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Teens face health and safety risks exploring sex online

Online sexual experiences can predict whether they become victims of sexual assault one year later.

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Teens spend hours every day on internet-connected devices, where limitless opportunities to explore sexuality online. These opportunities don’t come without big risks, though. A researcher from Michigan State University found that online sexual experiences can predict whether they become victims of sexual assault one year later.

The findings, published in the Journal of Youth and Adolescence and funded by the National Institutes of Health, are part of a study that is the first of its kind to investigate online sexual experiences using a person-centered approach, which identifies specific patterns of behaviors in sub-groups of people rather than general observations across a large group. This approach allowed researchers to track the girls’ online experiences – and subsequent offline experiences – more intricately than prior studies.

“It makes sense that engaging in risky behavior online would translate to offline risks,” said Megan Maas, research author and MSU assistant professor of human development and family studies at MSU. “But we were able to identify specific online behavioral patterns that correlated with susceptibility to different offline outcomes – which was never captured from conventional approaches before.”

Maas and colleagues assessed data from 296 girls between 14- and 17-years-old, who self-reported their online and offline sexual experiences over five years. Additionally, the girls would visit a lab each year for a trauma interview to measure experiences such as sexual abuse, assault or violence that may go undetected in a survey.

“By assessing the teens’ online sexual experiences using the person-centered approach, we were able to group the teens into four classes of experience patterns, which predicted sexual health and victimization outcomes one year later,” Maas said.

The four classes were:

  • Online inclusive: These teens have a high probability of having several online sexual experiences, including looking at internet porn, chatting with strangers about sex, sending nude photos and posing provocatively on social media. This class often has strangers posting sexy comments on their social media accounts, requesting nude photos and soliciting them for sex.
  • Seekers: These teens purposefully seek out internet porn, chat with others about sex and post sexy photos on social media, but purposefully do not have a sexy profile picture and do not receive a lot of online attention from others.
  • Attractors: This class of teens gets attention from others online, though they’re not explicitly looking for it. They had a sexy social media profile, had people requesting nude photos, received comments about how sexy they are and have strangers solicit them for offline sex.
  • Online abstinent: This group had little probability in having online sexual experiences.

The goal was to pinpoint online patterns of sexual experiences related to three offline outcomes one year later: HIV risk, sexual assault and intimate partner violence, Maas said.

They discovered that attractors were more likely to be sexually assaulted than the seekers; online inclusive were likely to be sexually assaulted or engage in risky sex, especially if they’d experienced prior sexual abuse or assault; whereas, the seekers were more likely to have a physically violent romantic partner, especially if they’d experienced prior sexual abuse or assault.

Maas explained that her findings demonstrate how critical it is for teens to receive education to understand how online sexual experiences may shape their offline experiences. Specifically, she hopes that schools and families will educate youth on sexual health and consent as well as healthy relationships, as their online experiences could have serious consequences.

“Rather than trying to tackle the impossible – like eliminating teens’ exposure to porn or ability to sext – we can and should educate them about these realities and risks and offer alternatives for learning about and expressing sexuality,” Maas said.

Maas hopes that her findings will inspire parents to proactively talk to their kids about risks they face online, as well as to establish rules early in their lives that can prevent girls’ from putting too much emphasis on their sexy social media presence.

“The best strategy for parents to follow is to limit time and space for internet usage,” Maas said. “Establish a time limit they can be on a device, and don’t allow screens in bedrooms. There are apps for parents that can help control screen time – and plenty of ways to involve their kids in activities that don’t rely on the internet at all.”

Next, Maas plans to explore why these online experiences predict offline risk and victimization. For instance, if teen girls feel obligated to engage in unwanted sexual activity if they have already sent a nude photo, or if boys feel entitled to sex from girls with sexy social media profiles. She hopes this follow-up study will clarify these findings to provide more specific guidance for sexual health and internet safety programming without attributing blame to survivors.

Health & Wellness

Trans women can safely maintain estrogen treatments during gender affirming surgery

The practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

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There was no difference in blood clots when estrogen hormone therapy was maintained during gender affirming surgery.

This is according to a study (titled, “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender Affirming Surgery”) helmed by John Henry Pang with Aki Kozato from Mount Sinai, and was published in the Journal of Clinical Endocrinology & Metabolism.

Historically, the lack of published data contributed to heterogeneity in the practice of whether doctors and surgeons advised transgender women to withhold their estrogen therapy before surgery. The sudden loss of estrogen in the blood was sometimes very uncomfortable with symptoms that amounted to a sudden, severe menopause.

So the researchers tapped 919 transgender patients who underwent gender affirming surgery at Mount Sinai’s Center for Transgender Medicine and Surgery between November 2015 and August 2019. Notably, including 407 cases of transgender women who underwent primary vaginoplasty surgery.

This study found that the practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

The bottom line: This study found that most transgender women can  safely maintain their estrogen hormone treatments during gender affirming surgery.

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Health & Wellness

Facebook posts help facilitate belief that HPV vaccine is dangerous to health

Nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

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The human papillomavirus infection, or HPV, is one of the most common sexually transmitted infections, according to the Centers for Disease Control and Prevention (CDC). HPV is associated with health problems including genital warts and cancers, but a vaccine has been available since 2006 to help stop the virus. The CDC reports more than 12 years of data supports the HPV vaccine is safe and effective, yet HPV vaccination rates still remain low.

Social media has a history of being a popular place for sexual health discussions, and the HPV vaccine is one of the most discussed vaccines on the internet. Monique Luisi, an assistant professor in the University of Missouri School of Journalism, has studied more than 6,500 public HPV vaccine-related posts on Facebook from 2006 to 2016. In a previous study, Luisi used these Facebook posts to identify a negative trend on Facebook related to how people perceive the HPV vaccine.

Now, she suggests this negative trend on Facebook may also cause people to develop a false perception of the health risk of the vaccine. After looking at the percentage of posts that made the vaccine seem more dangerous, less dangerous or neither, Luisi found nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

“We should not assume that only the disease is perceived as a risk, but when research supports it, that medical treatments and interventions might unfortunately also be perceived as risks,” she said. “It’s more likely that people are going to see things on social media, particularly on Facebook, that are not only negative about the HPV vaccine, but will also suggest the HPV vaccine could be harmful. It amplifies the fear that people may have about the vaccine, and we see that posts that amplify fear are more likely to trend than those that don’t.”

Luisi suggests the spread of this negative information may lead people to have a false perception of the vaccine, so people should consult their doctor or health care provider before making an informed decision.

“Facebook remains a very popular social media platform for adult audiences, which necessitates action to address HPV vaccine risk messages,” she said. “People are going to see what they are going to see on social media, so it’s important to not only take what you see on social media, but also talk to a doctor or health care provider. Just because it’s trending doesn’t mean it’s true.”

Luisi notes research must continue to address the perception of vaccine safety where the vaccine is perceived as a greater health threat than the virus or disease it prevents, and her study could also inform officials for the ongoing COVID-19 vaccine roll out and distribution.

“As the COVID-19 vaccine is being rolled out, people are likely going to see a lot of negative information, and that negative information will be what trends on social media,” she said. “But, if the public can anticipate this negative information, it will be interesting to see if that will that make them less sensitive to the perceived risk of the vaccine.”

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Health & Wellness

Depression and stress could dampen efficacy of COVID-19 vaccines

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

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Decades of research show that depression, stress, loneliness, and poor health behaviors can weaken the body’s immune system and lower the effectiveness of certain vaccines.

A new report accepted for publication in Perspectives on Psychological Science suggests that the same may be true for the new COVID-19 vaccines that are in development and the early stages of global distribution. Fortunately, it may be possible to reduce these negative effects with simple steps like exercise and sleep.

Vaccines are among the safest and most effective advances in medical history, protecting society from a wide range of otherwise devastating diseases, including smallpox and polio. The key to their success, however, is ensuring that a critical percentage of the population is effectively vaccinated to achieve so-called herd immunity.

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

This is particularly troubling as the novel coronavirus continues to rage across the world, trigging a concurrent mental health crisis as people deal with isolation, economic stressors, and uncertainty about the future. These challenges are the same factors that have been previously shown to weaken vaccine efficacy, particularly among the elderly.

“In addition to the physical toll of COVID-19, the pandemic has an equally troubling mental health component, causing anxiety and depression, among many other related problems. Emotional stressors like these can affect a person’s immune system, impairing their ability to ward off infections,” said Annelise Madison, a researcher at The Ohio State University and lead author on the paper. “Our new study sheds light on vaccine efficacy and how health behaviors and emotional stressors can alter the body’s ability to develop an immune response. The trouble is that the pandemic in and of itself could be amplifying these risk factors.”

Vaccines work by challenging the immune system. Within hours of a vaccination, there is an innate, general immune response on the cellular level as the body begins to recognize a potential biological threat. This frontline response by the immune system is eventually aided by the production of antibodies, which target specific pathogens. It is the continued production of antibodies that helps to determine how effective a vaccine is at conferring long-term protection.

The good news, according to the researchers, is that the COVID-19 vaccines already in circulation are approximately 95% effective. Even so, these psychological and behavioral factors can lengthen the amount of time it takes to develop immunity and can shorten the duration of immunity.

“The thing that excites me is that some of these factors are modifiable,” said Janice Kiecolt-Glaser, director of the Institute for Behavioral Medicine Research at The Ohio State University and senior author on the paper. “It’s possible to do some simple things to maximize the vaccine’s initial effectiveness.”

Based on prior research, one strategy the researchers suggest is to engage in vigorous exercise and get a good night’s sleep in the 24 hours before vaccination so that your immune system is operating at peak performance. This may help ensure that the best and strongest immune response happens as quickly as possible.

“Prior research suggests that psychological and behavioral interventions can improve vaccine responsiveness. Even shorter-term interventions can be effective,” said Madison. “Therefore, now is the time to identify those at risk for a poor immune response and intervene on these risk factors.”

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Health & Wellness

Bisexual men more prone to eating disorders than gay or straight men – study

80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

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Bisexual men are more likely to experience eating disorders than either heterosexual or gay men. This is according to a report from the University of California San Francisco, published in the journal Eating and Weight Disorders.

A handful of studies have actually indicated that gay men are at increased risk for disordered eating, including fasting, excessive exercise and preoccupation with weight and body shape. This newer study, however, suggests that bisexual men are even more susceptible to some unhealthy habits.

For this study, the researchers surveyed over 4,500 LGBTQ adults, and a quarter of the bisexual male participants reported having fasted for more than eight hours to influence their weight or appearance. This is higher when compared to 20% for gay men.

The research also found that 80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

Now this is worth stressing: According to study co-author Dr. Jason Nagata, not everyone who diets or feels fat has an eating disorder. “It’s a spectrum — from some amount of concern to a tipping point where it becomes a pathological obsession about body weight and appearance,”Nagata was quoted as saying by NBC News.

For Nagata, several factors may be at play here, including “minority stress” (the concept that the heightened anxiety faced by marginalized groups can manifest as poor mental and physical health outcomes).

“LGBTQ people experience stigma and discrimination, and stressors can definitely lead to disordered eating,” Nagata was also quoted as saying. “For bi men, they’re not just facing stigma from the straight community but from the gay community, as well.”

Of all the respondents, 3.2% of bisexual males were clinically diagnosed with eating disorders (compared to 2.9% of gay men). For heterosexual men, it’s only 0.6%.

For the researchers, there is a need to conduct eating disorder research on various sexual identities independently. This is also to raise awareness on this issue (and how it affects different people of various SOGIESCs).

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Health & Wellness

Timing and intensity of oral sex may affect risk of oropharyngeal cancer

Love giving head? Consider this: Having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer.

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Human papillomavirus (HPV) can infect the mouth and throat to cause cancers of the oropharynx.

This is according to a study published in CANCER, a peer-reviewed journal of the American Cancer Society, which has found that having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer. The study also shows that having oral sex at a younger age and more partners in a shorter time period (oral sex intensity) were associated with higher likelihoods of having HPV-related cancer of the mouth and throat.

Previous studies have shown that performing oral sex is a strong risk factor for HPV-related oropharyngeal cancer. To examine how behavior related to oral sex may affect risk, Virginia Drake, MD, of Johns Hopkins University, and her colleagues asked 163 individuals with and 345 without HPV-related oropharyngeal cancer to complete a behavioral survey.

In addition to timing and intensity of oral sex, individuals who had older sexual partners when they were young, and those with partners who had extramarital sex were more likely to have HPV-related oropharyngeal cancer.

“Our study builds on previous research to demonstrate that it is not only the number of oral sexual partners, but also other factors not previously appreciated that contribute to the risk of exposure to HPV orally and subsequent HPV-related oropharyngeal cancer,” said Dr. Drake. “As the incidence of HPV-related oropharyngeal cancer continues to rise… our study offers a contemporary evaluation of risk factors for this disease. We have uncovered additional nuances of how and why some people may develop this cancer, which may help identify those at greater risk.”

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Health & Wellness

Sexual, gender minority youths more likely to have obesity, binge eating disorder

Findings suggest that weight and eating disorder disparities observed in SGM adolescents/adults may emerge in childhood. As such, “clinicians should consider assessing eating- and health-related behaviors among SGM youths.”

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Sexual and gender minorities (SGM) youths were more likely to have obesity and full-threshold or subthreshold binge eating disorder. This is according to research – “Obesity and Eating Disorder Disparities Among Sexual and Gender Minority Youth” by Natasha A. Schvey, PhD; Arielle T. Pearlman, BA; David A. Klein, MD, MPH; et al -published in JAMA Pediatrics.

SGM are those who identify as lesbian, gay, bisexual and/or transgender, or whose sexual orientation and/or gender identity/expression do not conform to societal conventions.

For this study, the researchers noted that as it is, “obesity and eating disorders in youth are prevalent, are associated with medical and psychosocial consequences, and may persist into adulthood. Therefore, identifying subgroups of youth vulnerable to one or both conditions is critical.”

For them, one group that may be at risk for obesity and disordered eating is SGM.

In total, 11,852 participants were considered (aged 9-10 years), derived from the Adolescent Brain Cognitive Development Study. The mean age was 9.91, and 5,672 (47.9%) of the total number were female. The sample comprised 1.6% (n = 190) probable sexual (n = 151) and/or gender minority (n = 58) youths, of whom 24.7% (n = 47) responded yes and 75.3% (n = 143) responded maybe to the SGM queries.

The researchers found that one in six youths (1,987 [16.8%]) had obesity and 10.2% (n = 1,188) had a full-threshold (86 [0.7%]) and/or subthreshold (1103 [9.4%]) eating disorder.

They also reported that adjusting for covariates, SGM youths were more likely to have obesity (odds ratio, 1.64; 95% CI, 1.09-2.48) and full-threshold or subthreshold binge eating disorder (odds ratio, 3.49; 95% CI, 1.39-8.76).

SGM and non-SGM youths did not differ in the likelihood of full-threshold or subthreshold anorexia nervosa or bulimia nervosa. The same pattern of results remained when limiting SGM youths to those responding yes to the SGM items, although significance for the likelihood of obesity was attenuated.

For the researchers, the findings suggest that weight and eating disorder disparities observed in SGM adolescents/adults may emerge in childhood. As such, “clinicians should consider assessing eating- and health-related behaviors among SGM youths.”

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