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.

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