Assessing Differential Dyadic Mechanisms of Women’s Sexual Functioning

Emory University, Atlanta GA

Investigators

Abstract

Project Summary/Abstract Female sexual function (FSF) refers to how desire, arousal, orgasm, pain, pleasure, and satisfaction are experienced by women. Female sexual dysfunction (FSD) is categorized into three DSM-5 diagnoses: sexual interest/arousal disorder, female orgasmic disorder, and genito-pelvic pain/penetration disorder. Differentiating problems with FSF from FSD, the morbidity criteria for FSD suggest there must be distress, symptom duration of at least six months, and experience of dysfunction in 75% or more of sexual experiences. Approximately 40.9% of premenopausal women, and between 40-50% of women regardless of menopausal status, experience FSD, which impacts subjective experiences of sex, increases feelings of distress (e.g., sadness, guilt, anxiety), and reduces their overall quality of life. Incidences of specific types of FSD include decreased desire (26.4-28.42% of premenopausal women), genital arousal (15.4-22.6%), lubrication of the vagina (16.3-20.6%), orgasm (20.9-25.7%), and increased sexual pain (14.4-20.8%). Black women are an understudied demographic within FSF/FSD research, despite research suggesting they find sex more important than women of other races. The Heteronormativity Theory of Low Sexual Desire (HTLSD) asserts socio-structural factors such as heteronormativity, expressed via romantic relationship dynamics, impact FSF, but Black women face the added intersection of racism. Intersectionality suggests racism compounds the negative impact of heteronormative socio- structural oppression on Black women’s sexual functioning. Notably, Black women's cultural values (e.g., collectivism) may moderate how relationship factors influence FSF/FSD due to socio-structural oppression, thus romantic relationship dyads are one area ripe for assessment and future intervention development. Aligned with PAR-21-281 (NIMHD and Office of Women’s Health priorities), innovation is needed to accurately capture the dyadic process of how Black women’s partners’ report of relationship factors (e.g., romantic gender roles and other variables related to the HTLSD) influence Black women’s FSF/FSD. Additionally, as White women have been the focus of most US-based FSF/FSD studies, examining the differential relationship predictors of FSF/FSD among Black and White women is an important step toward racially specific FSF/FSD interventions. The Assessing Differential Dyadic Mechanisms of Black and White Women’s SEXual FUNctioning (ADD SEX FUN) project will employ an intersectional adaptation of HTLSD, using a Black feminist, comparative mixed-method, dyadic examination of relationship factors associated with Black and White women's sexual functioning through actor-partner interdependence modeling (APIM). ADD SEX FUN will also employ dyadic qualitative interviews (dyadic framework analysis, relation mapping) and focus groups to glean the lived experience of Black women and their partners related to FSF/FSD, eliciting the key moments in their relationships that influenced FSF/FSD. ADD SEX FUN will conclude with a message test to determine which FSF/FSD messages distilled from the first and second project aims are preferred among Black women’s romantic partners, based on partner demographic and attitudinal profiles (latent profile analyses). The overall goal of the project is to identify modifiable relationship dynamics that are acceptable for dyadic FSF/FSD intervention among Black women and their partners.