Sexual behaviour

Question 1

What motivates sexual behaviour?
1- Biological motivation?
2- Sexual motivation?

Answer 1

1- Not a basic biological need
However, even though an individual does not need to have sex to survive, the species needs individuals to have sex if the species is to survive

2- Biological mechanism = Sexual drive e.g. testosterone … to back up evolutionary reason.
Controlled by the brain, but it is strongly influenced by learned experience and environment (Internal + external factors)

Question 2

1- What is sexual behaviour?
2- Why is it important to understand sexual behaviour as a clinician?

Answer 2

1- What people do sexually (including their motivations and consequences their actions)
2- To assess the patient’s risk of acquiring/transmitting an STI

Question 3

What factors determine an individuals sense of sexual self?

Answer 3

• What you bring of yourself, both emotionally and physically, to sex and relationships*
• Biological
• Cultural
• Religious
• Parental
• Life experiences

Question 4

Why do people engage in risky sexual behaviour?

Answer 4

• Low self esteem
• Lack of skills (e.g. using condoms)
• Lack of negotiating skills (e.g. saying ‘no’)
• Lack of knowledge about risky sexual behaviours
• Availability of resources such as condoms or sexual health services
• Peer pressure
• Attitudes and prejudices of society

Question 5

What behaviours increase risk of acquiring STIs?

Answer 5

1. Number of partners / high rate of partner change
2. Condomless sex (i.e. unprotected sex)
   Anal sex > vaginal sex > oral sex
3. Use of alcohol and/or other substances
4. Early onset of sexual activity

Question 6

How does alcohol influence decisions we make about engaging in sex?

Answer 6

1- Increases confidence therefore possibility of sex
> Meet new sexual partners in pubs = more alcohol and drugs = more sexual partners

2- Vulnerable to sexual assault > forget safe sex messages, reduce potential to consider consequences > increase risk taking

Question 7

What is chemsex?

Answer 7

• A term commonly used by men who have sex with men (MSM) to describe sex that occurs under the influence of drugs, which are taken immediately preceding and/or during the sexual session.

Question 8

How do we learn about sexual behaviour in the UK?

Answer 8

• National Survey of Sexual Attitudes and Lifestyles
  > Measures differences in sexual behaviour over time.

Question 9

What are adverse physical health consequences of sexual behaviour?

Answer 9

• Sexually transmitted infections
• Unintended pregnancy
• Physical trauma and consequences

Question 9

What are adverse psychological and social consequences of sexual behaviour?

Answer 9

• Anxiety (eg re STIs / pregnancy, fear of someone finding out, fear of ‘commitment’)
• Activity associated with pain or discomfort
• Actions conflicted with own moral / ethical beliefs
• Consequences of non-consensual sex

Question 10

The impact of STIs remain greatest in what people?

Answer 10

• Young people ages 15-24
• Black ethnic minorities
• Gay+ bisexual and other men who have sex with men.

Question 11

Describe the epidemiology of STIs?

Answer 11

• Prevalence has decreased
  > Due to reduction in testing and therefore diagnosis!

-Chlamydia is the most commonly diagnosed STI in England