Brian Dodge

Interests

No activities entered.

Courses

Scholarly Contributions

Journals/Publications

• McGray, T. L., Dodge, B., Peterson, Z. D., Bedrick, E. J., & Koss, M. P. (2025). Examining Sexual Exploitation in a National US Sample of LGBTQ+ Individuals Using the Revised Sexual Experiences Survey-Victimization. Journal of sex research, 1-18.
  More info

  Sexual exploitation (SE) refers to sex acts imposed without freely given permission. Despite the elevated risks of SE experienced by LGBTQ+ individuals, limitations in many existing datasets and research reports preclude a comprehensive understanding by incorporating few LGBTQ+ individuals, not disaggregating by sexual orientation and gender identity (SOGI), and using non-inclusive measures of SE items. This paper presents the first use of the 2024 revised Sexual Experiences Survey-Victimization to quantify SE in a national adult LGBTQ+ sample ( = 474) using measurement beyond prototypical cisgender heterosexual scenarios. Prevalences of noncontact, technology-facilitated, illegal acts, and verbal pressure SE were stratified by SOGI. Logistic regression was used to assess associations between SOGI and SE. Findings suggest alarmingly high sample-wide prevalence, with 95.23% of participants reporting any experience of SE. Asexual and lesbian cisgender women had significantly lower odds of experiencing verbal pressure and illegal acts than bisexual cisgender women. High prevalence provides evidence for the urgent need to continue investigating LGBTQ+ SE, particularly illegal acts and technology-facilitated SE. Future research should oversample underrepresented SOGI subgroups to bolster cell sizes and increase reliability. Understanding LGBTQ+ SE is essential for informing targeted prevention and intervention.
• Ferrand, J., Dodge, B., Eastman-Mueller, H., Carter, G., Green, H., & Walsh-Buhi, E. (2024). Correlates of pre-exposure prophylaxis (PrEP) use among college students in the United States. Journal of HIV/AIDS & Social Services, 1-22.
• McGray, T., Hutton, B., Dodge, B., & Koss, M. (2024). Effects of social support interventions on LGBTQ+ survivor-victims of intimate partner violence: a systematic review. Sexual and Gender Diversity in Social Services, 1-33.
• Feinstein, B. A., Ford, J. V., Lattanner, M. R., Bo, N., Tu, W., & Dodge, B. (2023). The Role of Partner Gender in Bisexual Men's Stigma-Related Experiences and Mental Health: Results From a Probability-Based Sample in the United States. Stigma and health, 8(2), 179-186.
  More info

  Bisexual men are disproportionately affected by negative mental health outcomes compared to heterosexual and gay men. These disparities are related to the unique stressors that they experience, and emerging evidence suggests that their experiences of these stressors can be different depending on the gender of their partner. However, previous studies have largely focused on bisexual women and little is known about the role of partner gender in bisexual men's experiences and mental health. We examined the associations between relationship type and outness, stigma-related experiences, and mental health using data from Wave 1 of the National Study of Stigma and Sexual Health, a probability-based sample of 502 gay and bisexual men in the U.S. Analyses focused on the subset of 128 men who identified as bisexual (44.53% in relationships with women, 14.84% in relationships with men, 40.63% not in relationships). Bisexual men in relationships with men reported being more out than those in relationships with women and those who were not in relationships; furthermore, bisexual men in relationships with men reported more discrimination and family stress than those in relationships with women. Bisexual men who were not in relationships reported more anticipated and internalized stigma than those in relationships with men; additionally, bisexual men who were not in relationships reported more anticipated stigma and depression than those in relationships with women. Partner gender plays a role in bisexual men's stigma-related experiences and mental health, and efforts to improve bisexual men's health should attend to sexual orientation, relationship status, and partner gender.
• Ferrand, J., Walsh-Buhi, E., Dodge, B., Svetina, D., & Herbenick, D. (2023). Variations in Pre-exposure Prophylaxis (PrEP) Awareness and Healthcare Provider Interactions in a Nationally Representative Sample of American Men Aged 15-49 Years: A Cross-Sectional Study. AIDS and behavior, 27(9), 2932-2943.
  More info

  Awareness of and discussions with a healthcare provider (HCP) around pre-exposure prophylaxis (PrEP), an effective HIV prevention method, are associated with PrEP uptake, yet few studies utilize representative samples or report on these outcomes using distinct behavioral risk subgroups. This cross-sectional study utilized responses given by men on the 2017-2019 National Survey of Family Growth, a nationally representative survey of Americans aged 15-49 years. Multiple logistic regression models were used to determine how respondents' sociodemographic characteristics and HIV risk behaviors were related to PrEP awareness and HCP discussions. PrEP awareness was low (29.40%) as was the proportion who reported ever discussing PrEP with an HCP (4.48%). Odds of being PrEP aware and discussing PrEP with an HCP varied significantly within sexual behavior subgroups based on sociodemographic and behavioral characteristics highlighting the differential risks within distinct behavioral subgroupings of men. Sexual behavior subgroupings should be considered when promoting PrEP awareness and discussions as HIV risk behaviors vary considerably and sexual identity alone may not sufficiently capture one's HIV risk.
• Mata, D., Korpak, A. K., Macaulay, T., Dodge, B., Mustanski, B., & Feinstein, B. A. (2023). Substance Use Experiences Among Bisexual, Pansexual, and Queer (Bi+) Male Youth: A Qualitative Study of Motivations, Consequences, and Decision Making. Archives of sexual behavior, 52(3), 1169-1181.
  More info

  Sexual minority youth are at increased risk of substance use compared to their heterosexual peers, and bisexual youth appear to be at greatest risk. However, little is known about their motivations for and against using substances, how they make decisions, and what consequences they experience. We used qualitative data from a study of 54 cisgender and transgender male youth (ages 14-17 years) who reported attractions to more than one gender or regardless of gender (i.e., bisexual, pansexual, or queer; collectively referred to as bi+) to explore these aspects of substance use. Participants completed a survey and an interview, and interviews were thematically analyzed. Qualitative analyses revealed that participants described diverse motivations for using substances (e.g., to cope with stress, to experiment, to have fun) and for not using them (e.g., concern about consequences, not having access). The most common sources of stress were mental health problems, school, and family. They did not describe sexual orientation-related stress as a motivation for their use, but they acknowledged that it could influence others' use. Participants also described thinking about when, where, and with whom they were going to use prior to doing so (e.g., only using in safe places and with people who they trusted). Finally, they described a range of consequences they experienced (e.g., getting sick, getting in trouble), and a subset of transgender participants described experiencing dependence symptoms. These findings suggest that substance use prevention and harm reduction interventions for bi+ male youth should address diverse motivations for use, including general stressors, which are often overlooked compared to minority-specific stressors. Further, interventions should approach youth as capable of making decisions. Findings also highlight the particular need to address substance use among transgender youth.
• Owens, C., Voorheis, E., Lester, J. N., Green, H. D., Herbenick, D., Dodge, B., & Hubach, R. D. (2023). The lived experiences of rural HIV social workers. AIDS care, 35(1), 48-52.
  More info

  HIV service providers are the primary implementers of HIV care services, but rural HIV service providers are under researched. We used an interpretative phenomenological analysis to explore rural HIV service providers' lived experiences of working in HIV care, who work in a rural region of a Midwestern state in the United States. From July to August 2019, 15 HIV service providers participated in a one-hour semi-structured telephone interview that elicited their experiences working in the rural HIV care continuum. Participants were tired of constantly educating and working to reduce HIV stigma; however, they received support from family and friends once they educated them about HIV. Participants felt they lacked control over systems and they developed emotional-based coping to address constant occupational stressors. Findings highlight the importance of resiliency and advocacy research and practice across ecological levels.
• Eastman-Mueller, H., Fu, T. C., Dodge, B. M., & Herbenick, D. (2022). The relationship between college students' campus sexual health resource utilization and self-reported STI testing: Findings from an undergraduate probability survey. Journal of American college health : J of ACH, 70(3), 843-851.
  More info

  To examine the prevalence of student utilization of campus sexual health resources and their association with sexually transmitted infection (STI) testing. Undergraduate students ( = 7020) at a large Midwestern university completed a confidential online survey in 2015. A probability-based sample of undergraduate students completed a cross-sectional online survey. Commonly accessed sexual health resources were student orientation activities about sexual assault or rape, sexuality/gender classes, gender and sexual orientation panels, class panels on sexual assault, birth control and STI presentations, and having joined a sexuality-related student organization. Campus sexual health resource utilization was significantly associated with greater STI testing since college. Gender, race, class level, enrollment status, sexual orientation, timing of last sexual event, and perceived STI risk were significantly associated with STI testing in college. Campus sexual health resources play an important role in student sexual health promotion.
• Fritz, N., Malic, V., Fu, T. C., Paul, B., Zhou, Y., Dodge, B., Fortenberry, J. D., & Herbenick, D. (2022). Porn Sex versus Real Sex: Sexual Behaviors Reported by a U.S. Probability Survey Compared to Depictions of Sex in Mainstream Internet-Based Male-Female Pornography. Archives of sexual behavior, 51(2), 1187-1200.
  More info

  Using data from a 2014 U.S. nationally representative probability survey and a 2014 content analysis of 2562 male-female videos from two popular pornographic websites, this study aimed to: (1) compare the prevalence of survey respondents' event-level sexual behaviors with those depicted in mainstream pornography online videos; (2) compare event-level condom use with condom use prevalence in pornographic videos; (3) compare event-level orgasm with prevalence of orgasms in pornographic videos; and (4) assess whether respondents' partnered use of pornography was associated with the sexual behaviors in which they report engaging. We found that kissing, male orgasm, female orgasm, and condom use were significantly less prevalent in the pornographic videos than in survey respondents' most recent sexual experiences. Conversely, penile-anal intercourse and fellatio were significantly more prevalent in the pornographic videos than in participants' reports of their most recent sexual experience. There were no significant differences between the prevalence of cunnilingus or sex toy use represented in the videos as compared to survey respondents' reports. Finally, we found that individuals who reported partnered pornography use during their most recent sexual experience were more likely to report having engaged in oral sex, penile-anal intercourse, and sex toy use and were also more likely to report female orgasm during their most recent sexual experience.
• Mata, D., Korpak, A. K., Sorensen, B., Dodge, B., Mustanski, B., & Feinstein, B. A. (2022). A mixed methods study of sexuality education experiences and preferences among bisexual, pansexual, and queer (bi+) male youth. Sexuality research & social policy : journal of NSRC : SR & SP, 19(2), 806-821.
  More info

  Bisexual male youth are more likely to engage in certain behaviors that contribute to HIV/STI transmission (e.g., substance use) than are heterosexual and gay male youth. However, sexuality education rarely addresses the unique needs of sexual minority youth, especially bisexual, pansexual, and queer (bi+) youth, and little is known about their sexuality education experiences and preferences. As such, the goal of this study was to examine bi+ male youth's experiences learning about sex and their preferences for sexuality education.
• Williams, D., Bartelt, E., Thomas, B., Guerra-Reyes, L., Carspecken, L., Rosenstock Gonzalez, Y. R., Klimek, S., & Dodge, B. (2022). Beyond the Boundaries: Exploring the Identity-Related Experiences of Biracial/Multiracial and Bisexual Adults. Archives of sexual behavior, 51(4), 2241-2259.
  More info

  Most prior bisexual research takes a monolithic approach to racial identity, and existing racial/ethnic minority research often overlooks bisexuality. Consequently, previous studies have rarely examined the experiences and unique health needs of biracial/multiracial and bisexual individuals. This exploratory qualitative study investigated the identity-related experiences of biracial/multiracial and bisexual adults within the context of health and well-being. Data were collected through 90-min semi-structured telephone interviews. Participants were recruited through online social network sites and included 24 adults between ages 18 and 59 years. We aimed to explore how identity-related experiences shape biracial/multiracial and bisexual individuals' identity development processes; how biracial/multiracial and bisexual individuals negotiate their identities; how the blending of multiple identities may contribute to perceptions of inclusion, exclusion, and social connectedness; and how biracial/multiracial and bisexual individuals may attribute positive and negative experiences to their identities. Interview transcripts were analyzed using an inductive thematic approach. Analysis highlighted four major themes: passing and invisible identities, not measuring up and erasing complexity, cultural binegativity/queerphobia and intersectional oppressions, and navigating beyond boundaries. Our findings imply promoting affirmative visibility and developing intentional support networks may help biracial/multiracial and bisexual individuals cultivate resiliency and navigate sources of identity stress. We encourage future research to explore mental health and chronic stress among this community.
• Willis, M., Fu, T. J., Jozkowski, K. N., Dodge, B., & Herbenick, D. (2022). Associations between sexual precedent and sexual compliance: An event-level examination. Journal of American college health : J of ACH, 70(1), 107-113.
  More info

  Most studies on agreeing to unwanted sex have assessed sexual encounters between people who have had sex before. Thus, we examined instances of sexual compliance with a novel sexual partner. A probability sample of college students at a university in the Midwest United States ( = 7,112). Participants completed an online survey based on measures from the National Survey of Sexual Health and Behavior. Only 2.5% ( = 179) agreed to unwanted sexual activity at their most recent sexual encounter. People who were sexually compliant with a novel sexual partner frequently did so due to their own alcohol intoxication. Further, sexual compliance with novel sexual partners was less frequently associated with affectionate sexual behaviors or orgasm. Our initial findings regarding the effect of sexual precedent on sexual compliance warrant further research on instances when people agree to sex they don't want with novel partners.
• Barnhart, K. J., Dodge, B., Sayegh, M. A., Herbenick, D., & Reece, M. (2021). Shared injection experiences: Interpersonal involvement in injection drug practices among women. Substance abuse, 42(4), 912-918.
  More info

  Many women who inject drugs are aware of the associated risks, however social influences play a part in their behavioral decisions. Incorporation of others in drug use behaviors may be common practice among women who use drugs. The aim of this study was to gain an in-depth understanding of women's injection drug use experiences with a focus on interpersonal involvement. : Venue-based recruitment was conducted in collaboration with a harm reduction program. A group of 30 women, ages 18 and older, who reported injecting drugs within the past 30 days took part in a demographic survey and semi-structured interview to gain an understanding of their injection practices. In vivo coding and thematic analysis were conducted. Three main themes that relate to incorporating others into injection drug behaviors surfaced, including: (1) injection practices described as we and not I, (2) partnered purchase and drug preparation, and (3) assisted injection. This group of women most often incorporated sexual and/or romantic partners (same and other-gender), friends, or family members into their injection drug use behaviors. Some women described a lack of ability to inject themselves and require assistance every time they use. Women also reported helping other women during drug use behaviors. Our primary themes indicate that a variety of relationship partners are important conceptual links in theoretical frameworks explaining drug use behaviors among women. Findings suggest same gender assistance during drug use behaviors, including injection, that may reduce harm. The interpersonal nature of injection drug use among women may indicate the expansion of treatment options designed for couples or other relationship partners, such as family, together.
• Beckmeyer, J. J., Herbenick, D., Fu, T. C., Dodge, B., & Fortenberry, J. D. (2021). Pleasure During Adolescents' Most Recent Partnered Sexual Experience: Findings from a U.S. Probability Survey. Archives of sexual behavior, 50(6), 2423-2434.
  More info

  Compared to studies on sexually transmitted infections and pregnancy prevention, sexual pleasure has received limited attention in the adolescent sexual development literature. In the present study, we used data from 157 adolescents (66 females; 14 to 17 years old), with a partnered sexual experience in the past 12 months to explore adolescents' sexual pleasure. First, we examined adolescents' perceptions of pleasure during their most recent partnered sexual experience. We then used information about those sexual experiences to identify correlates of sexual pleasure. Adolescents' reports of sexual pleasure were mixed. Although 17.8% reported their sexual experience was extremely pleasurable and 36.5% reported it was quite pleasurable, 26.6% indicated moderate pleasure, 13.1% a little pleasure, and 3.3% reported no pleasure. Sexual pleasure was primarily associated with aspects of sexual experiences that reflected socioemotional intimacy and desire. Specifically, cuddling with partners, emotional intimacy, and wantedness were all associated with greater sexual pleasure. Additionally, adolescents found sex more pleasurable when it occurred with a friend, but less pleasurable when it involved genital rubbing. Most sexual behaviors, having experienced orgasm, and the situational context of sexual experiences were not associated with sexual pleasure. Thus, specific sexual behaviors and orgasm may have less impact on sexual pleasure than feelings of emotional intimacy and desire. The diversity of perceived sexual pleasure and its associations with intimacy and desire suggest that, during adolescence, partnered sexual experiences are not primarily motivated by anticipated physical pleasure.
• Bowling, J., Bowling, J., Simmons, M., Simmons, M., Blekfeld-Sztraky, D., Blekfeld-Sztraky, D., Bartelt, E., Bartelt, E., Dodge, B., Dodge, B., Sundarraman, V., Sundarraman, V., Lakshmi, B., Lakshmi, B., Herbenick, D., & Herbenick, D. (2021). "It's a walk of shame": Experiences of unintended pregnancy and abortion among sexual- and gender-minoritized females in urban India. Medicine access @ point of care, 5, 23992026211027698.
  More info

  Unintended pregnancy and safe abortion access in India remain critical public health concerns. The health of sexual- and gender-minoritized females (SGMF; those assigned female at birth and identify as other than heterosexual and/or as other than cisgender women) in India is understudied.
• Fu, T. C., Herbenick, D., Dodge, B. M., Beckmeyer, J. J., & Hensel, D. J. (2021). Long-Acting Reversible Contraceptive Users' Knowledge, Conversations with Healthcare Providers, and Condom Use: Findings from a U.S. Nationally Representative Probability Survey. International journal of sexual health : official journal of the World Association for Sexual Health, 33(2), 163-174.
  More info

  Objectives To describe long-acting reversible contraceptive (LARC) users' knowledge, patient-provider interactions, and condom use associated with LARC use. : Data are from the 2018 National Survey of Sexual Health and Behavior, a probability survey of Americans aged 14-49. : Of 1,451 sexually active women, 11.2% used intrauterine devices, and 3.1% used implants. Approximately 19-26% of LARC users reported inaccurately on LARC longevity, and 30% reported relying on their provider to indicate the timing of intrauterine device removal. Consistent condom use among LARC users was rare (6.1%). : Our findings have implications for how clinicians educate patients on LARC and condom use.
• Hensel, D. J., Herbenick, D., Beckmeyer, J. J., Fu, T. C., & Dodge, B. (2021). Adolescents' Discussion of Sexual and Reproductive Health Care Topics With Providers: Findings From a Nationally Representative Probability Sample of U.S. Adolescents. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(3), 626-628.
  More info

  National practice guidelines encourage providers address sexual and reproductive health (SRH) as part of all clinical encounters with adolescents. Yet, no studies provide nationally representative estimates of how frequently adolescents are screened.
• Lattanner, M. R., Ford, J., Bo, N., Tu, W., Pachankis, J. E., Dodge, B., & Hatzenbuehler, M. L. (2021). A Contextual Approach to the Psychological Study of Identity Concealment: Examining Direct, Interactive, and Indirect Effects of Structural Stigma on Concealment Motivation Across Proximal and Distal Geographic Levels. Psychological science, 32(10), 1684-1696.
  More info

  Psychological theories of identity concealment locate the ultimate source of concealment decisions within the social environment, yet most studies have not explicitly assessed stigmatizing environments beyond the immediate situation. We advanced the identity-concealment literature by objectively measuring structural forms of stigma related to sexual orientation (e.g., social policies) at proximal and distal geographic levels. We linked these measures to a new, population-based data set of 502 gay and bisexual men (residing in 44 states and Washington, DC; 269 counties; and 354 cities) who completed survey items about stigma, including identity-concealment motivation. Among gay men, the association between structural stigma and concealment motivation was (a) observed across three levels (city, county, and state), (b) conditional on one's exposure at another geographic level (participants reported the least motivations to conceal their identity if they resided in both cities and states that were lowest in structural stigma), and (c) mediated by subjective perceptions of greater structural stigma.
• Rothman, E. F., Beckmeyer, J. J., Herbenick, D., Fu, T. C., Dodge, B., & Fortenberry, J. D. (2021). The Prevalence of Using Pornography for Information About How to Have Sex: Findings from a Nationally Representative Survey of U.S. Adolescents and Young Adults. Archives of sexual behavior, 50(2), 629-646.
  More info

  We analyzed cross-sectional data collected from a U.S. nationally representative survey of individuals ages 14-24 years old on what sources of information from the past year they considered to be the most helpful about how to have sex (n = 600 adolescents ages 14-17 years old, and n = 666 young adults ages 18-24 years old). Among the 324 adolescents who indicated that they had been helped by at least one source of information, helpful information was most likely to have come from parents (31.0%) and friends (21.6%). Only 8.4% of adolescents said pornography was helpful. However, for those in the 18-24-year-old age group, pornography was the most commonly endorsed helpful source (24.5%), as compared to other possible options such as sexual partners, friends, media, and health care professionals. Multivariable regression analyses revealed that indicating that pornography was the most helpful source of information about how to have sex, compared to the other sources, was inversely associated with being female (OR = 0.32, p = .001), inversely associated with identifying as bisexual compared to heterosexual (OR = 0.15, p = .038), positively associated with being Black compared to being white non-Hispanic (OR = 4.26, p = .021), inversely associated with reporting a household income of either $25 K to $49,999 (OR = 0.31, p = .010) or $50 K to $74,999 (OR = 0.36, p = .019) compared to more than $75 K, and positively associated with having masturbated (OR = 13.20, p = .005). Subsequent research should investigate the role of pornography in both adolescent and adult sexual development, including why one-quarter of U.S. young adults say that pornography is a helpful source of information about how to have sex and what they think that they are learning from it.
• Sandfort, T. G., Bos, H. M., Fu, T. J., Herbenick, D., & Dodge, B. (2021). Gender Expression and Its Correlates in a Nationally Representative Sample of the U.S. Adult Population: Findings from the National Survey of Sexual Health and Behavior. Journal of sex research, 58(1), 51-63.
  More info

  We explored the associations of gender expression with childhood gender expression, sexual identity, and demographic characteristics in a representative sample of the U.S. population aged 18 to 65 years (N = 1277), using data from the 2015 National Survey of Sexual Health and Behavior. As expected, gay men were less gender conforming than heterosexual men. However, among women, persons with a bisexual identity were less gender conforming compared to heterosexual and lesbian persons. In multivariate analyses, childhood gender expression trumped the role of sexual identity. In terms of demographic characteristics, gender conformity seemed to be more present among persons with positions with less social status in terms of age, race/ethnicity, education, income, and relationship status. Finally, we found among both men and women, that a large proportion saw themselves as more masculine or feminine than men and women on average, respectively, suggesting that accentuating one's gender conformity has a psychological function.
• Beckmeyer, J. J., Herbenick, D., Fu, T. J., Dodge, B., & Fortenberry, J. D. (2020). Prevalence of Romantic Experiences and Competencies Among 14 to 17 Year Olds: Implications for the Primary Care Setting. Clinical pediatrics, 59(2), 116-126.
  More info

  Using data from 600 adolescents (14-17 years old) from the 2015 National Survey of Sexual Health and Behavior, we examined the prevalence and demographic correlates of adolescents' romantic activities (ie, group dating, dyadic dating, and relationship involvement) and their confidence in avoiding unwanted romantic experiences. Overall, 55.8% of adolescents had engaged in at least one romantic activity. More adolescents reported having gone on dyadic (42.1%) and group (37.3%) dates than had been involved in romantic relationships (32.9%). Age and gender were the most consistent correlates of each romantic activity. Each type of romantic activity becomes more common as adolescents mature. Female adolescents were less likely to report romantic activities. Approximately 25.7% of adolescents were not confident that they could turn down unwanted dates, and 34.3% were not confident that they could end a relationship they no longer wanted to be in. Clinicians can draw on our results when discussing romantic development with their adolescent patients.
• Bowling, J., Bowling, J., Blekfeld-Sztraky, D., Blekfeld-Sztraky, D., Simmons, M., Simmons, M., Dodge, B., Dodge, B., Sundarraman, V., Sundarraman, V., Lakshmi, B., Lakshmi, B., Dharuman, S. D., Dharuman, S. D., Herbenick, D., & Herbenick, D. (2020). Definitions of sex and intimacy among gender and sexual minoritised groups in urban India. Culture, health & sexuality, 22(5), 520-534.
  More info

  Understandings of sex and intimacy carry important implications for individuals' behaviours and health. In many research studies, sex is narrowly defined as penile-vaginal intercourse, which may exclude the experiences of sexual and gender minoritised individuals. Likewise, sexual intimacy, or intimacy related to sexual experience between two or more people, is under-researched. Even less is known about how sexual and gender minoritised individuals in countries such as India understand these concepts. This qualitative study included focus group discussions and interviews conducted in three urban areas in India - Chennai, Bangalore and Kolkata. Data were analysed thematically. Participants described sex as a context-dependent experience, acknowledging that their definitions might not capture others' characterisations. Participants reported numerous barriers to intimacy, especially for transgender and other gender minority individuals. We discuss the implications of simplistic definitions related to gender and sexuality for future sexuality research and public health in settings such as those discussed here.
• Feinstein, B. A., & Dodge, B. (2020). Meeting the Sexual Health Needs of Bisexual Men in the Age of Biomedical HIV Prevention: Gaps and Priorities. Archives of sexual behavior, 49(1), 217-232.
  More info

  The field of HIV/STI prevention has primarily focused on gay men (or "men who have sex with men" [MSM] as a broad category) with limited attention to bisexual men in particular. Although bisexual men are also at increased risk for HIV and other STI, they are less likely to utilize HIV/STI prevention services than gay men, and very few interventions have been developed to address their unique needs. Further, while biomedical advances are changing the field of HIV prevention, bisexual men are also less likely to use biomedical HIV prevention strategies (e.g., pre-exposure prophylaxis [PrEP]) than gay men. In an effort to advance research on bisexual men and their sexual health needs, the goals of this commentary are: (1) to review the empirical literature on the prevalence of HIV/STI among bisexual men, the few existing HIV/STI prevention interventions developed for bisexual men, and the use of biomedical HIV prevention among bisexual men; (2) to describe the ways in which the field of HIV/STI prevention has largely overlooked bisexual men as a population in need of targeted services; and (3) to discuss how researchers can better address the sexual health needs of bisexual men in the age of biomedical HIV prevention.
• Jennings Mayo-Wilson, L., Coleman, J., Timbo, F., Ssewamala, F. M., Linnemayr, S., Yi, G. T., Kang, B. A., Johnson, M. W., Yenokyan, G., Dodge, B., & Glass, N. E. (2020). Microenterprise Intervention to Reduce Sexual Risk Behaviors and Increase Employment and HIV Preventive Practices Among Economically-Vulnerable African-American Young Adults (EMERGE): A Feasibility Randomized Clinical Trial. AIDS and behavior, 24(12), 3545-3561.
  More info

  Economic vulnerability, such as homelessness and unemployment, contributes to HIV risk among U.S. racial minorities. Yet, few economic-strengthening interventions have been adapted for HIV prevention in this population. This study assessed the feasibility of conducting a randomized clinical trial of a 20-week microenterprise intervention for economically-vulnerable African-American young adults. Engaging MicroenterprisE for Resource Generation and Health Empowerment (EMERGE) aimed to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors. The experimental group received text messages on job openings plus educational sessions, mentoring, a start-up grant, and business and HIV prevention text messages. The comparison group received text messages on job openings only. Primary feasibility objectives assessed recruitment, randomization, participation, and retention. Secondary objectives examined employment, sexual risk behaviors, and HIV preventive behaviors. Outcome assessments used an in-person pre- and post-intervention interview and a weekly text message survey. Several progression criteria for a definitive trial were met. Thirty-eight participants were randomized to experimental (n = 19) or comparison group (n = 19) of which 95% were retained. The comparison intervention enhanced willingness to be randomized and reduced non-participation. Mean age of participants was 21.0 years; 35% were male; 81% were unemployed. Fifty-eight percent (58%) of experimental participants completed ≥ 70% of intervention activities, and 74% completed ≥ 50% of intervention activities. Participation in intervention activities and outcome assessments was highest in the first half (~ 10 weeks) of the study. Seventy-one percent (71%) of weekly text message surveys received a response through week 14, but responsiveness declined to 37% of participants responding to ≥ 70% of weekly text message surveys at the end of the study. The experimental group reported higher employment (from 32% at baseline to 83% at week 26) and lower unprotected sex (79% to 58%) over time compared to reported changes in employment (37% to 47%) and unprotected sex (63% to 53%) over time in the comparison group. Conducting this feasibility trial was a critical step in the process of designing and testing a behavioral intervention. Development of a fully-powered effectiveness trial should take into account lessons learned regarding intervention duration, screening, and measurement.Trial Registration ClinicalTrials.gov. NCT03766165. Registered 04 December 2018. https://clinicaltrials.gov/ct2/show/NCT03766165.
• Owens, C., Hubach, R. D., Lester, J. N., Williams, D., Voorheis, E., Reece, M., & Dodge, B. (2020). Assessing determinants of pre-exposure prophylaxis (PrEP) adherence among a sample of rural Midwestern men who have sex with men (MSM). AIDS care, 32(12), 1581-1588.
  More info

  Pre-exposure prophylaxis (PrEP) efficacy in preventing HIV among gay, bisexual, and other men who have sex with men (MSM) is dependent upon adherence. Little is known about the PrEP adherence experiences among MSM who live in rural areas of the US. This qualitative study was informed by a modified version of Straussian Grounded Theory. Thirty-four 34 rural Midwestern MSM participated in telephone interviews that assessed their PrEP adherence factors. Overall, participants adhered to the PrEP regimen, ranging from missing none to a couple of doses per month. Participants had high self-efficacy (competence) and self-reliance (autonomy) in taking PrEP daily. Participants incorporated PrEP into their already existing routines. Participants were motivated to adhere to prevent HIV acquisition and be financially responsible. All participants mentioned their PrEP provider discussed the importance of adherence with PrEP's effectiveness, but future patient-provider PrEP adherence communication varied among participants. Future PrEP adherence interventions should address counseling strategies that leverage these constructs to support pill taking. Future research should explore patient-provider conversations surrounding PrEP adherence to inform provider- and patient-level interventions.
• Owens, C., Hubach, R. D., Williams, D., Lester, J., Reece, M., & Dodge, B. (2020). Exploring the Pre-exposure Prophylaxis (PrEP) Health Care Experiences Among Men Who Have Sex With Men (MSM) Who Live in Rural Areas of the Midwest. AIDS education and prevention : official publication of the International Society for AIDS Education, 32(1), 51-66.
  More info

  Most pre-exposure prophylaxis (PrEP) research samples men who have sex with men (MSM) who live in metropolitan cities. There is a limited understanding of the PrEP experiences among rural MSM. Thirty-four semi-structured interviews were conducted to explore the PrEP health care experiences among 34 rural Midwestern MSM. Of the 34 participants, 23 obtained PrEP from their non-primary care provider (PCP). Three themes were present: (1) PrEP is unavailable in rural areas, (2) PrEP is inaccessible in rural areas due to PCPs being unwilling to prescribe PrEP, and (3) PrEP services are unamicable in rural areas due to stigmatizing attitudes and behaviors of PCPs. It is important to address PrEP care continuum factors in all settings; however, these factors are often exacerbated in rural areas due to social determinants. Without further research and programming, organizational and social determinants may contribute to lower rates of PrEP outcomes in rural areas.
• Owens, C., Hubach, R. D., Williams, D., Voorheis, E., Lester, J., Reece, M., & Dodge, B. (2020). Facilitators and Barriers of Pre-exposure Prophylaxis (PrEP) Uptake Among Rural Men who have Sex with Men Living in the Midwestern U.S. Archives of sexual behavior, 49(6), 2179-2191.
  More info

  Facilitators and barriers of Pre-exposure Prophylaxis (PrEP) uptake have been established in prior studies; however, most of these studies comprise samples of MSM from metropolitan cities and hypothetical PrEP use. There is a dearth of literature on the uptake factors among rural U.S. MSM who are prescribed PrEP. Thirty-four rural Midwestern MSM who currently take PrEP participated in semi-structured telephone interviews about their barriers and facilitators to their PrEP use. Interviews were analyzed using an inductive thematic analysis approach. There were four barriers: (1) lack of rural dissemination of PrEP information, (2) concern about side and adverse effects of using PrEP, (3) cost of PrEP uptake and engagement, and (4) lack of access to PrEP care and PrEP care quality. Individual and social facilitators that participants utilized to overcome these barriers are discussed. Findings elevate the importance of multilevel interventions that address PrEP adoption from a patient, provider, and healthcare system perspective.
• Banik, S., Dodge, B., Schmidt-Sane, M., Sivasubramanian, M., Bowling, J., Rawat, S. M., Dange, A., & Anand, V. (2019). Humanizing an Invisible Population in India: Voices from Bisexual Men Concerning Identity, Life Experiences, and Sexual Health. Archives of sexual behavior, 48(1), 305-316.
  More info

  Research examining the sexual identities, behaviors, and experiences of bisexual men outside of Western contexts (including in India) is limited. Individuals who self-identify as bisexual due to their orientation toward partners of more than one gender face distinct psychosocial challenges relative to exclusively heterosexual, gay/lesbian, or other individuals. We conducted four focus group discussions (n = 22) and in-depth interviews (n = 50) with self-identified bisexual men (age 18 years and older) who were recruited from the metropolitan area of Mumbai, India, between June and August 2013. We triangulated and analyzed focus group and interview data using standard qualitative research techniques. Findings from our study suggest that multiple factors influence the sexual experiences of self-identified bisexual men in Mumbai, including contexts of sexual interactions, sexual positioning, and the gender of sexual partners. Participants described cultural meaning systems and psychosocial dynamics that regulate bisexual identity development, disclosure, and sexual decision making with male, female, and other partners. Secrecy, discretion, and sexual pleasure also influenced sexual behaviors and relationships. Although Western sexual identity categories are not necessarily equivalent in the Indian context, it is interesting and important to note that a number of individuals in India continue to use the identity label of "bisexual." Before developing interventions to meet unique sexual health needs of bisexual men, it is crucial to understand how these men perceive themselves, reconcile the ordinary aspects of their lives with their sexuality, and structure their relationships with partners.
• Batteiger, T. A., Jordan, S. J., Toh, E., Fortenberry, L., Williams, J. A., LaPradd, M., Katz, B., Fortenberry, J. D., Dodge, B., Arno, J., Batteiger, B. E., & Nelson, D. E. (2019). Detection of Rectal Chlamydia trachomatis in Heterosexual Men Who Report Cunnilingus. Sexually transmitted diseases, 46(7), 440-445.
  More info

  Rectal infection with Chlamydia trachomatis (CT) is frequent in women who deny receptive anal sex and is thought to arise from autoinoculation of the rectum from vaginal secretions. An alternate hypothesis is that oral sex inoculates and establishes gastrointestinal tract infection. Distinguishing these hypotheses is difficult in women. In men, autoinoculation is unlikely and heterosexual men frequently perform oral sex, but rarely participate in receptive anal exposure behaviors.
• Beach, L., Bartelt, E., Dodge, B., Bostwick, W., Schick, V., Fu, T. J., Friedman, M. R., & Herbenick, D. (2019). Meta-Perceptions of Others' Attitudes Toward Bisexual Men and Women Among a Nationally Representative Probability Sample. Archives of sexual behavior, 48(1), 191-197.
  More info

  Researchers posit that negative attitudes, prejudice, and discrimination (i.e., binegativity) from heterosexual and gay/lesbian individuals may contribute to health disparities among bisexual individuals relative to heterosexual and gay/lesbian individuals. Recent studies have focused on gay, lesbian, and heterosexual people's (e.g., "others") attitudes toward bisexual people. No studies have investigated how bisexual individuals perceive others' attitudes toward bisexual people, which are generally known as "meta-perceptions." As part of the 2015 National Survey of Sexual Health and Behavior, we collected data from a nationally representative probability sample of 2999 adults, including from a subsample of 33 men and 61 women self-identified as bisexual. The Bisexualities: Indiana Attitudes Scale-bisexual (BIAS-b), a modified 5-item scale assessing bisexual people's perceptions of others' attitudes toward bisexual individuals, was included and was followed by an open-ended text box question. Quantitative scale data were analyzed using descriptive and gamma regression methods. Two coders thematically analyzed the open-ended text box data. The internal consistency of the BIAS-b was high (Cronbach's α = 0.85). An exploratory factor analysis supported a one-factor solution. Participants responded to statements regarding others' attitudes toward them as bisexual people, including the domains of confusion, HIV/STD risk, incapability of monogamy, promiscuity, and instability ("just a phase"). Participants' text box descriptions largely aligned with these five domains, with the exception of HIV/STD risk. Additionally, some participants reported others' positive perceptions of them as bisexual individuals. In sum, we observed a range of meta-perceptions, primarily neutral to negative, but also including some relatively positive. These results show the need for interventions to promote acceptance of bisexual individuals among heterosexual and gay/lesbian individuals.
• Beckmeyer, J. J., Beckmeyer, J. J., Herbenick, D., Herbenick, D., Fu, T. J., Fu, T. J., Dodge, B., Dodge, B., Reece, M., Reece, M., Fortenberry, J. D., & Fortenberry, J. D. (2019). Characteristics of Adolescent Sexting: Results from the 2015 National Survey of Sexual Health and Behavior. Journal of sex & marital therapy, 45(8), 767-780.
  More info

  Using data from 78 sexting-experienced adolescents from the 2015 National Survey of Sexual Health and Behavior, we describe sexting frequency, sexting partners, sexual relationships with such partners, and characteristics associated with sexting. Most (59.2%) respondents sexted at most monthly, usually with romantic partners (62.0%). About 41% of sexting-experienced adolescents did not usually have sexual relationships with sexting partners, 36.6% usually sexted after starting a sexual relationship, and 16.8% reported that their sexting typically preceded sexual relationships. Younger adolescents sexted more frequently. Those without vaginal sex/anal sex experience, or prior romantic experience, were more likely to have sexted a non-romantic/sexual partner.
• Bostwick, W. B., & Dodge, B. (2019). Introduction to the Special Section on Bisexual Health: Can You See Us Now?. Archives of sexual behavior, 48(1), 79-87.
  More info

  Despite comprising the largest proportion of the "lesbian, gay, and bisexual" population, research focusing on the unique health concerns and needs of bisexual individuals is relatively scarce. While health disparities are increasingly well documented among lesbian, gay, bisexual, and transgender individuals relative to their heterosexual and cisgender counterparts, gaps remain in our basic understanding of how health status, behaviors, and outcomes vary within these groups, especially bisexual individuals. The lack of specified research on bisexual health is even more curious given that, when separated from both heterosexual and gay/lesbian individuals, bisexual individuals consistently report higher rates of a wide range of negative health outcomes, including mood and anxiety disorders, substance use, suicidality, as well as disparities related to healthcare access and utilization. Indeed, in scientific research, mass media, and in public health interventions, bisexual individuals remain relatively invisible. This Special Section represents an effort to shed light on a new generation of quantitative, qualitative, and mixed methods research studies that examine health-related concerns, outcomes, and intervention opportunities specifically among diverse samples of bisexual individuals from a variety of social and cultural contexts. The research herein focuses on intersections of multiple identities, the development of new measures, the use of large national data sets, and diverse groups of self-identified bisexual men (who tend to be least visible in health research). Findings from these studies will significantly advance our knowledge of factors associated with health disparities, as well as health and well-being more generally, among bisexual individuals and will help to inform directions for future health promotion research and intervention efforts.
• Bowling, J., Dodge, B., Bartelt, E., Simmons, M., & Fortenberry, J. D. (2019). Paths to Parenthood Among Self-Identified Bisexual Individuals in the United States. Archives of sexual behavior, 48(1), 277-289.
  More info

  Bisexual parents have been notably absent from prior research on parenting, despite comprising the largest proportion of parents among "lesbian, gay, and bisexual" (LGB) individuals. Indeed, recent national probability data indicate that young bisexual women are more likely than their heterosexual counterparts to report having at least one child. Intentions to have children, patterns of family planning and contraception use, and related issues have important implications for health and healthcare-related decisions and priorities among bisexual parents. We conducted in-depth interviews with a sample of 33 bisexual parents from across the U.S. who reported having at least one child (genetic, adopted, step or foster child, guardian, and/or warden of the state). In cases of intentional pregnancies, participants considered relationship and financial stability, job security and their ideal family size. Unintentional pregnancies, as well as pregnancy terminations, were often reframed as positive experiences. After deciding not to have more children, participants reported using contraceptive methods, including sterilization or long-acting reversible contraceptive methods (e.g., intrauterine devices). Instances of deception, in which partners deceived participants with false beliefs regarding their contraceptive use, were recalled negatively for the relatively small number of participants who reported such experiences. Overall, our findings point to a diversity in the intentions and ways bisexual individuals become parents, similar to parents of other sexual identities. Acknowledgements of the diverse experiences and concerns faced by bisexual parents may be beneficial in improving efforts related to providing appropriate and relevant health- and healthcare-related services.
• Bowling, J., Simmons, M., Dodge, B., Sundarraman, V., Lakshmi, B., Dharuman, S. T., & Herbenick, D. (2019). Family Formation Goals Among Sexual and Gender Minority Individuals in Urban India. Studies in family planning, 50(4), 357-373.
  More info

  Sexual and Gender Minority (SGM) individuals' (nonheterosexual or noncisgender) desires and intentions to form families have been under-researched. Further, research on family formation among SGM individuals is even more scant in India. Family formation, a significant milestone for many individuals, has important implications for overall health. Using data from interviews (n=25) and focus group discussions (8 participants) with SGM individuals in Bangalore, Chennai, and Kolkata, we explore desires and intentions related to parenting. Pressure to have children was ubiquitous, though participants' parenting-related desires varied. Participants considering parenting noted many priorities including their financial stability, relationships with partners, and the legality and legitimacy of their partnerships. Adoption and assisted biological reproduction (e.g., IVF) were the preferred methods of family formation. Experiences and expectations of stigma for themselves and their children shaped participants' limited control over parenting-related decisions. However, they exerted agency as they navigated achieving their ideals for family formation.
• Carter, A., Carter, A., Ford, J. V., Ford, J. V., Luetke, M., Luetke, M., Fu, T. J., Fu, T. J., Townes, A., Townes, A., Hensel, D. J., Hensel, D. J., Dodge, B., Dodge, B., Herbenick, D., & Herbenick, D. (2019). "Fulfilling His Needs, Not Mine": Reasons for Not Talking About Painful Sex and Associations with Lack of Pleasure in a Nationally Representative Sample of Women in the United States. The journal of sexual medicine, 16(12), 1953-1965.
  More info

  Although much research has examined correlates of pain during sex, far less research has examined why women have sex despite having pain and why they avoid telling their partner.
• Dodge, B., Ford, J. V., Bo, N., Tu, W., Pachankis, J., Herbenick, D., Mayer, K., & Hatzenbuehler, M. L. (2019). HIV Risk and Prevention Outcomes in a Probability-Based Sample of Gay and Bisexual Men in the United States. Journal of acquired immune deficiency syndromes (1999), 82(4), 355-361.
  More info

  Although gay and bisexual men (GBM) represent the largest group of HIV-infected individuals in the United States, nearly all evidence on their HIV risk and prevention outcomes derive from nonprobability samples.
• Feinstein, B. A., Feinstein, B. A., Dodge, B., Dodge, B., Korpak, A. K., Korpak, A. K., Newcomb, M. E., Newcomb, M. E., Mustanski, B., & Mustanski, B. (2019). Improving the health of cisgender men who identify as bisexual: What do they want from interventions?. Sexuality research & social policy : journal of NSRC : SR & SP, 16(3), 385-391.
  More info

  Self-identified bisexual men are at increased risk for negative health outcomes, but there are no interventions tailored to their unique needs. In order to develop interventions for this population, it is first necessary to understand their preferences. As part of a larger study, 128 cisgender men who identified as bisexual reported on their preferences for different intervention components. Large proportions of participants prioritized addressing both health (e.g., mental health, HIV/STI) and psychosocial experiences (e.g., dating/relationships, discrimination/victimization). A slightly larger proportion of participants preferred an intervention for gay and bisexual men together compared to an intervention for bisexual men only. However, those who reported more discrimination and recent female sexual partners were more likely to prefer an intervention for bisexual men only. Larger proportions of participants preferred a group intervention compared to an individual intervention and an in-person intervention compared to an online intervention. These findings highlight the importance of addressing both health and psychosocial experiences in tailored interventions for self-identified bisexual men. Further, while in-person and group interventions may appeal to larger proportions of self-identified bisexual men, the appeal of an intervention for gay and bisexual men together compared to an intervention for bisexual men only may depend on individual and social/contextual factors.
• Fu, T. C., Hensel, D. J., Beckmeyer, J. J., Dodge, B., & Herbenick, D. (2019). Considerations in the Measurement and Reporting of Withdrawal: Findings from the 2018 National Survey of Sexual Health and Behavior. The journal of sexual medicine, 16(8), 1170-1177.
  More info

  Although withdrawal use is routinely measured as part of contraceptive surveillance in the United States, its assessment may be prone to underreporting and measurement errors. Additionally, at the population level, little is known about subjective experiences of withdrawal.
• Fu, T. C., Herbenick, D., Dodge, B., Owens, C., Sanders, S. A., Reece, M., & Fortenberry, J. D. (2019). Relationships Among Sexual Identity, Sexual Attraction, and Sexual Behavior: Results from a Nationally Representative Probability Sample of Adults in the United States. Archives of sexual behavior, 48(5), 1483-1493.
  More info

  Sexual orientation is a multi-dimensional concept, at a minimum comprised of sexual identity, sexual attraction, and sexual behavior. Our study aimed to assess relationships among self-identified sexual identity, sexual attraction, and sexual behaviors in a probability sample of adults in the U.S. and to identify associated factors with diverse patterns. We collected data from adults in the 2015 National Survey of Sexual Health and Behavior, an Internet-based nationally representative probability survey of the general U.S. population. Concordance between sexual identity versus sexual attraction and sexual behaviors was assessed using percent agreement. We identified correlates of discordance using logistic regression. Concordance between sexual identity versus sexual attraction and past-year sexual behaviors was 94% and 96%, respectively, though our sample was predominately composed of heterosexual individuals. Women and sexual minority individuals reported greater discordance across sexuality-related measures than men and heterosexual individuals. Younger adults (aged 18-24 years) were more likely to report sexual behaviors discordant with sexual identity compared with older adults (including those ages 25-34 years). Higher levels of educational attainment were significantly associated with less discordance of reported recent sexual activity and sexual identity. Measures of sexual identity, attraction, and behaviors are not interchangeable. Future research should consider multiple sexuality-related measures in order to capture the complexity and variability of sexualities.
• Herbenick, D., Eastman-Mueller, H., Fu, T. C., Dodge, B., Ponander, K., & Sanders, S. A. (2019). Women's Sexual Satisfaction, Communication, and Reasons for (No Longer) Faking Orgasm: Findings from a U.S. Probability Sample. Archives of sexual behavior, 48(8), 2461-2472.
  More info

  We aimed to assess, among a U.S. probability sample of adult women: (1) the prevalence of, and reasons given for, faking and no longer faking orgasm, (2) women's histories of sexual non-communication and reasons for non-communication, (3) associations between sexual non-communication and sexual satisfaction and faking orgasm, (4) associations between specific sexual communication and recent sexual satisfaction, and (5) associations between specific sexual communication and faking orgasm. Respondents were 1008 adult women ages 18-94 from the GfK KnowledgePanel (a nationally representative probability sample of non-institutionalized and English-speaking adults), who completed a confidential Internet-based survey. Although 58.8% of female respondents reported having ever faked/pretended orgasm, 67.3% of those who had ever faked orgasm no longer did. Women who continued to fake orgasms were more likely to indicate embarrassment talking about sex with their partner in explicit ways and were less likely to agree that they and their partner are able to talk specifically about what makes sex more pleasurable for them. More than half (55.4%) of women reported they had wanted to communicate with a partner regarding sex but decided not to; the most common reasons were not wanting to hurt a partner's feelings (42.4%), not feeling comfortable going into detail (40.2%), and embarrassment (37.7%). Greater self-reported sexual satisfaction was associated with more comfortable sexual communication. Study findings and implications for professionals are discussed in the context of adult sexual development and learning. This includes growing more comfortable talking with a partner about sexual preferences and sexual pleasure.
• Herbenick, D., Fu, T. J., Dodge, B., & Fortenberry, J. D. (2019). The alcohol contexts of consent, wanted sex, sexual pleasure, and sexual assault: Results from a probability survey of undergraduate students. Journal of American college health : J of ACH, 67(2), 144-152.
  More info

  To examine, in a probability sample of undergraduate students, characteristics of students' most recent sexual experiences (including alcohol use) as well as their experiences with nonconsensual sex.
• Herbenick, D., Herbenick, D., Fu, T. J., Fu, T. J., Owens, C., Owens, C., Bartelt, E., Bartelt, E., Dodge, B., Dodge, B., Reece, M., Reece, M., Fortenberry, J. D., & Fortenberry, J. D. (2019). Kissing, Cuddling, and Massage at Most Recent Sexual Event: Findings From a U.S. Nationally Representative Probability Sample. Journal of sex & marital therapy, 45(2), 159-172.
  More info

  Using data from the 2014 National Survey of Sexual Health and Behavior, a probability survey of Americans aged 14+, we assessed the prevalence and correlates of kissing, cuddling, and massage during 1,493 individuals' most recent sexual event from the past year. Most respondents reported kissing (87%) and cuddling (70%); fewer (23%) reported massage. Each was significantly associated with age, education, and relationship structure. Respondents younger than 30 were significantly more likely to indicate they did not kiss because kissing would have been too intimate with their partner. Only cuddling was significantly associated with event-level emotional intimacy and sexual pleasure.
• Mayo-Wilson, L. J., Glass, N. E., Ssewamala, F. M., Linnemayr, S., Coleman, J., Timbo, F., Johnson, M. W., Davoust, M., Labrique, A., Yenokyan, G., Dodge, B., & Latkin, C. (2019). Microenterprise intervention to reduce sexual risk behaviors and increase employment and HIV preventive practices in economically-vulnerable African-American young adults (EMERGE): protocol for a feasibility randomized clinical trial. Trials, 20(1), 439.
  More info

  Economic vulnerability, such as homelessness and unemployment, contributes to the HIV risk among racial minorities in the U.S., who are disproportionately infected. Yet, few economic-strengthening interventions have been adapted for HIV prevention in economically-vulnerable African-American young adults. Engaging Microenterprise for Resource Generation and Health Empowerment (EMERGE) is a feasibility randomized clinical trial of an HIV prevention microenterprise intervention with integrated text messages ("nudges") that are informed by behavioral economic principles. The trial aims to reduce sexual risk behaviors and increase employment and uptake of HIV preventive behaviors.
• Baldwin, A., Dodge, B., Schick, V. R., Light, B., Scharrs, P. W., Herbenick, D., & Fortenberry, J. D. (2018). Transgender and Genderqueer Individuals' Experiences with Health Care Providers: What's Working, What's Not, and Where Do We Go from Here?. Journal of health care for the poor and underserved, 29(4), 1300-1318.
  More info

  Research demonstrates health disparities between gender-minority individuals and cisgender individuals. These disparities arise from multiple sources, including negative health care experiences. This study examines interactions between transgender and gender non-binary (TGGNB) individuals and their health care providers. We analyzed 119 participants' descriptions of positive and negative health care experiences, and what they wish providers knew about caring for TGGNB patients. Health care experiences went well when providers and staff used inclusive language, demonstrated their experience and education, and treated identity disclosure as routine. Negative interactions were characterized by misgendering, unfamiliarity with TGGNB people and health issues, and transphobic practices. Participants wished providers understood their health concerns, did not expect their patients to educate them, and created a welcoming clinical environment. Medical educators, administrators, and providers share responsibility for improving TGGNB patient experiences. Through a framework of cultural safety, we recommend several changes to ensure more equitable treatment in health care.
• Bowling, J., Bowling, J., Dodge, B., Dodge, B., Banik, S., Banik, S., Bartelt, E., Bartelt, E., Mengle, S., Mengle, S., Guerra-Reyes, L., Guerra-Reyes, L., Hensel, D., Hensel, D., Herbenick, D., Herbenick, D., Anand, V., & Anand, V. (2018). Social support relationships for sexual minority women in Mumbai, India: a photo elicitation interview study. Culture, health & sexuality, 20(2), 183-200.
  More info

  Little research exists on women who do not identify as heterosexual in India. Social support for sexual minority women may protect against the effects of discrimination. An examination of significant social relationships may point to both strengths and weaknesses in this support. We aimed to understand relationship prioritisation and communication patterns associated with the social support of sexual minority women in Mumbai. In partnership with the Humsafar Trust, India's oldest and largest sexual and gender minority-advocacy organisation, we conducted photo-elicitation interviews with 18 sexual minority women, using participants' photographs to prompt dialogue about their social support. Intimate partners were a source of dependable support and many of those without relationships were seeking them. Participants' extended networks included friends and family as well as less formal relationships of social support. Participants mediated their communication with particular social network members, which involved filtering information sexual identity, romantic interests, and personal aspirations, among others. The diverse relationships that sexual minority women have in their social support networks may be used to guide programmes to improve health outcomes.
• Bowling, J., Dodge, B., Banik, S., Bartelt, E., Rawat, S., Guerra-Reyes, L., Hensel, D., Herbenick, D., & Anand, V. (2018). A multi-method study of health behaviours and perceived concerns of sexual minority females in Mumbai, India. Sexual health, 15(1), 29-38.
  More info

  This multi-method study explores the perceived health status and health behaviours of sexual minority (i.e. self-identifying with a sexual identity label other than heterosexual) females (i.e. those assigned female at birth who may or may not identify as women) in Mumbai, India, a population whose health has been generally absent in scientific literature.
• Bowling, J., Dodge, B., Bindra, N., Dave, B., Sharma, R., Sundarraman, V., Thirupathur Dharuman, S., & Herbenick, D. (2018). Female condom acceptability in urban India: Examining the role of sexual pleasure. Journal of health psychology, 23(2), 218-228.
  More info

  This qualitative study examined the acceptability of female condoms in urban India, with a focus on sexual pleasure. We conducted focus group discussions with 50 women and 19 men, as well as a small number of individual interviews with women ( n = 3), in Chennai and New Delhi. Perceived benefits of female condoms included protection against unintended pregnancy and sexually transmitted infections, increased sense of empowerment for women, and simple clean up. The most common drawback was reduced sensation. Participants suggested structural changes to the female condom to ease insertion and use. Consent and privacy were discussed as increasing sexual pleasure. Pleasure should be acknowledged in design and education efforts to increase female condom use.
• Collazo-Vargas, E. M., Dodge, B., Herbenick, D., Guerra-Reyes, L., Mowatt, R., Otero-Cruz, I. M., & Rodríguez-Díaz, C. (2018). Sexual Behaviors, Experiences of Sexual Violence, and Substance Use among Women Who inject Drugs: Accessing Health and Prevention Services in Puerto Rico. Puerto Rico health sciences journal, 37(2), 88-97.
  More info

  People who inject drugs (PWID) face numerous gender-specific health risks, which increase their susceptibility to adverse outcomes, including violence. There is a need for research on female PWID to capture their unique experiences and understand behavioral and gender-based differences. This study aimed to understand which drug use and sexual behaviors are the most prevalent among female PWID accessing health services in Puerto Rico and to gather preliminary information on those individuals' experiences of sexual violence.
• Ensign, K. A., Dodge, B. M., Herbenick, D., & Docherty, C. L. (2018). Development of an Instrument to Assess Athletic Trainers' Attitudes Toward Transgender Patients. Journal of athletic training, 53(4), 431-436.
  More info

    The unique contexts in which athletic trainers (ATs) work require specific tools in order to understand their attitudes toward diverse patient populations, including sexual and gender minorities.
• Guerra-Reyes, L., Fu, T. J., Williams, D., Herbenick, D., Dodge, B., Reece, M., & Fortenberry, J. D. (2018). Knowledge of Zika and perception of risk among sexually-active adults in the United States of America: results from a nationally representative sample. Revista panamericana de salud publica = Pan American journal of public health, 42, e43.
  More info

  To examine knowledge of Zika transmission and risk perception and to assess variability by condom use in a probability sample of sexually-active adults in the United States.
• Herbenick, D., Herbenick, D., Fu, T. J., Fu, T. J., Arter, J., Arter, J., Sanders, S. A., Sanders, S. A., Dodge, B., & Dodge, B. (2018). Women's Experiences With Genital Touching, Sexual Pleasure, and Orgasm: Results From a U.S. Probability Sample of Women Ages 18 to 94. Journal of sex & marital therapy, 44(2), 201-212.
  More info

  The study purpose was to assess, in a U.S. probability sample of women, experiences related to orgasm, sexual pleasure, and genital touching. In June 2015, 1,055 women ages 18 to 94 from the nationally representative GfK KnowledgePanel® completed a confidential, Internet-based survey. While 18.4% of women reported that intercourse alone was sufficient for orgasm, 36.6% reported clitoral stimulation was necessary for orgasm during intercourse, and an additional 36% indicated that, while clitoral stimulation was not needed, their orgasms feel better if their clitoris is stimulated during intercourse. Women reported diverse preferences for genital touch location, pressure, shape, and pattern. Clinical, therapeutic, and educational implications are discussed.
• Levine, E. C., Herbenick, D., Martinez, O., Fu, T. C., & Dodge, B. (2018). Open Relationships, Nonconsensual Nonmonogamy, and Monogamy Among U.S. Adults: Findings from the 2012 National Survey of Sexual Health and Behavior. Archives of sexual behavior, 47(5), 1439-1450.
  More info

  People in open and other consensually nonmonogamous partnerships have been historically underserved by researchers and providers. Many studies group such partnerships together with nonconsensual nonmonogamy (NCNM) under the banner of "concurrent sexual partnerships." Discrimination from service providers poses a substantial barrier to care. Responding to such concerns, this investigation explored sociodemographic correlates with open relationships and associations between relationship structure and sexual risk, HIV/STI testing, and relationship satisfaction in a nationally representative probability sample. Data were drawn from the 2012 National Survey of Sexual Health and Behavior (n = 2270). We used multinomial logistic regression to identify correlates with relationship structure, and linear and logistic regression to investigate associations between relationship structure and testing, condom use, and relationship satisfaction. Eighty-nine percent of participants reported monogamy, 4% reported open relationships, and 8% reported NCNM. Males, gay/lesbian individuals, bisexual individuals, and those who identified as "Other, Non-Hispanic" were more likely to report open relationships. Bisexual individuals and Black, Non-Hispanic participants were more likely to report NCNM; older participants were less likely to do so. Participants in open relationships reported more frequent condom use for anal intercourse and lower relationship satisfaction than monogamous participants. NCNM participants reported more HIV testing and lower satisfaction. Identities, experiences, and behaviors within open and other consensually nonmonogamous populations should be regarded as unique and diverse, rather than conflated with those common to other relationship structures. There is a need for greater awareness of diverse relationship structures among researchers and providers, and incorporation of related content into educational programming.
• Levine, E. C., Martinez, O., Mattera, B., Wu, E., Arreola, S., Rutledge, S. E., Newman, B., Icard, L., Muñoz-Laboy, M., Hausmann-Stabile, C., Welles, S., Rhodes, S. D., Dodge, B. M., Alfonso, S., Fernandez, M. I., & Carballo-Diéguez, A. (2018). Child Sexual Abuse and Adult Mental Health, Sexual Risk Behaviors, and Drinking Patterns Among Latino Men Who Have Sex With Men. Journal of child sexual abuse, 27(3), 237-253.
  More info

  One in five Latino men who have sex with men has experienced child sexual abuse. Although concerning in itself, child sexual abuse may increase an individuals' likelihood of depression and risk-taking in adult life, including engagement in HIV risk behaviors and alcohol and substance use. It is therefore urgent that researchers and practitioners better understand the long-term effects of child sexual abuse. We utilized logistic and linear regression to assess associations between child sexual abuse (operationalized as forced or coerced sexual activity before age 17) and depression, sexual behaviors, and drinking patterns in a sample of 176 adult Latino men who have sex with men from New York City. Over one-fifth (22%) of participants reported child sexual abuse. In multivariable models, participants with histories of child sexual abuse were significantly more likely than participants without such histories to screen for clinically significant depressive symptoms and heavy drinking and reported more anal sex acts, male sexual partners, and incidents of condomless anal intercourse in the previous three months. These findings confirm a high prevalence of child sexual abuse among Latino men who have sex with men and associations between child sexual abuse and adulthood depressive symptoms, high-risk alcohol consumption, and sexual risk behaviors. We recommend that providers who serve Latino men who have sex with men incorporate child sexual abuse screenings into mental health, HIV prevention, and substance use treatment programs, utilizing approaches that are inclusive of resilience.
• Morgan, A., Saunders, B., Dodge, B., Harper, G., & Arrington Sanders, R. (2018). Exploring the Sexual Development Experiences of Black Bisexual Male Adolescents Over Time. Archives of sexual behavior, 47(6), 1839-1851.
  More info

  Scant research has sought to explore the development of dimensions of sexual orientation among Black bisexual male adolescents (BBMA). Understanding how sexual attractions, behaviors, and identities evolve among BBMA over time is crucial to understanding the most appropriate support strategies to provide during this developmental period. We sought to understand and describe the sexual orientation development experiences in a sample of BBMA over the course of 1 year. We further sought to understand the sociocontextual factors that may play a role during this development process. Fifteen BBMA, aged 15-19 years, were interviewed about sexual debut experiences (baseline) and were re-interviewed three times over a 1-year period about sexual attractions, behaviors, and identity at each follow-up point. A three-person team used inductive open coding to analyze each participant's data set. The mean Kinsey scale score for the sample was 2.93 (SD = 1.2) most closely translating to "heterosexual/gay-equally." A case study analysis was used to identify themes related to sexual attractions, behavior, and identity over time, within and across participants. Among the sample of young men, two unique groups were identified based on self-reported sexual identity and experiences of same- and other-sex sexual attractions and behaviors over time. The first group consisted of seven young men who consistently described their sexual identity as bisexual from baseline to the final follow-up. These young men also described similar experiences related to same- and other-sex sexual and romantic attractions and more consistently described same- and other-sex sexual behaviors. The second group consisted of eight young men that described changing sexual identity and same- and other-sex sexual romantic attractions over time. Participants described sociocontextual factors such as religion, masculinity, and homophobia played during their development. Findings from this study underscore the complexity of sexual orientation development and sociocultural factors and expectations that may influence sexual identity and behavior among BBMA.
• Baldwin, A. M., Dodge, B., Schick, V., Sanders, S. A., & Fortenberry, J. D. (2017). Sexual Minority Women's Satisfaction with Health Care Providers and State-level Structural Support: Investigating the Impact of Lesbian, Gay, Bisexual, and Transgender Nondiscrimination Legislation. Women's health issues : official publication of the Jacobs Institute of Women's Health, 27(3), 271-278.
  More info

  Structural discrimination is associated with negative health outcomes among sexual minority populations. Recent changes to state-level and national legislation provide both the opportunity and the need to further explore the impact of legislation on the health indicators of sexual minorities. Using an ecosocial theory lens, the present research addresses the relationship between structural support or discrimination and satisfaction with one's health care provider among sexual minority women.
• Baldwin, A., Baldwin, A., Dodge, B., Dodge, B., Schick, V., Schick, V., Herbenick, D., Herbenick, D., Sanders, S. A., Sanders, S. A., Dhoot, R., Dhoot, R., Fortenberry, J. D., & Fortenberry, J. D. (2017). Health and identity-related interactions between lesbian, bisexual, queer and pansexual women and their healthcare providers. Culture, health & sexuality, 19(11), 1181-1196.
  More info

  Disclosure of sexual identity among sexual minority women is related to better outcomes and improved quality of care. The existing literature on sexual minority women's experiences of identity disclosure and related interactions with healthcare providers draws little distinction between different groups of sexual minority women, despite the different barriers, stigma and health outcomes that exist between them. This paper presents factors influencing identity disclosure and describes the characteristics of interactions that sexual minority women have with their healthcare providers around sexual identity and health. Using a mixed-methods approach, both qualitative and quantitative data were gathered using an online survey. The sample included lesbian, bisexual, queer and pansexual women from across the USA. Qualitative and quantitative data were analysed concurrently, and qualitative themes were quantified and integrated into quantitative analyses. Identity disclosure, reasons for disclosing identity and characteristics of interactions with providers varied by identity, but often overlapped. Bisexual and pansexual participants were significantly less likely to disclose identity than lesbian participants. There were no significant differences related to age or ethnicity. Findings from this study have the potential to inform ethical medical practices and improve healthcare quality among sexual minority women.
• Herbenick, D., Bowling, J., Fu, T. J., Dodge, B., Guerra-Reyes, L., & Sanders, S. (2017). Sexual diversity in the United States: Results from a nationally representative probability sample of adult women and men. PloS one, 12(7), e0181198.
  More info

  In 2015, we conducted a cross-sectional, Internet-based, U.S. nationally representative probability survey of 2,021 adults (975 men, 1,046 women) focused on a broad range of sexual behaviors. Individuals invited to participate were from the GfK KnowledgePanel®. The survey was titled the 2015 Sexual Exploration in America Study and survey completion took about 12 to 15 minutes. The survey was confidential and the researchers never had access to respondents' identifiers. Respondents reported on demographic items, lifetime and recent sexual behaviors, and the appeal of 50+ sexual behaviors. Most (>80%) reported lifetime masturbation, vaginal sex, and oral sex. Lifetime anal sex was reported by 43% of men (insertive) and 37% of women (receptive). Common lifetime sexual behaviors included wearing sexy lingerie/underwear (75% women, 26% men), sending/receiving digital nude/semi-nude photos (54% women, 65% men), reading erotic stories (57% of participants), public sex (≥43%), role-playing (≥22%), tying/being tied up (≥20%), spanking (≥30%), and watching sexually explicit videos/DVDs (60% women, 82% men). Having engaged in threesomes (10% women, 18% men) and playful whipping (≥13%) were less common. Lifetime group sex, sex parties, taking a sexuality class/workshop, and going to BDSM parties were uncommon (each
• Dodge, B., Herbenick, D., Friedman, M. R., Schick, V., Fu, T. J., Bostwick, W., Bartelt, E., Muñoz-Laboy, M., Pletta, D., Reece, M., & Sandfort, T. G. (2016). Attitudes toward Bisexual Men and Women among a Nationally Representative Probability Sample of Adults in the United States. PloS one, 11(10), e0164430.
  More info

  As bisexual individuals in the United States (U.S.) face significant health disparities, researchers have posited that these differences may be fueled, at least in part, by negative attitudes, prejudice, stigma, and discrimination toward bisexual individuals from heterosexual and gay/lesbian individuals. Previous studies of individual and social attitudes toward bisexual men and women have been conducted almost exclusively with convenience samples, with limited generalizability to the broader U.S.
• Martinez, O., Martinez, O., Wu, E., Wu, E., Levine, E. C., Levine, E. C., Muñoz-Laboy, M., Muñoz-Laboy, M., Spadafino, J., Spadafino, J., Dodge, B., Dodge, B., Rhodes, S. D., Rhodes, S. D., Rios, J. L., Rios, J. L., Ovejero, H., Ovejero, H., Moya, E. M., , Moya, E. M., et al. (2016). Syndemic factors associated with drinking patterns among Latino men and Latina transgender women who have sex with men in New York City. Addiction research & theory, 24(6), 466-476.
  More info

  Alcohol consumption is a significant public health concern among Latino men and Latina transgender women who have sex with men. However, characteristics and behaviors associated with alcohol consumption in this population, particularly in regard to the complex influence of syndemic factors, remain understudied. The purpose of this study was to examine predictors of high-risk alcohol consumption (i.e. binge or heavy drinking). Between January and March of 2014, 176 Latino men and Latina transgender women in New York City completed an interviewer-administered questionnaire. We developed a syndemics scale to reflect the total number of syndemic factors - clinically significant depression, childhood sexual abuse, intimate partner violence, and discrimination - reported by each participant. We also carried out a multinomial logistic regression model predicting binge and heavy drinking. Forty-seven percent of participants reported high-risk alcohol consumption in the past 30 days (21% binge and 26% heavy). Approximately 16% of participants reported no syndemic factors, 27% reported one factor, 39% reported two factors, and 18% reported three or four. In the multinomial logistic regression model, our syndemic factors scale was not significantly associated with binge drinking. However, participants who reported three or four factors were significantly more likely to report heavy drinking. In addition, having multiple sexual partners was associated with an increased risk of binge and heavy drinking; involvement in a same-sex relationship was associated with binge drinking. Further work is needed to develop effective prevention intervention approaches for high-risk alcohol consumption within this population.