Women Arousal loss related to safer sex was more strongly linked to unprotected sex among women than it was among men. This difference of 25 percentage points is more than twice the difference between these two categories among men.
Arousal loss related to safer sex remained strongly associated with unprotected sex for women even when covariates were controlled for Table 2.
Compared with women who strongly disagreed that safer-sex products undermine their arousal, women who strongly agreed and those who agreed were significantly more likely to have had unprotected sex in the last 12 months odds ratios, 3.
In analyses controlling for covariates Table 3 , pregnancy-related arousal loss remained associated with unintended pregnancy experience. The odds of reporting involvement in an unintended pregnancy were about twice as high among men who disagreed or strongly disagreed that pregnancy risk diminishes arousal as among those who strongly agreed odds ratios, 1. Compared with women who agreed or strongly agreed that pregnancy risk diminishes arousal, women who strongly disagreed had a greater likelihood of having experienced an unintended pregnancy odds ratios, 1.
This exploratory study suggests that safer-sex practices such as condom use and the perceived risk of unintended pregnancy can undermine sexual arousal and enjoyment for substantial proportions of men and women. What is more, both arousal loss related to safer-sex practices and arousal loss related to pregnancy risk appear strongly related to sexual health outcomes, even when age, relationship type and other covariates are taken into account.
These findings contradict some relatively common gender-based assumptions in the field of sexual and reproductive health. They also carry implications for efforts aimed at sexual risk reduction. Nearly one in three women in this study reported decreased arousal due to safer-sex practices such as condom use. Although the proportion was significantly higher among men, arousal loss related to the practice of safer sex was much more strongly associated with unprotected sex in the last 12 months for women than for men.
Some previous research suggests that although women want to enjoy sex, at times their erotic fulfillment depends on their pleasing their partners—in some cases, by encouraging unprotected sex. Our findings also point to limitations of standard condom promotion programs among heterosexual women and men. We need to learn how to identify and understand individuals who find their arousal affected by different kinds of risk, and to devise risk reduction options for those strongly averse to condoms.
The findings presented here also challenge some commonly held notions regarding men and unintended pregnancy. Few studies have surveyed men about unintended pregnancy, 35 , 36 in part because researchers assume that men do not know about, or will underestimate, unintended pregnancies. Men whose arousal is diminished by perceived pregnancy risk may hold the key to our efforts to prevent unintended pregnancies and promote effective contraceptive use. Limitations Our study has a number of limitations, the first of which is the measurement of our safer-sex variable.
Men were asked specifically about erection loss related to condoms, but women were asked about arousal loss related to condoms and other safer-sex products. Because of the latter phrasing, we cannot be certain about what product or practice women had in mind when responding to this question, and women may have given different responses for different methods.
Thus, for example, a woman who felt that condoms decrease her arousal, but that spermicide does not, could have been unsure as to whether to agree or disagree with the statement; and some women could have thought of oral contraceptives or other methods that are not effective for STD prevention when responding.
We also note that despite the association between arousal and sexual risk behaviors, this analysis has not accounted for many other factors that more strongly influence risk-related practices. The majority of both men and women disagreed or strongly disagreed that engaging in safer sex causes them to lose their arousal, yet the majority also had engaged in unprotected sex in the past 12 months.
Thus, there are many other factors related to unprotected sex not assessed in this study. Since men were more likely than women overall to engage in unprotected sex, regardless of how condoms shaped their arousal, the association between condom-related arousal loss and unprotected sex was bound to be smaller for them.
Our study is also limited by our use of an Internet-based convenience sample. Despite increasing evidence that online questionnaires can produce higher quality and less biased data than once believed, 40 , 41 our sample captures a select group of individuals, who may have been unusual in their willingness to spend 45—50 minutes answering questions about sexuality for no monetary compensation.
Yet, using an online format to collect data on sexuality can also enhance data validity, since respondents feel assured of their privacy and anonymity. Reported levels of some key behaviors and outcomes were higher in our sample than they are nationwide e.
However, the data are not strictly comparable because of sampling differences. Whereas our survey interviewed adults 18 and older, both national data sets cited here limited their samples to 15—year-olds. Even though our sample may have captured a group of people who are particularly willing to engage in potentially risky sexual behaviors, and thus are of particular interest to researchers and practitioners, it will be very important to explore arousal profiles and their associations with sexual risk using nationally representative data.
Conclusion The main goal of our study was not to make definitive claims about the prevalence of arousal loss or about associations between arousal and sexual risk. Rather, we wanted to generate and explore hypotheses about some of these associations, and the role of gender in those associations. For these purposes, the sample and survey served us well despite their limitations.
Our findings demonstrate that arousal profiles may be a small but important part of the framework explaining sexual behaviors and risk-taking. Some people are clearly turned off by risk, while others are turned off by safer-sex practices. Therefore, sexuality and arousal profiles should be taken seriously in behavioral models of risky sex. These profiles could contribute an essential element to effective collaboration with clients on improving sexual health outcomes.
Finally, we argue that men need to be involved in sexual health promotion—for themselves, for their partners, and for the reduction of both unintended pregnancy and STDs.
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