by Kait Scalisi | Aug 14, 2014 | News
Sex education continues to be a controversial topic for just about everyone. Beyond the comprehensive versus abstinence-only argument, there is significant debate among researchers, educators, and advocates about what defines “comprehensive.” Another layer of this dialogue is how early and how often sexual and reproductive health (SRH) information should be taught. A recent analysis from Georgetown University advocates for investment in SRH promotion in very young adolescents (aged 10-14 years).
The article has an global focus but its implications are relevant to developed and developing countries alike. The authors looked at SRH development of very young adolescents as well as meso- and macro-level influences on this development. They ultimately conclude that earlier intervention is beneficial for numerous reasons:
- Addressing root causes of SRH problems (e.g. STIs, unplanned pregnancy, etc) rather than focusing on fixing them as they develop.
- Ensuring the majority of adolescents receive SRH information before their sexual initiation. According to the CDC, this is not currently the case.
- Guiding adolescents through the changes of puberty with known support system (e.g. teachers) focused on these issues.
- Giving them time and self esteem needed to make empowered SRH decisions later in life.
- Teaching coping mechanisms, including the normalizing of the puberty experience, to handle changes they are experiencing.
- Providing a foundation for future healthy relationships and sexual and reproductive health.
Both puberty and the solidification of gender roles begins during early adolescence, making this an especially critical time to reach the population. As the authors write, “Investing in younger adolescents can produce an ‘SRH and gender’ dividend […]” that may carry on into later years.
Most research shows that comprehensive sex education curriculums do have positive SRH outcomes in the short term, but that these outcomes diminish over time. This is not unsurprising, given what we know about adolescents’ brain development, especially their frontal lobe. Their idea of “risk” is diminished. Though this can be a scary concept, it supports the idea that the most effective sex education is not only comprehensive in terms of topic but also ongoing over several years. The messages can be increasingly complex as students get older, but by repeating similar information in new and engaging ways, it allows messages to better sink in and for those short-term impacts to be repeated and combined into more long-term improvements.
At the end of the day, the authors summarize the end goal best:
“As the [very young adolescent] population burgeons worldwide, advocates must strive to put this critical group on the global health and development map, moving them from a position of vulnerability to one of empowerment.”
Other Sexual Health News This Week
Federal Judges Refuse to Stay Decision Striking Va. Same-Sex Marriage Ban (The Washington Post)
ACLU Leader Wants Federal Review of Polk Sex Stings (WTSP 10 News – Tampa Bay Sarasota)
Why the Price of Commercial Sex Is Falling (The Economist)
Poor Condom Use Among Gay, Bisexual Black Men (Reuters)
GSU Addictions Studies Professor Awarded for Innovation (NWI Times)
Important Dates
The following conference proposals are due in September. Click on each title for more information and to submit.
Nuestras Voces (our voices) National Bilingual Sexual Assault Conference, August 29
Southern College Health Association Conference 2015, September 1
American College Health Association 2015 Annual Meeting, September 15
Wyoming Sexual Assault Summit XIV: Start by Believing, September 19
The following conferences take place in August and September. Click on each title for more information and to register.
Woodhull Sexual Freedom Summit, August 14-17, Alexandria, VA.
National Sexual Assault Conference, August 20-22, Pittsburgh, PA Be sure to check out “Sexual Violence in ‘The Scene’:Lessons from and Challenges Within BDSM/Kink Circles” presented by Aida Manduley from SHR’s partner organization, The CSPH.
Catalyst Con, September 11-14, Los Angeles, CA Say hi to staff writer Kait Scalisi who is presenting on two panels: “Sex, Dating, Kink, and the ‘C’ Word,” and “How to Be a Sex-Positive Warrior in Public Health.”
Widener University’s Sexuality, Intimacy, & Aging Conference, September 19-20, Chester, PA Check out Kait’s session, “Sexual Health and Pleasure in Cancer Survivorship.”
Reproductive Health 2014, September 18-20, Charlotte, NC
by Kait Scalisi | Aug 8, 2014 | News
At the beginning of July, the HIV/AIDS community received what felt like a major blow: After 27 months, a baby thought to be cured of the disease tested positive for it. The so-called “Mississippi baby” was born with the HIV but thanks to an aggressive treatment regimen given for 18 months, was later found to be virus-free. Just over two years later, after the baby turned four, traces of the virus were again found in the child’s blood.
Though the rebound in the toddler’s HIV status is certainly a disappointment, it allows researchers to look at what went wrong, insights that will undoubtedly be invaluable when it comes to finding new treatments. The focus for researchers now then, is not only a treatment regimen that can be given at birth to cure or at the least repress the disease but also a regimen to incite prolonged remission in infants and older children who did not receive said initial treatment.
At a recent HIV/AIDS conference, the focus was decidedly on what can be learned from this case. The Voice of America quoted comments made by Anthony Fauci, director of the U.S. National Institute of Allergy and Infectious Diseases:
“‘So, something was keeping the virus suppressed,’ he said. ‘We need to know what that was and we also need to know what triggered it. But there is no guarantee we are going to get a cure; we may be faced with the fact that we do have to treat people indefinitely. We do not know that right now.'”
Four major questions stemming from this case are:
- What about the treatment kept the disease under control without regular treatment for 27 months, a significantly longer period that ever reached before?
- How does the virus maintain a “latent reservoir?”
- What shocks it out of latency?
- Once it’s out, how can it be sent back?
Ultimately, these questions will drive the future of HIV/AIDS research, demonstrating that science doesn’t always progress in a linear fashion; and that a setback is not necessarily a failure.
Other Sexual Health News This Week
6 Charts That Prove We Actually Are Making Progress Towards Gender Equality (Huffington Post)
Both Sides in Gay Marriage Fight in Utah Agree: Supreme Court Should Hear Case (New York Times) Meanwhile, in Ohio, the 6th Circuit Court of Appeals weighs four states’ gay marriage cases (USA Today)
Too Much Sex in Sex Education Book, Fremont Parents Say (San Jose Mercury News)
Sex Ed Classes Should Start as Early as Age 10, Researchers Recommend (Think Progress)
Kansas City Bans Sexual Orientation Discrimination (Lawrence Journal-World)
Several states have seen changes in their STI rates: These include areas of Spokane and North Idaho, rural southwestern Oregon, and San Diego County. In Illinois, increased rates led to the re-opening of an STI clinic.
Important Dates
The following conference proposals are due in September. Click on each title for more information and to submit.
Southern College Health Association Conference 2015, September 1
American College Health Association 2015 Annual Meeting, September 15
The following conferences take place in August and September. Click on each title for more information and to register.
Woodhull Sexual Freedom Summit, August 14-17, Alexandria, VA.
National Sexual Assault Conference, August 20-22, Pittsburgh, PA Be sure to check out “Sexual Violence in ‘The Scene’:Lessons from and Challenges Within BDSM/Kink Circles” presented by Aida Manduley from SHR’s partner organization, The CSPH.
Catalyst Con, September 11-14, Los Angeles, CA Say hi to staff writer Kait Scalisi who is presenting on two panels: “Sex, Dating, Kink, and the ‘C’ Word,” and “How to Be a Sex-Positive Warrior in Public Health.”
Widener University’s Sexuality, Intimacy, & Aging Conference, September 19-20, Chester, PA Check out Kait’s session, “Sexual Health and Pleasure in Cancer Survivorship.”
Reproductive Health 2014, September 18-20, Charlotte, NC
by Kait Scalisi | Jul 25, 2014 | News
Earlier this week, the WHO released its latest guidelines on HIV prevention, diagnosis, treatment, and care. The guidelines focus on five key groups who both are at the highest risk for getting HIV and receive the least care. The groups include:
- Men who have sex with men (MSM).
- Sex workers
- Prisoners
- IV drug users
- Trans* individuals
The guidelines are meant to be adapted for each country’s unique setting. However, the groups, regardless of where you are in the world, remain the same. In other words, in both the developed and developing world, these five groups are the ones most likely to get HIV and not receive treatment for it.
Reasons for this exist at almost every level. Individuals in these groups tend to mistrust healthcare providers and establishments based on past negative experiences. Additionally, they experience higher rates of violence, poverty, and mental illness. As a result, the WHO recommends an overall HIV strategy that is comprehensive and intersectional. Health sector interventions are one part of said strategy and PrEP is just one of such intervention.
More specifically, the WHO views PrEP as an additional HIV prevention choice for MSM. The recommendation moved from provisional due to persistently high rates of HIV among MSM as well as evidence that is “strong” and “high quality.” Given that the WHO estimates PrEP could produce a 20-25% global reduction in HIV incidence in this population, it is no surprise they moved forward with recommending it.
Given the major concern that this recommendation will reduce condom use, it is also worth noting that the study on which the WHO made the recommendation actually showed an increase in condom use among PrEP users. This, of course, can be a false result given that we know many people prefer to answer surveys with the most socially acceptable answer.
Ultimately, I feel that much of the fear expressed by US public health and healthcare providers comes from a deeper fear and shame of talking about sex. “Use a condom. Every time.” has become almost standard. At this point it is easy and routine. The new recommendation, however, shifts how a conversation about safe sex will need to happen. In other words, it requires actually having a conversation about sex that goes beyond “Are you sexually active?” Determining whether PrEP is the best HIV prevention choice calls for an inquiry into patients’ sexual history, repertoire, preferences, etc. Since comparisons between PrEP and contraception abound, it is worth noting that such a conversation rarely happens for something as established and relatively well-accepted as birth control options. Healthcare providers receive little to no training on how to broach these topics. Additionally, as the report mentions, “PrEP does not fit well in current (US) models of care, which do not include frequent, regular clinic visits.” Taken together a cycle forms:
- Healthcare providers receive minimal training about sexual health.
- Healthcare providers are at risk of offending, traumatizing, or generally just having a poor response to MSM.
- MSMs develop a mistrust of healthcare providers and share minimal information. Or their mistrust is confirmed upon hearing about another negative experience. They may avoid treatment completely.
- There is an apparent lack of need for more comprehensive sexual health training.
- No training is created and sex continues to be ignored and mishandled by healthcare.
It is exciting to see the WHO take a strong harm-reduction stance around this issue. While the recommendation is not without potential negative consequences and difficulties, it provides one way to meet people where they’re at and offer a different kind and level of prevention. Ultimately, the more tools we have to prevent HIV, the better we will be able to target campaigns, outreach, and programs to groups that will be a best fit. Like with most things in life, a one size approach will not fit all. The clearer HIV prevention efforts get on their target audience the more effective they can be in reaching their goal.
Other Sexual Health News This Week
Institutional Summit Calls for Action Against Sexual Assault on College Campuses (Madame Noire)
Training For a Triathlon Commonly Leads To Urinary Incontinence and Other Pelvic Floor Disorders (Prevention)
President Obama to Sign Order Barring Federal Discrimination Against Sexual Orientation, Gender Identity Monday (NY Daily News)
Rochester, NY Extends Protections for Gender Identity and Expression (Human Rights Campaign)
10 States Join Indiana’s Appeal of Federal Judge’s Same-Sex Marriage Ruling (IndyStar)
Transgender Inmates Pushing Policy Changes (WLBZ2)
State Agencies Launch LGBT Data-Collection Effort (Capital New York)
Important Dates
Proposals for the following conferences are due in July. Click on each title for more information and to apply.
Playground: A Sex-Positive Inclusive Event for All Communities. Proposals due by 31 July 2014.
The following conferences take place in August. Click on each title for more information and to register.
National Reproductive Health Conference, Aug 2-6, Orlando, FL.
Woodhull Sexual Freedom Summit, August 14-17, Alexandria, VA. Look for SHR writer Kait Scalisi who is volunteering at the conference.
National Sexual Assault Conference, August 20-22, Pittsburgh, PA Be sure to check out “Sexual Violence in ‘The Scene’:Lessons from and Challenges Within BDSM/Kink Circles” presented by Aida Manduley from SHR’s partner organization, The CSPH.
by Kait Scalisi | Jul 11, 2014 | News
A new report commissioned by Senator McCaskill, D-Mo. surveyed over 300 colleges and universities to assess how they report, investigate, and adjudicate sexual violence. It also looked at how schools coordinate with law enforcement around this issue.
To anyone who has been following sexual assault news, the results are unsurprisingly disheartening. But before we get there, lets talk about why the report was commissioned, how it was performed, and what it measured.
Twelve years ago, a report funded by the National Institute of Justice found that most colleges and universities were not using best practices to address sexual violence on their campus. Given the White House’s recent focus on this topic (see here, here, and here), it is not surprising that someone decided it was time to update these results and see if anything had changed in the last decade plus.
The information in the report is based on data from 2011-2012 school year. The following three samples of schools, representing more than 5.3 million students, were chosen:
- A nationally representative sample of all four years schools receiving Title IV funding.
- The 50 largest public four-year institutions.
- The 40 private, non-profit four-year schools with 15,000 or more students.
Schools were contacted multiple times via telephone, e-mail, and regular mail. Response rates from the samples were fairly high at 67%, 98%, and 85%, respectively.
I already mentioned that the results were not very positive. However, what exactly did they find? Most schools surveyed are not incorporating best practices for any dimension of this issue. Specifically, colleges and universities…
- lack knowledge about the scope of the problem. Though reporting of campus sexual assault is increasing, rates still hover around 5%. Additionally, the majority of campuses are not giving climate surveys which give more accurate estimates.
- don’t encourage reporting. Of the nationally representative sample, only around half offer webs-based or telephone options for reporting. Additionally, 8% of schools do not offer confidential reporting.
- do not provide sexual assault response training to faculty, staff, students, and law enforcement. This result varies greatly depending on the type of school. For example, a majority (~75%) of private, for-profit institutions and those with less than 1000 students offer no such training to students. There is also a gap in training for high-risk student groups such as those involved in Greek life or athletics. With regards to faculty and staff one third of schools in the nationally representative sample (group 1) train neither law enforcement of officials involved in the adjudication process.
- are not necessarily investigating all reports of assault. Between one tenth and one fifth of schools conducted fewer investigations than the number of incidents reported to the Department of Education. Some schools, however, reported investigating more.
- do not have an established system for working with law enforcement. Nearly three quarters of institutions in the national sample (group 1) do not have a protocol for how the various departments and law enforcement units should work together to respond to an incident.
- aren’t providing adequate services for survivors. While most schools in all of the samples report using having a Sexual Assault Response Team (SART), those teams often lack not only adequate representatives but also a protocol for how to coordinate their response. Representatives missing from the SART include Sexual Assault Nurse Examiners, local prosecutors, and victim advocates.
- do not follow requirements and best practices for adjudication. Some schools do not provide information about the adjudication process to students, many use the same process as for other student conduct issues (e.g. cheating), and follow different procedures for student athletes. Furthermore, between a quarter and one half of schools allow other students to participate in the process which has been shown to create conflicts of interests. Finally, schools are not providing effective punishments for perpetrators.
- have not designated a Title IX coordinator.
Other issues that this report brings up:
- Victims are confused over reporting methods and definitions.
- Victims are worried about punishment for activities like drinking that often precede sexual assault.
- Because schools do not understand the scope of the problem, they have less of a motivation to do anything about it.
- There is an imbalance in the due process rights afforded to perpetrators and survivors. Often the imbalance favors the former group.
Overall, the schools needing the most improvement are those with less than 1000 students. It is easy to understand why this is so. First, smaller schools generally have fewer resources and more individuals doing multiple jobs. This makes something like training on sexual assault response burdensome. Potential concerns include cost and personnel. Who is going to pay for it? And who has the time to put together a program or attend it? Secondly, smaller schools tend to have very close communities. An event such as investigating a sexual assault, especially if students are involved in the adjudication process, can cause serious rifts. While these certainly are valid concerns, they do not make up for the fact that many of these schools are ignoring both the law and best practices and run the risk of hurting their students and their (fragile) reputations.
Though the report does not provide an abundance of new information for those working on this issue, what it does offer is solid evidence in support of the claims made by advocates. Like all studies, it has its faults. For example, many of the claims made in the media do not differentiate among the different groups studied. However, it was certainly time for an updated review of the current situation. A second benefit of the report is that it identifies specific areas where schools can improve. Some are more easily addressed than others; for example naming a Title IX coordinator versus effectively training all staff, faculty and students which involves changing ingrained assumptions about consent, rape culture, etc. Given that the public conversation around this issue is finally happening with some regularity, this report was released at a good time and will hopefully inspire not only more conversation but also some definitive change as part of the White House’s larger strategy.
Other Sexual Health News This Week
Colorado Claims Contraception Program Caused Big Drop in Teen Birth Rates (The Denver Post)
States Continue to Enact Abortion Restrictions in First Half of 2014, but at a Lower Level Than in the Previous Three Years (Guttmacher Institute)
Remote-Controlled Chip Could be the Future of Contraceptives (CNet)
Gay Rights Groups Halt Support for ENDA Workplace Discrimination Bill (Los Angeles Times)
Colorado’s Same-Sex Marriage Ban Ruled Unconstitutional, But Ruling Stayed (KDVR)
Transgender Restroom Policy Stands after Appeal (The Courier-Journal)
Important Dates
Proposals for the following conferences are due in July. Click on each title for more information and to apply.
Playground: A Sex-Positive Inclusive Event for All Communities. Proposals due by 31 July 2014.
The following conferences take place in July and August. Click on each title for more information and to register.
National Reproductive Health Conference, Aug 2-6, Orlando, FL.
Woodhull Sexual Freedom Summit, August 14-17, Alexandria, VA. Look for SHR writer Kait Scalisi who is volunteering at the conference.
National Sexual Assault Conference, August 20-22, Pittsburgh, PA Be sure to check out “Sexual Violence in ‘The Scene’:Lessons from and Challenges Within BDSM/Kink Circles” presented by Aida Manduley from SHR’s partner organization, The CSPH.
by Kait Scalisi | Jun 27, 2014 | News
A few weeks ago, we looked at the media’s coverage of a study examining the impact of porn on marriage. This week, we’re once again delving into the world of hyperbolic headlines by examining a new study focused on the connection between STI rates and use of hook-up apps.
Before we delve in, lets first look at some of these headlines:
Breaking: Grindr-ing Leads to Gonnorhea (The Daily Beast)
The Starling Link Between Dating Apps And STI Risk (Huffington Post)
Grindr, Scruff, and Recon: Want An STI? There’s an App for That (Science 2.0)
Now let’s back (that app) up for a second and look at the research itself. Here are the highlights:
There were 7,184 men in the study.
36% of participants used apps to meet partners. Of these 17% used only app(s).
App users were more likely to be under 40, Caucasian, Asian, or other (including 3+ races), college educated, and more likely to use drugs.
App users were more likely to test positive for gonorrhea and chlamydia compared with those who used in-person networking only.
STI diagnoses were also associated with age, race, education level, and drug use.
Looking at this information as a whole, we begin to see that the connection between app use and STI diagnoses is not nearly as clear as the above headlines would make it seem. For one, correlation does not equal causation. Therefore, it is impossible to say with certainty “Grindr causes STIs!” especially since the study found app users also had other risk factors such as younger age and drug use. The question then becomes: are higher-risk MSM using these apps or are MSM becoming higher risk because they use the apps?
Furthermore, the age differences among both app users and those more likely to have STI diagnoses cannot be ignored here. Condom use is inconsistent among adolescents, a group that includes the younger MSM in this study who had the highest STI incidence. Some speculate that this is related to younger generations not being around during or remembering the early days of the AIDS epidemic. Either way, age most likely accounts for some of the increased diagnoses among app users, because they were both more likely to use apps and less likely to use condoms.
Additionally, over the last 20 years or so, safe-sex messaging geared towards adolescents has focused almost exclusively on prevention. At least in the US, there is little focus on harm-reduction methods. This is understandable given the way the adolescent brain works, but it is at least worth noting that individuals who do not want to use condoms also most likely do not know their other options, however more or less effective they may be.
Sadly, this study will likely be used to heap more shame and blame upon users of hook-up apps rather than empower gay and bisexual men to take charge of their sexual health and use available resources” as the researchers reportedly intended. Hopefully it will inspire new approaches to STI prevention and harm-reduction as well as more open conversations beyond the “hook-up culture/sex ed/sexual promiscuity is bad” argument. Ultimately, it calls for change by adding to the growing body of research showing that public health’s efforts to slow STIs simply are not working as many had hoped.
Other Sexual Health News This Week
Week of June 22
Teen Sex Rates Plateaued, Cigarette Smoking Down: Survey (Washington Times)
North Alabama’s Only Abortion Clinic to Surrender Its License by Monday, Close Downtown Huntsville Facility (AL.com)
Bans against same sex marriage were struck down in Utah and Indiana. Meanwhile, a federal judge in Louisiana will decide not only whether to recognize same-sex marriages performed in other states but also whether to strike down the state’s ban. (Los Angeles Times, Fox 59, The Times-Picayune)
Health Challenges Make Bisexual Men More Prone to Sexual Disease (Psych Central)
Both Alabama and Santa Barbara county saw spikes in STI diagnoses. (AL.com and KEYT)
Massachusetts to Cover Gender Identity Treatment (WCVB)
Week of June 15
US Presbyterians to Allow Clergy to Perform Gay Weddings (BBC World)
OPM Lifts Ban on Trans-Related Healthcare for Fed’l Employees (Washington Blade)
SCOTUS Gives Anti-Choice Group Green Light in “Right to Lie” Legal Challenge (Slate)
James Madison University Punished Sexual Assault with ‘Expulsion after Graduation’ (Huffington Post)
Kentucky High School Passes Gender Identity Non-Discrimination Policy (Human Rights Campaign)
Important Dates
Early-bird pricing for the following conferences ends in June and July. Click on each title for more information.
Catalyst Con West, September 11-14, Los Angeles, CA.
Proposals for the following conferences are due in July. Click on each title for more information and to apply.
Playground: A Sex-Positive Inclusive Event for All Communities. Proposals due by 31 July 2014.