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Health | Bringing Sexy Back — To Fight H.I.V.
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Bringing Sexy Back — To Fight H.I.V.
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The Fight Against H.I.V. An estimated 40 million people are living with H.I.V. worldwide. About 10 million of them do not have access to treatment. A New Shot : An injection every two months rather than a daily pill could shield many more women from H.I.V. , but the shot is unavailable in places that need it most. Pandemic Setbacks : Before Covid-19, the world had been making strides against global illnesses like H.I.V. The pandemic has changed that for the worse . A Visionary : Ravindra Gupta led the efforts that resulted in the second case of a patient being cured of H.I.V. Then he was drawn into Covid research . A Promising Treatment: In February, researchers announced that a woman became the third person ever to be cured of H.I.V. thanks to a new transplant method that could help more people from racially diverse backgrounds.
Most safer sex campaigns focus on danger and disease. Acknowledging the importance of pleasure — and how to make safe sex good sex — could make them more effective.
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Efforts to make sex safer almost always focus on the bad stuff: what to do to avoid a terrible infection or potentially deadly virus. They rarely acknowledge the good stuff: usually the reason people have sex in the first place.
And that’s why safe sex campaigns throughout the world aren’t as effective as they could be.
Research shows that when safe sex campaigns acknowledge pleasure — by talking about sex as something that makes life good, or showing how condoms can be erotic — more people use a condom the next time they have sex.
That is what the World Health Organization and a small nongovernmental organization called the Pleasure Project found when they reviewed the results of safer-sex trials and experiments over the past 15 years. They assessed more than 7,000 interventions for their treatment of pleasure (and lack thereof). The peer-reviewed findings were published in the journal PLOS One.
“Sexual health education and services have traditionally promoted safer sex practices by focusing on risk reduction and preventing disease, without acknowledging how safer sex can also promote intimacy, pleasure, consent and well-being,” said Lianne Gonsalves, a co-author of the paper and an epidemiologist who researches sexual health with the W.H.O. “This review provides a simple message: Programs which better reflect the reasons people have sex, including for pleasure, see better health outcomes.”
The stakes are high. Sexually transmitted infections are at record levels in the United States and rising around the world since Covid-19 pandemic closures set back testing and treatment. Globally, 1.5 million people were diagnosed with H.I.V. in 2021, a rate of new infections that has hardly budged in the last four years. Taking a daily pill known as PrEP, or pre-exposure prophylaxis, offers the promise of preventing some infections, but condoms remain a simple and surefire way to do it.
The Pleasure Project has for years maintained that recognizing the role of pleasure would have a major impact on condom use, reducing not only sexually transmitted infections but also unwanted pregnancies. Still, Anne Philpott, a British public health specialist who founded the initiative in 2004, said the strength of the results of the analysis came as a surprise even to her.
“If you had a pill or a vaccine where you could show this kind of effect, everybody would be talking about it, it would have all the headlines,” she said. “Now we have evidence: Ignoring this blind spot, all the way through the AIDS pandemic, has led to less condom use, and deaths we could have prevented.”
The good news, she noted, is that the pleasure message is a comparatively cheap and easy addition for programs. It’s a change in conversation, rather than a new drug or device that needs regulatory approval and infrastructure to be delivered to far-flung places.
I’ve been crossing paths with Ms. Philpott at global gatherings on AIDS for nearly two decades. But her message is only slowly taking root in the vast sexual and reproductive health community that delivers safer-sex messages and technologies in much of the world.
There is some progress. In September, the International Planned Parenthood Federation, the largest sexual and reproductive health organization in the world, endorsed what are called the Pleasure Principles, guidelines for centering enjoyment in healthy sex . It was the first move by a global sexual health organization to embrace the P-word explicitly in delivering its services.
And there are scattered programs around the world taking this approach — projects such as Phénix, in Montreal, which taught “erotic skills” to men who have sex with men, using videos that made condoms sexy and fun.
The best demonstration of the pleasure message I’ve seen comes from Arushi Singh, who is co-director of the Pleasure Project. When she demonstrates what it means to eroticize safer sex, she pulls a little blue pouch out of her bag .
“This is a sex toy I was introduced to by sex workers at an AIDS conference in Bangkok,” she says in the tone of a friend with a delightful discovery to share.
“It’s small, convenient, you can carry it in your bag, insert it by yourself, or your partner can help,” she explains. “It’s nicely lubricated. It comes with two rings — one anchors against the cervix. And this outer ring is the secret: When a penis or a dildo goes into your vagina, the outer ring is pressing against the clitoris.”
She gives a little shimmy. “That’s what does it.”
The toy Ms. Singh is demonstrating is, in fact, a female condom. And that, she says, is how you flip the narrative and make a conversation about disease prevention first about having a good time.
So why, given the millions of dollars spent globally every year to change how people have sex, is the actual point of sex mostly left off the agenda?
Ms. Philpott has a theory. “People who work in sexual health often come from a biomedical background, and they focus on death, danger and disease,” she said. “They’re not encouraged to think of themselves as sexual beings.”
The fact that most sexual and reproductive health programs are delivered by big aid agencies doesn’t help, she added. “There’s an international development narrative that historically comes from a very sex-negative place or a Christian colonial perspective aimed at saving the ‘poor unfortunates.’”
Sonali Silva, who until recently did advocacy work for the Pleasure Project in Sri Lanka, told me that during the years she worked on sexual health-related issues, including abortion rights and H.I.V., with big international organizations such as the W.H.O., she kept running into the same phenomenon.
“The big elephant in the room that nobody wants to make eye contact with is why people have sex in the first place,” she said. “We’re all just going to act like it’s only for reproduction. As long as people have been alive, they’ve been having sex for pleasure, but the world of international development is not having that conversation.”
The prudish resistance may be a colonial import, she said, but it’s entrenched. She encounters the same reluctance from Sri Lankans. When she pushed for the seventh-grade health curriculum in Sri Lanka to say more about masturbation than that it is not a mental illness, she was called to appear before a parliamentary committee.
“I really saw how forceful the resistance is,” she said, to the idea that people have a “right to pleasure.”
Mahmoud Garga, who leads strategic communications in the Africa office of the International Planned Parenthood Federation, recently launched a social media campaign called “Treasure Your Pleasure,” which I love. It was designed for East Africa, but he and his colleagues have been asked to expand it to Southeast Asia.
The campaign features words for orgasm in different African languages, emphasizing that pleasure is not an imported idea .
“We want to debunk that myth that sexual pleasure is a Western theme that is pushed on other cultures,” Mr. Garga said. “It’s simply not true. I’m Egyptian, so I’m familiar with Arab literature, and there was just this history of erotic poetry.”
Mr. Garga told me that the topic was never part of sexual health education when he was growing up in Egypt, and that even in progressive environments like Planned Parenthood, sexual health typically means “contraception, sexually transmitted infections, and unwanted pregnancies, going to clinics and consulting with doctors. That, I mean, I don’t find that sexy at all.”
“But when you shift the narrative from that fear-based framing,” he continued, “when you talk about sexual pleasure as a big component of sex and your sex life, then you turn it into something that needs to be talked about.”
“Using a condom frees up your mind to feel pleasure.”

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Key points

Previous research shows that people who masturbate are less satisfied with their sex lives, but the reason is unclear.
New research finds that women masturbate to complement their sex lives, while men do it to compensate.
Traditional attitudes about sexuality influence the connection between solo sex and sexual satisfaction.

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Our conversations are sprinkled with slips, pauses, lies, and clues to our inner world. Here’s what we reveal when we speak, whether we mean to or not.

Posted November 15, 2022

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Reviewed by Ekua Hagan

It’s a well-established finding that people in committed relationships are generally more satisfied with their sex lives than those who are not. The received wisdom is that having ready access to a sex partner is what makes people so happy in their relationships.
This point of view assumes that committed couples generally have as much sex as they want. However, we also know that a discrepancy in sexual desire is one of the most common reasons that couples seek counseling. Typically, the partner with the higher sex drive is quite unsatisfied with their sex life, and oftentimes the lower sex drive partner is, too. Clearly, just being in a relationship doesn’t guarantee that you’ll get your sexual needs met.
Likewise, people who aren’t in a relationship but do engage in frequent partnered sex also tend to report high levels of sexual satisfaction. This suggests that it’s the frequency of intercourse, or at least getting as much as you want, that leads to sexual satisfaction.
Another well-established finding is that people who masturbate frequently are less satisfied with their sex life than those who don’t. This is true both for those who are partnered and for those who are unpartnered. It could be that frequent masturbation dampens the desire for partnered sex, but it could also mean that they’re compensating for unmet sexual needs.
Yet even this finding falls apart on closer inspection. It is true that men who masturbate frequently do tend to report lower sexual satisfaction. At the same time, women who engage in lots of solo sex tend to report higher sexual satisfaction than women who don’t.
Clearly, we still lack a good understanding of how masturbation affects sexual satisfaction in a relationship. To gain greater insight into this issue, University of Oslo (Norway) psychologists Nantje Fischer and Bente Traeen surveyed over 4,000 Norwegian adults, ranging in age from 18-89 years, regarding their frequency of solo and partnered sex as well as their degree of sexual satisfaction.
The researchers found that the respondents fell into four clearly defined categories:
Each of these categories was associated with a different pattern of sexual behavior, and there were gender differences in each of the categories as well.
Not surprisingly, women who reported frequent partnered sex also reported high sexual satisfaction. But what was surprising was that they also tended to masturbate frequently. In general, these women had strong sexual appetites and were very open to new sexual experiences. For these women, masturbation was one way to enhance their overall sexual satisfaction. In other words, solo and partnered sex were complementary aspects of their sex lives.
Likewise, men who engaged in frequent partnered sex reported higher sexual satisfaction than those who didn’t. However, most of these men also reported little or no masturbation. In other words, men generally only reported high levels of solo sex when they weren’t getting as much partnered sex as they wanted. Furthermore, men who reported a lot of masturbation, especially while viewing porn , reported lower sexual satisfaction. This suggests that, in contrast with women, men use masturbation as compensation for the lack of partnered sex.
For both men and women, those who were in cohabiting relationships reported less masturbation than those who were unpartnered. There are several possible reasons for this. First, to the extent that having a live-in sex partner enabled them to meet their sexual needs, they felt less need to masturbate.
Even among those who were cohabiting but sexually dissatisfied, there was less masturbation than among those who were unattached. This could simply be due to a lack of privacy for solo sex. But it could also be due to attitudes about the inappropriateness of solo sex within a committed relationship. In fact, it’s not uncommon for partnered persons to report feelings of guilt about their autoerotic behaviors, nor is it unusual for the other person to feel betrayed when they catch their partner masturbating.
Fischer and Traeen also found, consistent with other studies and with common assumptions, that men are more likely to masturbate than women, and they do so more frequently. The researchers speculate that this difference may be due to traditional sexual scripts, in which men are supposed to have higher sex drives than women and have fewer reservations about engaging in solo sex when partnered sex is unavailable.
In contrast, according to the traditional script, women aren’t supposed to want sex as much as men do. Rather, they’re supposed to engage in intercourse to please their partner.
Even her achieving orgasm is supposed to be for him, to stroke his ego. If a woman engages in solo sex, then, it’s a sign that she has improper urges, something a “good girl” shouldn’t feel and certainly shouldn’t give into. Granted, people’s attitudes about sex have changed radically over the last 60 years, but the old stereotype of the man as the active partner and the woman as the passive one still persists.
Fischer and Traeen’s article, however, does end on a positive note. That is, most of the men and women in this study were generally satisfied with their sex lives. In fact, the category of high sexual satisfaction and low masturbation was the largest by far for both men and women. Likewise, the categories with low sexual satisfaction and either high or low masturbation were the smallest for both genders. That, in itself, is encouraging news.
Fischer, N. & Traeen, B. (2022). A seemingly paradoxical relationship between masturbation frequency and sexual satisfaction. Archives of Sexual Behavior. Advanced online publication. https://doi.org/10.1007/s10508-022-02305-8
David Ludden, Ph.D. , is a professor of psychology at Georgia Gwinnett College.

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Our conversations are sprinkled with slips, pauses, lies, and clues to our inner world. Here’s what we reveal when we speak, whether we mean to or not.

If the guy ejaculates inside the vagina, there is a high chance of pregnancy. There are no ifs and buts.
There are male protection methods for sex, like condoms and pills. Yes, pills for men exist!
Condoms are actually pretty effective so if anybody says otherwise, it’s false.
Hormonal birth control pills aren’t harmful as many doctors prescribe them. It’s a personal choice that people adhere to.
Men always do not have a high libido. Stress, anxiety and frustration are a few reasons why men may not be in the mood to have sex at all.
False. It is not just about sex but consent relates to different areas in life as well such as personal space, relationships, professional life etc.
Women actually take a lot of time to orgasm. Stimulating the clitoris, foreplay, touching and sensual grabbing are some of the ways in ways a woman can climax quickly.
Women also have a high sex drive, contrary to what most people believe.
A big penis or a small vagina doesn’t mean the sex will be incredible. How you do it is all that matters.

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and last updated 4:55 PM, Nov 18, 2022
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