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Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults

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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (30 June 2021) | Viewed by 106321

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Special Issue Editors

Prof. Dr. David L. Rowland

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Guest Editor

Department of Psychology, Valparaiso University, Valparaiso, IN 46383, USA
Interests: sexual psychology; sexual behavior; sexual response; sexual dysfunction in men and women; psychological distress; sexual health; sexual psychophysiology; cross-cultural perspectives
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Zainab Zadeh

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Guest Editor

Institute of Professional Psychology, Bahria University, Karachi, Pakistan
Interests: marriage systems in Pakistan and socio-economic dynamics; mental health issues in young adults; intervention based studies in Pakistani youth; disability and youth; emotional intelligence, work stress and gender

Dr. Nieves Moyano

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Guest Editor

Department of Psychology, Faculty of Humanities and Education Sciences, University of Jaén, CP 23009 Jaén, Spain
Interests: sexuality; gender; validation; cognition; education
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are organizing a Feature Paper Special Issue on the “Intersections of Mental and Sexual Health in Youth and Adults” for the International Journal of Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information about the journal, we refer you to https://www.mdpi.com/journal/ijerph.

Sexual health is a global issue of critical importance, and while medical and social resources are often devoted to reproductive health and function, sexual health is often not viewed as a priority. As a result, a dearth of information is available regarding the sexual experiences of men and women across large swaths of the world, their covariates, and their consequences on the psychological well-being of individuals and their relationships. Stark racial, cultural, economic, and educational disparities characterizing these populations are frequently linked to differences in psychological and sexual health, with the two often being intertwined. In this Special Issue, we invite and encourage global/international/cross-cultural perspectives on the intersections of physical, mental, and sexual health, with sexual health broadly defined by the key phrases listed below. We express further interest in understudied phenomena (e.g., paraphilia in non-Western cultures), understudied problems in various areas of the world (Asia, Africa, etc.), and understudied populations, including vulnerable peoples—whether beset by comorbidities/disease/disability or by oppression or neglect. The goal is to bring to light issues concerning sexuality by provoking thought, initiating discussion, and suggesting strategies for understanding and improving sexual health in all types of settings—both high- and low-resource environments.

Prof. Dr. David L. Rowland
Prof. Dr. Nieves Moyano
Prof. Dr. Zainab Zadeh
Guest Editors

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Keywords

sexual health (including sexual response, sexual satisfaction, sexual dysfunction)
gender issues and sexual identity
disability, disease, and sexuality
sexual abuse/victimization/trafficking
sexuality, illness, and disease (including mental illness)
sexual diseases and mental health
sexuality in vulnerable populations, including the aged
paraphilic and sexual diversity (e.g., sexual addictions, non-conventional practices, etc.)
drug use/addiction and sexuality
treatment of sex-related issues (particularly mental health based treatment)
sex education for adolescents and adults

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Published Papers (13 papers)

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15 pages, 582 KiB

Open AccessArticle

Sextech Use as a Potential Mental Health Reprieve: The Role of Anxiety, Depression, and Loneliness in Seeking Sex Online

by Alexandra S. Marcotte, Ellen M. Kaufman, Jessica T. Campbell, Tania A. Reynolds, Justin R. Garcia and Amanda N. Gesselman

Int. J. Environ. Res. Public Health 2021, 18(17), 8924; https://doi.org/10.3390/ijerph18178924 - 25 Aug 2021

Cited by 11 | Viewed by 6626

Abstract

Depression, anxiety, and loneliness have long been recognized as global mental health concerns. To temporarily relieve psychological distress, self-soothing behavior is common, including engagement in sexual behaviors that are linked to positive mental well-being. Considering the COVID-19 pandemic further exacerbated many mental health ailments alongside physical distancing regulations, we specifically examined online sexual behavior via the use of emergent digital sexual technologies, or sextech. In a 2019 study of 8004 American adults, we assessed whether people experiencing higher anxiety, depression, and/or loneliness were more likely to engage in sextech use. Furthermore, we examined whether anxiety or depression mediated the association between loneliness and sextech use, as loneliness is one contributor to anxiety and depression. People with higher anxiety and depression were more likely to engage in sextech. However, those who were more lonely were less likely to engage with sextech, suggesting the aforementioned patterns were not due to lack of social connection. Our findings suggest people with mental health struggles may be drawn to interactive, digital forms of sexual behavior as a means of alleviating symptoms through distraction or self-soothing. This insight offers an important pathway for expanding the scope of mental health interventions, particularly as technology becomes increasingly prevalent and accessible in everyday life. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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15 pages, 1594 KiB

Open AccessArticle

Attention Bias and Recognition of Sexual Images in Depression

by Ondřej Novák, Klára Bártová and Kateřina Klapilová

Int. J. Environ. Res. Public Health 2021, 18(16), 8880; https://doi.org/10.3390/ijerph18168880 - 23 Aug 2021

Viewed by 2477

Abstract

Depression greatly affects sexuality. Theoretical and empirical evidence account for the existence of attention bias to sex-related stimuli. This attention bias might be impaired in depression, resulting in sexual problems. A sample of 13 patients with depression and 13 matched healthy controls were tested using the dot-probe and picture recognition task to measure attention to erotic images. No difference in attention to sex-related stimuli (ω² = 0, p = 0.22) and in memory bias (ω² = 0, p = 0.72) was found between the two groups. Explorative analyses were conducted to identify the sexual content-induced delay effect in the data, assess variability differences, and compare trial-level bias score-based indexes between groups. Across all analyses, there was little evidence for depression affecting sexual-related cognitive processing, and even this might be explained by other means. Our results suggest that restrained attention is probably not the main factor behind sexual problems in depression. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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14 pages, 364 KiB

Open AccessFeature PaperArticle

Depression as a Function of Social Support in Transgender and Cisgender Individuals with Sexually Transmitted Diseases

by Tahira Yousuf, Mahwish Naz, Candace B. Roberson, Suzanna M. Wise and David L. Rowland

Int. J. Environ. Res. Public Health 2021, 18(5), 2462; https://doi.org/10.3390/ijerph18052462 - 3 Mar 2021

Cited by 2 | Viewed by 2896

Abstract

This study focused on the relationships among social support, self-esteem, and depression in transgender and cisgender individuals suffering from an incurable or curable sexually transmitted disease. Data were collected from 210 participants with an STI using a semi-structured interview along with culturally adapted standardized instruments. Results indicated no differences between transgender and cisgender groups in depression, although there were large differences in social support and self-esteem. Preliminary regression analysis identified only STI type and duration of STI as significant predictors of depression. However, when moderating roles for both social support and self-esteem were tested, each added to the explained variance and, equally importantly, revealed the effects of both gender status and social support on depression. These findings not only demonstrate how the compound stressors of gender minority status and STI type affect depressive symptoms, but also reveal the critical role that social support can play in mitigating depressive symptoms in those with gender minority status. Findings are interpreted within the context of South/Central Asian cultures that have pre- and post-colonial traditions regarding the social role of non-binary individuals. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

10 pages, 349 KiB

Open AccessArticle

Self-Esteem, Attitudes toward Love, and Sexual Assertiveness among Pregnant Adolescents

by Nieves Moyano, Reina Granados, Christian Andrés Durán and Carlos Galarza

Int. J. Environ. Res. Public Health 2021, 18(3), 1270; https://doi.org/10.3390/ijerph18031270 - 31 Jan 2021

Cited by 12 | Viewed by 6697

Abstract

Adolescence is a stage of growth and development of great relevance. Unplanned teenage pregnancies can be considered a global public health problem due to the high impact on the present and future of these young people, as well as their possible offspring. The aim of this study was to analyze the relationship between self-esteem, attitudes toward love, and sexual assertiveness among pregnant and non-pregnant teenagers. We also considered whether their pregnancy was planned or not. The study was conducted with 225 women from Ecuador (34.2% pregnant; Mean age = 16; SD = 1.15). We administered self-reported measures such as the Rosenberg Self-Esteem Scale, the Love Attitudes Scale, and the Sexual Assertiveness Scale between 2018 and 2019. Self-esteem was higher in adolescents with a planned pregnancy than in those women whose pregnancy was not planned. Pregnant women reported greater acceptance and endorsement of beliefs related to the myth of “soulmate” in comparison to non-pregnant women. Sexual assertiveness related to the negotiation of the use of contraceptive methods was greater in non-pregnant adolescents than in pregnant girls. We discuss the implications of our findings in terms of sexual education and prevention in the sex education field. This study shows differences in self-esteem, attitudes toward love, and sexual assertiveness between pregnant and non-pregnant adolescents. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

18 pages, 1095 KiB

Open AccessArticle

Harm Reduction Practices and Needs in a Belgian Chemsex Context: Findings from a Qualitative Study

by Corinne Herrijgers, Karolien Poels, Heidi Vandebosch, Tom Platteau, Jacques van Lankveld and Eric Florence

Int. J. Environ. Res. Public Health 2020, 17(23), 9081; https://doi.org/10.3390/ijerph17239081 - 4 Dec 2020

Cited by 28 | Viewed by 4278

Abstract

Chemsex is a growing public health concern, with little evidence-based care and support available. The aim of this study is to understand current risk reduction practices, and the information and care needs of gay, bisexual, and other men who have sex with men (GBMSM) who engage in chemsex. Between January and March 2020, semi structured in-depth interviews with drug-using GBMSM (n = 20) were conducted. Data were analyzed thematically. The reported preparatory measures were: deliberately scheduling chemsex sessions, and discussing preferences regarding setting and attendees. During the event, a logbook is kept to monitor drugs taken by each participant. People try to take care of each other, but this is often counteracted. Respondents highlighted needs: reliable and easily-accessible information, anonymous medical and psychological healthcare, chemsex-specific care, and a value-neutral safe space to talk about chemsex experiences. Results imply two types of users: planned and impulsive users. Adherence to intended harm reduction practices are complicated by drug effects, peer pressure, and feelings of distrust among users. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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17 pages, 407 KiB

Open AccessArticle

Tinder Users: Sociodemographic, Psychological, and Psychosexual Characteristics

by Juan Ramón Barrada and Ángel Castro

Int. J. Environ. Res. Public Health 2020, 17(21), 8047; https://doi.org/10.3390/ijerph17218047 - 31 Oct 2020

Cited by 17 | Viewed by 11678

Abstract

Tinder is the most popular and most used dating app in the world today. Due to the recent popularization of the phenomenon of dating apps, there are still some gaps in the literature. Therefore, this study had a threefold objective: (1) to determine the prevalence and characteristics of Tinder users and Tinder use among young university students; (2) to know why these young people use Tinder; and (3) to analyze the relationship between Tinder use and different psychosocial correlates (positive and negative affect, body satisfaction, sociosexuality, and attitudes towards consensual nonmonogamy) and psychosexual well-being (self-esteem as a sexual partner, satisfaction with sex life, and preoccupation with sex). Participants were 1261 Spanish university students (77.4% women, 77.5% heterosexuals) between ages 18 and 26 (M = 20.59, SD = 2.04) who completed a battery of online questionnaires. A prevalence of Tinder use of about 15% was found. The motives for use most frequently reported by the participants were those of curiosity, passing time/entertainment, and sexual orientation. Besides, Tinder users showed greater sociosexuality than nonusers, as well as increased dissatisfaction with their sex life and sexual preoccupation, and more positive attitudes towards consensual nonmonogamy. Importantly, no or very small differences were found in the general emotional well-being-related variables. Tinder seems like just another tool used by young people for their romantic and/or sexual interactions, without any negative connotation. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

13 pages, 1063 KiB

Open AccessArticle

A Transdiagnostic Approach to Sexual Distress and Sexual Pleasure: A Preliminary Mediation Study with Repetitive Negative Thinking

by Patrícia M. Pascoal, Catarina F. Raposo and Magda Sofia Roberto

Int. J. Environ. Res. Public Health 2020, 17(21), 7864; https://doi.org/10.3390/ijerph17217864 - 27 Oct 2020

Cited by 18 | Viewed by 4414

Abstract

Sexual distress is a core characteristic of sexual dysfunction; however, little is known about its correlates. In the current study, we aimed to contribute to the understanding of both sexual distress and its positive counterpart, sexual pleasure, by taking a transdiagnostic approach to sexual distress using two types of repetitive negative thinking: worry and rumination. Because sexual activity mostly occurs in a dyadic context, we also looked at the potential mediating effect of co-worry and co-rumination, and we used them as mediators. Our preliminary exploratory quantitative study used a cross-sectional design, with a sample of 206 partnered heterosexual people. We used path analysis with parallel mediation, with structural equation modelling being performed using lavaan designed for R environment. Overall, our results show that repetitive negative thinking is associated with both sexual distress and sexual pleasure, and that neither co-rumination nor co-worry mediates these associations. The exception is the indirect effect of rumination on sexual pleasure that is mediated by co-rumination. These results demonstrate that a transdiagnostic approach to sexual distress is a new field worth exploring, and they contribute to establishing the relevance of a cognitive approach to sexual dysfunction. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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15 pages, 579 KiB

Open AccessArticle

Three Diagnoses for Problematic Hypersexuality; Which Criteria Predict Help-Seeking Behavior?

by Piet van Tuijl, Aerjen Tamminga, Gert-Jan Meerkerk, Peter Verboon, Ruslan Leontjevas and Jacques van Lankveld

Int. J. Environ. Res. Public Health 2020, 17(18), 6907; https://doi.org/10.3390/ijerph17186907 - 21 Sep 2020

Cited by 8 | Viewed by 8150

Abstract

This study aimed to assess the best combination of indicators of problematic hypersexuality (PH), in a survey (n = 58,158) targeting individuals wondering if they were sex addicted. The survey allowed for testing of criteria from three theoretical models used to conceptualize PH. Factor analyses for women and men yielded an interpretable grouping of indicators consisting of four factors. In subsequent logistic regressions, these factors were used as predictors for experiencing the need for help for PH. The factors Negative Effects and Extreme positively predicted experiencing the need for help, with Negative Effects as the most important predictor for both women and men. This factor included, among others, withdrawal symptoms and loss of pleasure. The Sexual Desire factor negatively predicted the need for help, suggesting that for the targeted population more sexual desire leads to less PH. The Coping factor did not predict experiencing the need for help. Outcomes show that a combination of indicators from different theoretical models best indicates the presence of PH. Therefore, a measurement instrument to assess existence and severity of PH should consist of such a combination. Theoretically, this study suggests that a more comprehensive model for PH is needed, surpassing existing conceptualizations of PH. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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13 pages, 911 KiB

Open AccessArticle

Can Physical and/or Sexual Abuse Play a Role in the Female Choice of a Partner? A Cross-Sectional, Correlational Pilot Study

by Erika Limoncin, Caterina Solano, Giacomo Ciocca, Daniele Mollaioli, Elena Colonnello, Andrea Sansone, Filippo Maria Nimbi, Chiara Simonelli, Renata Tambelli and Emmanuele Angelo Jannini

Int. J. Environ. Res. Public Health 2020, 17(18), 6902; https://doi.org/10.3390/ijerph17186902 - 21 Sep 2020

Cited by 5 | Viewed by 2714

Abstract

The present study aims to evaluate the relationship in women between a history of physical/sexual abuse and the preferences regarding the choice of a partner for a short/long-term relationship in terms of male facial dimorphism, and to assess their sexual functioning. We enrolled 48 abused women and 60 non-abused women. Facial preferences were evaluated with the Morphing test. Sexual functioning was measured with the Female Sexual Function Index (FSFI). Regarding the choice for a short-term partner, abused and non-abused women did not show any differences, and both groups chose a less masculine male face. On the other hand, regarding the choice for a long-term partner, abused women showed a preference for an average male face, whilst non-abused women preferred a less masculine face. The sexual functioning of abused women was found significantly dysfunctional in all domains of the FSFI. These data, generated from a small but highly selected cohort, demonstrated that physical/sexual abuse may be associated with a more rational and conscious choice of a male partner for a long-term relationship, but not with an instinctive one, as the choice of an occasional partner. In addition, the sexual functioning of abused women appears to be compromised by the traumatic experience. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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9 pages, 312 KiB

Open AccessArticle

Comparison of Self-Reported Sexual Activity Among Heterosexuals with Sexual Spread of Poorly Transmittable Agents: A Minimalistic Approach to Estimating Sexual Activity Based on HIV Incidence

by Andreas Hahn, Christoph Kröger, Christian G. Meyer, Ulrike Loderstädt, Thomas Meyer, Hagen Frickmann and Andreas Erich Zautner

Int. J. Environ. Res. Public Health 2020, 17(15), 5504; https://doi.org/10.3390/ijerph17155504 - 30 Jul 2020

Cited by 3 | Viewed by 1933

Abstract

The aim of this study was to assess whether epidemics of sexually transmitted infections caused by poorly transmittable agents corresponded to self-reported sexual activity in a distinct population. To exemplify this, a model was used to investigate whether HIV infection incidences corresponded to the extent of sexual activity as assessed by a questionnaire-based study. The model suggested between 97 and 486 sexual contacts per German individual during a sexually active lifetime based on the annual HIV incidence of 680 among the heterosexual population reported by the German National Health Authority. This is in line with the estimated 296 sexual contacts during one’s lifetime, which was indicated by questionnaire respondents. The model confirms the correspondence of self-reported sexual activity with HIV incidence as reported by the German National Health Authority. Accordingly, HIV incidence- and prevalence-based modeling of sexual activity in a population provides crude estimations in situations where a range of uncertainty is acceptable. The model’s veracity is limited by a number of assumptions necessitated by the paucity of data. Nevertheless, the model may be suitable in settings where severe reporting bias has to be expected for legal or socio-cultural reasons. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

17 pages, 1281 KiB

Open AccessArticle

An Explanatory Model of Sexual Satisfaction in Adults with a Same-Sex Partner: An Analysis Based on Gender Differences

by Cristóbal Calvillo, María del Mar Sánchez-Fuentes and Juan Carlos Sierra

Int. J. Environ. Res. Public Health 2020, 17(10), 3393; https://doi.org/10.3390/ijerph17103393 - 13 May 2020

Cited by 29 | Viewed by 9167

Abstract

This study aimed to develop an explanatory model of sexual satisfaction in same-sex attracted individuals with a partner, based on personal and interpersonal variables. The participants were 410 men (mean age = 29.24, SD = 9.84) and 410 women (mean age = 29, SD = 8.57) who maintained a relationship with another person of the same sex. Internalized homophobia was considered as a personal variable, and as interpersonal variables, the dimensions of attachment (anxiety and avoidance), sexual functioning, dyadic adjustment, relationship satisfaction, the components of the Interpersonal Exchange Model of Sexual Satisfaction, the number of sexual costs and the number of sexual rewards were considered. The degree to which sexual satisfaction was related to these variables was examined separately, for both men and women, through multiple linear regression models within the framework of structural equation models. The results indicated that sexual satisfaction is associated in a negative sense with internalized homophobia, the number of sexual costs, anxiety, and avoidance, and in a positive sense with the remaining variables. Relational variables were more relevant in the explanation of sexual satisfaction. The clinical implications are discussed. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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16 pages, 357 KiB

Open AccessArticle

Effects of Pornography Use and Demographic Parameters on Sexual Response during Masturbation and Partnered Sex in Women

by Sean M. McNabney, Krisztina Hevesi and David L. Rowland

Int. J. Environ. Res. Public Health 2020, 17(9), 3130; https://doi.org/10.3390/ijerph17093130 - 30 Apr 2020

Cited by 23 | Viewed by 38424

Abstract

The effect of pornography on sexual response is understudied, particularly among women. A multinational, community-based sample of 2433 women at least 18 years of age completed a 42-item, opt-in questionnaire collecting information on demographic and sexual history characteristics, use of pornography during masturbation, frequency of pornography use, and sexual response parameters. Pornography use and average frequency were compared across demographic variables. We also examined how pornography frequency predicted differences in self-reported arousal difficulty; orgasmic difficulty, latency, and pleasure; and the percent of sexual activities ending in orgasm during both masturbation and partnered sex. On average, women using pornography were younger, and reported more interest in sex. Pornography frequency differed significantly by menopausal status, sexual orientation, anxiety/depression status, number of sexual partners, and origin of data collection. During masturbation, more frequent pornography use predicted lower arousal difficulty and orgasmic difficulty, greater pleasure, and a higher percentage of masturbatory events leading to orgasm. Frequency of pornography use predicted only lower arousal difficulty and longer orgasmic latencies during partnered sex, having no effect on the other outcome variables. Pornography use frequency did not predict overall relationship satisfaction or sexual relationship satisfaction. Overall, more frequent pornography use was generally associated with more favorable sexual response outcomes during masturbation, while not affecting most partnered sex parameters. Several demographic and relationship covariates appear to more consistently and strongly predict orgasmic problems during partnered sexual activity than pornography use. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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25 pages, 900 KiB

Open AccessSystematic Review

Improving the Sexual Health of Young People (under 25) in High-Risk Populations: A Systematic Review of Behavioural and Psychosocial Interventions

by Ellie Brown, Samantha Lo Monaco, Brian O’Donoghue, Hayley Nolan, Elizabeth Hughes, Melissa Graham, Magenta Simmons and Richard Gray

Int. J. Environ. Res. Public Health 2021, 18(17), 9063; https://doi.org/10.3390/ijerph18179063 - 27 Aug 2021

Cited by 6 | Viewed by 4721

Abstract

Background: Ensuring young people experience good sexual health is a key public health concern, yet some vulnerable groups of young people remain at higher risk of poor sexual health. These individuals require additional support to achieve good sexual health but the best way to provide this remains needs to be better understood. Methods: We searched for randomised controlled trials of behavioural and psychosocial interventions aimed at promoting sexual health in high-risk young populations. Outcomes of interest were indicators of sexual health (e.g., condom use, attitudes to contraception, knowledge of risk). Participants were under 25 years old and in one of the following high-risk groups: alcohol and other drug use; ethnic minority; homeless; justice-involved; LGBTQI+; mental ill-health; or out-of-home care. Results: Twenty-eight papers from 26 trials met our inclusion criteria, with all but one conducted in North America. Condom use was the most frequently reported outcome measure along with knowledge and attitudes towards sexual health but considerable differences in measures used made comparisons across studies difficult. Change in knowledge and attitudes did not consistently result in long-term change in behaviours. Conclusions: There remains a dearth of research undertaken outside of North America across all high-risk groups of young people. Future interventions should address sexual health more broadly than just the absence of negative biological outcomes, with LGBTQI+, homeless and mental ill-health populations targeted for such work. An international consensus on outcome measures would support the research field going forward, making future meta-analyses possible. Full article

(This article belongs to the Special Issue Feature Papers: Intersections of Mental and Sexual Health in Youth and Adults)

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