active women reporting difficulties becoming sexually aroused or achieving orgasm. For men difficulties getting and maintaining an erection was the most common problem, reported by 40% of those who were sexually active. Chronic health conditions and poor self-rated health seemed to have more obvious negative impacts on the sexual health of men compared to women. Men were more concerned about their sexual activities and function than women and, with increasing age, these concerns tended to become more common. Take a look at Men's Review Zone for help with and solutions for any problems you may be experiencing. Sexually active women were less dissatisfied with their overall sex lives than men, and also reported decreasing levels of dissatisfaction with increasing age. (more…)
Author Interviews, PLoS, Sexual Health / 18.01.2015

MedicalResearch.com Interview with: Matthew Golden MD, MPH Director, PHSKC HIV/STD Program Professor of Medicine, University of Washington Harborview Medical Center Medical Research: What is the background for this study? What are the main findings? Dr. Golden: Gonorrhea and chlamydial infection are the most common reportable infections in the United States and, in women, are associated with pelvic inflammatory disease, ectopic pregnancy, infertility and chronic pelvic pain. One way to decrease the number of cases of gonorrhea and chlamydia is to increase our success in treating the sex partners of persons diagnosed with these infections. Expedited partner therapy (EPT) - treating partners without requiring them to first undergo a medical evaluation - is one way to increase partner treatment. This usually involves giving people medication to give to their partners. Prior randomized trials have found that EPT decreases patients' risk of becoming reinfected. We conducted a community-level randomized trial to evaluate whether making free Expedited partner therapy available to medical providers would increase the use of Expedited Partner Therapy and decrease gonorrhea and chlamydial infections at the population level. We found that a public health program that made Expedited partner therapy widely available could dramatically increase medical providers use of EPT. Although our final result was not statistically significant, our findings suggest that the program likely decreased both gonorrhea and chlamydial infection by about 10% at the population-level. (more…)
Author Interviews, CDC, Sexual Health / 09.01.2015

MedicalResearch.com Interview with: Dr. Catlainn Sionean Epidemiologist, CDC’s Division of HIV/AID Medical Research: What is the background for this study? Dr. Sionean: Previous research has shown that heterosexuals in low socio-economic communities are disproportionately affected by HIV, so we analyzed data on low-SES heterosexuals in 21 metropolitan areas with a high AIDS burden from CDC’s National HIV Behavioral Surveillance system to better understand individual risk and HIV testing behaviors within this population. Medical Research: What are the main findings? Dr. Sionean: This analysis makes it clear that we must do a better job reaching heterosexuals in urban areas with prevention services. CDC recommends that everyone be tested at least once for HIV. However, we found that overall, 1 in 4 (25%) participants had never been tested for HIV.  HIV testing rates were notably low among Latinos, who, with African Americans, share a disproportionate burden of HIV in the U.S. Additionally, 1 in 3 participants (34%) received free condoms in the last year and only 11 percent of participants participated in a prevention intervention. (more…)
Author Interviews, HPV, Sexual Health / 16.11.2014

Eduardo L. Franco DrPH, FRSC, FCAHS James McGill Professor Departments of Oncology and Epidemiology & Biostatistics, Director, Division of Cancer Epidemiology Minda de Gunzburg Chair, Department of Oncology, Division of Cancer Epidemiology Department of Oncology McGill University Montreal, Quebec, CanadaMedicalResearch.com Interview with; Eduardo L. Franco DrPH, FRSC, FCAHS James McGill Professor Departments of Oncology and Epidemiology & Biostatistics, Director, Division of Cancer Epidemiology, Minda de Gunzburg Chair, Department of Oncology, Division of Cancer Epidemiology Department of Oncology McGill University, Montreal, Quebec, Canada Medical Research: What should clinicians and patients take away from your report? Dr. Franco: Our findings of oral transmission of human papillomavirus (HPV) infection in men are part of a larger molecular epidemiologic study called ‘HPV Infection and Transmission among Couples through Heterosexual Activity’ (HITCH) cohort study. The focus of the HITCH study is to understand how HPV is transmitted within couples via sexual contact and other behaviors. We measure the presence of this virus using highly-sensitive molecular assays for HPV DNA in the genital surfaces (vagina and penis), oral cavity, and hands. We also take a blood sample to look for the presence of antibodies against HPV. We take multiple samples over a period of two years at pre-scheduled visits. We have previously published results focused exclusively on genital transmission. The present report is the first in the HITCH study to look at what happens in terms of characteristics that place male participants to be at risk of oral HPV infection. To our knowledge, this is the first study to show a high risk of oral HPV infection among men whose female partners had a genital or oral HPV infection, suggesting that transmission may occur through oral or genital routes. We looked at transmission for 36 individual HPV genotypes, which improved our ability to study risk determinants. Risk was also significantly higher among men who had ever smoked, had a high number of lifetime sex partners, or were in non-monogamous relationships. Our results are largely consistent with previous studies that have found male sex practices and smoking to be the most significant risk factors for oral HPV infection. (more…)
Author Interviews, General Medicine, Pediatrics, Sexual Health / 07.10.2014

Jeff R. Temple, PhD Associate Professor and Psychologist Director, Behavioral Health and Research Department of Ob/Gyn UTMB Health Galveston, TX 77555-0587MedicalResearch.com Interview with: Jeff R. Temple, PhD Associate Professor and Psychologist Director, Behavioral Health and Research Department of Ob/Gyn UTMB Health Galveston, TX 77555-0587 Medical Research: What are the main findings of the study? Dr. Temple: Through previous research, we know that teen sexting is related to actual sexual behaviors, but we did not have any information on the temporal link between these two behaviors. In short, we found that teens who sexted had 32% higher odds of being sexually active over the next year relative to youth who did not sext – this was even after controlling for history of prior sexual behavior, ethnicity, gender, and age. We also found that active sexting (actually sending a naked picture to another teen) mediated the relationship between passive sexting (asking for or being asked for a sext) and sexual behaviors. In other words, while sending a sext was predictive of subsequent sexual behavior, asking for/being asked for a sext was only associated with sexual behavior through its relationship with active sexting. (more…)
Alcohol, Author Interviews, BMJ, HPV, Sexual Health / 03.10.2014

Matthew B. Schabath, Ph.D Assistant Member, Department of Cancer Epidemiology  Moffitt Cancer Center Tampa, Florida MedicalResearch.com: Interview with: Matthew B. Schabath, Ph.D Assistant Member, Department of Cancer Epidemiology Moffitt Cancer Center Tampa, Florida   Medical Research: What are the main findings of the study? Dr. Schabath: Overall, the results from these analyses demonstrated that men who consumed the highest amounts of alcohol were associated with an increased risk for genital human papillomavirus (HPV) infections. (more…)
Author Interviews, Pain Research, Sexual Health / 15.09.2014

MedicalResearch.com Interview with: Natalie Sidorkewicz, MSc (Kin) PhD (HSG) Student Spine Biomechanics Laboratory School of Public Health and Health Systems, Faculty of Applied Health Sciences University of Waterloo Waterloo, ON Medical Research: What are the main findings of the study? Answer: First, we successfully documented male spine motion and muscle activity during sex -- this biomechanics study was the first of its kind. Second, we used this data to develop general recommendations for low back pain patients whose pain is worsened by motions and postures. The general recommendations focus on changing how people move, and position themselves during sex, as seen on websites similar to Nu-Bay. To make any sex position more spine-sparing, we recommend that the individual controlling the movement use their hips and knees more than their spine and that the individual not controlling the movement maintain a more neutral-spine position. An excellent working example is one of the sex positions that we studied: the missionary position. The man, who is controlling the movement with pelvic thrusting, is recommended to do so with more hip and knee movement than spine movement. The women, who is lying on her back, is recommended to use a back support placed underneath the natural curve of her spine to maintain a more neutral spine position. The general recommendations can be applied to any sex position for both men and women. Finally, we developed specific guidelines for men whose back pain is worsened by two specific types of motion: flexion and extension. If a man's low back pain is worsened by spine flexion movements, such as touching their toes or sitting for long periods of time, we would consider them to be flexion-motion-intolerant. The ideal sex position for a flexion-motion-intolerant patient would then be one that uses minimal spine flexion, so as not to worsen that patient's pain. When we compared the five sex positions, which you can do yourself by checking out some videos on a website such as sex free hd xxx, we found that men used the least amount of spine flexion in doggy-style as well as the missionary position as long as the male was propped up on his hands (as opposed to his elbows). If a man's low back pain is worsened by spine extension movements, such as arching their back or lying on their stomach, we would consider them to be extension-motion-intolerant. The ideal sex position for an extension-motion-intolerant patient would then be one that uses minimal spine extension, so as not to worsen the patient's pain. When we compared the five sex positions, we found that men used the least amount of spine extension in spooning and the missionary position as long as the male was propped up on his elbows (as opposed to his hands). (more…)
Author Interviews, Sexual Health / 15.08.2014

MedicalResearch.com Interview with: Dr. Cicely Marston Senior Lecturer in Social Science Department of Public Health and Policy London School of Hygiene and Tropical Medicine London WC1H 9SH Medical Research: What are the main findings of the study? Dr. Marston: Young people talked to us about an oppressive environment where some men compete with each other to have anal sex with women, even if they expect women to find it painful. Women also reported they were repeatedly asked for anal sex by their male partners and on some accounts, women enjoy it websites like https://bitchtopia.com/true-sex-stories/ go into detail about how the women asked for anal sex but we have found this is largely the minority among those we spoke too. Their accounts also raise the real possibility of coercion for young women – who were sometimes put in situations where they are penetrated anally without their explicit consent. Young people often suggested that pain for women was inevitable, or that it was the woman’s fault, ideas that may make them less likely to change their practices to reduce pain. Some young people said they thought STIs were less of a problem for anal sex compared with vaginal sex. Some young men put their own desire to have anal sex ahead of the desires and needs of their partners. (more…)
Sexual Health, Statins / 29.03.2014

Dr. John B. Kostis, MD Chief of Medical Service, RWJUH Professor of Medicine & Pharmacology Chair - Department of Medicine Rutgers Robert Wood JohnsonMedicalResearch.com Interview with: Dr. John B. Kostis, MD Chief of Medical Service, RWJUH Professor of Medicine & Pharmacology Chair - Department of Medicine Rutgers Robert Wood Johnson MedicalResearch.com: What are the main findings of the study? Dr.Kostis:  In this meta-analysis statins improved erectile function in men with decreased function on the average. (more…)
Accidents & Violence, Lancet, Sexual Health / 14.02.2014

MedicalResearch.com Interview with: Professor Naeemah Abrahams Senior Specialist Scientist:  Gender & Health Research Unit, South African Medical Research Council Extraordinary Professor:  Faculty of Community Health Sciences -School of Public Health: University of the Western Cape Associate Professor: Faculty of Health Sciences - School of Health and Rehabilitation Sciences: University of Cape Town MedicalResearch.com: What are the main findings of the study? Prof. Abrahams: We found a global estimate of non-partner sexual violence of 7.2%  for women 15 years and older - but this estimate varied across the globe. The regions with the highest prevalence was Sub Sahara Africa Central and Southern with a prevalence was 21% in the central region and  17.4 % in the Southern region. This is nearly 3 times the global estimate . The region with the lowest prevalence was  Asia South at 3.3%. The low level could be due to a number of reasons. Firstly data from this region was very limited – from 2 countries only  and we have found that if sexual violence questions are added to other larger studies the level of disclosure is not very high. It is also  more likely that people from Asia region do not disclose the violence in research studies because of stigma and shame. (more…)
Author Interviews, JAMA, Menopause, Sexual Health, University of Pittsburgh / 11.02.2014

MedicalResearch.com Interview with: Holly Thomas, MD General Internal Medicine Fellow, Women's Health and Clinical Research University of Pittsburgh Pittsburgh, PA 15213 MedicalResearch.com: What are the main findings of the study? Dr. Thomas: We found that, despite popular perception, the majority of women (85%) who are sexually active at midlife will remain sexually active four years later. We also found that the majority of women score low on a measure of sexual function. However, low sexual function scores did not mean women stopped having sex. In fact, the score on the sexual function measure did not predict whether women maintained sexual activity. Finally, we found that importance of sex was a strong predictor of whether women remained sexually active. Women who felt sex was moderately to extremely important in their lives were 3 times more likely to maintain sexual activity. (more…)
Author Interviews, Duke, JAMA, Pediatrics, Sexual Health / 31.12.2013

Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North CarolinaMedicalResearch.com Interview with: Stewart C. Alexander, PhD Department of Medicine Duke University Medical Center Durham, North Carolina MedicalResearch.com: What are the main findings of the study? Dr. Alexander: Adolescents are reluctant to talk about sex with their doctors and won't raise the topic with their doctors. For physicians, there are common and valid barriers to talking about sexuality with adolescents, including time pressures and discomfort with the topic. Two-thirds of adolescents in our study had some sexuality talk during their annual visit, lasting 36 seconds long. Girls, African Americans, and older teens were more likely to receive sexuality talk. Additionally, longer visits and visits where the physician talked confidentially with their adolescent patient were more likely to have sexuality talk. Our study suggest that sexuality conversations in annual visits can be improved. (more…)