Sexual violence history predicts changes in vaginal immune parameters during sexual arousal

Abstract

Objective: To examine the influence of sexual arousal on vaginal mucosal inflammatory cytokine and antibody production in healthy women with and without histories of childhood and/or adult sexual violence.

Methods: Ninety-one premenopausal healthy women (ages 18-42) attended a single laboratory session in which they provided vaginal fluid samples before and after viewing one neutral and one erotic film. While viewing the films, participants' vaginal sexual arousal was recorded using vaginal photoplethysmography.

Results: Of the 91 participants, 41 (45%) reported no history of sexual violence, 17 (19%) reported a history of childhood sexual abuse (CSA) only, 19 (21%) reported a history of adult sexual assault (ASA) only, and 10 (11%) reported a history of both CSA and ASA, with 4 participants choosing not to provide information on their sexual violence history. For women with a history of ASA but not CSA, there was a significant increase in vaginal IL-1β following arousal, while for women with a history of CSA (with or without ASA), there was a significant decrease. Women without CSA histories had a significant increase in vaginal IgA following sexual arousal, while women with CSA histories had a decrease.

Conclusion: Sexual arousal possibly plays a role in modifying vaginal immune responses in young, healthy women. Moreover, these effects may vary depending upon sexual assault histories, such that relative to women without assault histories, women with a history of early life sexual trauma showed significantly altered vaginal immune responses following sexual arousal. If replicated, these findings may help explain the increased risk for sexually transmitted infections observed among women with sexual assault histories.

Keywords: Antibody; Childhood sexual abuse; Cytokine; Sexual arousal; Sexual violence; Vaginal; Women.

Fig. 1.

Correlations between vaginal cytokine concentrations. All values are adjusted for weight/dilution, and compared to similar timepoints (pre- or post-arousal) within individuals. * p < 0.05; ** p < 0.01; *** p < 0.001.

Fig. 2.

a–c. Changes in vaginal cytokines following sexual stimulation as a function of degree of vaginal sexual arousal. All values are adjusted for weight/dilution. For presentation we designated high and low arousal by median split, but analyses all used the continuous variable of percent change in vaginal pulse amplitude. Higher vaginal blood flow during sexual stimulation was associated with significant decreases in vaginal cytokines from pre- to post-arousal, while lower vaginal blood flow was associated with either no change or moderate increases in vaginal cytokines. There were marginally significant differences at the pre-arousal timepoint in vaginal TNF and IFN between women who went on to have either high or low vaginal arousal. † p < 0.1, * p < 0.05; ** p < 0.01; *** p < 0.001, ns = not significant.

Fig. 3.

Changes in vaginal immunoglobulin A (IgA) following sexual stimulation as a function of degree of vaginal sexual arousal. All values are adjusted for weight/dilution. Note that for presentation we designated high and low arousal as defined by median split, but analyses all used the continuous variable of percent change in vaginal pulse amplitude. There was a decrease in vaginal IgA among women who had lower vaginal arousal, while women with higher levels of vaginal arousal showed a non-significant increase in IgA following sexual stimulation. † p < 0.1, * p < 0.05; ** p < 0.01; *** p < 0.001, ns = not significant.

Fig. 4.

a–c. Changes in vaginal cytokines following sexual stimulation as a function of sexual violence history. All values are adjusted for weight/dilution. CSA = Childhood sexual abuse; ASA = Adult sexual assault. For women with a history of ASA but not CSA, there was a significant increase in vaginal IL-1β following arousal, while for women with a history of CSA (with or without ASA histories), there was a significant decrease. Women with a CSA history had a significant decrease in vaginal TNF-α and IFN-γ following sexual arousal, while women without CSA histories had either no change or an increase. Among women with ASA histories, there were significant differences at the pre-arousal timepoint in vaginal IL1β between women with vs without CSA histories. Among women without ASA histories, there were significant differences in the pre-arousal timepoint in vaginal TNF- α between women with vs. without CSA histories. † p < 0.1, * p < 0.05; ** p < 0.01; *** p < 0.001, ns = not significant.

Fig. 5.

Changes in vaginal immunoglobulin A (IgA) following sexual stimulation as a function of sexual violence history. All values are adjusted for weight/dilution. CSA = Childhood sexual abuse. Women without CSA histories showed a significant increase in vaginal IgA following sexual arousal, while women with CSA histories had a significant decrease. † p < 0.1, * p < 0.05; ** p < 0.01; *** p < 0.001, ns = not significant.