Australian Centre for Sexual Health

ABSTRACT Sexual revictimization can have a negative impact on many facets of women’s wellbeing, yet limited evidence exists regarding specific interventions that support healing and the reduction of further revictimization. This paper will explore regional and rural women’s experience of a group-based empowerment program, the Shark Cage program, in Victoria, Australia. The “Shark Cage” program aims to address revictimization by empowering women and girls to build personal boundaries and assertiveness within the context of gender equality and human rights. Data were collected via participant observations across the 8-week program, in combination with semi-structured interviews with participants (N = 11) pre and post intervention. All participants had access to therapeutic support outside of the program. Findings indicate that the program fostered connections among women with shared experiences of sexual revictimization, reducing feelings of isolation. Participants detailed the benefit of developing and practicing skills in reducing revictimization, such as assertiveness and boundary setting. Program learning and recovery was embedded within a network of embodied emotions, social connections, cultural norms and place-based relations that influenced how participants recovery could be understood, processed and addressed.

Fifteen years have passed since the International Society of Sexual Medicine first established the 3-pronged criteria for premature ejaculation (PE): a short ejaculation latency, lack of ejaculatory control, and bother/distress. Although the process of establishing valid criteria for any condition or disorder is an ongoing one, a dearth of targeted research on these criteria has hindered professional societies from updating and revising them. To review and critique existing criteria used in the diagnosis of PE, to identify specific problems with them, and to recommend studies that will address shortcomings. Each of the PE criteria was evaluated and compared against standard procedures for establishing validated measures. Following each analysis, targeted research to address the gaps has been recommended. Each PE criterion has shortcomings and each can be improved by using standard validation procedures, as noted by the targeted research outcomes. Professional societies can play an important role by encouraging broad participation in research that generates new and relevant data supporting, validating, or challenging the existing criteria. The concepts underlying the diagnostic criteria for PE have both broad consensus and functional utility. Nevertheless, much of the research investigating PE has uncritically adopted these criteria without concomitantly recognizing their limitations. These limitations prevent determining accurate prevalence rates, interpreting research findings with confidence, and establishing efficacious treatment outcomes. Rowland DL, Althof SE, McMahon CG. The Unfinished Business of Defining Premature Ejaculation: The Need for Targeted Research. Sex Med Rev 2022;10:323-340.

IntroductionThe National HPV Vaccination Program, utilising the quadrivalent HPV vaccine, was implemented in Australia in 2007. As the first country to introduce this scheme, Australia is ideally placed to identify changes in HPV genoprevalence in a vaccinated population, as well as in cervical intraepithelial neoplasia grade 3 (CIN3) lesions.MethodsThe VACCINE (Vaccine Against Cervical Cancer Impact and Effectiveness) study was designed to assess prevalence of vaccine-targeted HPV genotype infections. In sub-study A, sexually active Victorian women aged 18–25 years, recruited through targeted social media advertising on Facebook, were asked to complete an online questionnaire and provide a self-collected vaginal swab for HPV DNA genotyping. The National HPV Vaccination Program Register (NHVPR) was utilised to verify self-reported vaccination status. In sub-study B, causal HPV genotypes in 529 CIN3 cases among vaccine-eligible young women were determined using laser capture microdissection and compared with pre-vaccine era data.ResultsIn sub-study A, 1095 participants were recruited (18% were virginal so no swab was collected) and 774 (77%) completed all study requirements. Vaccine-targeted HPV genotypes were detected in only 13 samples (1.7%); 11 HPV16 and two HPV6: none were in participants vaccinated prior to sexual debut. In sub-study B, 333 women (62.9%) had a HPV16/18 positive CIN3 detected. The pre-vaccine era population included 98 women aged 18–25, and 115 women aged 26–32, recruited between 2001 and 2005. Compared to the pre-vaccine cohort, the proportion of HPV16/18 positive CIN3 was significantly lower in the post-vaccine 18–25 year old group (71.4% vs 54.9%, p=0.009), but was not significantly different in the 26–32 year old age group (61.7% vs 65.9%, p=0.409). ConclusionThe VACCINE study demonstrates that vaccine-related HPV genotype prevalence is remarkably low amongst vaccine-eligible Victorian women, and also demonstrates a reduction in the proportion of CIN3 caused by vaccine preventable HPV types in younger, vaccine-eligible women. Support:I Professor Suzanne Garland, have received Grants to my institution from Commonwealth Department of Health for HPV genoprevalance surveillance post vaccination, Merck and GSK (GlaxoSmithKline) to perform phase 3 clinical vaccine trials: Merck to evaluate HPV in RRP post vaccination programme, CSL for HPV in cervical cancer study, and VCA (Victoria Cancer Agency) for a study on effectiveness of public health HPV vaccine study plus a study on associations of early onset cancers. I have received speaking fees from MSD and SPMSD for work performed in my personal time. Merck paid for travel and accommodation to present at HPV Advisory board meetings.

While male sex work (MSW) is a highly gendered practice involving the commodification of the male body, masculinity has rarely been examined to understand this new occupational environment. Semi-structured interviews were conducted with twenty male independent internet-based escorts in Brisbane, Australia. Masculinity was used as a conceptual tool to understand the nuances of the escorting experience, resulting in two themes: Endurance and Technical Skill. These themes were aligned with hegemonic expressions of masculinity, a system that orders masculinity into a hierarchy and potentially marginalises escorts. Participants thus used features of a system that subordinated them to attain primacy in the same framework, avoiding stigma. These themes described were far removed from dialogues of deviance oft-repeated by past sex work research, and instead bolster the view that male escorting is moving toward a paradigm of normalisation. We thus argue that masculinity is a critical conceptual tool in understanding the contemporary dynamics of the male escorting experience as it becomes increasingly normalised.

Rates of sexually transmitted infections (STIs) are increasing in older cohorts in Western countries such as Australia, the United Kingdom, and the United States, suggesting a need to examine the safer sex knowledge and practices of older people. This article presents findings from 53 qualitative interviews from the study Sex, Age, and Me: A National Study of Sex and Relationships Among Australians Aged 60+. Participants were recruited through an online national survey. We consider how participants understood “safer sex,” the importance of safer sex to them, the safer sex practices they used (and the contexts in which they used them), and the barriers to using safer sex. Older adults had diverse understandings, knowledge, and use of safer sex practices, although participants tended to focus most strongly on condom use. Having safer sex was strongly mediated by relationship context, trust, perceived risk of contracting an STI, concern for personal health, and stigma. Common barriers to safer sex included erectile difficulties, embarrassment, stigma, reduced pleasure, and the lack of a safer sex culture among older people. The data presented have important implications for sexual health policy, practice, and education and health promotion campaigns aimed at improving the sexual health and well-being of older cohorts.

The second Ad Hoc International Society for Sexual Medicine (ISSM) Committee for the Definition of Premature Ejaculation defined acquired premature ejaculation (PE) as a male sexual dysfunction characterized by a the development of a clinically significant and bothersome reduction in ejaculation latency time in men with previous normal ejaculatory experiences, often to about 3 minutes or less, the inability to delay ejaculation on all or nearly all vaginal penetrations, and the presence of negative personal consequences, such as distress, bother, frustration and/or the avoidance of sexual intimacy. The literature contains a diverse range of biological and psychological etiological theories. Acquired PE is commonly due to sexual performance anxiety, psychological or relationship problems, erectile dysfunction (ED), and occasionally prostatitis and hyperthyroidism, consistent with the predominant organic etiology of acquired PE, men with this complaint are usually older, have a higher mean BMI and a greater incidence of comorbid disease including hypertension, sexual desire disorder, diabetes mellitus, chronic prostatitis, and ED compared to lifelong, variable and subjective PE.