Category Archives: Health Communication

Genital Herpes (part 2): Actually, it IS a joke.

Ever notice that the only time we hear herpes mentioned in movies or on TV is when it’s the butt of a joke? Genital herpes is an easy target for humor because it is not fatal and the people who suffer from this STI are not usually considered victims. Unlike HIV/AIDS, genital herpes is a relatively mild condition that does not warrant the seriousness or sensitivity that society grants fatal illness. Instead, genital herpes is understood to be a punishment, or something you “ bring upon yourself.”  People with genital herpes aren’t though of as victims; they’re thought of as sluts, monsters, lepers, or just stupid.  When we combine these factors, people with genital herpes are obvious subjects for ridicule.

A quick search on the Internet Movie Database will reveal that the majority of the films and scripted TV shows that mention genital herpes are comedies. The Hangover features a classic herpes joke: “ What happens in Vegas, stays in Vegas. Except for herpes – that shit’ll come back with ya.”  Another common quip dubs genital herpes “ the gift that keeps on giving.”  Let’s not forget this one from Sue Sylvester on Glee: “You know, for me trophies are like herpes. You can try to get rid of them but they just keep coming. You know why? Sue Sylvester has hourly flair ups of burning itchy highly contagious talent.”

Herpes jokes are also common in stand-up comedy. In a routine called “ Herpes Facts,”comedian John Ramsey discusses a statistic from a Valtrex commercial:

The Valtrex commercial Ramsey refers to is part of an advertising campaign that marked thefirst time a herpes medication was advertised to a national audience, making the disease morevisible than it had ever been in the mainstream media. The commercials could have beengroundbreaking in their attempt to normalize the STI, but instead they became a popular vehiclefor the same sorts of stigmatizing jokes the ads were intended to diffuse. The huge number ofValtrex parodies on Youtube demonstrates just how entrenched genital herpes humor is in ourculture, and Valtrex’ s inability to overcome it.

On her talk show, Tyra Banks interviewed Michelle Landry, a woman with genital herpes, about how she felt when she was first diagnosed.  She responded: “ I was so shocked. Thinking back to that day, all I thought about was the jokes I’ d heard about herpes, the stigmas.” Tyra then commented on the profusion of herpes jokes in popular culture: “ Like we were talking about earlier, jokes, jokes, jokes… so many people have herpes that I bet a lot of people telling the jokes probably have it.”

So why are these jokes so popular?  And why isn’t anyone saying anything about how miserable it must be for people with genital herpes to hear them and have to laugh along in order to avoid detection?

The jokes generally go unchecked since those who find them offensive or cruel are silenced by the fear of association with genital herpes, or the fear of being exposed as having genital herpes.  Both outcomes carry the very real risks of shame, judgement, and rejection.

At the root of the “ herpes humor” phenomenon is the extreme stigmatization of genital herpes as a grotesque or disgusting indicator of promiscuity and infidelity.  Stay tuned for more on stigma in part 3 of this series.

Part 1: This is a post about genital herpes.

This is a post about genital herpes (part 1)

I have been MIA the past few weeks because I have been working on a paper for my grad program on genital herpes.  The paper is about the social representation of the disease – how genital herpes is discussed and framed in pop culture and the media, etc.  I have learned a lot writing this paper and I’m excited to share it with you.  Most of what I learned came from my research survey of blogs, film, TV shows, Youtube videos, online forums, images, and health communication theory texts.  But a lot of what I learned was more organic than that.  I learned a lot about the social perception of genital herpes just from the experience of writing a paper about genital herpes.  Let me explain what I mean.

I am a pretty open person and I like to be controversial.  That’s why it was strange to me that when I chose genital herpes as my paper topic, I was a little hesitant to share it with my classmates and the world, aka Facebook.  But being me, I did it anyway.  Dr. Anna Wald, a virologist at the University of Washington, told the New York Times, “ Herpes has a stigma attached to it that even H.I.V. doesn’ t have anymore.”  I think she’s right.  Recently, Mondo Guerra publicly announced his HIV positive status on Project Runway and there was an outpouring of tears, love, and empathy.  This would not be the case for anyone who openly revealed that they had genital herpes on TV.  Can you even imagine anyone doing that?  We assume that one would have to be crazy to share such a shameful, stigmatizing, and personally damaging secret.

I realized that I was uncomfortable associating myself with genital herpes.  Will people think I have it? Why else would someone write a paper about genital herpes and risk that association if they didn’t have it, right?  So I pressed on, putting myself at the center of an itty-bitty social experiment.  I told everyone about my paper on genital herpes.

For two weeks, my gchat and AIM away message read “herpes, herpes, herpes, herpes.”  I received the gamut of responses, from “you have herpes????” to “ewwww” to “I love the fact that you’re comfortable enough to leave herpes as your status message.”  I posted updates about my herpes paper to Facebook all the time.  Most of them got “likes” from classmates and my former sex counseling buddies from college.  In response to a status update noting that just about every Judd Apatow movie includes a herpes joke, a friend joked, “herpes is no joke.”

I wrote the majority of my paper in the Emerson College and Tufts Med School libraries.  I couldn’t help but wonder what someone would think if they checked my browser history to find a plethora of articles, info guides, and support forums about genital herpes.  I also was wary of judging eyes walking past that might catch a glimpse of “genital herpes” on my screen.  I even felt this way in the med school library, where real medical students were making powerpoints with much grosser-looking slides right next to me.  (Abdominal surgery pics? Yuck!)

I’m not exactly new to this feeling.  I spend a lot of time and energy talking and writing about STI prevention, not to mention about rights and respect for people who have STIs. I’m sure plenty of people have already wondered if I do this because I have an STI.  Hell, you’re probably wondering right now.  (Would it make me more credible as a sexual health writer if I did?  Less credible?  Would it change your opinion of me as a person?)

I’ll be completely honest.  When I started writing this post, I paused for a second because I realized that writing this post would forever associate my name with genital herpes in the annals of internet history.  Me and genital herpes, total Google search bffs.  (“Writing about herpes on the internet is like herpes, it will be there for life.”)  But I don’t shy away from things like this.  That’s kindof what I’m about.  Genital herpes is NOT A DIRTY WORD.  But think about it.  Genital herpes is so stigmatized that even a veteran sexual health blogger thought twice about writing about it.

In the next few days I’ll be sharing some more from my paper about genital herpes stigma, metaphors, “herpes humor,” and narratives.  Stay tuned, and take a second to think:  Would you be willing to speak out for genital herpes awareness, or openly support those with genital herpes?  Or would the risk of stigma-by-association be too great?

Read on to part 2 – Genital Herpes: Actually it IS a joke

True Blood Danger: The Health Risks of Vampire Sex

It was only a matter of time.

For the past couple years (thanks to Twilight and it’s R-rated cousin True Blood) the world has been seduced by the notion of vampire sex. After finishing season 3 of True Blood, I remember remarking to a friend, “I wonder if people are actually trying this?” Turns out, they are.

This MSNBC report identifies biting and licking each other’s blood as a new “teen fad.”

Teenagers obsessed with the “Twilight” vampire saga, or those simply fascinated with fangs, reportedly have been biting each other — hard – and then licking or sucking the blood.

It reports some important health risks of this behavior as well:

Such talk alarms medical experts, who warn about the dangers of blood-borne diseases such as hepatitis and HIV, as well as the risk of nasty infections. Typically, 10 to 15 percent of human bites wounds become infected.

“If you break the skin, your mouth is pretty dirty,” said Dr. Thomas Abshire, a pediatric blood and cancer specialist and spokesman for the American Academy of Pediatrics. “The human mouth flora is dirtier than a dog or cat’s.”

It doesn’t surprise me that people are doing this. In True Blood, we see blood sucking as a sexual act – one that heightens intimacy and pleasure. After watching 2 seasons of True Blood back to back, I cannot say it hadn’t occurred to me that this was something people might want to try.  Plenty of people are kinky, and considering the popularity of Twilight and True Blood, biting and blood has become sexualized – even fetishized. I agree that those who have been tempted to experiment with this should be aware of the health risks listed above. It looks like there may need to be a call for education about STI transmission through blood and biting, as well as information on keeping human bite wounds clean.

But much of the MSNBC story annoys me. I highly doubt that teenagers are the only people who have tried, or are doing this. I also doubt that “These are kids who think they are real vampires,” as Dr. Orly Avitzur, the medical advisor to Consumers Union, the agency that publishes Consumer Reports magazine, stated. I agree with a student quoted in the piece who argued that biting is a common practice that has “gotten a bad rap because of this whole vampire thing. In reality… a lot of teens bite – and leave marks – for the thrill of it.” According to his statement, it sounds like biting is common, but licking or drinking blood is not. The MSNBC article suffers from the obvious sensationalism of the story, but does make a necessary point about health risks of biting and licking blood.

So how do we educate adventurous and curious folk about the health risks of playing vampire? Can we find a way to provide non-judgmental education without encouraging the behavior? And who’s responsibility is it to provide this education?

At the base level, we need to remind people that blood is dangerous; even if vampires cannot be infected with HIV or other STIs, (although in an early episode of True Blood, they reveal that vamps are susceptible to Hep D), humans can. Any time another person’s blood gets in your body, you are at risk for STIs like HIV – which, unlike vampires, is a very real threat.

Medicalization and Machines: Is Bad Breath a Disease?

I’ve been doing some readings for my course in health communication and I have been thinking about the idea of medicalization – how it has changed how we think about our bodies, health, and its implications for health communicators and educators.

In The Body and Social Theory (1993), C. Shilling identified “the body as a machine” as a common metaphor we use to think about our bodies and health. From this perspective, our bodies are a collection of parts that, when functioning properly, work like a, er, “well-oiled machine.” If a part breaks, it can be fixed. For every malfunction, there is a scientific solution. Regardless of whether this metaphor is a good one, it certainly plays a role in what we call “medicalization.” In a medicalized society, the mechanics are doctors who use medicine to repair the body when it malfunctions. So when we talk about medicalization, we’re talking about the idea that every physical “malfunction” has a treatment or remedy. And that works oh-so-well with another hugely prevalent force in our society: consumerism.

If every ailment has a remedy, then someone is going to get rich off of selling remedies. A doctor once pointed out to me that the more options there are to treat an ailment, the less effective the treatment is likely to be. I guess that’s the difference between a “remedy” and a “cure.” When we’re talking about something curable, there’s usually only one cure. If it’s just “treatable” like the common cold, there are likely to be more options. And none of them really “cure” anything, they only treat the symptoms.

Viral illnesses like the common cold are great for people selling remedies; they are malfunctions of the body-as-machine that need fixing, but they aren’t really “curable” so we shell out money hoping for that “magic remedy” to fix the problem and get our bodies back in working order. Rather than put a hole in the body-as-machine metaphor, we accept the remedies as necessary, just as necessary as medical “cures.” The body-as-machine metaphor transcends the reality of the common cold as something that can’t be “fixed” and instead legitimizes our need or demand for products like Advil Cold and Sinus.

But what if you have a product for which there is no medical need? If you’re Listerine, you invent one. Ever heard of halitosis? It’s a term for “bad breath,” which is not, by the way, an actual “disease” or “illness” of any kind. Halitosis is a term invented by Listerine as part of an epically successful ad campaign.

Joseph Lister developed antiseptic at the end of the 19th Century. A similar but less potent form was developed by Jordan Wheat Lambert, who asked the famous Lister if he could use his name to market the product. Thus, Lambert’s Listerine was born. It was used for sterilization, cleaning floors, and even treating gonorrhea. In 1895 it began to be marketed towards the dental profession as they discovered it was good at curing oral germs. And then, Lambert hit on the best idea ever: medicalize bad breath and sell Listerine as the cure.

He and his copywriters all but invented the term “halitosis” and used it in an aggressive ad campaign designed to make everyone self-conscious about our smelly breath. Remember, at this period in history, there were different standards of oral hygiene. This ad campaign is in part responsible for the difference in standards today. The campaign asked, “Always a bridesmaid, never a bride?” or “Could I be happy with him in spite of that?” and stated plain and simple, “Halitosis makes you unpopular!”

(I know there were a few ads directed towards men, but I can’t find them online. It seems as though the majority of these ads were aimed at women.)

Do you remember a time before we had to carry mints or gum, talked about “coffee breath,” or just spoke freely without worrying about the smell of our words? Well, Listerine killed it. James B. Twitchell, author of Twenty Ads that Shook the World (2000), names this advertising strategy “generating constructive discontent,” and Listerine wasn’t the only company to use it successfully.

Body odor came from Lifebuoy soap; athlete’s foot came from Absorbine Jr.; “five o’clock shadow” from Gilette; tooth film from Pepsodent; and split ends from Alberto V05. Americans today spend almost $4 billion a year on products whose only purpose is to alter natural body odors, odors unsmelled a generation ago!

(I wonder what Twitchell would think of vaginal rejuvenation surgery and the Va-J-J Visor…)

The halitosis ad campaign was so successful that most of us know the word, and understand it to be the “medical term for bad breath.” We also consider athlete’s foot a medical condition, and can buy “prescription strength” deodorant that costs over $10 a stick. They say that “sex sells,” but I think health may sell more directly. And as these products are labeled as health remedies or medical treatments, they expand the medicalization of our society and reinforce the idea that our bodies can run like machines if we maintain them properly.

It makes me wonder about my own so-called “health condition”: eczema, or “dry skin.” While some have more extreme cases of eczema, or psoriasis, my eczema is mild. It’s just dry skin that gets worse in dry weather. In a worst case scenario, patches of dry skin become itchy and feel rough to the touch. Yet, I have seen a dermatologist and I have been diagnosed with mild eczema. I was even prescribed a steroid cream to use during “outbreaks,” and it was recommended that I use a “dermatologist approved” moisturizer like Eucerin or Cetaphil every day. A bottle of Eucerin costs nearly $15, compared to something like Jergens, which costs $4. But then again, I think Eucerin is in a different class than “regular” moisturizers, and does a better job with my eczema. Or do I just feel that way because I have developed brand loyalty, and enjoy feeling like I have a medical condition with a simple, successful, medical treatment?

So is my eczema a disease? Or is dry skin, like bad breath, just an occasional annoyance of being human? Would I feel differently about my skin if I had never been diagnosed by a dermatologist?  Would it change the fact that I find comfort in the routine of, literally, “oiling” my body-as-machine?

And if eczema, like halitosis, is just a made up word in order to medicalize a normal physical thing, is the deceit harmful or benign?

Kudos to Emerson College for their exemplary Sexual Assault pamphlet!

I’ve barely been in school a week and I already have been having trouble finding time to blog. I forgot how much work this whole “school” thing would be – crazy, I know. Anyway, there is one thing I’ve been meaning to do and that is give Emerson College, my new alma matter, a pat on the back for their EXEMPLARY Sexual Assault pamphlet distributed during orientation.

I’m sure most of us are familiar with the usual women-focused, victim-blaming approach taken by most colleges and universities. The standard “ways to prevent rape” include: not leaving your drink unattended, not walking alone at night, not dressing provocatively, not drinking excessively, etc. These “prevention methods” are all directed at women, putting the onus of their own protection ON THEM, suggesting that if anything happens, it was their own fault for not being smart and following the rules.

The worst example of this kind of language is probably one published by Valdosta State. It includes some “tips” like these (actual language):

  • Women are always trying to be sympathetic: STOP IT, it may get you raped, or killed.
  • If he’s driving, find the right time, and stick your fingers in his eyes. He must watch the road, so choose an unsuspecting time, and gouge him. It maybe your ONLY defense. While he is in shock, GET OUT. (This sounds gross, but the alternative is your fault if you do not act.)
  • If you don’t have a cell phone, shame on you.

It’s “tips” like these that spurred Feminally to write the now famous list that turns victim-blaming on its head by giving “tips” to would-be rapists telling them not to drug people to control their behavior, etc: Sexual Assault Prevention Tips Guaranteed to Work! It may sound like a joke, but it draws serious attention to the fact that sexual assault prevention is usually directed towards the would-be victims and not the would-be rapists. But to my unexpected and pleasant surprise, at least one college was listening!

Behold: The exemplary Emerson College Sexual Assault pamphlet.

I knew we were already off to a good start by glancing at the cover, which reads: “Sexual Assault: Information for Men and Women.”

The first page is a letter to all Emerson students giving some stats about rape, and explaining what acquaintance/date rape is and that it is not tolerated at the college. The next page has this at the top:

RAPE IS A CRIME OF VIOLENCE: It is motivated by the desire to control and dominate, not by sexual desire.

Then there is a list of FACTS ABOUT SEXUAL ASSAULT, which explain that acquaintance rape is rape, that men can also be victims of sexual assault, that it’s okay to say no without giving an explanation, and that “No one wants to be raped.”

It then gives some legal information, and some more detail about acquaintance rape. Then – oh then – the cream filling!

The following is quoted directly from the pamphlet:

WHAT CAN YOU DO TO PREVENT SEXUAL ASSAULTS IN SOCIAL SITUATIONS:

Certain contributing factors repeatedly surface in acquantaince rape situations: ineffective communication, the use of drugs and alcohol, and sex role stereotypes. Understanding some of these factors can help prevent sexual assaults.

This pamphlet offers men and women ways to understand both their role in intimate relationships and the issue of sexual assault in a college environment. Mena dn women need to understand their right to be free from harm, and the legal consequences that may fall upon persons who compel sexual relations by force or threat of force.

If by force or threats, you compel a person to have sex against his or her will, even if you know the person and have had sex with him or her before you are committing a rape - even if you think he or she has been teasing and leading you on, even if you have heard that women say “no” but mean yes, even if you think it’s “manly” to use force to get your way.

Being turned down by sexual relations is not necessarily a rejection of you personally. A person who says “no” to sexual relations is expressing his or her unwillingness to participate in a specific act at a specific time.

Accept a person’s decision. “No” means no. Don’t read in other meanings. Don’t continue after the person says “no.”

Don’t assume that just because a person flirts or dresses in a manner you consider sexy that he or she wants to engage in sexual relations.

Don’t assume that previous permission for sexual relations means a person is under continuing obligation to have sex with you.

Don’t assume your date wants the same degree of intimacy you do.

Don’t assume that spending money on a date entitles you to sex.

Don’t force anyone either verbally or physically to have sex with you.

Don’t allow others to attempt forced sex with another person.

The pamphlet then follows with a list of things you can do to minimize the risk of being sexually assaulted that contain tips like “be assertive,” “trust your intuition,” “think ahead about how you will get home,” and “avoid excessive use of alcohol and drugs.” But the point is, they came SECOND, and that they don’t claim to be “ways to prevent sexual assault.” They are only things you can do to “minimize risk.” The first list is about “prevention.”

The pamphlet then goes on to give information about what you can do if you have been assaulted and includes a directory of resources, police departments, organizations, crisis hotlines, etc.

This pamphlet is a model of what sexual assault prevention should look like. I hope other colleges and universities will stand up and take note. Needless to say, I am proud to call myself an Emerson student.

New beginnings, new directions

Today is Rosh Hashanah which means that all of us Jews are celebrating the beginning of a new year. (5771? But I was just getting used to writing 5770! Har, har.) Today is also the day I begin my MA program in Health Communication at Emerson College (in partnership with Tufts University). And you can bet pretty soon, I’m going to be even more obsessed with health issues than I already am.

A lot of people ask me what health communication is and at this point I am starting to feel like I can give them a relatively accurate answer. Health communication is essentially communications tailored for the health field – more specifically, the study of creating and disseminating messages that will be effective in getting people to change their behavior – to quit smoking, wash their hands, eat more fruits and veggies, etc. I was attracted to this field because I already work and enjoy working in communications, and I wanted to mix that together with my interest in sexual health and healthy sexuality. Basically, I chose this program because I wanted to learn how to effectively communicate a few messages in particular, like “use a condom,” and “no seriously, just use a freaking condom!”

I’m pretty sure this program was a match made in heaven because I just got the syllabus for my first class and my first assignment is to pick an illness and analyze how it is perceived in our culture. I am so excited; that’s like my hobby. I’m pretty sure I’m already halfway through a video about just that. I know I’m a huge nerd, but I can’t wait to sit down and learn some theory and some skills to create effective health messaging and save the world, one sexually active teenager at a time. But, of course, I can already tell that it’s not going to be that simple.

Today a couple posts on Feministe caught my eye. The first is from former-Feministe blogger Zuzu, and is about fat and health, and succinctly states near the beginning: “Feminists typically agree that body policing is a bad bit of business, correct?” She then goes on to argue that being overweight does not necessarily mean someone is unhealthy, and that “There’s no Duty of Health”:

“Health” seems to be a codeword these days. It’s something to throw around when you get busted as a fat-hater: “I’m just concerned about your health!”

Well, let’s talk about health. First off, why is any individual obligated to be healthy in order to be accorded all the rights and dignity accorded to all human beings? What is this, “Starship Troopers,” with health substituted for military service? If you argue that fat people don’t “deserve” certain rights because in your judgment they aren’t “healthy,” then how do you feel about disabled people and their rights? If your argument is that the disabled can’t help it and fat is a choice, do you make the same argument for religious discrimination? Because religion is a choice, too.

The second is about slut-shaming, and hits on another feminist bulwark - “My body, my business.” And this ties closely into the pro-Choice “My body, my choice” philosophy too. The author illustrates this nicely:

Clearly, there is some conflict between the feminist approach to bodies and healthcare and the health communications goal of getting individuals to make healthier choices. It assumes that there is an objectively “healthier” choice, and also places the burden on the individual to be responsible for his or her own health. Zuzu wrote:

I’ve written about this before, and it ties into the whole good fattie/bad fattie defensiveness thing, but whenever we start focusing on the health of the individual, we erase the systemic problems that contribute to health issues. This is a perfect example of the personal being political.

Institutions love to shift the burden onto the individual, because it means the institution doesn’t have to examine its own behavior or its own contribution to a problem. Let’s look at bullying. States and schools love to have zero-tolerance policies so they can look like they’re being tough on bullying — but then when bullying incidents happen, they just don’t define it as bullying, and suggest that the victim change his or her behavior. Problem solved!

It’s really tricky.

The personal responsibility issue relates pretty directly to what we were discussing here earlier about safer sex, where I argued that the most effective way to prevent STD transmission was to emphasize personal responsibility in sex education and health messaging. But we do have to be careful not to ignore the social structures and institutions that make it difficult to make healthy choices, and perhaps the ethical route is to work towards changing those institutions and systems as well as changing individual behavior.

It’s also problematic to assume that we all agree on what “healthy choices” are. I am a believer in western medicine, but even doctors and scientists don’t always agree on what’s healthy. (Coffee? Having a glass of wine while pregnant? Hormone therapy?) So who am I to tell other people how to live their lives?

On the flip side, health is one of those things that as a society, we feel is important. And so there is some context for health messaging and health education being generally accepted as a positive thing. But there are ethical potholes to be wary of, and I’m definitely going to have them on my mind as I enter this program.

As we enter into this New Year, I plan to keep blogging on sexual health issues. I am excited to see how my new program will influence and inform my thoughts. I am also terrified to see how I will manage full time school and a full time job and my own health in the midst of the stress and chaos – and still find time to blog. It’s going to be a hell of a ride folks, I hope you come along with me.

Now, here’s a sex study that makes sense

After a dubious study from The Heritage Foundation nearly drove a friend of mine to insanity, it’s nice to see some conclusions based on actual research that account for and acknowledge socio-economic forces at work. In this study, researchers from the London School of Hygiene and Tropical Medicine (UK) analyzed data from 59 countries. They conclude that sexual health strategies must go beyond individual risk reduction and address social and economic determinants of behavior. (They also use funny spellings like “analyse” and “behaviour.”) (I’m allowed to make jokes because I lived there, ok? Sheesh.)

Here is the first part:

The analysis revealed the huge regional variation in sexual behaviour but also showed that there has been less change in behaviour over the past two decades than was thought:

  • There is no universal trend towards sex at a younger age. However, a shift towards later marriage in most countries has led to an increase in premarital sex, more so in developed countries and for men. Sexual activity in single people tends to be sporadic.
  • Most people are married (or live together in partnerships) and most sex happens in stable partnerships. Marriage does however not always safeguard sexual health.
  • Monogamy is the dominant pattern everywhere, but having had two or more sexual partners in the last year is more common for men and in industrialised countries.
  • Condom use has increased almost everywhere, but rates remain low in many developing countries.
  • School-based sex education improves awareness of risk and ways to reduce it. It increases the intention to practise safer sex and delays rather than hastens the onset of sexual activity.

So, contrary to certain bio-determinist beliefs, it seems as though we aren’t experiencing an “unprecedented rise in casual sex.” No universal trend towards sex at a younger age, either! Instead of looking at rates of “sex outside of wedlock” as evidence of moral decay, this study uses social logic to explain how premarital sex has increased while people aren’t having sex any younger: delay of marriage. And hey, they found that sex education actually “increases the intention to practise safer sex and delays rather than hastens the onset of sexual activity.” (We knew that, but it bears repeating!)

Regional variations in sexual behaviour do not correlate with sexual health status. Higher rates of partner change in industrialised countries are offset by higher levels of condom use and better access to treatment results in better health. The authors explored the main reasons for the variations:

  • Some of the variations can be explained by demographic and structural changes. The age structure and ratio of men to women in a population can limit or extend opportunities to form new partnerships.
  • There is a striking gender difference in sexual behaviour. Multiple partnerships are more common for men than for women. This is in line with a double standard in most societies that makes non-exclusive relationships more acceptable for men than for women.
  • Poverty, deprivation and unemployment work with gender inequity to promote partner change, multiple partners and unprotected sex.

Let’s talk about that “striking gender difference.” At first glance you might see this as support for the bio-determinist argument that men are just less monogamous and/or can’t keep it in their pants. But not so!  The authors make sure to first of all use the word “gender” and not “sex” to imply that this is not a XY/XX distinction, but a man/woman, “gender-as-a-social-construct” distinction. They point out, rightly so, that the data correlates with the double standard in most societies that makes non-exclusive relationships more acceptable for men than women (aka the “player” v. “slut” double standard). They also point to the influences of poverty, deprivation and unemployment on promoting partner change, multiple partners, and unprotected sex.

The authors highlight the need to base interventions on evidence rather than myths or moral stances. Approaches focusing exclusively on expectation of individual behaviour change are unlikely to produce substantial improvements in sexual health. Comprehensive multi-level behavioural interventions are needed that reflect the social context. These should attempt to modify social norms and tackle the structural factors that contribute to risky behaviour. Examples include mainstreaming HIV and sexual health in development projects; empowering sex workers through business and IT training; and integrating sexual health education into microfinance schemes. However, the success of these strategies requires decision-makers to accept the reality of sexual practices.

Wow.  I have shivers. Can we just read that again?

The authors highlight the need to base interventions on evidence rather than myths or moral stances. Damn straight!

Approaches focusing exclusively on expectation of individual behaviour change are unlikely to produce substantial improvements in sexual health. Comprehensive multi-level behavioural interventions are needed that reflect the social context. Amen!

These should attempt to modify social norms and tackle the structural factors that contribute to risky behaviour. Examples include mainstreaming HIV and sexual health in development projects; empowering sex workers through business and IT training; and integrating sexual health education into microfinance schemes. HELL YES!

However, the success of these strategies requires decision-makers to accept the reality of sexual practices. BAM.

And then, just when you thought this couldn’t get any better? They list and link to their sources and give an explanation of who funded the research. And guess what? It’s academic! Not a lobby group!

It’s work like this that gets me excited to begin my MA in Health Communications at Emerson next week. There is such a need for information about sexual health that serves not to moralize or control, but to actually reduce the spread of STDs based on the reality of sexual behavior and the social forces that influence it.

The Girl Who Played With Statistics: A Cautionary Tale

On a recent post, a commenter that goes by the name Clarence asked me what I thought of a certain study. It’s called The Harmful Effects of Early Sexual Activity And Multiple Sexual Partners Among Women: A Book of Charts. The report contains 18 charts that demonstrate that, you guessed it, early sexual activity and multiple sexual partners among women has harmful effects!

The study was released by The Heritage Foundation, an extreme right-wing lobby group. The four authors of the study (only one of whom has any academic credentials) all work for The Heritage Foundation. According to them, the data for these charts comes from the CDC’s 1995 National Survey of Family Growth. The CDC being a credible and generally unbiased institution, this seemed a bit fishy.

Clarence said that he couldn’t find any “definitive debunking” of The Heritage Foundation’s terrifying conclusions and that the only way to get to the bottom of this was to study the methodology of the CDC’s 1995 National Survey, and “make sure the Heritage people aren’t trying to pull a fast one by misrepresenting something.” When I suggested that “pulling a fast one by misrepresenting something” was exactly what The Heritage Foundation was doing, Clarence wrote, “I’m not a fan of The Heritage Foundation, but I can’t dismiss a study like this based solely on who put it out.”

But sometimes, folks, it really is in your best interest to dismiss a study based solely on who put it out, especially if it’s The Heritage Foundation. Seriously. For I am about to share a cautionary tale of a young woman who did NOT dismiss this study. Nay, she tried to get to the bottom of it, completely unaware of the risk to her own health and sanity she was taking. This is the story of my good friend, who wished to remain anonymous, in her own words.

A fever- fueled hysterical breakdown

I like stats. Reading this comments section spurred one of those crazy stats urges.  Pre-martial sex and the stability of marital partnerships! Social theory with numbers!  I generally like and trust the CDC when it comes to numbers-making.  In my mind they are a shiny quarter-fed number machine.

Looking at the first chart, it seemed a little strange to me that there would only be marriages recorded for women over 30 since the CDC’s data covers ages 15-44.  I also knew that the CDC keeps record of religious belief and other fun stuff.  Maybe those people who are more religious are a large portion of the ones who have fewer partners and understandably also prioritize avoiding divorce? Or maybe cohabitation has replaced marriage for lots of people?  So many fun things that this graph might be hiding in its finer points.

…Four hours later of reading through everything I never knew I never knew about marriage in 1995, I realized I had to stop. I had found the CDC pages that were probably referenced within the first thirty minutes and nothing else was coming forward.

They are here, here, and here.

If there is someone reading this who knows what I’m missing please read them and tell me what it is.

I tried to wrap my brain around how the Heritage Foundation got to the stats they did. It was terrible. I thought I was playing a fun game of find the numbers and discover how they came to be, or how they might have been misrepresented.

There was no game.
No rules.

Either the chart was made up and has nothing to do with the original numbers or I’ve lost my ability to read coherently.  I couldn’t even find any stats that cover more than 10 partners. Where are the 11-20+ partners? Where are the 80% of stable first partner relationships?

These pages, Leah, I think they are where the answer is. I just want someone to tell me for the love of god where the numbers are. I think I would almost be relieved. I also have a fever from flu, which might be driving my hysteria. But that doesn’t make me dumb.

Please find the numbers for me.  I’m trapped in one of those schizophrenic mathematician movies in the final scenes where the universe is created by their own mind and there are no numbers really there at all.  I would also be super-sad and way too naively surprised if the graph was actually not drawn from the stats on the CDC’s report at all, but after searching and searching, I’m afraid I must conclude that they made it up.

This, my friends, is why it’s so hard to argue against the anti-sex, anti-feminist lobby’s use of “data” and “studies” and “surveys” and “statistics.” It’s because, more often than not, their data is absolute bullshit. Groups like The Heritage Foundation and people like Susan Walsh are pushing extreme political agendas based on an outdated model of sexist morality. They believe they are “battling” to preserve the future of society as we know it, and since all is fair in love and war, they have no problem bending, twisting, appropriating, or even fabricating data that supports their cause. It’s hard to fight bullshit with logic, and as my poor friend’s descent into madness demonstrates, the psychological effects of attempting to do so can be severe.

So, folks, next time someone asks you to “definitively debunk” a “Book of Charts” disseminated by The Heritage Foundation, go ahead and dismiss it solely because it was put out by The Heritage Foundation. Save yourself. It’s just not worth it.

As for my dear friend, I wish her a speedy recovery. Maybe Delusions of Gender, a promising new book in which a cognitive neuroscientist uses good science to identify and eviscerate those who do not, could provide some much-needed therapy for her poor, stats-loving soul.

Why fear-based STD prevention PSAs are a bad idea

Recently, I started to pay attention to the sorts of messages being sent in STD prevention PSAs. I kept finding examples of ads that portrayed people with STDs as monsters or murderers, and with this video, I explain why this is not only cruel, but detrimental to health education goals.

This is my first video, so please be kind.