Over 8% of Men Have Some Form of Compulsive Sexual Behavior Disorder (Sex Addiction)

MedicalResearch.com Interview with:
"Sex in stone" by Nagarjun Kandukuru is licensed under CC BY 2.0Janna A Dickenson, PhD

Doug Braun-Harvey Postdoctoral Fellow
Program in Human Sexuality
Department of Family Medicine
University of Minnesota Medical School

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Researchers and clinicians have contested the term “sex addiction” in favor of alternative definitions and symptom presentations. Recently, the ICD-11 has characterized compulsive sexual behavior disorder (CSBD) as a persistent pattern that involves failing to control intense sexual urges or sexual behaviors that results in significant levels of distress and/or impairment in one’s functioning.

Researchers estimate that CSBD affects 2-6% of the population and is much more common among cisgender men than cisgender. Using a randomized national sample, we assessed the prevalence of a key feature of CSBD that researchers and clinicians agree upon: distress and impairment associated with difficulty controlling sexual feelings, urges, and behaviors.

We performed this assessment with a screening tool called the Compulsive Sexual Behavior Inventory (CSBI). Of the 2,325 adults, 8.6 percent overall (10.3 percent of individuals who identified as men and 7 percent of individuals who identified as women) met the clinical threshold of the CSBI; meaning that 8.6% of people expressed difficulty controlling their sexual feelings, urges and behaviors and experienced distress and/or impairment as a result.  Continue reading

Strong Link Between HPV and HIV Infection in MSM

MedicalResearch.com Interview with:

Brandon Brown, MPH, PhD Associate Professor Center for Healthy Communities Department of Social Medicine, Population and Public Health UCR School of Medicine Riverside, CA 

Dr. Brown

Brandon Brown, MPH, PhD
Associate Professor
Center for Healthy Communities
Department of Social Medicine, Population and Public Health
UCR School of Medicine
Riverside, CA

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The authors have been working in Lima, Peru on HIV-related projects for over 17 years. This particular study arose out of interest from our main community collaborator and the only gay men’s health NGO in Lima, Epicentro Salud (http://epicentro.org.pe/index.php/en/). The NGO noticed that one of the main health issues among their clients was genital warts. When we learned this, we applied for funding through the Merck Investigator Initiated Studies Program to conduct a study examining the link between genital warts and incident HIV infection.

The relationship between anogenital HPV types and incident HIV infection among men who have sex with men and transgender women in Lima, Peru

The relationship between anogenital HPV types and incident HIV infection among men who have sex with men and transgender women in Lima, Peru

Although most studies have shown a general link between HPV and HIV co-infection, our findings illustrate the strong relationship between individual HPV types and HIV infection. Specifically, individuals in our study with any HPV type, more than one HPV type, or high-risk HPV were more likely to acquire HIV.

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Bisexual Adults Have Highest Prevalence of Sleep Problems in NYC Survey

MedicalResearch.com Interview with:

Dustin T. Duncan, ScD Associate Professor Director, NYU Spatial Epidemiology Lab Department of Population Health NYU School of Medicine NYU Langone Health

Dr. Duncan

Dustin T. DuncanScD
Associate Professor
Director, NYU Spatial Epidemiology Lab
Department of Population Health
NYU School of Medicine
NYU Langone Health

MedicalResearch.com: What is the background for this study?

Response: Sleep and sleep hygiene have emerged as one of the major determinants of health and wellbeing (alongside good diet, regular exercise, and not smoking). However, a small number of studies have used population-representative samples to examine sexual orientation disparities in sleep. Our study aimed to fill this gap in knowledge.
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Powerful Men More Inclined to Sexually Harass When They Fear Being Perceived As Incompetent

MedicalResearch.com Interview with:

Leah Halper, PhD Associate Director Office of Student Life Center for the Study of Student Life Columbus, OH 43210

Dr. Halper

Leah Halper, PhD
Associate Director
Office of Student Life Center for the Study of Student Life
Columbus, OH 43210

MedicalResearch.com: What is the background for this study? What are the main findings?

 Response: We started to run these studies in 2014 given mutual research interests that we shared. We knew that there was much research on sexual harassment that focused on the victim, the victim’s experience and the reporting process for sexual harassment. This work is extremely valuable. We noticed, however, that there was less research on the perpetrator and if there were personality variables related to the likelihood of sexual harassment. In our studies, we demonstrate that a personality variable (Fear of Negative Evaluation, or anxiety that others will see one as incompetent) is related to sexual harassment among men in powerful positions. Our results held up after taking into account other personality variables, such as narcissism and self-esteem. Also, we found that men who felt insecure in their power (i.e., those that were anxious that others would see them as incompetent) were more likely to engage in both quid pro quo harassment – asking for sexual favors in return for something else – and gender harassment – creating a hostile environment for women.

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Why Do People Choose Monogamy vs Consensually Non-Monogamous Relationships?

MedicalResearch.com Interview with:

Jessica Wood, MSc PhD Candidate, Applied Social Psychology Department of Psychology University of Guelph

Jessica Wood

Jessica Wood, MSc
PhD Candidate, Applied Social Psychology
Department of Psychology
University of Guelph 

MedicalResearch.com: What is the background for this study?

Response: We are at time in history where we expect more from our romantic partners than at any point in our recent past (e.g., love, emotional and financial support, sexual excitement/fulfillment, friendship etc.). This can place pressure on relationships and make it difficult for each person to have their needs fulfilled. In consensually non-monogamous (CNM) relationships, sexual and emotional needs are dispersed among multiple partners, potentially decreasing pressures placed on a primary relationship. However, CNM relationships are stigmatized and often viewed as less stable or satisfying. In our study, we assessed the legitimacy of this perception by comparing relational outcomes among CNM and monogamous individuals. We also examined whether the motives a person reports for engaging in sex was important to how fulfilled a person was in the relationship, and how this was linked to relational outcomes (such as relationship and sexual satisfaction). That is, having sex for more intrinsic/autonomous motives (e.g., pleasure, intimacy, valuing sex) has been associated with higher relationship quality. In contrast, having sex for more extrinsic reasons (e.g., feeling pressured, wanting to manage feelings of guilt or shame), has been linked to lower relational quality.

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Bisexual Men Face Greater Risk of Heart Disease

MedicalResearch.com Interview with:

Billy A. Caceres, PhD, RN, AGPCNP-BC NYU Rory Meyers College of Nursing New York, NY 10010

Dr. Caceres

Billy A. Caceres, PhD, RN, AGPCNP-BC
NYU Rory Meyers College of Nursing
New York, NY 10010

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Although current evidence, primarily based on self-reported data, suggests gay and bisexual men report higher rates of cardiovascular risk factors (such as poor mental health and tobacco use) than heterosexual men, few studies have examined heart disease risk in this population. This study is one of the few studies to examine heart disease risk in gay and bisexual men using biological measures.

Using data from a nationally representative sample we identified higher rates of mental distress, obesity, hypertension, and diabetes among bisexual men compared to exclusively heterosexual men after adjusting for traditional risk factors (demographic characteristics, mental distress, and health behaviors). We also included men who identified as heterosexual but report a history of same-sex sexual behavior. Gay and heterosexual-identified men who have sex with men displayed similar risk profiles to exclusively heterosexual men.

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CPAP Improved Sexual Quality of Life for Women

MedicalResearch.com Interview with:

“The new CPAP machine” by Bryan Alexander is licensed under CC BY 2.0

One CPAP model
Image by Bryan Alexander

Sebastian M. Jara, MD
Resident Physician & Research Fellow
Department of Otolaryngology – Head & Neck Surgery
University of Washington Affiliated Hospitals 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Sleep apnea is a common disorder associated with numerous health consequences and reduced quality of life. There is growing evidence that sleep apnea also affects sexual quality of life and that treatment for sleep apnea, with CPAP (continuous positive airway pressure), may improve sexual quality of life. The goal of this study was to evaluate the impact of long-term CPAP therapy on sexual quality of life in a group of men and women with sleep apnea.

Our study included 182 men and women with newly diagnosed obstructive sleep apnea, each of whom were prescribed a CPAP. Subjects completed a quality of life survey, which included questions on sexual quality of life, at their initial clinic visits and again one year later. Changes in sexual quality of scores over time were then compared between CPAP users and non-users.

Among the subjects, 72 used a CPAP nightly and 110 did not. When looking at all subjects, an overall improvement in sexual quality of life was observed in subjects that used their CPAP compared to subjects that did not, after accounting for several factors that can also affect sexual quality of life. When subgroup analysis was performed, a large improvement in sexual quality of life was noticed for women in the study. In contrast, men in the study experienced little-to-no improvement in sexual quality of life.

MedicalResearch.com: What should readers take away from your report?

Response: These findings add to a large body of evidence that CPAP improves overall health and quality of life, in both men and women with sleep apnea. Because sleep apnea is more common men, there are fewer studies, especially those assessing sexual dysfunction, in women. However, there’s growing recognition that women, too, are affected and can benefit from CPAP use. Our findings demonstrate that improved sexual quality of life is one of the many health benefits that comes with CPAP treatment for women.While this study showed no improvements in sexual quality of life for men, CPAP has been shown to have numerous other health benefits in men and use should still be encouraged. Our hope is that the findings of this study will help motivate patients of both sexes who sleep poorly to seek evaluation for sleep apnea as treatment can have a wide-range of health benefits, including improved sexual quality of life. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In future studies, it will be important to study more comprehensive measures of sexual quality of life in sleep apnea patients. This will include both a more extensive assessment of sexual quality of life in patients themselves and effects on their bed partners. Additionally, it will be important to test the effects of other sleep apnea treatments, such as surgery. Although CPAP is the first-line treatment for sleep apnea, it can be cumbersome to wear and might adversely affect intimacy and sexual quality of life compared to other treatments. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: This study was funded by the National Institutes of Health. The authors of this study otherwise have no other funding, financial relationships, or conflicts of interest to disclose. 

Citation:

Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep ApneaFollow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online May 24, 2018. doi:10.1001/jamaoto.2018.0485

 

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Men Use Dating Apps for Casual Sex More Than Women

MedicalResearch.com Interview with:
“Droid Apps Cell Phone” by Carissa Rogers is licensed under CC BY 2.0Leif Edward Ottesen Kennair  PhD
Professor, Department of Psychology
Norwegian University of Science and Technology 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: The background is all earlier research on sexual behavior, showing both robust individual differences predictors as well as sex differences. We wished to investigate to what degree picture (PBMDA) based mobile dating apps differ from other arenas of sexual behavior.

  • How many have used or are current users:
  • Nearly half of the participants reported former or current Picture-Based Mobile Dating Apps (PBMDA) use. One in five was a current user.”

Our main prediction was confirmed:

  • We found that PBMDA-users tend to report being less restricted in their sociosexuality (as measured with the SOI-R) than participants who have never used PBMDAs

Including  specifation:

  • This effect was equally strong for men and women. Sociosexuality essentially accounted for the effects of other variables such as seeking a casual sex partner, being comfortable picking up strangers, and self-reported short-term mate value.

Sex differences were also found:

  • As predicted, women and men’s reasons for using PBMDAs differed. Relative to women, men emphasized desire for sex as a reason for using PBMDAs.

The most surprising finding was as often due to a discussion with reviewer who was worried whether unrestricted sociosexuality was not more likely a result of use rather than a predictor of use. This improved the detail of our analysis and the conclusion that “When controlling for sex, age and SOI Desire there was no evidence that length of use increased lifetime casual sex partners.”

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The Economic Burden of Child Sexual Abuse is in the Billions

MedicalResearch.com Interview with:

Dr. Xiangming Fang, PhD Associate professor of Health Management and Policy School of Public Health Georgia State University

Dr. Xiangming Fang

Dr. Xiangming Fang, PhD
Associate professor of Health Management and Policy
School of Public Health
Georgia State University

MedicalResearch.com: What is the background for this study?

Response: Child sexual abuse is a serious public health problem in the United States. The estimated prevalence rates of exposure to child sexual abuse by 18 years old are 26.6 percent for U.S. girls and 5.1 percent for U.S. boys. The effects of child sexual abuse include increased risk for development of severe mental, physical and behavioral health disorders; sexually transmitted diseases; self-inflicted injury, substance abuse and violence; and subsequent victimization and criminal offending. Continue reading

HIV Incidence Decreasing But Not Among Latino and AA Gay and Bisexual Men

MedicalResearch.com Interview with:
Sonia Singh, PhD, Epidemiologist
Division of HIV/AIDS Prevention
CDC 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: HIV infection is a persistent health concern in the United States, particularly for people at high risk of infection such as gay and bisexual men. We used data from the National HIV Surveillance System to estimate HIV incidence and prevalence and the percentage of undiagnosed HIV infections overall and among gay and bisexual men.

Estimated HIV incidence declined nearly 15% overall in the U.S. from an estimated 45,200 infections in 2008 to 38,500 in 2015. Estimated HIV incidence declined for both males (9%) and females (33%) over this period. Estimated HIV incidence declined 32% among heterosexuals, 42% among people who inject drugs and 20% among gay and bisexual men who also inject drugs. Estimated HIV incidence remained relatively stable among gay and bisexual men; however, it increased over 25% among Latino gay and bisexual men, almost 45% among gay and bisexual men ages 25 to 34 and 30% among gay and bisexual men ages 55 and older.

The percentage of undiagnosed HIV infections decreased nearly 20%, from 18.1% in 2008 to 14.5% in 2015. The percentage of undiagnosed HIV infections among gay and bisexual men declined 21.6%, from 21.3% in 2008 to 16.7% in 2015. In 2015, the percentage of undiagnosed HIV infections was highest among gay and bisexual males ages 13-24 (52.2%) compared to other age groups and higher among Latino (20.1%) and African American (19.6%) gay and bisexual men, as well as Asian gay and bisexual men (20.5%), compared to white gay and bisexual men (11.9%).

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Topical Estrogen No Better Than Moisturizer for Postmenopausal Vaginal Dryness

MedicalResearch.com Interview with:

Caroline Mitchell, MD, MPH Vincent Center for Reproductive Biology Assistant Professor, Obstetrics, Gynecology & Reproductive Biology

Dr. Caroline Mitchell

Caroline Mitchell, MD, MPH
Vincent Center for Reproductive Biology
Assistant Professor, Obstetrics, Gynecology & Reproductive Biology
http://massgeneral.link/MitchellLab

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In this study we compared two commonly recommended treatments for menopausal vaginal discomfort – low dose vaginal estradiol tablets and a vaginal moisturizer – to placebo, and found no difference in reduction of symptom severity; all three groups improved over 12 weeks of treatment.  This is great news for women, as it means that using any treatment regularly is likely to have benefit, whether it costs $20 or $200.

Symptoms of vaginal dryness, irritation and pain with sex, which occur in over half of postmenopausal women, cause a significant decrease in quality of life and negatively impact intimate relationships.  The significant impact of these symptoms is reflected in the fact that we enrolled all 302 participants in under a year, a faster enrollment than any of the four prior trials  conducted by the MsFlash research network that evaluated treatments for hot flashes.  Women were desperate for some kind of intervention for these symptoms. Continue reading

ZIKA: Mouse Study Finds Antioxidant Ebselen Reduces Risk of Sexual Transmission

MedicalResearch.com Interview with:

Image of a baby with microcephaly (left) compared to a normal baby (right). This is one of the potential effects of Zika virus. Signs of microcephaly may develop a few months after birth. Wikipedia image

Image of a baby with microcephaly (left) compared to a normal baby (right). This is one of the potential effects of Zika virus. Signs of microcephaly may develop a few months after birth.
Wikipedia image

Yogy Simanjuntak PhD
Postdoctoral Research Fellow
Institute of Biomedical Sciences
Academia Sinica, Taiwan 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Despite the low case fatality, Zika virus infection has been associated with microcephaly in infants and Guillain-Barré syndrome. Primarily transmitted by Aedes species mosquitoes, Zika also can be sexually transmitted in humans. By August 2016, the sexual transmission of Zika had been documented in 11 countries worldwide and most of the cases were from male to female. Infectious Zika in semen has been reported. Moreover, unlike in serum or urine samples, Zika RNA can still be detected in semen up to 188 days after the onset of symptoms. In the absence of approved antiviral drugs or vaccines for Zika infection, preventing the disease transmission is critical.

We observed Zika progressively damaged testes by gaining access to testicular cells including sperm. Notably, Zika caused signs of increased testicular oxidative stress and inflammation, characterized by high levels of reactive oxygen species and pro-inflammatory cytokines. Our data indicate that these factors may contribute to testicular damage as well as successful sexual transmission of Zika; thus, we speculate antioxidants might display beneficial effects to alleviate these disease outcomes.

We found that antioxidant ebselen both alleviated testicular damage and prevented sexual transmission of Zika via sperm from infected male mice to uninfected female mice.

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Cancer Diagnosis and Treatment Leaves Young Adults Vulnerable to Sexual Dysfunction

MedicalResearch.com Interview with:

Chiara Acquati, Ph.D., MSW Assistant Professor Graduate College of Social Work University of Houston Houston, TX  

Dr. Acquati

Chiara Acquati, Ph.D., MSW
Assistant Professor
Graduate College of Social Work
University of Houston
Houston, TX  

MedicalResearch.com: What is the background for this study?

Response: Adolescents and young adults (AYAs) with cancer are individuals between the ages of 15 and 39 years at diagnosis, as defined by the National Cancer Institute. Considerable research has unveiled unique psychosocial challenges experienced by AYAs, including poor quality of life, an altered body image, and social isolation.

As a result of these life disruptions, normative psychological and emotional development is affected by the disease and its treatment, particularly with respect to sexual identity, development, and behavior. However, few studies have examined sexual functioning and AYA patients’ needs with respect to emotional intimacy and sexual relationships. Estimates of the prevalence of sexual dysfunction in AYAs are limited to date and vary because of data derived from mixed-age groups, single items instead of standardized instruments, and cross-sectional designs. Yet, the state of the science suggests that one-third to two-thirds of cancer patients experience sexual dissatisfaction and a reduced frequency of intercourse. Furthermore, failure to address sexual health may place AYAs at risk for long-term consequences related to sexual functioning and identity development, interpersonal relationships, and quality of life. Hence, detecting changes in the rate of sexual dysfunction over time may help in identifying the appropriate timing for interventions to be delivered.

This study was conceptualized to increase our current knowledge of sexual functioning among AYAs by examining the prevalence of sexual dysfunction over the course of 2 years after the initial cancer diagnosis and the identification of variables that contribute to the probability of reporting sexual dysfunction in order to recognize individuals at higher risk. Young adult patients (≥18 years old) were administered the sexual functioning scale as part of a larger longitudinal multisite survey, and only those who completed the instrument at least once were included in this analysis; for this reason the article focuses on the experience of “young adults”.

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Urban Transgender Females Likely To Get HIV Testing

MedicalResearch.com Interview with:

Adrian Juarez, PhD, RN Assistant Professor The State University of New York School of Nursing  Department of Family, Community and Health Systems Sciences Buffalo, New York 14214

Dr. Juarez

Adrian Juarez, PhD, RN
Assistant Professor
The State University of New York
School of Nursing
Department of Family, Community and Health Systems Sciences
Buffalo, New York 14214

 

 

MedicalResearch.com: What is the background for this study?

Response: HIV testing is considered the initial component of HIV eradication strategies such as “seek, test, treat, and retain.” This study examines the characteristics of an urban, transgender population in western New York when volunteering for an HIV test. The use of an intersectional lens was observed in order to determine the level of influence of sexual partnership types, previous HIV and STD testing, substance use, housing status referral source and racial/gender identification on HIV testing.

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U.S. Army Administrative Data Can Be Used To Predict Sexual Assault Perpetration

MedicalResearch.com Interview with:

Anthony J. Rosellini, Ph.D. Research Assistant Professor Center for Anxiety and Related Disorders Department of Psychological & Brain Sciences Boston University Boston, MA 02215

Dr. Rosellini

Anthony J. Rosellini, Ph.D.
Research Assistant Professor
Center for Anxiety and Related Disorders
Department of Psychological & Brain Sciences
Boston University
Boston, MA 02215

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sexual assault among service members is a significant concern of the Department of Defense (DoD) and U.S. Army. Although the annual rate of sexual assault among soldiers is believed to be decreasing, there have also been increases in the number of victims coming forward to report their experiences. The DoD and Army have responded by creating a framework of universal prevention in which all soldiers are required to participate in relatively brief programs aimed at decreasing rates of sexual assault. More intensive preventive interventions could be required, but would only be cost-effective if targeted at a subset of soldiers who are most likely to perpetrate sexual assault.

The goal of this study was to use DoD and U.S. Army administrative records that are available for all soldiers to develop prediction models for sexual assault perpetration. We used the records from all 821,807 male soldiers who served between 2004 and 2009 to develop separate models to predict assaults directed against within-family and non-family adults and minors.
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Television Storylines Influence Public’s Perception of Transgender Issues

MedicalResearch.com Interview with:

Traci-Gillig

Traci Gillig

Traci K. Gillig
Doctoral Candidate
Annenberg School of Communication and

Erica L. Rosenthal Senior Research Associate

Erica L. Rosenthal

Erica L. Rosenthal
Senior Research Associate

Hollywood, Health & Society
University of Southern California
Los Angeles, CA 90211

 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Time magazine declared America reached a “transgender tipping point” in 2014, with the media visibility of transgender people reaching new levels. While research has shown that entertainment shapes viewers’ attitudes, no prior studies had explored the cumulative effects of exposure to media portrayals of transgender people. To address this gap, we worked with the TV show Royal Pains (USA Network) to assess how viewers’ attitudes toward transgender people and related policy issues were influenced by seeing a brief fictional portrayal of a transgender teen as well as other transgender TV characters.

We had advance notice of the storyline through Hollywood, Health & Society (HH&S), an organization affiliated with the USC Annenberg School of Communication. HH&S serves as a free resource to the entertainment industry, providing accurate health (and other) information through consultation with subject matter experts. Royal Pains assisted us in recruiting viewers for our study through their social media accounts. A total of 391 viewers who saw the episode featuring a transgender teen participated in our study, and we supplemented this sample with Royal Pains viewers who had not seen the episode, accessed through market research panels.

Findings of our study showed that viewers who saw the Royal Pains episode featuring a transgender character had more supportive attitudes toward transgender people and related policies, compared to viewers who did not see the episode. Additionally, cumulative exposure to transgender entertainment narratives improved viewers’ attitudes toward transgender people and policies. Neither exposure to transgender issues in the news nor Caitlyn Jenner’s story influenced attitudes.

Further, aligning with prior research, viewers who were more politically conservative reported more negative attitudes toward transgender people and less support for transgender-affirming policies. However, seeing multiple such storylines reduced the strength of this link by one half. Political ideology also influenced viewers’ responses to the Royal Pains episode. Those who were politically liberal were more likely to feel hope or identify with the transgender character in the episode, while those who were politically conservative were more likely to react with disgust. 

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Our Eyes Scan Potential Friends and Lovers Differently

MedicalResearch.com Interview with:
Omri Gillath PhD
Department of Psychology
University of Kansas
Angela Bahns, PhD
Wellesley College

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: We tracked the eye movements of 105 heterosexual participants while they viewed photos of strangers and answered questions about their interest in either becoming friends with or dating the person.

We found that in looking at others, people scan the body differently depending on whether a person is judged as a potential friend or a potential romantic partner. Heterosexual men and women looked at the head or chest of an opposite-sex person longer and more often when evaluating dating potential compared to friendship potential.

In contrast, both men and women looked at the legs or feet more for friendship judgments than for dating judgments (although overall legs and feet were looked at less than other body regions).

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Cross-Sex Hormone Therapy Associated With Medical Risks and Psychosocial Benefits in Transgender Patients

MedicalResearch.com Interview with:

Carl G Streed Jr. M.D. Pronouns: he, him, his, himself Fellow, Division General Internal Medicine & Primary Care Brigham & Women’s Hospital

Dr. Streed

Carl G Streed Jr. M.D.
Pronouns: he, him, his, himself
Fellow, Division General Internal Medicine & Primary Care
Brigham & Women’s Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent reports estimate that 0.6% of adults in the United States, or approximately 1.4 million persons, identify as transgender. Despite gains in rights and media attention, the reality is that transgender persons experience health disparities, and a dearth of research and evidence-based guidelines remains regarding their specific health needs. The lack of research to characterize cardiovascular disease (CVD) and CVD risk factors in transgender populations receiving cross-sex hormone therapy (CSHT) limits appropriate primary and specialty care. As with hormone therapy in cisgender persons (that is, those whose sex assigned at birth aligns with their gender identity), existing research in transgender populations suggests that CVD risk factors are altered by CSHT.

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Transgender Actors Effective in Teaching Residents to Provide Respectful and Effective Health Care

MedicalResearch.com Interview with:

Richard E. Greene, MD, FACP Medical Director, Bellevue Adult Primary Care Center Assistant Professor, NYU School of Medicine Associate Program Director, Primary Care Residency Program Director, Gender and Health Education, Office of Diversity Affairs, NYU School of Medicine, OUTList Medical Director, CHIBPS, The Center for Health, Identity, Behavior and Prevention Studies VP of Membership and Development, GLMA-Health Professionals Advancing LGBT Equality 

Dr. Greene

Richard E. Greene, MD, FACP
Medical Director, Bellevue Adult Primary Care Center
Assistant Professor, NYU School of Medicine
Associate Program Director, Primary Care Residency Program
Director, Gender and Health Education, Office of Diversity Affairs, NYU School of Medicine, OUTList
Medical Director, CHIBPS, The Center for Health, Identity, Behavior and Prevention Studies
VP of Membership and Development, GLMA-Health Professionals Advancing LGBT Equality 

MedicalResearch.com: What is the background for this study?

Response: Transgender individuals face complex health disparities and have historically been mistreated and even denied care in medical settings. As a provider in New York City, I saw how this affected my trans patients, resulting in mistrust of the health care system, resulting in negative health outcomes. This sparked my interest in improving medical education to serve the needs of trans patients. It’s important to teach medical students and residents that they are not just treating a set of symptoms, they are working with a individuals with complex lived experiences who deserve compassionate care.

I found with traditional didactic methods, like lectures, learners smiled and nodded in agreement, but when faced with a patient who was transgender, they would stammer and feel uncomfortable with aspects of the cases that were specific to transgender patients, from pronouns to hormones.

Residents should be prepared to treat transgender patients not only with dignity, but also in medically appropriate ways. Without exposure to the transgender community, it’s difficult for providers to decipher their trans patients’ health care needs and contextualize them within a care plan.

In order to provide a low stakes environment for residents to practice these skills, we developed an OSCE focused on a transgender woman with health care needs specific to her transition. The goal of the case was to discuss the patient’s medical concerns while also taking into consideration her goals around her hormone therapy and surgical interests.

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Frequent Sex In Older Adults Linked To Better Cognitive Function

MedicalResearch.com Interview with:

MedicalResearch.com Interview with: Dr Hayley Wright BSc(Hons) MSc PhD C.Psychol Research Associate Faculty of Health and Life Sciences, Coventry University Centre for Research in Psychology, Behaviour and Achievement, Coventry University MedicalResearch.com: What is the background for this study? What are the main findings? Response: Last year, we published a study that showed a significant association between sexual activity and cognitive function (Wright & Jenks, 2016). This study showed that sex is linked to cognition, even after we account for other factors such as age, education, and physical and mental wellbeing. One important question that emerged from this study was centred around the role of frequency with which we engage in sexual activity. In the current study (Wright, Jenks & Demeyere, 2017), we found that engaging in sexual activity on a weekly basis is associated with better scores on specific cognitive tasks. MedicalResearch.com: What should clinicians and patients take away from your report? Response: We have demonstrated that sexual activity in later life may have measurable benefits that stretch beyond pleasure-seeking. We - society at large, and individual researchers - should challenge notions of embarrassment around sexuality that may prevent older people from accessing help and support for sexual or relationship issues. MedicalResearch.com: What recommendations do you have for future research as a result of this study? Response: It may be advisable to take relationship factors into account when conducting studies around cognitive ageing. Researchers often make statistical adjustments for factors that are known to influence cognition and health (such as age, education and health problems), but actually, more personal factors may also have an effect on how our brain works. MedicalResearch.com: Is there anything else you would like to add? Response: The research so far has been cross-sectional (or correlational), and so we cannot say at this time whether sexual activity is causing better scores on cognitive tests. This issue of causality is something that we will address in future research as more data becomes available. We are currently researching whether all types of sexual activities are associated with cognitive function to the same extent. We are also working with support services to address barriers to relationship and sex therapy for older people and marginalised groups. MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community. Citation: Hayley Wright, Rebecca A. Jenks, Nele Demeyere. Frequent Sexual Activity Predicts Specific Cognitive Abilities in Older Adults. The Journals of Gerontology: Series B, 2017; DOI: 10.1093/geronb/gbx065 Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

Dr. Wright

Dr Hayley Wright BSc(Hons) MSc PhD C.Psychol
Research Associate
Faculty of Health and Life Sciences, Coventry University
Centre for Research in Psychology, Behaviour and Achievement,
Coventry University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Last year, we published a study that showed a significant association between sexual activity and cognitive function (Wright & Jenks, 2016). This study showed that sex is linked to cognition, even after we account for other factors such as age, education, and physical and mental wellbeing. One important question that emerged from this study was centred around the role of frequency with which we engage in sexual activity. In the current study (Wright, Jenks & Demeyere, 2017), we found that engaging in sexual activity on a weekly basis is associated with better scores on specific cognitive tasks.

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Flibanserin- Addyi -Improved Sexual Health in Women With Hypoactive Sexual Desire Disorder

MedicalResearch.com Interview with:

Dr. Michael Krychman, MD Executive Director: The Southern California Center for Sexual Health and Survivorship, Medical Director: Sexual Medicine at Hoag Hospital Newport Beach CA Clinical faculty member University of Southern California Los Angeles, CA

Dr. Krychman

Dr. Michael Krychman, MD
Executive Director: The Southern California Center for Sexual Health and Survivorship,
Medical Director: Sexual Medicine at Hoag Hospital Newport Beach CA
Clinical faculty member
University of Southern California
Los Angeles, CA

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This post hoc analysis pooled data from three 24-week, double-blind, placebo-controlled studies (VIOLET, DAISY, and BEGONIA) of flibanserin in premenopausal women with acquired, generalized HSDD5-7. Patients who received flibanserin 100 mg once daily at bedtime (qhs) or placebo were included in the analysis. The Female Sexual Function Index (FSFI) consists of 19 items across 6 domains. Scores range from 2 to 36. Higher scores indicate better sexual functioning. Scores under 26 indicate sexual dysfunction. Analysis of covariance was used to evaluate changes from the first week to week 24 in the FSFI domain and total scores were compared for flibanserin 100 mg qhs versus placebo. For patients who discontinued study participation prior to week 24, the last postbaseline observation was carried forward (LOCF).

Results found that treatment with flibanserin 100 mg qhs produced statistically significant improvement, relative to placebo, on all domains of the FSFI (desire, arousal, lubrication, orgasm, satisfaction and pain) in premenopausal women with acquired, generalized hypoactive sexual desire disorder (HSDD).

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LGBTQ+ Patients Have Poor Sleep Compared to Heterosexuals

MedicalResearch.com Interview with:

Jen-Hao Chen PhD Assistant Professor Department of Health Sciences and School of Public Affairs University of Missouri - Columbia

Dr. Jen-Hao Chen

Jen-Hao Chen PhD
Assistant Professor
Department of Health Sciences and School of Public Affairs
University of Missouri – Columbia

MedicalResearch.com: What is the background for this study?

Response: It has been well known that sexual minority adults in the US have worse health as compared with heterosexual peers. Queer folks are found to have poorer physical, mental and behavioral health outcomes because of their marginalized status and social environments. But we know very little about prevalence of sleep problems in the population of sexual minorities compared to heterosexual people. Do sexual minorities lose sleep? Do they wake up more often during the night? Do they sleep less? This study aims to address this important gap in the LGBT health literature. Using recent nationally representative data, we exam whether sexual minority adults have greater odds of having short sleep duration and poor sleep quality. In addition, we also investigate sexual minorities’ sleep in the context of gender and race/ethnicity  Continue reading

Too Busy? Too Tired? Not in a Relationship? Why are Americans Having Less Sex?

MedicalResearch.com Interview with:

Brooke E. Wells, Ph.D. Associate Professor & PhD Program Director Center for Human Sexuality Studies Widener University One University Place Chester, PA 19013

Dr. Brooke Wells

Brooke E. Wells, Ph.D.
Associate Professor & PhD Program Director
Center for Human Sexuality Studies
Widener University
One University Place
Chester, PA 19013

MedicalResearch.com: What is the background for this study?

Response: It is widely believed that Americans today are more sexually liberated and open than ever before. While research indicates that Americans do indeed have more liberal attitudes about a range of sexual behaviors, Americans are actually reporting fewer sexual partners and higher rates of adult sexual abstinence. But are Americans reporting similar levels of sexual frequency with fewer partners? Our research set out to examine changes over time in sexual frequency to better understand our changing sexual landscape.

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Radiofrequency Therapy For The Treatment Of Vaginal Laxity

MedicalResearch.com Interview with:

Dr. Michael Krychman

Dr. Michael Krychman

Dr. Krychman is Executive Director, President, and CEO of the Southern California Center for Sexual Health and Survivorship Medicine and Associate Clinical Professor at the University of California, Irvine, Department of Obstetrics and Gynecology. He is a Member of the International Society for the Study of Women’s Sexual Health (ISSWSH), The International Society for Sexual Medicine (ISSM) and a Certified Sexual Counselor by the American Association of Sexuality Educators, Counselors and Therapists (AASECT). He served as a member of the Standards Committee for the International Society for Sexual Medicine during their 2016 International Consensus Meeting.  

MedicalResearch.com:  What is the background for this technology and study? What are the main findings?

Response: Viveve Medical, Inc. is a women’s health and wellness company committed to advancing new solutions to improve women’s overall well-being and quality of life.  The internationally patented Viveve® technology and the GENEVEVE™ treatment, incorporates clinically-proven, cryogen-cooled monopolar radiofrequency (CMRF) energy to uniformly deliver non-ablative, deep penetrating volumetric heat into the submucosal layer of the vaginal introitus (opening) while gently cooling surface tissue to generate robust neocollagenesis.  One 30-minute in-office session tightens and restores the tissue around the vaginal introitus addressing the common medical condition of vaginal laxity and can improve a woman’s sexual function.

VIVEVE I is a landmark study.  Results of the VIVEVE I clinical study, “Effect of Single-Treatment, Surface-Cooled Radiofrequency Therapy on Vaginal Laxity and Female Sexual Function: The VIVEVE I Randomized Controlled Trial,” were recently published in the February 2017 issue of the Journal of Sexual Medicine (JSM) under the Female Sexual Function category.   Some of my high-level thoughts to reiterate from this study are:

It is the first-ever large, randomized, sham-controlled study to demonstrate the safety and efficacy of energy-based procedures in gynecological applications, including vaginal laxity, which is a significant medical condition affecting millions of women worldwide that may lead to a reduction in sexual function.

The primary endpoint of the VIVEVE I study was a comparison of the proportion of women reporting no vaginal laxity in the treatment group versus the sham group at 6 months post-treatment.

Subjects receiving the active treatment were three times more likely to report no vaginal laxity at six months versus the sham group (p-value = 0.006).

Statistically significant and sustained improvement in sexual function (baseline FSFI total score ≤26.5) after a single treatment, with an adjusted mean difference in the active group vs sham group of 3.2 at 6 months (p-value = 0.009). “Placebo Effect” in the sham group did not rise above dysfunctional (FSFI ≤26.5) and diminished at 6 months.

Statistically significant improvement in sexual function was achieved in 93% of subjects in the active group vs the sham group in two individual key domains of FSFI (p-value = 0.007).

Bottom line: Geneveve is a safe effective treatment that can be performed as an outpatient in one 30-minute visit to improve sexual function as it has been affected by vaginal laxity.

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Does HAART Treatment for HIV Contribute To Rapid Rise in Syphilis Infections?

MedicalResearch.com Interview with:

Michael Rekart, MD, DTM&H Clinical Professor, Medicine and Global Health The University of British Columbia .... On behalf of my co-authors

Dr. Michael Rekart

Michael Rekart, MD, DTM&H
Clinical Professor, Medicine and Global Health
The University of British Columbia
…. On behalf of my co-authors

MedicalResearch.com: What is the background for this study?

Response: The background for this study is the observation that new syphilis cases over the last decade in British Columbia, Canada, have been escalating more rapidly than anyone could have predicted and that syphilis incidence has outpaced the incidence of other sexually transmitted diseases (STDs), including gonorrhea and chlamydia. This unexpected increase in syphilis has been almost wholly concentrated in men who have sex with men (MSM). Most of these MSM are HIV-1 infected and many are taking highly active antiretroviral therapy (HAART). In fact, the expansion in HAART coverage in MSM parallels the growth in syphilis in the same population. In addition, my co-authors and I had serious doubts as to whether ‘treatment optimism’, the generally accepted explanation for this phenomenon, was robust enough to account for such a dramatic increase in new syphilis cases. Treatment optimism posits that HAART availability and effectiveness have led to the perception in both HIV-1-infected and HIV-1-uninfected individuals that HIV-1 transmission has become much less likely, and the effects of HIV-1 infection less deadly. This is expected to result in increased sexual risk-taking, especially unprotected anal intercourse, leading to more non-HIV-1 STDs, including gonorrhea, chlamydia and syphilis.

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