PSY 457 exam 1

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scrotum

Skin sac that testicles are held in Hangs away from body because sperm need temperature lower than body temp (93 degrees) Dartos muscle causes the surface of the scrotum to wrinkle Cremaster muscle raises and lowers the testes These two muscles pull testicles closer to the body when its cold, and if it hot the testicles will be lowered away from the body Sperm production happens 24/7, which is why it's important that the testicles are kept at a constant temperature conducive to sperm production Word testicle comes from latin word to testify, men placed their hands on their testicles to swear in court in ancient times

testicles and prostate

Testicular cancer -Half of the cases of testicular cancer occur in younger men (20 to 30 years old) -The best way to screen is self examination -Should be done every month, and is recommended to be done after a hot shower -Involves rolling testicles between fingers and look for lumps and/or changes Prostate -As men age, the prostate enlarges (BPH benign prostatic hyperplasia) -Can cause uncomfortable symptoms for men, which can be treated by medications or surgical procedures -One of the side effects of an enlarged prostate is that it can push up against the bladder, causing urinary urgency (the need to urinate frequently) -Can impinge upon urethra, causing urinary hesitancy (the feeling that you need to urinate, but stream is weaker and slower than it usually would be) Prostate cancer -More common among african american men -Important to know family history because certain cancers have a hereditary component -Men aged 59 to 65 should talk to their physician about the pros and cons of screening, which goes against 2012 guidelines that advised against screening PSA (prostate specific antigen) is detected in blood tests, which may indicate that prostate cancer is evident -One reason to advise against screening is the prevalence of false positives -High risk is defined as being african american or having a first degree relative diagnosed with prostate cancer before 65 -Need to talk to your doctor -In addition to PSA test, they might also do a rectal digital exam, in which a doctor palpates the prostate looking for bumps

intersectionality

a lens through which you can see where power comes and collides, where it interlocks and intersects. It's not simply that there's a race problem here, a gender problem here, and a class or LBGTQ problem there. Many times that framework erases what happens to people who are subject to all of these things. Addresses how an individual can be simultaneously oppressed and/or privileged in multiple different ways

methods of observation

case study survey -interviews -questionnaires -telephone surveys observation -naturalistic -laboratory -participant experimental method correlational method

The sexual health model application of a sexological approach to HIV prevention: weaknesses

A weakness of the article itself is that the authors make broad statements about the three groups (i.e., men who have sex with men, African-American women, and transgender individuals) that they have studied These sweeping statements undermine the central tenet of their paper that understanding individual differences is central to the creation of effective interventions. The complexity of their operational definition of sexual health creates difficulty in assessing this construct The model is also not a blueprint for a specific intervention. More specific details as to how to implement the model as an intervention are necessary. Standardization of the intervention would allow for researchers to study and compare its effectiveness with different subgroups of the population. A lack of empirical support for some of the components of the model, and a lack of understanding of how these components might interact and which components might have a more substantial impact on sexual health, and therefore HIV prevention, than others Limiting their focus to men who have sex with men, Black women, Latino men, and transgender people when discussing differences in issues that should be covered when addressing each component. Authors fail to address intersectionalities, such as how Black transgender women might be uniquely impacted by sexual health issues and the components of the sexual health model. Researchers did not use a random sample. The sample they used was far from representative, using only Black women and men who have sex with men in testing the efficacy of the model Only studied the effects of one or two-day workshops. All of these flaws negatively impact the external validity of their research on the efficacy of this model. Future research needs to determine the validity and efficacy of this model Future research should examine how each of these components predicts HIV related outcomes, as well as whether these components interact with each other Future research also needs to investigate how this model impacts groups other than men who have sex with men and Black women so it can be more generalizable In particular, future research should include a focus on nonwhite men who have sex with men, as they are more impacted by STDs than white men who have sex with men, as well as investigate variation in sexual health for other intersections of race, ethnicity, gender identity, sexual orientation, and socioeconomic status Future research should also evaluate the impact of using this model when implemented in contexts other than one or two-day workshops. Future research should utilize random sampling whenever possible

The Social Organization of Sexuality Sexual Practices in the United States: weaknesses

Age range -18-59 years old -People have sex before 18 and after 59, but these findings are only generalizable to americans ages 18-59 Only sampled from households -Did not sample from communal living (mi;itary, dormitories, group homes, prisons, nursing homes) Privacy envelopes -You might get more truthful info and lower social desirability bias -But you also might be reinforcing the idea that these topics are taboo No gender or race matching of interviewers to interviewees -People feel more comfortable talking to people of the same gender and race -But, most interviewers were women and we know that men feel comfortable talking to women, so the gender matching is not as much of a concern -Also drew interviewers from the areas in which they would be interviewing, so there's a good chance that many interviewers and interviewees were matched on ethnic background Can't do longitudinal follow up -The whole purpose of the study was to find out the sexual practices in how they relate to HIV/AIDS -If it were longitudinal, we could follow up and see who contracted HIV -But, the destruction of info could also be seen as a strength, because people might be more inclined to participate if they know their information is destroyed Incentives -It's important to standardize incentives -But, this study only gave incentives to some participants, and many were given different incentives (for example, in areas where they knew people would be less inclined to participate), or were only given incentives to convince them to participate -We don't know how these varying incentives might have impacted the truthfulness of people's responses (though the researchers claim to have analyzed the data and did not find any consistent differences in responses based on incentives) Despite these weaknesses, this study was extraordinary, the first study to examine the sexual practices of a representative sample in the US, the findings were generalizable, it took until 1994 for us to have generalizable findings from a study of sexual practices of americans

breasts

All breasts contain 15-20 mammary glands The only thing that contributes to breast size is fatty tissue Breast cancer -Women should get breast screening exams on a regular basis -Different organizations have different recommendations about how frequently and at what age they should occur -Generally speaking we are talking about a mammogram when we talk about screening -Women at average risk should start screenings at 50 (self breast exam, immediately after menstruation) -Not all agencies recommend this, because there are two many false positives -Cancer society recommends mammograms yearly at 45, and every other year at 55

ethical issues in sex research

All research must be approved by the IRB (determined to be ethical and not harmful to the participants, whether your findings will benefit science and are worth the participant risk, and determines that a participant will not feel badly about himself or herself after completing the study) Every study needs to ensure informed consent After the study, you have to debrief participants (especially if deception is used) Do not submit participants to painful or stressful situations (at least, the IRB determines such stress are valuable to the advancement of science and will not cause any permanent harm to the participants

Penis

Average penis size -Flaccid: length 3.5 inches, circumference 3.9 inches -A lot of variability in the measurements of a flacid penis -Erect: 5.8 inches, circumference 4.9 inches -Much less variability in the size of an erect penis -The length of a flaccid penis is not highly correlated with the length of a erect penis -Women do not have very many nerve endings for touch inside the vagina, and vaginal stimulation is not necessary to achieve an orgasm, only clitoral Glans -Tip of the penis -Most sensitive part, tremendous number of nerve endings -Homologous structure (same tissue that forms the glans of the clitoris) -The glans of the penis is covered when the penis is flaccid (if a man is uncircumcised) but always exposed in circumcised men because the foreskin (prepuce) has been cut away -Some people think that a non circumcised glans is more sensitive Corpus cavernosum -Runs the length of the penis -There are actually two (corpora cavernosa) -As does the corpus spongiosum (urethra runs through the center) -Erection is determined by blood flow -A penis bending slightly to the left or the right is normal (meaning there is some variation in the ize of the corpora cavernosa) -If it bends severely that is a sign of peyronie's disease

case study

Case study pros -Different kind of data from other research methodologies -Very rich in nature, very detailed info because you are following one person or a very small group of people -Flexibility in data gathering procedures, again because of small number of participants Case study cons -Limited generalizability -Fallibility of memory -Methodology not suitable for many research questions

History of masturbation

Changes in attitudes towards masturbation are also the changes in attitudes towards sex in general Evil -Originally masturbation was seen as evil, even by egyptians -associated with prevalence of religious attitudes about the evilness of masturbation and sexual pleasure in general (the belief that sex for any reason other than procreation was unnatural) Sick -Later on, masturbation was viewed as unhealthy and dangerous, thinking that ejaculating could make boys weak and sick (doctors bleieved masturbation could lead to blindness and insanity) -characteristic of the victorian era -They invented devices to try to prevent masturbation and nocturnal emission Immature -Freud thought that masturbation as an adult was a sign of immaturity, but for children it was natural to do (shouldn't be done after the phallic stage, doing so afterwards represented fixation or regression to phallic stage) Normal -Kinsey found that nearly all men masturbate, and later found that almost all women do as well -Healthy and therapeutic -Now masturbation is viewed as healthy and therapeutic, a view largely thanks to masters and johnson -Masturbation is actually a prescribed behavior in sex therapy to help deal with a number of sexual dysfunctions

History of sexuality

Darwin's origin of species -Westerners believed the way they engaged in sex (less promiscuous) was more evolved -Missionaries coined missionary position,missionaries sought to help other cultures become more sexually evolved Richard von kraft psychopathia sexualis -Portrayed many aspects of pleasure as deviant -Four categories: sadism, masochism, fetishism, and homosexuality -Claimed that masturbation caused all of these deviations Henry havelock ellis studies in the psychology of sex -Claimed that sex might actually be normal and masturbation was a common practice -Believes sexuality was on a spectrum End of victorian era -Victorian era was a period of sexual prudishness -Ended in 1901, but the values and ideals lasted well into the 20th century -Clothes in the victorian era fully covered women's bodies, from chin to feet Freud three essays on sexuality -Sex is normal and central to personality development Ivan block coined the term sexual science -sex is a scientific discovery Margaret sanger opened first birth control clinic -Arrested promptly -Considered a pornographer because she mailed information about birth control (illegal to mail material relating to sex at the time) -Seen as the founder of planned parenthood -Controversial because she aligned herself with the eugenics movement and was a partner of the movement Theodor van de Velde ideal marriage -Sex handbook for marriages -Focused on a man's sexual pleasure, not a woman's Robert dickinson 1000 marriages -Found that women can enjoy sex too -Based on 1500 case studies of women he had seen in his gynecology practice -Another step away from pathologizing sex Tuskegee Alfred kinsey begins his survey -Godfather of research in human sexuality -There is now a kinsey institute of indiana university -Assigned with teaching a course on marriage and sexuality and found there was very little reliable research, so he began his own Kinsey published the sexual behavior of the human male -Sample over represented younger urban protestant white men who were highly educated -Still the most comprehensive survey about sex at teh time, and had a good age range/participants from all 48 states Christine jorgenson -First person to challenge individual person's ideas about sex -She was one of the first people whose gender reassignment surgery was widely publicized -Changed the public's views as gender and sex, and whether what you were assigned at birth could be changed Kinsey published the sexual behavior of the human female -6,000 surveys -Like the male counterpart, sample was biased, he used a convenience sample Birth control pills were approved by the FDA -Many people attribute the beginning of the sexual revolution to the arrival of the birth control pill because it allowed women far more sexual freedom Masters and johnson published the human sexual response cycle =Just as important in research in human sexuality as kinsey is -They did observational research, wondering what happens to people physiologically when they were aroused sexually -Started with prostitutes then moved on to recruiting "normal" couples for fear that prostitutes had different physiology Stonewall riots -Police officers regularly arrested patrons of stonewall for things like wearing clothes typically worn by opposite gender -Patrons had enough and fought back Masters and johnson human sexual inadequacies -Beginning of sex therapy and diagnoses as we know it -A move away from pathologizing sex and towards acceptance, of understanding that people with sexual disorders were deserving of understanding and treatment Tuskegee study ends -For over 30 years there was a known cure for syphilis, yet the black men in the study were not provided penicillin because researchers wanted to see what the disease would do to their bodies -Not only did they not give penicillin, they went out of their way to make sure they did not receive penicillin -Participants did not receive a presidential apology until 1996 Roe v. wade legalizes abortion -This decision is still being debated today, and different states have passed laws restricting access to abortion -Politicians are still debating whether abortion should be legal at all Homosexuality removed from the DSM -Signifies tremendous shift in the medical community, homosexuality was no longer seen as pathological and as a point on the continuum of sexuality -Removing it from teh DSM meant doctors couldnot longer "treat" homosexual people 1st test tube (in vitro) fertilization -At the time some people objected to this and viewed it as too science fiction esque The janus reports -Samples were biased because they were based on volunteers, as with others before it -This meant that findings were not generalizable to the general population National health and social life survey (NHSLS) -First carefully conducted study on the sexual practices of Americans that used a probability sample -The very first study whose sample was representative of the population -Data was more diverse and findings were therefore more reflective of the population -The title of this survey did not include any mention of sex, but still represented a general weirdness about sex in the united states -Started a new era of sex surveys with probability samples National survey of family growth (NSFG) -As with NHSLS, had a title that avoided directly mentioning sex -Interviews with a national sample of almost 13,000 men and women in USA The youth risk behavior survey (YRBS) -Self report questionnaire -Biannual -National survey of adolescents grades 9 through 12, looking at pregnancies and STIs National survey of sexual health and behavior (NSSHB) -Actually includes sex in title -Addresses societal changes since 1994 (Viagra, online dating, changing attitudes towards LGBTQ community) -Data were collected over the internet and internet access was provided for those who did not have it (making the survey more accessible and more representative)

Masters and Johnson-Human Sexual Response Cycle research + stages

Did direct observation of sexual activity in a laboratory setting Observed over 10,000 orgasmic cycles, measuring the physical responses of men and women measure sexual arousal primarily by observing vasocongestion (blood flow to the genitals) and myotonia (muscle tension) Penile strain gauge, which measures penile circumference, with increases indicating arousal Vaginal photoplethysmograph: measures the amount of light reflected off of vaginal walls One of the hallmark signs of arousal is vasocongestion (increased blood flow) When blood flow increases to vaginal walls, the tissue becomes a deeper darker color, which would lead to a decrease in light reflected Men and women go through the same 4 stages, however, there are some unique differences Excitement Plateau Orgasm Resolution

Kaplan's Model of Sexual Response

Overlaps masters and johnson Excitement and orgasm are similar to masters and johnson's model (and incorporates this model) The most important difference between the models is Kaplan's inclusion of a desire phase She focused more on clients who had sexual dysfunction (making incorporating a psychological phase particularly relevant and useful) Has 3 stages Desire -Psychological in nature -Precedes body's physiological response to arousal Excitement Orgasm

Masters and johnson human sexual response cycle: orgasm

Difficult to describe how an orgasm feels Physiologically, what we are talking about is muscular contractions These occur at the same rate for men and women Men reach the point of ejaculatory inevitability -When a man gets to a certain amount of sexual arousal, even if sexual arousal/stimulation ceases, a man is going to have an orgasm and ejaculate which usually occur at the same time Women are different, if stimulation stops and a woman is not stimulate through orgasm, the orgasm stops Men and women can lose voluntary muscle control (spasms of some muscles) Blood pressure, respiration, and heart rates reach their peak Only women have the possibility of having multiple orgasms, but not all women do Masters and johnson definition of multiple orgasm: an individual has a multiple orgasm if that person can achieve orgasm more than one time without the arousal level dropping below the plateau level of arousal Men are incapable of doing this, because men have a refractory period Refractory period: when men are physiologically incapable of achieving another orgasm The length of time for the refractory period depends upon age (shorter for younger men)

racial/ethnic health disparities

Disparities continue to persist in rates of STDs among some racial minority or Hispanic groups when compared with rates among Whites. This is also true across a wide variety of other health status indicators, providing evidence that race and Hispanic ethnicity in the United States are population characteristics strongly correlated with other factors affecting overall health status, such as income, employment, insurance coverage, and educational attainment Those who cannot afford basic necessities often have trouble accessing and affording quality health care, including sexual health services. Access to, and routine use of, quality health care including STD prevention and treatment is key to reducing STD disparities in the United States many people in the United States continue to struggle to afford full, routine access to health care. Among all races or ethnic groups in the United States, Hispanics had the lowest rate of health insurance coverage in 2017 Even when health care is readily available to racial and ethnic minority populations, fear and distrust of health care institutions can negatively affect the health care-seeking experience. Social and cultural discrimination, language barriers, provider bias, or the perception that these may exist, likely discourage some people from seeking care. Moreover, the quality of care can differ substantially for minority patients In communities where STD prevalence is higher because of these and other factors, people may experience difficulties reducing their risk for STIs. With each sexual encounter, they face a greater chance of encountering an infected partner than those in lower prevalence settings do, regardless of similar sexual behavior patterns Black, native american, pacific islander, and hispanic women and men have much higher reported rates of chlamydia gonorrhea, and syphilis than white people. Asian people have lower rates than white people Inequities in the burden of disease for chlamydia, gonorrhea, syphilis and other STDs by race/Hispanic ethnicity continue to persist at unacceptable levels in the United States. These disparities are not explained by individual or population-level behavioral differences; rather they result in large measure from stubbornly entrenched systemic, societal, and cultural barriers to STD diagnoses, treatment and preventive services accessible to some groups on a routine basis.

sampling

How you select your participants determines if your sample is representative and therefore if your results are generalizable Both random and stratified random sampling are types of probability sampling -Random sample = every person in a population has an equal chance of being chosen to be in the sample -Stratified random sampling = ensures equal representation of different demographics while still using probability sampling Convenience sample -Janus survey was a convenience sample -The GSS/NORC asked the same question but used a probability sample -The Janus survey/convenience sample had much higher percentages of people having sex at least once a week, because of the characteristics of those who are likely to volunteer for sexuality surveys

Masters and johnson human sexual response cycle: excitement

Increase in vasocongestion Genitals swell because they are becoming engorged with blood (clitoris increases in length and diameter, for men penis becomes erect) For women vagina lubricates, lengthens, and becomes darker in color Major and minor labia thicken Scrotum tenses and thickens Testes lift Increase in myotonia for men and women Increase in heart rate for both men and women Blood pressure rises for both men and women

Pathway from sperm creation to sperm ejaculation

Inside each testicle there are seminiferous tubules, where sperm is produced (tangled web in each testicle, very long and if they were stretched out they would span several football fields) On the top of each testicle is an epididymis, after creation in tubules sperm are sent to epididymis to mature Sperm travel into vas deferens when men are aroused (tube extending into the abdomen, transfers sperm into seminal vesicles) In a vasectomy, the doctor cuts the vas deferens, forming scar tissue that blocks the sperm from passing through Sperm disintegrate and are reabsorbed into body, and are a tiny percentage of the ejaculate a man produces The seminal vesicles secrete fluid, called seminal fluid The volume of this fluid is 70% of the total of semen High in fructose which nourishes the sperm The sperm then travel through the prostate Produces prostatic fluid Makes up about 30% of total semen/ejaculate This fluid is alkaline Bulbourethral glands/cowper's glands Produce approximately 1 to 2% of semen Secrete a few drops of fluid prior to ejaculation Fluid is also alkaline, possibly counteracting acidity of a man's urethra, making it a more hospitable environment for sperm Occurs right before ejaculation and is referred to sometimes as precum Sometimes viable sperm make it into this fluid Couples who practice withdrawal method of birth control, there is still a possibility of pregnancy After this fluid is sent through the urethra, the remaining semen is expelled through the urethra and out of the penis Usually about one teaspoon of semen is ejaculated during orgasm This semen contains between 100 to 600 million sperm, which only take up about 1% of the total semen

response biases

Memory & recall -Fallibility of memory = people are often not good at remembering what they have done or how they felt. -People remember salient events in their lives, but those memories aren't even always accurate -Most respondents estimate their experience -People tend to report in multiples of 5 Degree of insight -We ask people why they do the things they do, which requires a degree of introspection -Some people have a greater degree of introspection than others Social desirability -Problem for all research methods -When someone consciously or unconsciously tries to present themselves in a positive light -They want to seem normal/typical -We don't necessarily know what typical is -In particular, when you ask about sexual behaviors, some behaviors have more stigma attached to them and might cause people to under report Motivation -We need to figure out the extent to which a participant's motivation might impact their responses -Many psych 100 students aren't motivated at all -Greater motivation leads to more accurate responses -It is hard to know for sure how motivated a participant is to accurately recall the info we are asking of them

The Social Organization of Sexuality Sexual Practices in the United States

National health and social life survey First study that used a representative sample of americans Up until this point, it was thought that doing research on sex was a taboo subject We relied for a very long time on kinsey's data (published in 1948 men and 1953 women, based on a convenience sample) HIV/AIDS occurred in 1981 We needed to figure out what americans were doing in the bedroom to help prevent the spread of HIV This is why the government called for more research, but the government wanted to be overly involved in the questions that were asked Researchers ended up going with private funding, resulting in a smaller sample (3,432 as opposed to the desired 10,000) Quality of sample > quantity of sample This study established a new standard for research in human sexuality You can't just have a plan A and plan B in research, you need a plan A - Z "Research design is never just a theoretical exercise, it is a set of practical solutions to a multitude of problems and considerations, that are chosen under constraints of limited resources, of money, time, and prior knowledge" (from NHLS methods section reading)

health disparities

Preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations -Populations can be defined by factors such as race or ethnicity, gender, education or income, disability, geographic location (e.g., rural or urban), or sexual orientation. Health disparities are inequitable and are directly related to the historical and current unequal distribution of social, political, economic, and environmental resources. Health disparities result from multiple factors, including -Poverty -Environmental threats -Inadequate access to health care -Individual and behavioral factors -Educational inequalities

The Social Organization of Sexuality Sexual Practices in the United States: strengths

Probability sample -Every single person has an equal chance of being in the sample -Which consisted of 18 to 59 year olds Huge response rate -Researchers previously thought the upper limit of response rate was 75% -NHLS received 80% response rate Used mixed mode of interviewing -Did face to face interviews which built rapport (which is important when asking about sensitive info) -Also used questionnaires for the most sensitive topics in privacy envelopes, decreasing social desirability bias -Used for questions on income, masturbation, and aids risk related behaviors 3 day training sessions for interviewers -Over 220 interviewers -Ensured standardization of interview as well as neutrality and interviewers being nonjudgmental Sent a letter beforehand -Acted as a way to legitimize the study -Came from the laboratory at the university and provided a telephone number for questions Operationally defined sex -"Here, by sex, or sexual activity, we mean any mutually voluntary activity with another person hat involves genital contact or sexual excitement and arousal, even if intercourse or orgasm didn't occur" They used standard english -Ex. used term oral sex instead of "********" or "fellatio"

descriptive studies

Quasi-experimental studies = involve self selected groups self selected = groups are preexisting (ex. age, gender) Cross sectional studies can have the issue of cohort effect cohort effect: -when a commonly aged group of people in research indirectly affect results due to their common age-related influences -may seem like there is a significant difference in dependent variable based on age,but actually has to do with another variable that one cohort has in common

response biases due to research methodology

Question wording and terminology -We want the people filling out surveys/in interviews to understand what we're asking -Important to pilot test surveys and have people tell you what they had difficulty understanding Response choices -People like to seem average -How researchers provide response choices might influence how an individual answers in hopes to seem normal -Participants might use choices to estimate what is normal, using the middle response choice by default assuming that the middle is supposed to be average Context effects -Which questions come before and after a question can impact how that question is answered

survey method

Questionnaire pros -Cheap -Quick way to get large amount of data -Can be used with more people than could be feasibly studied in a lab -Can be anonymous Questionnaire cons -Non response -Incomplete response -Not completing certain items (don't know why they didn't, maybe they were offended, maybe they didn't understand) -Volunteer bias (participants tend to be younger, more liberal, male, highly educated, sexually experienced, have more sex partners, and engage in sex more frequently) -People may not understand what a question or word means and they don't have access to the researcher to ask -People might give inaccurate information, either on purpose or accidentally -Questionnaires require literacy -Social desirability bias Interview pros -You can explain terms (participants can ask interviewers questions) -If you think someone doesn't understand a question, you can clarify -Opportunity to develop a rapport (which might get interviewee to answer more personal questions) -You can follow up questions to clarify answers -People don't have to be literate Interview cons -Interviewer bias (is the interviewer influencing the interviewee, through physical or psychological characteristics?) -Can include body language (nodding and smiling when the interviewee answers in a certain way) -Costly -Time consuming -Require extensive training to eliminate systematic bias that can occur on the part of the interviewer example: NHLS (interview and questionnaire) and kinsey (interview)

Problems encountered doing sex research

Researchers struggle with defining sex

The sexual health model application of a sexological approach to HIV prevention: importance of diversity

Sex always occurs within a context. Effective researchers and clinicians must strive to understand that context. All too often, interventions use a "one size fits all" approach. In the case of HIV prevention, the approach has been to implore individuals to use a condom This solution to a deadly pandemic is seemingly simplistic.Condoms prevent transmission of the virus. Therefore, wear a condom. The solution that public health officials came up with completely ignores the underlying complex relational and personal issues that many individuals face These complexities often prevent individuals from negotiating condom use to prevent the transmission of HIV and other sexually transmitted infections (STIs). Robinson et al. state that it is imperative that researchers try to uncover the underlying reasons that individuals engage in unsafe sexual practices. It is only then that effective interventions can be crafted. The title indicates a positive approach aimed toward healthy sexual fulfillment. Most (almost all) models take a more specific focus aimed solely at disease prevention. Those kinds of approaches seem to cast sex in a more negative and dangerous light. Robinson et al. suggest that disease prevention is a natural extension of a healthy approach to sexual expression. The article contains a very lengthy operational definition of sexual health on p. 45. This definition is so long because there are so many essential components to achieving a healthy sex life. Self-esteem,knowledge, communication, respect, and an appreciation of diversity are just some of the essential elements of this definition. Robinson et al, state that an individual's culture may dictate what his/her definition of sexual health may be. In turn, they also indicate that sexual pluralism is a necessary premise of their model In other words, there is no "correct definition" of sexual health There must be an underlying understanding that that others' beliefs and choices may differ from yours and that there is no room for moral judgments Instead, acceptance is a requirement The authors also conclude that culturally specific interventions are more likely to be successful because they meet the needs of the targeted subgroups

The sexual health model application of a sexological approach to HIV prevention: the model

The Sexual Health Model is rooted in research. The sexual health model is based on previous research and theory regarding the relationship between attitudes towards sex, sexual relationships, general mental and emotional health, and safe sex practices. The authors reference previous research showing that sexual attitudes are associated with safe sex practices. For example, they cite research that suggests being comfortable with one's sexuality correlates with more condom use and that guilt about sex is associated with less effective, or no, safe sex practices. Authors also reference the fact that previous prevention theories recognize that issues regarding sexuality, relationships, and general emotional factors impact an individual's HIV risk behavior. Additionally, the authors cite research regarding the potential relationship between practicing unsafe sex and emotional and mental problems, for example, research showing that unsafe sex is associated with anxiety, depression, anger, and a lack of adequate sleep. The model evolved from the empirical evaluation of two-day Sexual Attitude Reassessment Seminars that focused on educating small groups of individuals about sexuality and having participants gauge their own attitudes about sex Additionally, Robinson et al. continuously cite their research on three groups of individuals as they discuss the Sexual Health Model. These groups are: men who have sex with men, African-American women, and transgender individuals. The purpose of this model is to provide a model for effective HIV prevention by incorporating previously largely unaddressed factors that can contribute to general sexual health improvement, and therefore, safe sex practices This model is an advancement in the field because it considers more than just education about how to practice safe sex, incorporating HIV prevention into a broader sexual health context by addressing how fostering good sexual health can help prevent HIV The model is presented as a wheel with 10 spokes. This metaphor emphasizes that any spoke is not more important than another They are all of equal importance These ten components include communication about sex, the relationship between culture and sexual identity, understanding of sexual anatomy, safe sex practices and sexual health care, challenges an individual may face that negatively impact their sexual health, body image, masturbation and sexual fantasy, positive attitudes towards sex and sexuality, sexual relationships, and spirituality. Future research may dictate the inclusion of more spokes Additionally, these spokes may interact with one another (for example, there could be an interaction between Body Image and Sexual Health Care and Safer Sex. More specifically, an individual who is gender-nonconforming may not feel comfortable going to the gynecologist for an annual checkup) An individual's background (which consists of their culture, ethnicity, race, sexual orientation, gender identity, and socioeconomic status) impacts each of these components/spokes All these components, taken together and catered to an individual's background, serve to inform the interventions that should be used to promote sexual health and therefore reduce HIV risk.

sexual orientation disparities

The incidence of many STDs in gay, bisexual, and other men who have sex with men (MSM)—including primary and secondary (P&S) syphilis and antimicrobial-resistant gonorrhea—is greater than that reported in women and men who have sex with women only (MSW). In addition to the negative effects of untreated STDs, elevated STD burden is of concern because it may indicate high risk for subsequent HIV infection. Annual increases in reported STD cases could reflect increased frequency of behaviors that transmit both STDs and HIV (e.g., condomless anal sex), and having an STD increases the risk of acquisition or transmission of HIV. The relatively high incidence of STD infection among MSM may be related to multiple factors, including individual behaviors and sexual network characteristics. The number of lifetime or recent sex partners, rate of partner exchange, and frequency of condomless sex each influence an individual's probability of exposure to STDs. However, MSM network characteristics such as high prevalence of STDs, interconnectedness and concurrency of sex partners, and possibly limited access to healthcare also affect the risk of acquiring an STD. Furthermore, experiences of stigma - verbal harassment, discrimination, or physical assault based on attraction to men - are associated with increased sexual risk behavior among MSM. Disparities among MSM reflect those observed in the general population, with disproportionate incidence of STDs reported among racial minority and Hispanic MSM, MSM of lower socioeconomic status, and young MSM The higher burden of STDs among MSM with these characteristics, relative to the general population of MSM, may suggest distinct mixing patterns in their sexual networks, reduced access to screening and treatment, and differential experiences of stigma and discrimination, rather than greater numbers of sexual partners or frequency of condomless sex. Furthermore, disparities may be more pronounced for racial minority and Hispanic MSM who are also unemployed, young, and/or of lower socioeconomic status. Higher rates of syphillis for non-White MSM, which was also evident among MSW and women P&S syphilis was disproportionately prevalent among Black and Hispanic MSM, and data from MSM who attended SSuN clinics suggested that P&S syphilis and urogenital gonorrhea may be more prevalent among MSM living with diagnosed HIV infection than among HIV-negative MSM

The sexual health model application of a sexological approach to HIV prevention: strengths

The most important strength of this model is that it takes into consideration individual differences when creating an intervention to prevent the transmission of HIV The lengthy operational definition specifically states that an appreciation of diversity is an essential component of sexual health. The fact that the model is based upon empirical evidence derived from research is important The recognition that none of the spokes of the model is more important than another and the possibility of interactions among the spokes are strengths as well. there is flexibility within the model. Not all spokes will be relevant to all individuals. Therefore, interventions targeting certain subgroups may include spokes that are not included when targeting other subgroups of the population. More research is necessary to investigate these issues. Some strengths of this model include its holistic approach to sexual health, looking at how many factors contribute to sexual health and safe sex practices instead of merely focusing on safe sex techniques and contraceptives. By not singularly focusing on HIV prevention, this approach encourages addressing a multitude of issues that can impact an individual's well-being and, in turn, could also help promote safe sex practices. Another strength is that this model takes a positive, empowering approach instead of a negative, scare tactic, fear-mongering approach. This approach encourages people to feel as if they have agency and the ability to foster and protect their sexual health, instead of teaching them to view sex as something that is always scary, which might lead to an attitude of abstinence instead of a desire to seek out preventative safe sex methods.

Masters and johnson human sexual response cycle: resolution

The reversal of vasocongestion and myotonia The blood begins to flow out of the genitals and the genitals go back to their non aroused state Disappearance of sex flush Muscles become less tense Respiration, heart rate, and blood pressure go back to normal For women, during the resolution phase, the uterus lowers to its regular position and the cervical opening widens for 20-30 minutes The previous tenting of the vagina creates an area where the semen pools The uterus is therefore lowered into a pool of semen, and the widening of the cervix allowing for easier entry of the sperm If a man goes through the sexual response cycle but does not achieve orgasm, he might experience what some men call blue balls (aching in testes from swelling) Even if they don't have an orgasm, the flood flows out of the penis and the scrotum and testes return to normal Cold showers help because of a vasovagal response, in which cold temperatures prompt blood to flow away from the genitals and towards internal organs

Masters and johnson human sexual response cycle: plateau

There is a relatively constant state of arousal In women, the orgasmic platform occurs (happens regardless of type of sex, during masturbation, oral sex, or penetrative sex) -Vasocongestion swells the tissues of the outer ⅓ of the vagina (⅓ closest to the vaginal opening) -Vaginal opening contracts to grip the penis -Tenting: inner part of the vagina expands fully -Uterus is elevated Another thing that happens in this phase for women is that the clitoris retracts into the prepuce -This can cause partners to think a woman is no longer sexually aroused Further increase in muscular tension, respiration and heart rates, and in blood pressure About ¼ of men and ¾ of women show a sex flush during this phase (skin on chest and abdomen becomes red, has to do with blood flow)

experimental method

True experiment pros -Only research design that can determine cause and effect True experiment cons -Artificiality of the laboratory -Some research questions don't lend themselves to true experiments, especially for psych of sexuality (most of theses studies are correlational)

observation

Types of direct observation -Naturalistic observation = natural environment -Laboratory observation = occurs in a lab (ex. Masters & Johnson) Sometimes involves hooking someone up to physiological recording equipment Direct observation pros -Eliminates possibility of data falsification(people are often not very good reporters of their own behaviors) -Sessions can be videotaped and kept indefinitely Direct observation cons -Demand characteristics -Sometimes researchers see what they want to see and pay more attention to things that confirm their hypotheses -Volunteer bias -There can be an observer effect, researchers can affect the way participants act simply by watching them example: masters and johnson

vagina

Unaroused is 3 to 5 inches long and very narrow When the vagina is not aroused the walls are collapsed When sexually stimulated, the inner two thirds of the vagina expand (capable of expanding to about 4 inches) Vaginal opening actually narrows during sexual arousal The vagina is a potential space The vagina does not have very many nerve endings for touch, and the inner two thirds have basically no nerve endings The outer one third of the vagina has the majority of the nerve endings Vaginal stimulation is not necessary for an orgasm A woman would not be able to use a tampon comfortably if there were a lot of nerve endings in the bag 2 thirds vaginal lubrication -Occurs when the walls of the vagina become engorged with blood -Pressure causes fluid to be secreted from the blood vessels, can happen 1-30 seconds after sexual arousal begins hymen -Partial covering of vaginal opening, very thin tissue -Some women have it and some don't -Women have been killed because they were thought to not have been virgins at the time of their weddings -In some cultures, after wedding night sex, it is expected that the sheets will be spotted with blood (proof of virginity) and paraded around the neighborhood -Some women are born without hymen, or it tears during activities other than sexual intercourse -Some women actually go to plastic surgeons to have them reconstruct their hymen (some women might do this because they were sexually assaulted before their first consensual sexual experience, and might want to replace what has been taken from them) Gspot -Stands for the german doctor who first reported it in the 1950s (graffenberg) -Exception to the general statement that vaginal walls are insensitive to touch -Some women report an area of sensitivity on the front wall of the vagina, about one third or one half of the way inside the vagina -Stimulation of this area causes orgasms that some women claim are more intense -Originally it was thought that all women had one, now it is reported that only 10% or less -Some women have reported ejaculation of fluid from stimulation of this spot -Could be from skene's gland, female equivalent of prostrate, that produces fluid -Very controversial and not well researched at all -What possibly could be happening is that women are pressing up against the other side of the clitoris

uterus & cervix

Uterus -Here the fertilized egg attaches itself (to the wall) -Resembles an inverted pear -Is about 3 inches long and wide (at its widest point) in women who have not had children, those who have have a larger uterus Cervical cancer -One of the most common kinds of cancer -Occurs due to the HPV virus -There is a series of injections that can prevent HPV, but one should still get pap smears regularly Pap smear -Speculum is inserted into the vagina (opens up the vaginal area) -Spatula is inserted and rubbed against the cervix, collecting cells -different agencies , once again, have different recommendations about when to begin and how often to have them -At age 21, a woman should get a pap smear every 3 years (but many recommend annual pap smears) -Always best to discuss with your physician what is best for you when it comes to pap smears and screenings Os -Opening of the vagina that connects to the uterus -Usually no wider than a matchstick, but can dilate to about 4 inches during childbirth

correlational method

Very common Correlation pros -Can gather data from a large group of people (using questionnaires or interviews) Correlation cons -The third variable problem (sometimes there is a relationship between two variables, but a third variable could be creating that relationship)

vulva

Vulva = entire external female genitalia (in latin means covering) Mon verneris -Fatty covering, many nerve ending -We don't know the answer for why we have pubic hair -Some hypothesize that it holds onto secretions, which include pheromones, that could appeal to potential mates Labia majora -Protect vaginal and urethral opening -Also covered in pubic hair Labia minora -Very sensitive to touch -Become engorged with blood during sexual stimulation -Swell and become darker red -Can double or triple in size when aroused -Are hairless Bartholin's gland -Contributes a few drops of alkaline fluid to the inner surfaces of the vagina via ducts -Does not make a significant contribution to vaginal lubrication -Thought to counteract vaginal acidity Clitoris -A shaft in the body, only the tip of it is exposed -The same exact embryonic tissue as the penis -Many nerve endings and is extremely sensitive to touch -Only known structure in either gender with no known purpose other than sexual sensation -The visual portion of the clitoris is called the clitoral glans, and is very sensitive, most women find the glans to be painful when stimulated and prefer the side -Clitoral hood is also called prepuce, and it covers the clitoral glans -Clitoris is about 1 inch long and a ¼ inch in diameter -Contains two channels that become engorged with blood during arousal -Called corpora cavernosa -The same name of the channels engorged with blood in a man's penis -When a woman becomes aroused, the clitoris becomes much larger -A woman does not have an erection because the clitoris is attached to the pubic bone by the crura, preventing the clitoris from swinging forward when engorged with blood (unlike aman's penis) Perineum -Area of tissue between vaginal opening and anus -Very sensitive to touch

fallopian tubes and ovaries

fallopian tubes -On either side of the uterus -Approximately 4 inches long -Do not connect directly to the ovaries, fingerlike projection (fimbriae) undulate and pick up an ovum from the ovary -Sperm fertilizes the ovum in the fallopian tubes, travels 3-4 days in the tubes before reaching the uterus and implanting itself in the wall -Fertilized egg can implant in the fallopian tube rarely, called an ectopic pregnancy and is very dangerous ovaries -Female gonads -First function is to produce ova -Second is to produce hormones (estrogen, progesterone) -Egg follicles are between 300,00 and 400,000 -We are now not sure if women are born with all of their eggs, it is possible that females continuously produce eggs throughout their lifetimes\ -Pituitary glad releases hormones once a month that impact ovaries -Eggs lie dormant until the monthly hormonal trigger

generalizability

you want to be able to say confidently that your sample findings would reflect findings in the population as a whole Goal is to try to get the most truthful responses from participants Participants can lie, but they can also just be biased Volunteer bias -Particularly concerning for convenience samples Who is going to say yes, and are they systematically different from the people who say no -People who volunteer for sexuality research are male, younger, more sexually experienced, more comfortable with sexual topics, and more liberal in their sexual attitudes


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