A few weeks ago colleagues and myself took part in a symposium at University College London’s Institute of Global Health. Our focus was stigma in relation to sex work, specifically focusing on how this can get in the way of providing healthcare to those involved in prostitution.

Professor Graham Scambler discussed core concepts of stigma and particularly focused on how we understand sex work. He also addressed issues of diversity within sex work (how people are involved in it and what their health needs might be) as well as reflecting on agency and wellbeing on sex workers – particularly in relation to debates on trafficking.

Professor Helen Ward focused on her work with female sex workers, particularly around physical, cultural and psychological barriers they encountered in relation to accessing healthcare and maintaining wellbeing. Drawing upon interviews with sex workers she outlined how stigma is enacted and how this impacts upon those involved in prostitution.

My contribution drew upon my past research background in this area and more recent practice in working with healthcare practitioners to embed evidence within their sexual health practice. Focusing on experiences of training practitioners globally and the wider evidence base on stigma related barriers to healthcare I talked about the problems experienced by practitioners, NGOs/charities, sex workers and communities in providing adequate, accessible and appropriate healthcare.

All three presentations questioned concepts such as stigma and sex work and particularly addressed the problems facing healthcare staff in knowing how to access and apply evidence to inform good practice. We also focused on challenging the rhetoric that can often run around terms like ‘evidence based practice’, ’stigma’ and ‘trafficking’ and encouraged the audience to think about ways to improve their research and healthcare provision, engage sex workers in decision making about their care, and reflect on what their role was as healthcare providers/researcher in relation to addressing sex work.

You can see the each presentation (including our slides) and the following panel discussion here.

Please feel free to share this link, which should be of particular interest if you are…
- a student or practitioner in healthcare (particularly global health)
- working for a charity, NGO or other organisation involved with addressing prostitution
- a sex worker or ally
- a researcher studying sex work
- a lecturer in medical education and/or evidence based practice

If you’ve any questions about the presentation feel free to contact me and I can pass them on to the relevant speakers. And if you’re working in health care (as a practitioner, charity or other organisation) and want further training on improving the care offered to those involved in sex work please get in touch if you think I can help you or your organisation.

The event provided a lot of discussion during the panel and afterwards and I know has led to further activities among researchers and practitioners. I’ll post updates on some of those activities in a future blog.

What made me start blogging?
Five years ago I sat down on a dark November evening and wrote my very first blog entry. It was a bit ranty. I’d been misquoted by a journalist and was anxious it would get me into hot water (again).

I didn’t have a game plan when I started blogging. My partner (who’s way more tech savvy than I am) thought it might be a good way of sharing ideas I was struggling to convey via the mainstream media (I was writing several advice columns in magazines at the time, as well as hosting a regular radio phone in for BBC Five Live).

I approached the blog as a form of therapy. I wanted to work with the media but was getting a lot of stick for it professionally (I’m an academic as well as a sex educator). Having a place to blog would allow me to correct any errors in reporting and disclose bad journalism. I even hoped it it might even let me bring evidence into sex/relationships reporting – and show it was possible to do so without things becoming worthy or dull.

One thing I felt sure of early on was this blog was something I enjoyed writing, but I wanted to be useful, and most importantly to deliver things about sex, relationships, science and journalism that readers wanted to know about. Which is why the blog has always been shaped by things you’ve asked for.

Readers make this blog (or “why don’t you have comments?”)
Last summer I asked regular readers to give me feedback on this blog and got some very helpful responses. It’s taken me a while to implement some of these, but I have now upgraded the blog to include the things you asked for – photos and images to liven things up, a better blogroll, summaries at the start of most entries so you can decide if you wish to read on. And categories. Something I didn’ think about five years ago and really wish I had. I’m now in the process of going back through all the 800+ posts and adding categories to them, which I hope will make this blog a lot more useful to you.

The one thing this blog doesn’t have is comments. I did start off having them, but encountered several problems. As I was offering advice within columns and websites elsewhere I hadn’t planned to also answer problems on this blog. However, not all readers understood this so I frequently found requests for advice on anything from infidelity to penis size included in discussions about blogs relating to research design or journalism ethics. This sometimes led to some readers mocking those asking for advice, which of course is completely unacceptable for me as an educator.

Moreover, I’ve always blogged openly – never behind a pseudonym. I work within the community on sex/relationships projects and educational activities (in the UK and internationally). This meant I was very accessible, and felt vulnerable when those whose comments were deleted or not posted, made very personal threats.

I found moderating the comments was time consuming and took me away from other educational activities which I felt were more worthwhile. So I decided to remove the comments option. When I’ve asked readers if they want them back the general response is ‘no’. That’s mostly from people who feel the blog’s a safe space to get information which they can use as they wish elsewhere.

Of course I strongly welcome respectful email feedback and am always happy to add information or correct errors within the blog. You’re always welcome to start discussions on other forums or your own blog about issues raised here. For now I’ve no plans to reinstate comments, but since I’m occasionally asked why I don’t have them I thought this was a good a time as any to clarify the issue.

Achievements so far
Having read back to 2004 I’m pretty pleased with this little blog. It’s nice to see it’s grown into a resource that people trust and enjoy reading.

The things I’m most proud to have written are activist blogs that highlight medicalisation, exploitation and abuse. These include the debates around female sexual dysfunction, questioning high street stores stocking ‘herbal’ erectile dysfunction drugs (not approved by the FDA), exposing the Advanced Medical Institute’s aggressive sales technique for men affected by premature ejaculation, or highlighting misleading media coverage of the availability of Viagra on the high street.

I initially planned to use the blog to set right bad sex coverage in the media (or occasions where I’d been misquoted). This has been a theme within the blog although I think it’s become more focused over time (although not necessarily less ranty than my very first post). I can’t say whether it’s made much difference to journalists, and I hope it’s not put people off working with the media. I’ve found it helpful to describe poor practice – not least because the general trend for ‘experts’ working with the media is to act grateful for any exposure, not publicly discuss poor experiences or document bad practice. Gems for me include an expose of GMTV sending a cab to my home at 6am on the off chance I might wake up and come to their studio. Or how a TV show wanted to discuss female sexual confidence without mentioning genitals or masturbation. Or some rather nasty experiences with snotty TV producers just after I’d had a baby. Not to mention the hilarious case of the science journalist who really took a dislike to me (and colleagues). Oh, and let’s not forget the journalist who wanted me to recommend them an ‘unethical psychologist’ .

Of course, the past five years have not been spent simply slagging off journalists. No. Sometimes I’ve also turned my gaze to bad science too. Where it’s been depressing to report on a carnival of studies which seem to set us back sexually. Studies complaining women orgasm too easily, or there’s a ‘clitorocentric conspiracy’ against the vagina, how sex with a partner is 400% better than any other kind of sex you might have, and you can tell whether a woman has vaginal orgasms by her walk.

Let’s not forget my other bugbears. The fake formula and shonky surveys and my goodness this blog’s a treasure chest for those. And if I’m not being irritated by that, then there’s always the problem of psychologists talking about celebrities, or the general ethical issues raised by Big Brother for me to moan about.

Of course, it’s not all been bad news. Anyone would think this blog is only about gripes and grumbles. I’ve always wanted to showcase a variety of sexual experiences within this blog and not just think about sex just for a Western audience. I’ll continue to discuss issues relating to sex and seniors; teenagers; disability; transsexuality; lesbian, gay and bi issues; open relationships; BDSM; sexual health; contraception; prostitution; pornography; reproductive health; pleasure; desire; asexuality; dating; psychosexual problems; showcasing great sex pioneers; talking about safer sex; and as many other topics as I can find for you to read about.

Where to next?
Unlike five years ago, I’m now thinking strategically about this blog – who it’s for, what it does, and seeking to find ways to assess any impact it may have. I’ve noticed over the years it sometimes deviates into areas that interest me, but may not appeal to all readers. So my aim is to ensure the focus of the blog remains around the core things you’re most interested in when you visit – sex, science, and media.

I’m currently involved in overhauling the site so in the new year I hope to have far more open access materials available for you – relationships and sex guides, information about sexual and reproductive health, more advice and links to sources of help, along with practical information for journalists, healthcare professionals, parents, teens and teachers.

I’ve been asked by many readers for more information about how to become an agony aunt/media sex educator, so I’ll be blogging about this – as well as how to write a sex blog – in the not too distant future.

I’ll also be making use of twitter soon, as sometimes I blog about issues people need to hear about fast (particularly developments in science/health), so hopefully that will make messages more accessible. I’ll let you know once I’ve sorted it.

Obviously I’d like to hear what you’d like to see. How would you like this blog to develop over the next year (or five!). Are there any particular things you’d like to see more/less of? Topics you want covered? People you’d like me to interview for the ‘quickies’ section of the blog? Campaigns you want covered? Let me know what your vision is for this blog.

So, happy fifth birthday blog. Big birthday kisses to those of you who’ve been with me from the beginning. For those of you who’ve only recently found this blog I hope you like it enough to stick around for the next half decade. I notice one of my favourite other blogs Mind Hacks has also celebrated it’s fifth birthday too, so congratulations to them.

Time to blow out the candles and make a wish. Of course, I can’t tell you what it is. You’ll have to come back in five years to find out if it’s come true.

A brief history of formulas as marketing tools

Over the past few years we’ve got used to seeing formula used as a promotional tool by PR companies. Sometimes these are simply presented as just a formula, other times they are fronted by an academic or other ‘expert’. This has presented problems for universities where staff members (or people claiming an affiliation with a particular institution) use the institution’s name as part of the formula promotion.

Critics of the ‘fake formula’ approach have argued they are often not based on sound science, make little or no mathematical sense, and usually seem to be created by the PR company for an ‘expert’ to front (although this is often disputed by those promoting formulas). There’s also the concern that such formula appearing in the media may devalue robust academic research and reduce public trust in science.

Those academics who do front such activity (and there’s a core group who specialise in this practice) argue they’re merely promoting science and engaging with the public. A view that might be easier to believe if the formula stood up to scientific scrutiny.

Until now, debates on this issue have focused on academics fronting formula, but recently PR companies have taken a new tack and have used undergraduate students to promote their products.

This raises a lot of issues for universities and students and we need to think carefully about how it ought to be addressed.

The new PR approach – the case of the ‘Perfect Night Out’
The case in question began with a competition for ‘Britain’s Best Job’. Drinks Company Global Brands wanted to promote VK Vodka Kick (primarily, it seems, at Fresher’s events). The job advert stated “Wanted! Talented maths or science student or graduate to spend the summer literally discovering the formula of fun. Must be over 18 years of age like bars, clubs and pubs and be prepared to have a fantastic time in the quest for knowledge, science and the pursuit of the perfect night out.” The press release also stated “But there is a serious side to this and the applicant will be expected to deliver a full thesis at the end of the trip that must stack up to academic scrutiny by Britain’s best brains”.

PR Company Brahm worked with Global Brands for this activity. 50 students applied, and one Biology undergraduate student from Leeds University was picked for the task – to identify the formula for a ‘Perfect Night Out’ (PNO) based on undertaking a survey, then creating the formula.

The report created by the student can be found here (as text document) and here (as pdf). (This was described by the PR company as the ‘full thesis ‘ that ‘Britain’s best brains’ would be scrutinising).

I will leave you to critically evaluate the student’s report. Further discussions of the formula comes courtesy of Steve at Irregular Shed. Meanwhile Tristan O’Dwyer at Cargo Cult Science tackles the wider issues about this formula in relation to science communication.

I’m going to focus on key methodological and ethical issues that the research invites, and the wider implications of such research for students and universities.

Perfect Night Out – Survey and Semi Structured Interviews
The survey can be found here. It mostly seems to be asking general questions about a night out. PR company Brahm confirmed the survey was designed by the student. While the questions may seem fairly standard (although not particularly robust) there is the wider issue of how this survey was conducted. The student’s report (linked above) states “an online questionnaire was completed by 2000 people (male and female) and had a 100% response rate”.

It is not made clear how this survey was delivered online. Who hosted the survey? How long was it available for? How were participants recruited? I’m also curious about the 100% response rate which is pretty much unheard of in genuine social research. I can only assume there’s been a misunderstanding in understanding completion and response rates.

Contradiction exists between the report and the promotional activity. The student’s report stresses data were collected by an online survey. But the Global Brand’s website show the survey being conducted inside clubs as part of promotional activity – for example at Chester University and Manchester Metropolitan University.

The student’s report does state they conducted additional semi structured interviews, but it’s not clear how many were undertaken and whether they based activity shown in the clips above (which indicate a survey being used, not semi structured interviews). It is therefore unclear whether the student knows the difference between the two methods, or whether reporting on two approaches is confused in their write up.

The report does not make it clear how the semi structured interviews and survey worked together. While it is perfectly fine to use a variety of methods within research (sometimes called ‘triangulation’) it is standard practice to demonstrate how those methods link together. In this report we’re told the semi structured interviews were carried out post survey, but not shown whether the survey answers informed the semi structured interviews or how both of these informed the subsequent formula.

Ethical questions about the research
What is more worrying is the study was conducted in part within clubs and social events. This raises key issues of researcher safety and wellbeing, ethics and consent. Those who may be drunk are not in a strong position to consent to research (and may pose potential risks to researchers or other participants). Indeed if you wish to study people who are drinking alcohol or may be drunk it requires particular sensitivity and ethical approval. [Leeds University confirmed this study was conducted independently of their institution and therefore had no ethical approval].

A press release for the activity states “The official VKendology tour will start on Saturday 19th September, where the Research Team will hit UK Student’s Union’s during Fresher’s Week and students will be in with a chance to win their Perfect Night Out.”

This indicates participants were directly incentivised to complete the survey, something that is frowned upon in reputable social research (and also requires careful management in market research). The mention of the ‘research team’ also suggests aspects of this work were not simply down to one student, a survey and subsequent formula. I’m not sure whether the ‘research team’ are actual researchers or glamorous guys and gals dressed up to deliver a survey (or both). I would question the former, as presumably anyone who did know anything about social (or market) research would know this activity wasn’t the most robust or ethical.

I would like to think this report and the research described represents something casual and fun, not the best quality work the student could offer – nor representative of research writing skills she may have been taught on her degree programme. There are key details missing and as a result the write up does not appear particularly professional or scientific (see critique and links above).

I can understand that this activity would appear very exciting. (In the past I have undertaken PR-based research and know how beguiling such an activity may appear – at first). In this case the student was promised loads of fun nights out, the promised opportunity to do a bit of science, the chance to get some media coverage – and most importantly for a student it also is a paid post.

My concern is that in undertaking such activity, what may look like a fun opportunity may result in numerous problems for students and Universities.

What issues does involving students in PR activity raise?
Firstly, we have the question of student wellbeing. Usually students who are conducting research will require ethics approval and tutor support for studies they’re undertaking. There are three main reasons for this:
- to protect the participants researchers are interacting with and ensuring they are not harmed by the research process
- to ensure the research undertaken is appropriate and of a high quality
- and to protect the wellbeing and safety of the researcher.

It’s easy to say in this case it was basically a promotional activity and nobody was likely to be harmed. The questions seemed innocuous and unlikely to upset anyone. However, if a participant had disliked the research, or someone had threatened or harassed the researcher, who would be responsible? The point of having ethical controls over research is to ensure people can’t be harmed, and that researchers don’t play god and decide just because they don’t think their research is problematic then it won’t be bothersome to the public.

University staff are often aware of students who don’t let them know about research they are undertaking, often trying ambitious projects without notifying tutors or gaining ethics approval for their work. This can make students very vulnerable.

If PR companies intend to continue to use this method of getting students to front their campaigns, who is going to look after student or participant welfare? (Particularly if the ‘research’ is of a more personal or invasive nature). PR companies are keen to use Universities to add clout to campaigns, but where do Universities’ responsibilities lie if the student technically undertakes work without informing them and any negligent or non negligent harms arise?

No doubt PR companies and the commercial organisations who hire students may care little about the actual quality of research and be in no position to check on key questions about consent, ethics and personal safety. That is why both researchers and participants could be at risk if such activity becomes standard practice.

We know researchers can and do make mistakes. In fact it’s part of the steep learning curve of being a researcher in the natural, health or social sciences. Usually such problems around misunderstanding methods or poor report writing can be overcome with tutor feedback and practice. And remain relatively private.

However, if you undertake PR activity like this you run the risk of any errors you make being picked up on in public. Already bloggers have begun critiquing this particular study for example here and here.

This raises further issues about student wellbeing. After all, if you undertake a piece of work that’s promoted as fun and exciting, but the backlash is to label you a poor scientist, then that’s got to hurt (it’s partly why I’ve not named the student in this blog and am focusing more on the wider issues this case raises as opposed to a personal attack).

But if you undertake research outside of your institution who will be there to support you when things might go wrong? And what issues might this raise for your future career if, when you apply for a job, you’re known not as someone who advanced public understanding of science, but someone who undertook a piece of substandard PR research?

There’s also the wider issue of student responsibility to their fellow students and academic institution. As well as thinking about your own possible career pathway, you also need to consider the impact of your work on the reputation of others who might be associated with you. You may not appreciate that presenting ’science’ or ‘research’ in a particular way may actually make other genuine researchers lives a lot less safe, and recruitment a lot more difficult. Not to mention reducing public trust in science.

Sadly, not many universities teach this within methods training (and it’s fair to say many academics don’t always reflect in this way). You can see why an enthusiastic student being wooed by a PR company is probably not going to think twice about what the end result of their work might be for either their own reputation, or for those associated with their subject area.

I emailed Leeds University’s PR office to ask them if the student in question was studying with them (she is), whether she had applied for ethics approval for the study (no, since the research was not conducted as part of the institution), and whether she undertook the research in her capacity as a Leeds student (the PR office said no it was unrelated to Leeds, although they had put journalists in touch with the student so they could write their own stories/take photographs of her).

This is a key issue for me. We can’t really expect students to be aware of wider ethical and methodological issues that underpin research. That’s our job to teach them. We can’t blame students for wanting to earn cash and seeing PR activity as a fun way to do this. We can’t also blame students for being unaware of the background to the whole ‘fake formula’ issue (after all many academics don’t take it that seriously).

Universities and PR companies need to be responsible here. PR companies cannot use institutional names as part of promotional activity without ensuring that institution is aware of what they are doing and approves it. [Not that I expect PR companies to take any notice of this]. Universities also can’t play the ‘research wasn’t conducted as part of our university so it’s nothing to do with us’ line. If students are getting involved in so-called research activity and are allowed to be linked to it with mentions of the university in the press or passing on the student’s contact details to journalists, then the work is partly linked to the institution.

Universities need to be aware that the problem of PR activity in misusing scientific approaches has now been extended to students. They need to consider what this means for their students wellbeing and institutional reputation. Some institutions may not care, perhaps they’ll just be glad of some publicity. However there is the wider duty of care issue, and if any student is undertaking research-related work during their time studying with you then you have a responsibility to ensure you are aware of what they are doing and can ensure they work safely.

If PR companies are going to use students for promotional events then the media will report this and draw attention to your institution. Do universities want to be associated with studies that imply their teaching of research and ethics plus their pastoral care is substandard?

The problem is we have no clear guidelines on this issue. It is something that is new and many institutions won’t have had to think about it.

However, we’ve seen the uptake of using academics for fake surveys and formula has grown and it is likely using students (particularly to promote products to other students) could follow the same path.

The issue we must now face is what our approach should be on this issue. Let students do as they wish, so long as we can argue it’s not done in our name/on our time? Or take a stand and make it clear we do not endorse student activity in this way?

After all, if students really are keen to learn more about research methods, want to undertake studies, write reports, or bring science to the public there are numerous ways that can be done. As academics maybe we should make these opportunities more obvious (and focus on making our teaching of these topics more engaging).

Sure, they may not pay as much as a PR activity like this one. But in the long term they might be a whole lot better for a student’s reputation and personal development.

One story you can’t have missed in the past week or so was the sacking of Professor David Nutt in a situation where the government (yet again) disregarded evidence. Sadly it’s something we’ve got used to with this current administration. There’s been an interesting discussion about this over on Bad Science forums, although my favourite story on the issue comes courtesy of the Daily Mail whose attempts to smear scientists is pure comedy gold. I’d strongly recommend using this piece in teaching around journalism/science communication. I particularly like the Mail’s understanding of science as lab-based, unimaginative, not working in the real world, arrogant, and resistant to being questioned/challenged. Unfortunately many people also hold those views about science – although they probably don’t go as far as the Mail and equate scientists to Hitler :-0

While we’re on the topic of science communication and evidence based practice, here are two very useful dates for your diary. On November 16 2009 Westminster Skeptics in the Pub are hosting an event ‘Evidence based policy making’ with Dr Evan Harris MP and Professor David Nutt. On November 24 (again hosted by Westminster Skeptics) there’s an event ‘What next for Science Activism and New Media’ where a group of science bloggers and activists will be discussing issues around science communication and the impact of science blogging. If you’re a science journalist it would be particularly great to see you there to get some additional input from you about your views on science blogging/activism.

Stonewall hosted their annual awards ceremony this week (which seemed a lot less controversial than last year). They named journalist Jan Moir as their ‘bigot of the year’ following her attack on the late Stephen Gately. It’s always good to see those supporting LGBT issues rewarded, although while the folk at Stonewall are celebrating it might be worth looking to other countries where thinks are not so good for lesbians and gays. Like Uganda, who are seeking the death penalty for LGBT people (and requiring friends/family to turn in their loved ones suspected of being LGBT). It’s truly terrifying stuff, but worth reminding ourselves about the situation many LGBT people are faced with across the world.

I’ll leave you with a spoof documentary from The Onion about sexual arson (which actually does exist, although not perhaps in the way described in this clip

Crime Reporter Finds Way Of Linking Warehouse Fire To Depraved Sex Act

Last night the Science Museum in London hosted one of its fabulous ‘Lates’ events. The theme of the evening was ’sex and science’ and there was a great range of things to do. From learning more about yourself in the ‘who am I?’ tour, through to speed dating, finding out about the history of sex toys, salsa dancing, an experiment in ‘dance, hormones and sexual selection’ and some sexy punk science. Condoms were available to all guests, just in case things got extra fruity, and judging by the amount of drink and giggling going on I think people had a good time

I hosted a talk called ‘So you think you’re a sexpert?’ where we took 10 commonly asked questions about sex or commonly quoted sex ‘facts’ and put them to the test with some interactive voting to find out how smart our audience were about sex.

I’d like to give a great big thank you to everyone who came to Science Lates last night. I thought it was a novel way to share science, and the range of talks/events going on ensured we could create a balance between the fun and frisky and the serious and scientific.

For those of you who weren’t able to make it, I’ve reproduced the ‘So you think you’re a sexpert?’ quiz below, and I’ll give you the answers tomorrow, along with incorporating questions from the audience last night.

1. What are the most common methods sex researchers use to study sex?
a. By looking – watching people have sex in a laboratory or on film
b. By measuring – assessing sexual behaviour via brain scanning or heat sensors
c. By listening – recording answers from surveys or interviews
d. By participating – having sex with the people they are studying
e. Not sure

2. How often does the average UK couple have sex per week?
a. 7-10 times
b. 4-7 times
c. Once a week or less
d. Not sure

3. The average (erect) penis size is 5 inches long
a. True
b. False
c. Not sure

4. Women and men are equally stimulated by visual images of sex
a. True
b. False
c. Not sure

5. Men can fake orgasm
a. True
b. False
c. Not sure

6. Men reach their sexual peak at 17 years old, women at around 40 years old
a. True
b. False
c. Not sure

7. Animals (other than humans) can be gay
a. True
b. False
c. Not sure

8. Where do most people get their sex information from?
a. Friends and family
b. School/college sex education
c. Self help/sex experts
d. The media (magazines, films, television, internet)
f. Pornography

9. What’s the most popular area in sex research currently?
a. Desire and pleasure
b. Sexual problems
c. Sexuality
d. Sex addiction
e. Love, romance and courtship

10. Why do sex researchers study sex?
This was an open-ended question we gave to the audience last night. I’ve got all their answers to sort through and I’ll be posting those in a blog next week, along with some answers from real-life sex researchers and educators.

Come back tomorrow and you can find out whether you’re a sexpert, and learn more about each question.