Incorporating sexual pleasure into sexual health education programs can improve safe sex behaviors

Summary: A meta-analysis study reports that interventions aimed at educating about the risk of STI/HIV infection could benefit from focusing on sexual pleasure and desire.

Source: PLOS

According to a study published in , sexual health programs that include sexual desire and pleasure can improve knowledge and attitudes about sex and condom use compared to those that don’t PLUS ONE.

The meta-analysis of the 2005-2020 research literature finds that incorporating pleasure into such programs can have positive effects on attitudes and safer sex behaviors, and recommends reconsidering sex education and health intervention approaches that do not acknowledge that sexual experiences can be pleasurable.

Billions of dollars are spent on sexual and reproductive health and rights services and programs around the world each year. Yet with less than ten years to go to reach the UN Sustainable Development Goals, which target sexual and reproductive health and rights, there is still an enormous global burden of STDs and HIV.

Researchers from The Pleasure Project, WHO’s Department of Sexual and Reproductive Health and Research, and colleagues review 33 unique STI/HIV risk reduction interventions that involve pleasure and meta-analyze eight of them.

They find evidence that including pleasure can have significant positive effects on information- and knowledge-based attitudes, including participants’ confidence in behavior change and motivation to use condoms, as well as behavior and condom use.

While the authors searched for interventions across a spectrum of sexual health interventions (including contraception and family planning interventions), the review ultimately included only STI/HIV-related programs that target populations traditionally considered “at risk.”

The authors note that future work is needed to include and evaluate pleasure-inclusive interventions in reproductive health and for the general population.

The team argues that continued avoidance of enjoyment from sexual health and education runs the risk of misallocating resources or using them ineffectively. The researchers call for a fundamental rethink in the direction of programs.

Billions of dollars are spent on sexual and reproductive health and rights services and programs around the world each year. The image is in the public domain

The authors add: “Pleasure has been overlooked and stigmatized in health promotion and sex education, despite its apparent link to sexual health and well-being. Our systematic review and meta-analysis, the first of its kind, shows that incorporating sexual desire considerations into sexual and reproductive health services improves condom use and thus may improve sexual and reproductive health outcomes as well.

“Policymakers and program managers should more readily recognize that pleasure is an important driver of sexual behavior and that including it in sexual and reproductive health services can reduce negative outcomes.

“Eight years after the SDGs deadline, innovative strategies that can accelerate progress toward the SRHR goals, including STI and HIV prevention, are urgently needed.

“Programs that take a sex-positive and pleasure-inclusive approach are one such innovation that deserves serious consideration.”

About this sexual behavior and news from psychological research

Author: Hannah Abdallah
Source: PLOS
Contact: Hanna Abdallah – PLOS
Image: The image is in the public domain

Original research: Open access.
What is the added value of including pleasure in sexual health interventions? A systematic review and meta-analysis‘ by Anne Philpott et al. PLUS ONE


abstract

What is the added value of including pleasure in sexual health interventions? A systematic review and meta-analysis

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Despite billions of dollars invested in sexual and reproductive health and rights (SRHR) efforts, the effect of including sexual pleasure, an important factor in why people have sex, in sexual health interventions is currently unclear.

We performed a systematic review and meta-analysis according to the PRISMA guidelines in 7 databases for relevant articles published between January 1, 2005 and June 1, 2020. We included 33 unique interventions in our systematic review.

Eight interventions reporting outcomes from condom use were meta-analyzed along with a methods random effects model. Quality assessment was performed using the Cochrane Collaborations RoB2 tool.

This study was pre-registered on Prospero (ID: CRD42020201822). We identified 33 unique interventions (18886 participants at baseline) that involve joy. All included interventions were aimed at reducing the risk of HIV/STI; none were related to pregnancy prevention or family planning.

We find that the majority of interventions targeted populations that the authors classified as high-risk. We were able to meta-analyze 8 studies (6634 participants at baseline) reporting condom use as an outcome and found an overall moderate, positive and significant effect of Cohen’s d=0.37 (95% CI 0.20-0.54). , p2 = 48%; τ2 = 0*043, P = 0.06). Incorporating sexual pleasure into SRHR interventions may improve sexual health outcomes.

Our meta-analysis provides evidence for the positive impact of pleasure-related interventions on condom use, which has direct implications for reducing HIV and STDs. Qualitatively, we find indications that joy can also have positive effects across different information- and knowledge-based attitudes.

Future work is needed to further elucidate the effects of pleasure within SRHR and across different outcomes and populations.

Considering all available evidence, we recommend that agencies responsible for sexual and reproductive health consider including considerations of sexual pleasure in their programs.

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