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Research on sexual behavior in late life is limited but is growing. Despite ageist stereotypes associating old age with asexuality, older adults continue to desire and engage in sexual behavior. Previous studies have examined the relationship between health and the ability to engage in sexual behavior, sexual satisfaction, desire, or interest in sex. Research has yet to examine the potential reverse of this relationship, where sexual behavior may serve as a protective factor against health outcomes. This dissertation examined three research questions to test the relationship between sexual activity or hugging and self-reported health outcomes (e.g., arthritis and diabetes) and biomarkers (e.g., C-reactive protein (CRP) and hemoglobin (HbA1c)). The first question explored whether sexual activity or hugging is associated health outcomes. The second question explored whether social support modifies the relationship between sexual activity or hugging and health outcomes. The final question explored whether sexual activity or hugging and demographic or health variables interact as moderators to health outcomes. This study examined data of older adults between 57 and 85 years, from two waves of the National Social Life, Health, and Aging Project (NSHAP). The subjective health outcomes were self-reported arthritis and self-reported diabetes diagnoses. Objective health measures were analyzed using biomarkers. Both C-reactive protein and HbA1c were collected from dried blood spots. The main independent variables of interest were sexual activity and hugging. Sexual activity was assessed by combining participant responses to frequency of intercourse, foreplay and masturbation in the last 12 months. Hugging was assessed by participant responses to frequency of close physical contact over the last 12 months. Results from question one indicated at wave 1, engaging in hugging was associated with higher likelihood of self-reported arthritis (OR = 1.23, p = 0.029), while sexual activity was associated with decreased likelihood of diabetes (OR = 0.61, p < 0.001). Examining objective markers of health, sexual activity was associated with 0.25 points lower HbA1c level (p < 0.001). Although some significant results were found at wave 1, none of the associations remained significant when examining change in health at wave 2. The findings from question two examined the interaction of social support and sexual activity or hugging on health outcomes. The interactions between social support and sexual activity or social support and hugging did not significantly influence health at wave 1 or change in health at 2. Question three examined potential moderators of the relationship between sexual activity or hugging and health, including age, race, education, income, gender, and hours of sleep. At wave 1, the findings showed a significant interaction between race and sexual activity associated with a decreased likelihood of reporting arthritis (OR = 0.79, p = 0.021). A significant interaction of age and sexual activity was associated with an increased likelihood of diabetes (OR = 1.04, p = 0.008). At wave 2, a significant interaction between age and hugging was associated with decreased likelihood of arthritis (OR = 0.97, p = 0.006), while the interaction term of sleep and hugging was associated with increased likelihood of diabetes (OR = 1.19, p = 0.015). The results from this study show some support for the exploration of a potential bi-directional pathway between sexual activity or hugging and health. This study provides some evidence indicating the importance of understanding the role of sexual activity or hugging in the lives of older adults, and the possible influence on physical health. Future studies should continue exploring this pathway indicating possible benefits of engaging in sexual activity or hugging on health, and a larger impact on quality of life for older adults who desire to maintain intimate relationships in late life.

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Sexual experiences of 1255 adolescents admitted to a juvenile detention facility were assessed through their responses to a health history questionnaire. More than 80% reported sexual experience. Age at first intercourse acknowledged by females was early (mean 13 years) but rarely prepubertal and was similar for blacks and non-blacks. Males commonly reported beginning sexual experience before age 10 years (40% in blacks and 20% in nonblacks). Sexual activity continued in most, with 73% of the sexually experienced teens reporting intercourse in the month prior to admission. Reports of recent sexual activity increased with age in all race/gender groups. For females, 26% reported sexual misuse compared to 2% of the males. Willingness to answer questions about sexual experiences varied with the question and increased with age. Prepubertal sexual activity is a more common phenomenon than is generally acknowledged. To what extent the experiences reported in our study represent the norm for behavior among individuals of similar back-ground requires further study.

This study examined associations between the prevalence of HIV testing and factors or behaviors that influence HIV testing in U.S.A. 9th to 12th graders using the 2017 Youth Risk Behavior Surveillance Survey (YRBSS) data. Selection criteria was based on a positive report of sexual debut (Ever had sex? Yes/No). Outcome of interest was having ever tested for HIV. Independent risk factors included age, sex, grade, race, condom use, age at first sexual intercourse, number of lifetime sexual partners, use of contraceptives, use of drug or alcohol before last sexual activity and several other factors. Chi-square and logistic regression analyses were conducted to evaluate factors associated with HIV screening participation. HIV testing prevalence was 20.34%. Females (53.97%) were more likely to participate in HIV screening test than males (67.37% females versus 32.63% males) and had higher odds of testing (OR: 2.229; p <.0001). Those in 11th and 12th grade, aged greater than 16 and with multiple sexual partners had higher rates of HIV testing. Strongest associations with HIV testing were older age at 1st sexual intercourse, odds ratio (OR): 0.413; (p ≤.0001), having three or more sexual partners (OR: 2.023; p ≤.0001), being female (OR: 2.021; p ≤.0001), use of contraceptives (OR: 1.828; p ≤.0001) and describing grades in school as mostly A’s or B’s (OR: 0.696; p ≤.001).

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Patients with brain injuries can encounter several neurological symptoms that affect physical and psychological functioning. This change in function can impact sexual health and intimacy. Patients with brain injuries who are referred to acute rehabilitation hospitals spend three hours a day in therapy. These patients develop rapport with their occupational therapy practitioners (OTPs) who are in a unique position to address sexual health and intimacy concerns. There is limited research on occupational therapy (OT) interventions for sexual health and intimacy with adults after brain injury. This paper proposes an application program that addresses sexual health and intimacy education for patients with brain injuries receiving occupational therapy. The smartphone application, Comfort, will assist occupational therapists to overcome barriers to include sexual health and intimacy in client-centered and occupation-based care.

The purpose of the study was to find the relationship between adolescent premarital sexual activity and involvement in the family, school, and church. The sample was composed of 192 adolescents. The data were analyzed for significant relationships by using chi square test of independence. The study found that there were significant relationships between adolescent premarital sexual activity and family structure, family mobility, parental employment, grade level achievement, and parental attendance at school functions. Since the findings of a study of this nature are pertinent to society, further research needs to be done using a more heterogeneous sample and a more refined, limited instrument. The instrument should be further tested for reliability and validity.