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It’s on Us—to Know About #ItsOnUs

Sex Stories

By Kait Scalisi, MPH

Did you know that this past week was It’s On Us Week of Action?

If you attend or work at a college or university, the answer is probably yes. If you’re involved in sexual health in practically any other way, it isn’t terribly surprising if you didn’t.

For those who are unfamiliar, It’s On Us Week is the next step in the White House’s strategy to end sexual violence on college campuses. The goal: to partner with colleges, universities, and a variety of organizations (e.g. NCAA, SnapChat, etc) to spread the word about the importance of everyone doing their part to prevent such violence. Over 200 schools joined the It’s On Us movement in September, leading to 130 events and 40 campus-created PSAs.

This is a great movement. It’s mobilizing students throughout the country, including athletes and members of Greek life, two key groups in this fight, to speak out about this issue. The PSAs featured people of all genders and race/ethnicities. Generation Progress, the group who is overseeing the entire It’s On Us campaign made some incredibly smart and strategic moves. These include:

  1. Partnering with Snapchat. Public health as a field is not always the most social media savvy. More and more we’re seeing organizations and schools get on board but in this case, the field’s reliance on data is holding it back. Meanwhile social platforms continue to evolve, Snapchat being one of the newest and most appealing to college students who are leaving Facebook and Twitter due to the invasion of the OPS (old persons). Props to Generation Progress for taking a very business approach to planning and meeting their target audience where they’re spending time.
  2. Partnering with the NCAA and SB Nation. Sports sports sports! Over the past few years we’ve seen numerous cases where the hero worship of sports stars has come crashing down in a blaze of sexual violence. SB Nation coordinated its social media efforts to reflect is relationship to the campaign and included a number of insightful pieces. My favorite piece acknowledges that fans can and should appreciate the beauty of the sports world without letting it blind them.

All that being said, there were some major disappointments of the week a well.

  1. The NCAA. Although the college sports association technically was a partner for the Week of Action, they did little to publicly show their support. None of their social profiles were changed to include the It’s On Us filter, there was no feature on the main page of their website, and they tweeted about the Week of Action exactly once. They certainly were not the most engaged partner, a move which implies this issue is still not that important to the college sports world for any reasons other than good PR.
  2. The lack of Greek Life buy-in. While many individual campuses’ Greek life participated in the Week of Action, there doesn’t seem to be be buy-in from the oversight councils. Individual chapters doing work is wonderful. Whole sorority and fraternity systems is even better.
  3. The continued disconnect among sex education, sexual health, and violence prevention. Where was Cosmo, Scarleteen, and Bedsider? Where were the PSAs on popular TV shows and Hulu? Perhaps such outlets were contacted and declined. However, in general these three fields tend to work in opposition to one another rather than supporting each other’s efforts during major campaigns like this. Obviously each area has its own unique agenda, target audience, etc. Nevertheless, each piece also supports the other. For example, more comprehensive sex education allows for more conversation around sex and also sexual health, decreasing the shame and stigma that It’s On Us is also working to limit. I’m not saying each group has to always talk about all the issues but during a campaign such as this week, it would allow for broader reach to audiences that may not have otherwise gotten involved. Almost any sex educator who works on a college campus can tell you a story about bearing witness to students’ stories of sexual assault. So though the connection between Sex Week and It’s On Us may not seem obvious at first, the underlying motivations and ideals are very similar. It would be nice to see that being acted out more overtly. And, for the record – sexual violence prevention organizations could also help out during major sexual health and sex education campaigns such as Get Yourself Tested.

None of this is to undermine the work of the White House or It’s On Us. Instead it’s a call for even more strategic thinking for future campaigns. What else do college stud nets do? Where are they spending their time? What are they reading? What makes them laugh? How can It’s On Us and all other sex-related campaigns hone their language and outreach strategies even more? The goal of course it to get broader attention for the campaign, including in places where it might be less likely found (e.g. more traditional or conservative schools).

I believe in progress, not perfection, and the this campaign certainly represents that. The very fact that the media, colleges, Greek Life, and more are openly discussing sexual violence is a positive step. By taking a stand and bringing sexual violence out into the open, It’s On Us is helping to reduce the shame and stigma survivors so often feel and create a cultural shift in how we think about responsibility and fault.

To learn more about the It’s On Us Campaign, click here.

Other Sexual Health News This Week

Rikers Island to Launch Unit for Transgender Inmates (New York Daily News)

State Can’t Make Sex Offenders Give Authorities Their Internet IDs (LA Times)

Judge Lifts Montana Same-Sex Marriage Ban (ABC FoxMontana)

More Women Getting Mastectomies They May Not Need (CBS News)

Olympic President Wants to Add Sexual Orientation to Non-Discrimination Policy (Think Progress)

Sex Ed Controversies in Gilbert, Tempe an Anomaly (AZ Central)

Important Dates

World AIDS Day, Dec 1. Click here to find events near you.

The following conferences have early registration deadlines in December. Click on each title for more information and to register.

National Conference on Sexual Assault and Violence, Feb 24-25, Berkley, CA.

The following conferences take place in November and December. Click on each title for more information and to register.

National Sex Ed Conference, Dec 3-5, Meadowlands, NJ Be on the lookout for presentations by SHR’s Kait Scalisi and the CSPH’s Megan Andelloux

Safer Sex Promotr

Sex Stories

By Kait Scalisi, MPH

In recent years, public health efforts have increasingly focused on higher-risk and hard-to reach populations including men who have sex with men (MSM). Despite these efforts, however, HIV rates remain stagnant and condom use is on the decline. In order to address these concerns, public health organizations and the owners of seven gay dating sites—BarebackRT, Daddyhunt, Dudesnude, Gay.com, Grindr, POZ Personals, and SCRUFF—and apps came together to determine the best way to meet both parties’ needs: making money and promoting health.

One of the biggest tensions between the sex-positive movement and the public health field is how to mitigate the risks of sex in a way that does not shame people. Public health often decries so-called hookup culture because of a large body of research linking numerous bad health outcomes to earlier sexual debut, a higher number of sexual partners, and other sexual choices identified as risky. Nevertheless, with the rise of smart phones and apps, hookups are easier than ever.

The meeting, held in San Francisco and organized by the San Francisco AIDS Foundation and the Foundation for AIDS Research (amfAR), was based in part on research from 2010 which explored the types of prevention strategies mobile and Web app users would be open to. However, the technology and the way people use it has changed drastically in the last four years, so the results were viewed more as a reference than a roadmap.

The meeting itself furthered the insights from the 2010 survey. Specifically,

  • App and Web site owners want to promote prevention strategies but need to know what works.
  • Top priorities included promoting STI testing and reducing stigma for those living with STIs.
  • Partner notification procedures need to be adapted for apps.

Ultimately, the meeting’s participants decided to focus on three areas: promoting testing, fighting stigma, and relationship building between the two fields.

This meeting is exciting for so many reasons. It helps debunk the idea that app owners care only about the bottom line and are not invested in being socially responsible. It highlights a sex-positive approach to STI prevention, rather than one rooted in fear tactics, shame, blame, or “don’t do it!” messaging. It shows that public health is evolving … and maybe our efforts don’t have to be in conflict with sex-positivity.

This collaboration is beautiful because it meets MSM, a group classified as hard-to-reach, right where they are—on the apps and Web sites they use daily. Holding this meeting was a strategic, business-like move, which isn’t public health’s traditional modus operandi. It takes the best of both sectors and combines them into a solid strategy to meet everyone’s objectives, whether those are measured in dollars, dates, or rates.

Read a full overview of the meeting here.

Other Sexual Health News This Week

Michigan Gay Rights: GOP Bill Would Add Sexual Orientation, But Not Gender Identity Protections (MLive.com)

Judge Strikes Down SC Same-Sex Marriage Ban (WLTX19)

Supreme Court Allows Same-Sex Marriages to Proceed in Kansas, Lifting Stay (Washington Post)

Transgender-Friendly Bathroom Legislation to be Subject of Cleveland City Council Hearing Today (Cleveland.com)

New York Initiative to Help Other Cities Clear Rape-Kit Backlogs (New York Times)

Military Sexual Assault in US Veterans: Results from the National Health and Resilience in Veterans Study (PubMed- NCBI)

Important Dates

World AIDS Day, Dec 1. Click here to find events near you.

The following conferences take place in November and December. Click on each title for more information and to register.

APHA’s 142nd Annual Meeting and Exposition, Nov 15-19, New Orleans, LA

National Sex Ed Conference, Dec 3-5, Meadowlands, NJ Be on the lookout for presentations by SHR’s Kait Scalisi and the CSPH’s Megan Andelloux

Everyone Is Doing It

Sex Stories

By Kait Scalisi, MPH

You won’t often find sexual fantasies being discussed as part of a standard public health curriculum. Yet fantasizing is shown to be both a normal and health part of sexuality. Now, researchers out of Canada have discovered just how normal certain fantasies are.

Spoiler alert: if you’ve wanked to it, someone else probably has too.

The study looked at data from over 1,500 adults. Notably, the numbers were nearly evenly split between men and women, a characteristic which lends credibility and generalizability to the results. With regards to the fantasies themselves, the majority of fantasies were classified as either “common” or “typical,” meaning that more than half of participants reported having them. Only 11 of the fantasies were statistically “rare” or “unusual”—that is, reported by less than 3% and 16% of the participants respectively. Rare fantasies included bestiality and pedophilia, while unusual ones included cross-dressing and urinating on one’s partner. It is important here to again highlight that the study focused only on the sexual scenarios that participants fantasized about, not acted on.

Notable results include:

  • Wanting to feel romantic emotions during sex was typical for both men and women. So much for those stereotypes about men being unfeeling horndogs.
  • Though fantasies related to submission (e.g. being tied up, spanked, etc.) were common for both genders, most women reported not wanting to act on those fantasies in real life.
  • Significantly more people fantasized about same-sex sex acts than identified as gay or not heterosexual.
  • People fantasized about having sex with their friends about as often as they fantasized about doing it with strangers.
  • Everyone fantasized about oral sex.
  • Many more women than men fantasized about having sex with more than three people at once.

The study also supported some commonly held perceptions for both genders. For example, many men fantasize about anal sex, ejaculating on their partner, and having a threesome with two women. Women, on the other hand, like to fantasize about sex with a celebrity, and were more apt to fantasize about sex with someone of the same gender.

Unsurprisingly, men reported having sexual fantasies more often than women, were more likely than women to want to realize their fantasies, and gave more vividly detailed descriptions of their favorite fantasies. This may be related to observed tendency of men to be less sexually inhibited than women. Women may fantasize less due to guilt and negative attitudes about thinking sexual thoughts; however, they may have under-reported their fantasies to conform with what they believed to be acceptable. Likewise, men might have over-reported their fantasies so they would seem more sexually experienced and open. Most likely, the discrepancy in frequency of fantasies incorporates all of these explanations to some extent.

This research is important on a multitude of levels. For individuals, it normalizes both the experience of fantasizing and the fantasies themselves. In other words, they’re normal. For mental health providers, it supports the idea that certain fantasies alone, such as domination and submission, may not actually be a paraphilic disorder but a natural and healthy part of patient’s sex life. Lastly, it supports the argument that there is so much more to sex than reproduction. As the researchers themselves said about the fantasies unique to men, including anal sex and watching their partner have sex with someone else, “Evolutionary biological theories cannot explain these fantasies.”

The researchers intend on doing additional analyses to make further connections among personal characteristics and specific fantasies.

For a graph showing the full list of fantasies and their frequency by gender click here.

Other Sexual Health News This Week

CALCASA Release Report on Campus Sexual Assault (CALCASA)

Chiaro Reboots the Pelvic Floor Exerciser as a Sleek Connected Wearable Called Elvie (TechCrunch)

MIT Survey Suggests How Campuses Can Address Sexual Assault (Central Maine)

Missouri Ban on Same-Sex Marriage Unconstitutional, Court Rules(Reuters)

Groups Ask School Districts to Reconsider Transgender Restroom Policies (The Daily Signal)

University Students, Faculty Push for Gender Identity Inclusion (The Cavalier Daily)

Coalition Of Parents Shocked To Discover Planned Parenthood Teaching Sex Ed At East Bay Schools (CBS San Francisco)

2014 Results: Sexual Health Ballot Measures

Colorado—Amendment 67, Definition of Personhood

Shall there be an amendment to the Colorado constitution protecting pregnant women and unborn children by defining “person” and “child” in the Colorado criminal code and the Colorado wrongful death act to include unborn human beings?

YES

   35%

NO

   65%  ❌  not passed

Source: Colorado Secretary of State, Unofficial Results (62 of 64 counties reporting)

Illinois—Birth Control in Prescription Drug Coverage Question

This non-binding advisory question on the Illinois ballot asks:

Shall any health insurance plan in Illinois that provides prescription drug coverage be required to include prescription birth control as part of that coverage?

YES

   66%  ✅

NO

   34%

Source: Ballotpedia.org

North Dakota—“Life Begins at Conception” Amendment, Measure 1

This constitutional measure would create and enact a new section to Article I of the North Dakota Constitution stating, “The inalienable right to life of every human being at any stage of development must be recognized and protected.”

YES

   36%

NO

   64%  ❌  not passed

Source: Ballotpedia.org

Tennessee—Legislative Powers Regarding Abortion, Amendment 1

Shall Article I, of the Constitution of Tennessee be amended by adding the following language as a new, appropriately designated section:

Nothing in this Constitution secures or protects a right to abortion or requires the funding of an abortion. The people retain the right through their elected state representatives and state senators to enact, amend, or repeal statutes regarding abortion, including, but not limited to, circumstances of pregnancy resulting from rape or incest or when necessary to save the life of the mother.

YES

   53%  ✅  passed

NO

   47%

Source: Ballotpedia.org

Colleges Vie for Sexual Health Title

Sex Stories

By Kait Scalisi, MPH

It’s that time of year again—pumpkin spice, homecoming, and the release of Trojan’s Sexual Health Report Card. The annual ranking of campus sexual health resources has become a fall tradition, and schools are stepping up their game in pursuit of the coveted No. 1 spot.

The report card provides valuable feedback about what schools do well, identifies where they could do better, and spurs improvement through competition. According to lead researcher Bert Sperling,

“The outside focus and attention placed on these programs has prompted schools to develop stronger sexual health initiatives and increase students’ access to resources.”

The report card ranks sexual health resources and information available to students on 140 campuses. Colleges are ranked on 11 categories including STI testing on-site, sexual violence prevention and response resources, and programming for sexual health education. To obtain this information, researchers both interview health center representatives and conduct their own research on the centers and their services.

Since the rankings began, schools have made vast improvements to the resources and information available to students. This year, the superstar is Oregon State University which went from No. 26 to No. 1. This incredible jump is due to factors like increasing condom availability, extending student health center hours of operations, and improving the usability and quality of their sexual health Web site. All of these factors reduce barriers to accessing safer sex materials and sexual health care. Other schools that saw large jumps in the rankings include the University of Oregon, recognized for its development of the SexPositive app, the University of Central Florida, and the University of Maryland. Coming in last, for the third year in a row, is Brigham Young University.

One limitation of the report card is that it only draws from schools in conferences within the Bowl Championships Series. That being said, the students on these campuses include individuals from all 50 states. Additionally, the report card only looks at resources available via student health centers, which may or may not be the main provider of sexual health services and information at a given school.

Despite such limitations, the Trojan report card provides valuable information about the types of resources and information available to students on campuses throughout the country, and it serves as a best-practices guide of sorts for other campuses, regardless of whether they are ranked. This year’s shakeup in the rankings highlights the increasing importance of sexual health issues to colleges and universities, and shows that lower-ranking schools can rise to the top by taking steps to improve.

Other Sexual Health News This Week

‘Swingers’ Multiple Drug Use Heightens Risk of Sexually Transmitted Diseases (Medical Press)

Transgender Federal Employee Wins Historic Discrimination Case (Washington Post)

Three States Wage Fight to Keep Same-Sex Marriage Bans (The Kansas City Star)

Planned Parenthood Thinks It Found a Way to Stop Middle Schoolers from Having Sex (Time)

Important Dates

The following conference proposals are due in October and November.

International Society for the Study of Women’s Sexual Health (ISSWSH) 2015 Meeting, October 30.

CatalystCon East, November 4.

Association of Schools and Programs of Public Health (ASPPH) 2015 Conference, November 5.

Southern HIV and Alcohol Research Consortium, November 7.

Making Strides in LGBT Patient-Centered Care

Sex Stories

By Kait Scalisi, MPH

A new report from the Human Rights Campaign (HRC) highlights the huge strides healthcare facilities have made in LGBT patient-centered care while also showing the need for more inclusive policies and practices and increased staff training. The report, called the Healthcare Equality Index (HEI), rates facilities on how they treat LGBT individuals, commends hospitals that show commitment to LGBT patient-centered care, and provide resources and information to facilities looking to become more equitable and inclusive. In their words:

[…] the HEI offers healthcare facilities unique and powerful resources for providing a long overlooked group of patients the care that everyone deserves — while also complying with new regulatory requirements and gaining access to high-quality staff training.

The ratings are based on four core criteria. These include:

  1. A patient non-discrimination policy that includes sexual orientation and gender identity and is communicated in at least two accessible ways.
  2. Visitation policies that are equal for LGBT patients and visitor snad are communicated in at least two accessible ways.
  3. An employment non-discrimination policy that follows the guidelines for patients.
  4. Training in LGBT patient-centered care.

“Accessible” forms of communication include being posted on the facility’s website, in materials given to the patient at registration or other times, posted in the waiting room or in materials located there.

This year, there were 31 other questions that participating facilities answered. These “additional best practices” further gauged facilities’ engagement and interest in recommendations for optimal care. Questions were asked about facilities’ current and planned non-clinical plans in these areas.

2014 was the largest HEI ever, including data from over 1,500 healthcare facilities. Of these, about one-third (500) actively participated by responding to the HRC’s request for information and answering questions in the aforementioned 35 areas. This number is nearly double the response received in 2013, showing a huge growth in facilities’ commitment to meeting the unique needs of LGBT individuals. Information from the remaining 1,000 facilities was gotten either through researching hospital policy or reviewing results from the 2012 and 2013 HEI.

Unsurprisingly, actively participating facilities were more likely to meet each of the core criteria, with 84% meeting all of them and earning the status of “2014 leader in LGBT healthcare equality.” All but two states, Idaho and North Dakota, had at least one “equality leader.” Additionally, 10,000 hospital and clinic staff received training in at least one aspect of LGBT health. Alongside the official news that the federal government will recognize same-sex marriage in seven new states, this data shows that the US is becoming increasingly inclusive of and, hopefully, compassionate towards LGBT individuals.

Among the hospitals that did not respond, 86% had an equal visitation policy. This likely is due to the fact that such policies are now required by Medicare/Medicaid; therefore, not having such a policy violates federal standards. More facilities included only sexual orientation in their non-discrimination policy than both that and gender-identity. This fact encapsulates the increased acceptance of same-sex partnerships as well as the work that still needs to be done to include trans* individuals. Generally speaking, the HEI provides a fairly accurate snapshot of national attitudes towards these groups. In recent years, there have been huge improvements in inclusion of LGB individuals and now the focus is rightfully shifting towards trans* people who remain more marginalized. Though these statistics are no ideal, they show drastic improvement from even two years ago and give hope that in another two years, the majority of healthcare facilities in the US will fully comply with all best practices for LGBT patient-centered care.

The results from facilities’ responses to “additional best practices” they currently or plan to enforce most clearly reflect this. Specifically, substantial improvements were noted in the following areas:

  • Providing transgender-focused training to employees
  • Recording domestic partnerships
  • Providing training to remind employees that LGBT-status is confidential
  • Providing healthcare benefits to same-sex partners of employees
  • Having at least one health insurance plan covering medically necessary services to transgender employees

The HEI also profiles several leaders who represent the very best of LGBT patient-centered care. Lastly, they provide four recommendations for hospitals who did not achieve Leader status this year. These recommendations include updating non-discrimination and visitation policies to cover both sexual orientation and gender identity and communicate these inclusive policies on the facility’s website alongside Patient Bill of Rights, visiting hours, and on the career page.

This report tells us both that huge strides are being made within healthcare and that there is still more work to be done. The nearly two-fold increase in the number of hospitals who willingly participated, the large number of staff who received training, and the hundreds of facilities designated as leaders offer an inspiring look at the future of LGBT patient-care.

Other Sexual Health News This Week

Despite Legal Reprieve On Abortion, Some Texas Clinics Remain Closed (NPR)

Alaska Asks U.S. Top Court to Block Gay Marriage (Reuters) Meanwhile, Horne Concedes Same-Sex Marriage Ruling Applies to Arizona. (AZ Central)

Gender Identity Training in Neb. Schools Frustrates Some, Applauded by Others (Christian Science Monitor)

Tougher Police Tactics Stinging Sex Buyers (Seattile Times)

Task Force to Tackle Sexual Assaults on Campuses (WWL)

Important Dates

International Society for the Study of Women’s Sexual Health 2015 Meeting, October 30.

CatalystCon East, November 4.

Association of Schools and Programs of Public Health (ASPPH) 2015 Conference, November 5.

Southern HIV and Alcohol Research Consortium, November 7.