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Psycho-social issues related to counseling bisexuals.

An increasing number of persons who experience bisexual feelings or behaviors are seeking professional counseling. This article explores the psycho-social issues related to counseling individuals and couples concerned about their own or their partner's feelings, fantasies, or behaviors with both men and women, and the appropriateness or inappropriateness of adopting a bisexual identity or developing a bisexual life-style. The steps for helping individuals to differentiate problems, handle confusion, and conceptualize bisexuality are outlined. The counseling process with bisexuals includes developing support systems, examining internalized homophobia and sex-role stereotyping, helping them deal with heterosexual concerns, and with issues which affect partners when one or both is bisexual.

Child Rearing↗

A study of the married bisexual male: paradox and resolution.

Men who live in conventional marriages and at the same time have significant love-sex relationships with members of their own sex are largely an invisible group in our society. However, there is evidence to suggest that they are not rare, only rarely identified. How these men perceive themselves, reconcile the ordinary aspects of their lives with their atypical sexuality, and conduct themselves in marriage and family life are the focus of this study. Particular attention is paid to two major paradoxes in their lives: the contradiction between their heterosexual public identity which places them comfortably in the mainstream of society and their stigmatized and forbidden homosexual desires and behavior; and the ethical issue of deceiving their wives as well as others to whom they are intimately related. Sixty men drawn from a non-clinical population presented their life stories in extended tape-recorded interviews. These men show great variations in their patterns of psychosexual development as well as in their accoMmodations to marriage and do not fit readily into simple categories. Most of them have found fulfillment and have no wish to change the pattern of their lives. In part, the study contrasts the more successful with the less successful marriages. A major conclusion is that some men are able to express with minimal conflict their homosexual and heterosexual impulses within the framework of a conventional marriage.

Adult↗

Human mate poaching: tactics and tempations for infiltrating existing mateships.

The authors explored the psychology of romantically attracting someone who is already in a relationship--what can be called the process of human mate poaching. In Study 1 (N = 236), they found that attempts at poaching were relatively common and were linked with distinctive personality dispositions. Study 2 (N = 220) documented that the perceived costs and benefits of poaching differed somewhat for men and women and depended on whether short-term or long-term poaching outcomes were targeted. Study 3 (N = 453) found support for 5 evolution-based hypotheses about the perceived effectiveness of poaching tactics. Study 4 (N = 333) found that poaching effectiveness was influenced by the type of relationship being encroached on-marital, dating, long distance, highly committed, just beginning, or about to end. Discussion focuses on the importance of placing mate poaching within the broader context of human sexual strategies.

Adult↗

Factors relating to transmission of viral hepatitis in a United States military population stationed in Thailand.

To determine the incidence of clinical and inapparent hepatitis in a US military population stationed in Thailand, the authors prospectively studied a cohort of 326 men during one year. Clinical hepatitis A occurred in one man (clinical attack rate = 3.1/1000 men/year), and clinical hepatitis B was found in four men (clinical attack rate = 12.3/1000 men/year). No non-A, non-B hepatitis was identified. There was no serologically identified inapparent hepatitis A but inapparent hepatitis B occurred in 17 men. The apparent/inapparent ratio for hepatitis B was 1:4.25. Serotype analysis suggested that hepatitis B virus largely originated from Thai contacts, although 23% of cases were derived from western sources. To determine the relative contribution of 16 statistically significant (out of 67 studied) behavioral variables to the transmission of HBV, a factor analysis and a multivariate correlation analysis were employed. Factor analysis indicated that social and sexual contact with the indigenous population, including prostitutes, residence within the Thai community and marijuana use were behavioral areas that were associated with the acquisition of hepatitis B. Residence in the Thai community during the first four-month period in Thailand, sexual contact with a prostitute during the third four-month period, and ever having maintained a Thai mistress were found to be significant and independent risk factors by multiple regression analysis.

Adolescent↗

Risk factors for HIV-2 seropositivity among older people in Guinea-Bissau. A search for the early history of HIV-2 infection.

Because the seroprevalence of HIV-2 has been shown to be high in older age groups, we conducted a survey of all persons aged 50 years or over in two districts in Bissau, investigating the presence of HIV antibodies and possible risk factors for HIV infection with a particular emphasis on age, the impact of the war of independence (1963-74), traditional marital and extramarital sex patterns, blood contact and contact with monkeys. In 670 participants, the HIV-2 prevalence was 14.3%; 16.1% in women and 12.3% in men. The HIV-1 prevalence was only 0.5% (3/670). The HIV-2 prevalence peaked for men in the 60-69 years age group, and for women in the 50-59 years age group, declining markedly in the following age group for both men and women (OR = 0.09 (0.01-0.51), OR = 0.37 (0.15-0.82), respectively). This pattern could be due to differential mortality for HIV-2 infected individuals or to a cohort effect for a generation who were sexually active at the time of the war of independence in the 1960s and early 1970s in Bissau. Supporting the link with the colonial army, women who had had sex with a white man had a higher seroprevalence (OR = 3.63 (1.12-11.24)). The ethnic group indigenous to Bissau city had a much lower prevalence, but demographic and cultural risk factors such as marital status, religion, education and having lived outside Bissau were not associated with HIV-2. In the multivariate analyses for women, variables related to extramarital sex or prostitution (having sex with a white man, having lived in Senegal, not living with husband, and not marrying first sexual partner) were associated with higher risk. For men, previous spouses who had died or had divorced were associated with higher prevalence. Having married the first sexual partner was protective against HIV-2 infection for both men (OR = 0.29 (0.09-0.76)) and women (OR = 0.19 (0.04-1.00)). Hospitalizations, possibly due to transfusions, tended to be associated with higher risk, but only for women (OR = 1.83 (0.97-3.48)). The focus of the HIV-2 epidemic in Guinea-Bissau is likely to be endogenous, and the war of independence and the colonial army with its associated prostitution may have played an important part in propagating the virus.

Aged↗

Vicissitudes in adult life resulting from traumatic experiences in adolescence.

The author deals with the difficulties in combining the concepts of trauma and phantasy. He evaluates Freudian observations relating to chance and trauma. He considers traumatic effects of chance in relation to the rupture of a narcissistic phantasy of invulnerability. The narrating of traumatic events may awaken in the analyst tendencies to repeat the aggression of these traumatic events towards the subject. The accusatory interpretation can be one of the means by which this repetition is established. The author explores a type of trauma which is essentially related to the disturbance of the structure which contains the ideals of the subject. This disturbance is a consequence of disillusionment resulting from the loss of an object who was the depository of these ideals. Trauma generates a state of mourning for lost ideals. The author describes traumatic events which occurred in a patient's life at puberty; paradoxical behaviours in the patient's parents caused the patient to have new traumas. The reluctance to explore the derivatives of the unconscious, and to investigate possible meaning in symbols, was a central problem in this patient's analysis. The author discusses disturbances in symbolization, and he examines the subject of projective identifications that were received by patients from their primary objects.

Adolescent↗

Destinations unknown: the gender construction and changing nature of the sexual expressions of Thai youth.

This paper discusses qualitative findings from a study of the sexual awareness, lifestyles and related health service needs of young, single factory workers in Thailand. The context of this study is Thailand's growing industrialization, the deepening intensity of the threats to sexual health (especially regarding HIV/AIDS transmission) and the vulnerability of young migrant women. Findings from 18 focus group discussions held with groups of young (15-24) male and female factory workers are outlined with principal reference to the gender construction of sexuality. Key themes explored include attitudes towards courtship, marriage, sexual feelings and arousal, expressions of involvement in pre-marital sexual activities and the consequences of such activity. In conclusion there is some discussion of the implication for young women's sexual health, of the interplay of a measure of pre-marital intercourse and the continuing emotional barriers to effective use of contraception.

Acquired Immunodeficiency Syndrome↗

Something's missing: need fulfillment and self-expansion as predictors of susceptibility to infidelity.

The present authors investigated whether an individual's motivations that are related to need fulfillment and self-expansion within a romantic relationship can predict self-reported susceptibility to infidelity. A sample of 109 college students (50 men, 59 women) who were in dating relationships completed questionnaires that assessed 5 types of variables of need fulfillment (i.e., intimacy, companionship, sex, security, and emotional involvement), 3 types of self-expansion variables (i.e., self-expansion, inclusion of the other in the self, and potential for self-expansion), and susceptibility to infidelity. As the present authors predicted, both sets of predictors (need fulfillment and self-expansion) significantly contributed to the variance in susceptibility to infidelity. The present findings indicated the possibility that, when a relationship is not able to fulfill needs or provide ample self-expansion for an individual, his or her susceptibility to infidelity increases.

Adolescent↗

The social constructions of sexuality: marital infidelity and sexually transmitted disease-HIV risk in a Mexican migrant community.

OBJECTIVES: This article explores the social context of the migration-related HIV epidemic in western Mexico. METHODS: Data collection involved life histories and participant observation with migrant women in Atlanta and their sisters or sisters-in-law in Mexico. RESULTS: Both younger and older women acknowledged that migrant men's sexual behavior may expose them to HIV and other sexually transmitted diseases.Younger Mexican women in both communities expressed a marital ideal characterized by mutual intimacy, communication, joint decisionmaking, and sexual pleasure, but not by willingness to use condoms as an HIV prevention strategy. CONCLUSIONS: Migrant Mexican women's commitment to an illusion of fidelity will hinder HIV prevention initiatives targeted toward them. Furthermore, the changing meanings of marital sex may make it harder to convince young couples to use condoms as an HIV prevention strategy. If the chain of heterosexual marital HIV transmission is to be interrupted in this community, prevention programs must target men.

Communication↗

Extramarital sexual crisis: common themes and therapy implications.

The extramarital crisis situation is defined and six common themes presented. These distinguishing features: cognitive and emotional turmoil, unresolved relationship issues, defensiveness, pressures related to the extramarital partner(s), search for an interpretive framework, and decisions about the future, are elaborated in terms of existing literature in the field of extramarital sex. The six themes constitute a general profile from which therapists can formulate specific client assessments. Therapy implications are dealt with for each theme and collectively represent an approach to extramarital crises and a summarization of existing clinical strategies. Some research data is presented as further verification of the six-theme framework.

Adult↗

States' implementation of the Section 510 abstinence education program, FY 1999.

CONTEXT: As part of its reworking of the nation's welfare system in 1996, Congress enacted a major new abstinence education initiative (Section 510 of Title V of the Social Security Act), projected to spend $87.5 million in federal, state and local funds per year for five years. The new program is designed to emphasize abstinence from sexual activity outside of marriage, at any age, rather than premarital abstinence for adolescents, which was typical of earlier efforts. The actual message and impact of the program, however, will depend on how it is implemented. METHODS: Program coordinators in all 50 states, the District of Columbia and Puerto Rico were surveyed concerning implementation of the Section 510 abstinence education program in FY 1999. The questionnaire asked about expenditures and activities performed, about policies established for a variety of specific situations and about how the term "sexual activity" is defined and what specific components of the federal definition of "abstinence education" are emphasized. RESULTS: Forty-five jurisdictions spent a total of $69 million through the Section 510 program in FY 1999. Of this total, $33 million was spent through public entities, $28 million was spent through private entities and $7million (in 22 jurisdictions) was spent through faith-based entities. Almost all jurisdictions reported funding school-related activities, with 38 reporting in-school instruction and presentations. Twenty-eight jurisdictions prohibited organizations from providing information about contraception (aside from failure rates), even at a client's request, while only six jurisdictions prohibited information about sexually transmitted diseases. Few reported having a policy or rendering guidance about providing services addressing sexual abuse, sexual orientation or existing pregnancy and parenthood. Only six respondents said they defined "sexual activity" for purposes of the program, and 16 reported focusing on specific portions of the federal definition of "abstinence education." CONCLUSIONS: More than one in 10 Section 510 dollars were spent through faith-based entities. Programs commonly conducted in-school activities, particularly instruction and presentations, not only through public entities, but also through private and faith-based entities. Most jurisdictions prohibited the provision of information about contraception, about providers of contraceptive services or about both topics, even in response to a direct question and when using other sources of funding. Most also left definitions of "abstinence" and "sexual activity" as local decisions, thus not clearly articulating what the program is designed to encourage clients to abstain from.

Adolescent↗

Swinging: a test of two theories and a proposed new model.

One objective was to test two of the major theories of swinging. The first, rooted in the concept of marginality, is based on the idea that swingers are relatively new to their communities and to the middle class. The second has argued that swingers are more likely to be less attached to the community and the institutions in society. A third theory takes a more social psychological approach, viewing swingers within an "emergent" situation. However, this approach does not include any predisposing factors. A second objective, therefore, was to analyze the effects of a predisposing variable thought to be important in swinging-jealousy. A group of 114 swingers, along with a control group of 114 nonswingers, responded to a questionnaire containing a number of demographic and attitudinal items. Results indicated that swingers, compared to nonswingers, had lived in their communities for fewer years, had moved more often within the past 5 years, and identified less with religion. However, swingers were no different on political identification or newness to the middle class. And, contrary to expectations, swingers belonged to more community organizations than nonswingers and responded in a less alienated fashion on two items. When jealousy was introduced, it was found that swingers perceived themselves as less jealous than nonswingers and that nonjealous swingers were more liberal than nonjealous nonswingers on a number of attitudinal items. Finally, a social psychological model of swinging, including predisposing factors, is presented.

Extramarital Relations↗

Secretive females or swaggering males? An assessment of the quality of sexual partnership reporting in rural Tanzania.

In population-based surveys on sexual behaviour, men consistently report higher numbers of sexual partners than women, which may be associated with male exaggeration or female under-reporting or with issues related to sampling, such as exclusion of female sex workers. This paper presents an analysis of data collected in the context of a longitudinal study in rural Tanzania, where a sexual partnership module was applied to all participating men and women in the study population. Since the study design included all men and women of reproductive ages and did not involve sampling, these data provide a unique opportunity to compare the consistency of aggregate measures of sexual behaviour between men and women living in the same villages. The analysis shows that non-marital partnerships were common amongst single people of both sexes--around 70% of unmarried men and women report at least one sexual partner in the last year. However, 40% of married men also report having non-marital partners, but only 3% of married women did so. Single women reported about half as many multiple partnerships in the last year as men. Under-reporting of non-marital partnerships was much more common among single women than among married women and men. Furthermore, women were more likely to report longer duration partnerships and partnership with urban men or more educated men than with others. If a woman reports multiple partners, biological data indicate that she is at high risk of contracting HIV. For men, however, there is only a weak association between number of partnerships and the risk of HIV, and it cannot be excluded that men, especially single men, exaggerate the number of sexual partners.

Adolescent↗

Rethinking the probative value of evidence: base rates, intuitive profiling, and the "postdiction" of behavior.

It is argued that American courts may be routinely admitting evidence with little to no probative value and great potential for prejudicial impact. This may be particularly likely with regard to what is essentially "intuitive profiling" or "stereotype" related evidence, defined herein as evidence suggesting that the defendant (or other party), or his (her) behavior, fits intuitive "profiles" (or stereotypes) of the type of person likely to commit the crime or behavior in question. In other words, "intuitive profiling" evidence is admitted to "postdict" behavior Formal empirically based "profiling" evidence (testimony regarding the fit of a defendants characteristics or behaviors to formal or scientific profiles of the typical perpetrator of the crime in question) for use to prove guilt is inadmissible in American courts. However, we suggest that everyday use of informal intuitive profiles underlies both judicial determinations of probative value (diagnosticity), and thus admissibility, of evidence, and jurors' use of the evidence in determining guilt. Demonstrations of the use of base rate information to evaluate the probative value of such intuitive profiling evidence both as evidence of guilt and as evidence of innocence are provided. Demonstrations of both how to evaluate the actual probative value of evidence (when all necessary values are known), and the theoretical limit of its probative value (in circumstances where some values are not known) are provided. It is argued that such evaluations may provide the basis for (1) support of motions to either admit or to exclude evidence, (2) testimony to the jury to help them weigh or interpret evidence, (3) exculpatory profiling (profiling evidence of innocence), (4) pretrial research to establish probative versus prejudicial value of evidence, and (5) sufficiency analyses to determine maximum likelihood of guilt, given multiple items of evidence. Among these, the first two are considered most important, as it can be demonstrated that many "profiling" characteristics currently admitted in trial (such as evidence of battery to support a murder charge) are not probative of guilt.

Decision Support Techniques↗

Sexual behaviors and reproductive health outcomes: associations with wife abuse in India.

CONTEXT: Wife abuse has been associated with a variety of health concerns. Associations between abuse and reproductive health in India are not well known. OBJECTIVE: To examine relationships between men's reports of wife abuse and reproductive health issues in northern India. DESIGN: Structured face-to-face interviews were conducted as part of the male reproductive health supplement of the PERFORM System of Indicators Survey, a systematic multistage survey conducted in 1995-1996. SETTING: The northern state of Uttar Pradesh, one of the least developed states in India. PARTICIPANTS: A total of 6632 married men aged 15 to 65 years who lived with their wives and completed all survey questions for the study variables reported here. MAIN MEASURES: Physically and sexually abusive behaviors toward wives, sexual activities outside marriage, sexually transmitted disease (STD) symptoms, contraception use, unplanned pregnancies, and sociodemographic characteristics. RESULTS: Fifty-four percent of men reported not abusing their wives, while 17% reported physically but not sexually abusing their wives, 22% reported sexual abuse without physical force, and 7% reported sexual abuse with physical force. Abuse was more common among men who had extramarital sex (for sexual abuse using force: odds ratio [OR], 6.22; 95% confidence interval [CI], 3.98-9.72). Similarly, men who had STD symptoms were more likely to abuse their wives (with current symptoms: OR, 2.43; 95% CI, 1.73-3.42). Unplanned pregnancies were significantly more common among wives of abusive men, especially sexually abusive men who used force (OR, 2.62; 95% CI, 1.91-3.60). CONCLUSIONS: Wife abuse appears to be fairly common in northern India. Our findings that abusive men were more likely to engage in extramarital sex and have STD symptoms suggest that these men may be acquiring STDs from their extramarital relationships, thereby placing their wives at risk for STD acquisition, sometimes via sexual abuse. These abusive sexual behaviors also may result in an elevated rate of unplanned pregnancies.

Adolescent↗

Extramarital relationships: a reapraisal.

Extramarital relationships may not always disturb marital interaction, but on the contrary, marriages may have more permanence because many individuals find an answer to unmet needs in such relationships. In addition, a factor that rarely is mentioned in our society, which has vestiges of a puritanical ethic, is that an extramarital relationship can be an enjoyable experience for the individuals in and of itself. In a democratic society, which values choice, perhaps extramarital relationships can be undertaken if the individuals involved recognize: (1) the consequences of discovery, which may result in a threat to the solidarity of the marriage(s) involved; (2) the possibility that individuals so involved ultimately may wish to leave their own mates; and (3) that such a relationship may strengthen, not destroy, the unity of marriage.

Attitude↗

Treating couples recovering from infidelity: an integrative approach.

Infidelity is one of the most difficult problems to address in couple therapy, most likely because it involves a traumatic relationship event that alters the ways in which couples process information about each other and established behavioral patterns. We present a three-stage treatment designed to address the cognitive, behavioral, and emotional sequelae of affairs that integrates cognitive-behavioral and insight-oriented strategies with the literatures on traumatic response and forgiveness. A case study with pretreatment, posttreatment, and 6-month follow-up data is presented to illustrate the treatment methods.

Adaptation, Psychological↗

Teaching fidelity.

Working therapeutically with individuals or couples either following an affair or prior to its occurrence requires teaching them about risks to monogamy and the challenges of recovering from infidelity. Risks to monogamy include cultural myths about both infidelity and marriage that may be shared not only by lay persons, but also by their ill-informed therapists. Exacerbating risks to fidelity are physiological components of emotional and physical attraction that contribute to cognitive and affective disorientation. Therapists can promote fidelity and recovery from infidelity by attending to the fundamental tasks of modeling compassion, debunking myths regarding infidelity, confronting individuals with their own choices, promoting emotional closeness, and helping individuals to understand both their own and their partner's learned attitudes that distract them from maintaining a faithful marriage. Several cases illustrate these fundamental therapeutic tasks.

Adaptation, Psychological↗