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Epidemiological, behavioral, and clinical data on sexual compulsivity in Brazil are very limited. This study sought to adapt and validate the Sexual Compulsivity Scale (SCS), the 22-item version of the Compulsive Sexual Behavior Inventory (CSBI-22), and the Hypersexual Disorder Screening Inventory (HDSI) for use in Brazil. A total of 153 participants underwent psychiatric assessment and completed self-reported measures. The adaptation process of the instruments from English to Portuguese followed the guidelines of the International Society for Pharmacoeconomics and Outcomes Research. The reliability and validity of the HDSI criteria were evaluated and the construct validity of all measures was examined. For the SCS and HDSI, factor analysis revealed one factor for each measure. For the CSBI-22, four factors were retained although we only calculated the scores of two factors (control and violence). All scores had good internal consistency (alpha >.75), presented high temporal stability (>.76), discriminated between patients and controls, and presented strong (ρ > .81) correlations with the Sexual Addiction Screening Test (except for the violence domain = .40) and moderate correlations with the Impulsive Sensation Seeking domain of the Zuckerman Kuhlman Personality Questionnaire (ρ between .43 and .55). The sensitivity of the HDSI was 71.93 % and the specificity was 100 %. All measures showed very good psychometric properties. The SCS, the HDSI, and the control domain of the CSBI-22 seemed to measure theoretically similar constructs, as they were highly correlated (ρ > .85). The findings support the conceptualization of hypersexuality as a cluster of problematic symptoms that are highly consistent across a variety of measures.

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The aim of this review is to present the beliefs related to sexual activity during pregnancy. We identified 13 studies (3,122 participants). The main positive beliefs about sex in pregnancy were that it makes labor easier, promotes marital harmony, prevents infidelity, and improves fetal well-being. Negative beliefs were more frequent: that sex could harm the unborn child (cause injuries, miscarriage, or fetal infection) and endanger the pregnancy or maternal health (cause membrane rupture, bleeding, preterm labor, and maternal infection). These findings are useful to clinicians and educational program developers.

Introduction There is evidence of an association between the practice of intentional unsafe sex among men who have sex with men (MSM) and sensation seeking and impulsivity. However, other aspects of personality have been less frequently investigated. Aims This study aims to investigate the association between the practice of intentional unsafe sex and personality traits in individuals who sought treatment and met the criteria for compulsive sexual behavior in São Paulo, Brazil. Methods The sample consisted of 69 sexually compulsive MSM. The participants underwent psychiatric evaluation and an interview to define intentional condomless sex and completed self-report instruments. Main Outcome Measures The participants completed the following measures: the Temperament and Character Inventory and the Sexual Compulsivity Scale. Results Twenty-five participants (36%) reported intentional unsafe sex with casual partners, of whom 84% were gay and 16% bisexual (P < 0.05). Fifteen (22%) individuals reported being HIV positive, and 11 (73%) of them practiced intentional unprotected anal intercourse (P < 0.05). The mean of sexual compulsivity was associated with men who engaged in intentional unsafe sex (P = 0.01). Men who reported intentional unsafe sex scored significantly higher on the novelty seeking temperament dimension (P < 0.05) and scored significantly lower on the self-directedness character dimension (P < 0.001). However, self-directedness predicted intentional unsafe sex in the multiple logistic regression (P = 0.001). Conclusions Sexually compulsive individuals who practiced intentional unsafe sex presented lower self-directedness than the group who did not engage in intentional unsafe sex, which suggests less autonomy regarding life itself. To the best of our knowledge, this is the first study to consider intentional unsafe sex in sexually compulsive men.

We describe the preliminary national experience and the early results of the use of robotic surgery to perform the posterior separation of abdominal wall components by the Transversus Abdominis Release (TAR) technique for the correction of complex defects of the abdominal wall. We performed the procedures between 04/2/2015 and 06/15/2015 and the follow-up time was up to six months, with a minimum of two months. The mean surgical time was five hours and 40 minutes. Two patients required laparoscopic re-intervention, since one developed hernia by peritoneal migration of the mesh and one had mesh extrusion. The procedure proved to be technically feasible, with a still long surgical time. Considering the potential advantages of robotic surgery and those related to TAR and the results obtained when these two techniques are associated, we conclude that they seem to be a good option for the correction of complex abdominal wall defects.

BackgroundLittle attention has been given to efficacious treatment and adherence to treatment of compulsive sexual behavior (CSB).AimsRandomized controlled trial investigated short-term psychodynamic group therapy followed by relapse prevention group (STPGP-RPGT) and pharmacological treatment (PT) for CSB men on sexual compulsivity and adherence.Method135 men, 38 (SD = 9) years old on average, were randomly assigned to 1) STPGP-RPGT; 2) PT; 3) Both. Participants completed measures at baseline, 25th, and 34th week. 57 (42.2%) participants dropped out between baseline and 25th week, and 68 (50.4%) between baseline and 34th week. 94 (69.6%) did not adhere (80% pills taken or attended 75% therapy sessions).ResultsA significant interaction effect was found between time and group (F (4, 128) = 2.62, P = 0.038, ES = 0.08), showing who received PT improved less in sexual compulsivity than those who received STPGP-RPGT (t = 2.41; P = 0.038; ES = 0.60) and PT + STPGP-RPGT (t = 3.15; P = 0.007, ES = 0.74). Adherent participants improved more in sexual compulsivity than non-adherent at the 25th week (t = 2.82; P = 0.006, ES = 0.65) and 34th week (t = 2.26; P = 0.027, ES = 0.55), but there was no interaction effect, F (2, 130) = 2.88; P = 0.06; ES = 0.04). The most reported behavior (masturbation) showed greater risk of non-adherence (72.6%).Discussion and conclusionsAdherent participants improved better than non-adherent. Participants who received psychotherapy improved better than those who received PT. Methodological limitations preclude conclusions on efficacy.

Introduction Sexuality plays an essential role in the psychosocial well-being of people living with HIV (PLHIV) but it is still less assessed by healthcare professionals during treatment. Aim To investigate the frequency of those screening positive for sexual dysfunction (SD) and associated factors according to gender/sexual orientation in PLHIV under long-term treatment with antiretroviral therapy (ART). Methods Between September 2013 and October 2016, 234 PLHIV adults in treatment in São Paulo were included. Participants were sexually active, did not present sexual orientation disorder or body dysmorphic disorder, and did not use sexual hormones. We performed clinical interviews and measured levels of depression, anxiety, and levels of sexual hormones. SD was assessed using a self-report questionnaire. Main Outcome Measures Proportion of participants screening positive for SD in the International Index of Erectile Function, the Index of Premature Ejaculation, and the Female Sexual Function Index. In the regression analyses, the outcome SD considered any SD presented with disregard to gender. Results 70% of participants reported consistent adherence to ART and 96% had an undetectable viral load. The median (Md) duration of ART was 198 months (inter quartil range, IQR 111.6–230.4) and the median CD4 was 655 cells/mm3 (IQR 443–871). Screening positive for erectile dysfunction was 49.7%, premature ejaculation 16.9%, female sexual dysfunction 27.4% and hypoactive desire 45.1%. Lower testosterone and prolactin levels were associated with erectile dysfunction in heterosexual men (n = 58); lower levels of oestradiol and higher levels of follicle stimulating hormone were associated with female sexual dysfunction and hypoactive desire in female participants (n = 63). The multivariable model used included comorbidities and hormonal abnormality and found that age (odds ratio, OR = 1.04, 95% confidence interval, 95%CI 1.00–1.08, P = .026) and the presence of depression/anxiety (OR = 2.96; 95%CI 1.52–5.77; P = .001) were associated with SD. Also, men reporting engaging in sex with other men were associated with screening positive for SD (OR 2.66; 95%CI 1.52–5.77, P = .013). During treatment of PLHIV, it is important to evaluate sexual health and symptoms of depression and anxiety specifically. The strength of this study consists in evaluating PLHIV who have been in long-term treatment with ART and analyzing those screening positive for SD and associated factors for each group (heterosexual men, men reporting engaging in sex with other men, and women). Limitation includes the difficulty to generalize the findings of the study, and not exploring women's sexual orientation. Conclusion PLHIV in long-term treatment with ART presented alarming rates of depression/anxiety which in turn is correlated with sexual and physical health problems.