The PANHIS Study: Sexual Health in Spanish-Speaking Adults - A Cross-Sectional Online Survey

This cross-sectional observational study uses an online survey to describe the epidemiology of sexual health, sexual behaviour and sexual function in Spanish-speaking adults, and to estimate the prevalence and phenomenology of expanded (altered) states of consciousness associated with orgasm. The study has two prespecified aims, analysed and reported as two separate manuscripts: 1. sexual health and behaviour epidemiology and associated factors; and 2. expanded states of consciousness associated with orgasm. Recruitment is via social media with complementary channels. Sexual function is assessed with a brief study-developed instrument administered identically to all participants, enabling direct between-sex comparison. Survey weights are applied. Reporting follows STROBE and CHERRIES.

Inclusion Criteria: * Age ≥ 18 years (self-reported) * Sufficient command of Spanish to understand and respond to the questionnaire * Internet access and a device compatible with the digital survey form * Explicit informed consent provided digitally before accessing the questionnaire Exclusion Criteria: * Refusal of informed consent * Questionnaire completion rate below 70% (the threshold also required to access the participation incentive) * Duplicate response, identified by exact email match (when provided) or by analysis of response patterns and technical fingerprint (timestamp, IP address, user agent) * Implausible response patterns (e.g., age of sexual debut greater than current age, systematic straight-lining on reverse-coded scales, completion times below the first percentile of the pilot) - Aged under 18