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e278 (Founder and Coordinator), Faculty of Medicine of the University of São Paulo, São Paulo, Brazil; 3Program of Studies in Human Sexuality, Faculty of Medicine of the University of São Paulo, São Paulo, Brazil Introduction & Objectives: Anal sexuality has been historically pervaded by a plethora of dogmas and taboos. Although the prevalence of anal intercourse has significantly increased regardless of the sexual orientation of those who practice it, little has been written about difficulties that may impede the experience of pleasure during anal sexual performance. Pain during receptive anal intercourse, also called anoreceptive pain, is one of the most common complaints among those who engage in anal intercourse. This systematic review aimed to analyze the biological, psychological and situational factors that lead to the experience of pain during anoreceptive intercourse. Methods: A bibliographic survey was developed through Brazil’s Portal of Scientific Journals of the Coordination for the Improvement of Higher Education Personnel which enables access to different databases across the globe. Only nine papers that directly analyze the experience of anoreceptive pain were found. Results: The etiology of anoreceptive pain is due to an overlapping among multiple biological, psychological and situational factors. The main biological factors are the presence of anorectal diseases and the mismatching between the insertive partner’s penis size and the receptive partner’s anorectal anatomy. The receptive partner’s lack of relaxation and arousal and the absence of intimacy and sexual experience are the keynote psychological factors associated to the experience of anoreceptive pain. Situational factors like insufficient lubrication, absence of anal foreplay, the “doggy style” sexual position and the increasing thrust of penetration exacerbate the experience of anoreceptive pain. The use of poppers, the administration of enema and high levels of internalized homophobia seem to play an important role in the pain/pleasure principle of receptive anal intercourse. Conclusions: Due to the paucity of scientific literature about this phenomenon, it is urgent to develop multidisciplinary and interventional studies to propose preventive measures and possible treatments for this sexual complaint that is getting more and more common in sexological practice. Keywords: anal sexuality, anoreceptive pain, receptive anal intercourse Conflict of Interest and Disclosure Statement: None.

REASONS FOR AND EXPERIENCES WITH REPARATIVE INTERVENTIONS FOR FEMALE GENITAL MUTILATION/CUTTING (FGM/C) Rigmor C. BERG Norwegian Institute of Public Health, Norway Sølvi TARALDSEN, Maryan SAID, Ingvil SØRBYE, Siri VANGEN Oslo University Hospital, Oslo, Norway Introduction and objectives: Female genital mutilation/cutting (FGM/C) leads to changes in normal genital anatomy and functionality. Increasingly, women are seeking reparative interventions for their FGM/C-related concerns. We conducted a systematic review that summarized research describing women’s motivations for and experiences with FGM/C-related reparative interventions. Population sample: The sample consisted of empirical studies on women who had undergone a reparative intervention for FGM/C. Methods: We conducted a systematic review in accordance with established guidelines, including systematic searches in 11 international databases and paired screening and methodological quality assessment. Results: We included 58 studies (5108 women, almost all had FGM/C type II or III). Most studies described defibulation, some excision of cysts (typically with some reconstruction), while nine studies (4245 women) addressed clitoral reconstruction. We identified four categories of reasons for seeking a reparative intervention: functional complaints, aesthetic aspirations, sexual aspirations, and identity recovery. The most common reasons for defibulation were a desire for improved sexual pleasure, vaginal appearance and efunctioning; for clitoral reconstruction it was to recover identity. Only 19 studies, primarily case reports, provided information on women’s experiences with a reparative intervention. The majority of women were satisfied with defibulation, with overall satisfaction in the 50-100% range, typically because of improvements in their sexual lives, but defibulation created distress in some women who disliked the new appearance of their genitalia. Most women were satisfied with reconstruction, but about a third were dissatisfied with or perceived a worsening in the aesthetic look. Conclusion and recommendations: Women’s reasons for seeking defibulation and clitoral reconstruction vary, but it is unclear whether these interventions are acceptable to most women with FGM/C. Because these surgeries imply aesthetic and physiological changes that can create mixed responses, healthcare professionals should provide

23rd Congress of the World Association for Sexual Health thorough information about the options available and manage women’s expectations, both before and after an eventual surgery. Keywords: female genital mutilation/cutting, intervention, systematic review Conflict of Interest and Disclosure Statement: None.

GENITAL SELF-IMAGE AND BODY EXPOSURE ANXIETY OF INDIVIDUALS IN SAME-GENDER VERSUS MIXED-GENDER RELATIONSHIPS Stephanie GAUVIN Queen’s University, Kingston, Canada Caroline F. PUKALL Department of Psychology, Queen’s University, Kingston, Canada Introduction & Objectives: Body image is thought to be negatively influenced in situations where there is greater bodily focus (Haimovitz et al., 1993), such as during sexual activity. Differences between individuals in same-gender and mixed-gender relationships on body image specific to sexual activity; however, remains largely unexplored. The objective of the current study was to compare individuals in samegender and mixed-gender relationships on measures of genital self-image and body exposure anxiety during sexual activity. Population sample/ Method(s): N ¼ 931 individuals (n ¼ 476 females with a male partner (FxM), n ¼ 121 females with a female partner (FxF), n ¼ 210 males with a female partner (MxF), n ¼ 124 males with a male partner (MxM)) completed online measures of genital self-image and body exposure anxiety during sexual activity. Results: There were no statistically significant differences between FxM and FxF or MxF and MxM on genital self-image. Individuals with male partners reported greater body exposure anxiety during sexual activity. Specifically, FxM reported higher body exposure anxiety during sexual activity (M ¼ 61.68, SD ¼ 24.43) than FxF (M ¼ 56.23, SD ¼ 24.24; t(595) ¼ 2.20, p ¼ .029), and MxM reported higher body exposure anxiety during sexual activity (M ¼ 56.64, SD ¼ 20.56) than MxF (M ¼ 52.08, SD ¼ 19.76; t(332) ¼ 2.00, p ¼ .046). Conclusions & Recommendations: Individuals with male partners endorsed greater body exposure anxiety during sexual activity but did not report lower genital selfimage. These results suggest that differences in body exposure anxiety between individuals with female or male partners may not be related to overall negative genital self-image but rather partnered expectations. Keywords: genital self-image, body exposure anxiety, same-gender versus mixedgender relationships Conflict of Interest and Disclosure Statement: None.

APPLYING A POSITIVE DEVIANCE APPROACH TO UNDERSTANDING MATERNAL HEALTHCARE USE IN BANGLADESH Tamar GOLDENBERG1,2 1 University of Michigan School of Public Health, Ann Arbor, MI, United States; 2 University of Michigan Center for Sexuality and Health Disparities, Ann Arbor, MI, United States Rob STEPHENSON1,2 1 University of Michigan Center for Sexuality and Health Disparities, Ann Arbor, MI, United States; 2University of Michigan School of Nursing, Ann Arbor, MI, United States Introduction: Utilization of maternal healthcare services is important for improving maternal and sexual health during pregnancy. One of the Sustainable Development Goals is to reduce the maternal mortality ratio (MMR) to less than 70 per 100,000 live births by 2030. However, in Bangladesh, the MMR in 2015 was 176 maternal deaths per 100,000 live births. To reduce maternal morbidity and mortality, we must gain new understandings of what facilitates maternal healthcare use in Bangladesh. Previous research recognizes community effects in maternal healthcare use; however, to capture the variation in women’s experiences, it is important to understand how deviation from community norms may be associated with maternal healthcare utilization. Population Sample: Data are from the 2014 Demographic and Health Survey in Bangladesh. Methods: Separate identical random-effects logistic regression models were fit to examine the relationship between deviance on socioeconomic characteristics, gender and fertility norms, health and media exposure and four maternal healthcare outcomes

J Sex Med 2017;14:e211ee350