Christmas is over, the New Year has begun. There’s only the last few unwanted choccies left in the tin and it’s time to take down the decorations. Pour yourself a glass of good cheer (or make a cup of tea), settle down, and let’s anticipate the year ahead. What’s 2011 going to bring us in terms of sex and relationships?

This is an annual task I set myself. To forecast things I think are going to happen which I glean from on my work as a Social Psychologist researching sex and relationships in an International Health context – and listening to other educators, practitioners, therapists, bloggers and healthcare staff working in the areas of sex/relationships. For this reason some of the predictions are focused more towards sex/science/health. You’ve doubtless got predictions of your own based on your interest in sex and relationships, so please don’t see this list as exhaustive. Maybe use it to create your own list of predictions for the coming year. (If you want to see my predictions from last year and whether I got any right, click here).

We’ll all get wedding fever
Well we might not, but the media certainly will. It’s no secret there’s a Royal Wedding in the spring. This is going to put the press into an absolute frenzy. The opportunities to talk about not only a Royal Wedding but also weddings generally will be too good to miss. Imagine the endless opportunities to discuss wedding dresses, rings, pumpkin coaches and no end of commercial nuptial possibilities you probably didn’t even know existed. There’ll be scores of chances for psychologists, body language experts and relationship therapists to discuss the ins and outs of the engaged couple’s experiences before, during and after their wedding. And loads of opportunities to speculate about the Royals’ lives, or prescribe to us how weddings and marriage should be.

Opportunities to talk about diverse relationships – non monogamies, cohabitation, or being less judgemental about singledom, will be few and far between. Although we may see the Royal Wedding be something to revisit debates around civil partnerships vs marriage. Whatever happens I predict if we’re not already heartily sick of the Royal Wedding and wedding fever – we most certainly will be by the end of April!

The ‘science of sex’ is going to be super popular
From kissing to orgasm we’re going to get very interested in the ‘science’ of sex in 2011. Books, television and radio programmes, plus public science events will be tackling a wide range of topics including the science behind sexual behaviours and sexuality. Along with deeper explorations into the methods used to study sex – and an insight into the lives of (some) sex researchers.

Some of these are going to be amazing, groundbreaking and exciting. Others will be the predictable reductionist approach to both ‘science’ and ‘sex’. These accounts will focus more on biology and neurology (although not necessarily in a cutting edge way). In the process ‘sex science’ will be treated in an ahistorical, heteronormative and culturally biased fashion. The media is going to love ‘sexy science’, will treat it as if it’s an entirely new discipline, but will give far more attention to the more simplistic views of sex/science than the more nuanced, interesting and ethical research that many sexologists strive for.

Related to a fascination with sexy science there are also several large scale (epidemiological) sex surveys already underway (such as the NATSAL survey which is in the midst of data collection currently), and a major International sexological conference in Glasgow this Summer there’s plenty to be interested in relating to sex research.

This isn’t a prediction but I do hope sex researchers take the opportunity to reflect on and share more of their work via blogs and the mainstream media as it is something that continues to fascinate the public and yet often remains highly inaccessible. Let’s make sexology more open access in 2011!

Sex research is going to have to do more for less
Academics are seeing cuts across the board, but sexology (particularly critical sexology) is going to be one area that is more affected than other disciplines. Sex research that falls within the health/medical areas may fend better, but critical research and practice around less ‘mainstream’ topics is certainly going to struggle. Topics such as non monogamies; challenging heteronormative approaches; critical thinking around mainstream topics like ‘sexualisation’; researching pleasure; porn studies; Queer and Trans studies and research on alternative sexualities and BDSM are in need of inquiry but will struggle to get funding. For this reason practitioners, academics and activists are going to have to work more collaboratively, find ways to do ‘more for less’, consider methodological approaches that permit them to ethically explore areas without large scale budgets, and think about new ways to share information with colleagues and the public.

It is going to be a difficult year for those working in the more thoughtful and political areas of sex research. Fortunately networks such as Onscenity are already being established among academic communities, working internationally and cross disciplines to try and broaden research opportunities and mentor researchers.

Similar problems will also be affecting sex and relationships research in international health/development, although I’ve not see the same kind of mobilisation there, particularly not in public health. With the exception of some more foresighted groups and individuals, the majority of research on sexual health internationally seems to becoming narrower in focus – not least because of budgetary restrictions. This in turn is having a depressing effect on training and support for people working in reproductive healthcare and education.

One thing is certain, money may be limited but people’s need for information on sex and relationships is not.

Austerity measures will affect our sexual (and other) lives
It’s all a bit doom and gloom with my predictions this year, but unfortunately we are looking at a bleak year ahead. Financial cuts plus increased demands will undoubtedly affect Sexual and Reproductive Health Services. Practitioners are already warning particularly about the negative impact this will have on GU clinics and maternity services. With the end of the Teenage Pregnancy Strategy it is unclear what established services for teen parents will be retained. Sexual, reproductive and relationships outreach services may also be affected by local government cuts – and we can be certain where this happens the first to be affected will be projects aimed at sex workers, LGBTIQ groups, ethnic minorities and excluded young people.

Also additional cuts on benefits, rising unemployment and stealth cuts to educational, youth and arts charities will have a knock on negative impact on the nation’s relationships health. This may not seem obvious but proposed cuts aimed at people with disabilities won’t just impact on standards of living and opportunities for work, they will also impact on the ability to be able to date, socialise, form or maintain relationships (or generally have any energy or confidence for intimacy). Young people face losing clubs and activities that give them things to do, aspirations and goals. After school clubs and similar social activities face closure as to arts programmes – all having funding cut via stealth. Realistic efforts to tackle housing and poverty issues seem unattainable (or counteracted by benefit cuts elsewhere). We know young people who lack supervision, activities and who live in poverty and without adequate schooling and support are at a far higher risk of unplanned pregnancy, early sexual debut and STIs (more info here). It is perhaps unsurprising many practitioners, educators, parents and young people are already anxious about what the year will bring – and sadly we may see many casualties of the cuts before the year is out.

You might get ‘nudged’
It’s not as naughty as it might sound. If you’ve not heard about ‘nudging’, it’s a theory by economist Richard Thayler that was popular in the US prior to being noticed here by civil servants, politicians and some health/social care practitioners. Sometimes described as ‘libertarian paternalism’ it’s a form of behaviour change. It was designed from a financial perspective but has been applied to various areas – including healthcare (particularly issues like reproductive health, obesity etc).

Because previous attempts at behaviour change (in healthcare at least) were viewed as clunky, top down and overbearing ‘nudging’ aims to still manage people’s behaviour but through changing aspects of their lives to making them feel more in control over what they are doing. Critics obviously still see this as top down and oppressive, not fully engaging communities and focused usually at particular groups politicians view as ‘problematic’ (the poor, ethnic minorities, young people). David Cameron has been a fan of nudging for a while, and it has slowly been gathering momentum within political and policy making circles. However, as with any theory it has limitations and requires understanding and critiquing within an academic context. There’s no real evidence the coalition has done this so in 2011 we will see a version of ‘nudging’ being adopted and sold to us via politicians, charities, healthcare groups etc. Most of whom will be keen on this latest buzzword but won’t necessarily understand the theory behind it. It won’t stop it becoming popular, however. Not just in the UK. Practitioners keen on behaviour change models are already adopting this theory for use in the global South – frequently overlooking cultural differences that may make such interventions untenable.

Sexualisation will remain a popular political cause
Over the past few years we’ve seen the term ‘sexualisation’ enter popular culture with several countries commissioning reports into its effects. In the UK these reports are currently being re-evaluated. In 2011 we’ll continue to see the media focus on this subject and politicians see it as a major issue (particularly for young girls). Critical debates of the term will be less common, but we will see debates on the impact on sexualisation extend to talking about porn – with more conservative plans suggested to implement various blocks and bans on accessing materials. Addressing wider issues around gender, sexuality, sex education access to information and advice for young people will not be given priority. Nor will listening to young people themselves or acknowledging they may have any opinions or agency in this area. I think we can also anticipate growing links between Conservative/faith based groups and anti porn feminists moving to make porn/sexualisation more of a campaign issue – much like some of you will remember from the 1980s and early 1990s, and echoing what has already happened in Australia.

Mainstream media sex coverage will become increasingly limited
I know I’m a bit of a broken record over poor media sex coverage, but I’m going a bit further and predicting this year it is going to get worse. I’m probably setting myself a hard task with this prediction since I’m going to have to find evidence to support such a claim at the close of 2011. Or perhaps journalists could just save me the job by vowing to produce quality sex reporting? My hunch is they won’t, not because they’re not aware of the problems with reportage, but because they are restricted by time, budgets, overreliance on PR stories (and surveys) and editors’ daft ideas about sex. An example of just how reductionist and poor media coverage is at the start of the year comes courtesy of USA Today who’ve already set the bar massively low – surely it can’t get any worse? (I bet you it can).

Self reflection and diary keeping will become a major phenomenon
After all this misery and grouchiness here’s a more positive prediction. Sex researchers have been inviting people to keep sex diaries for years. Sex bloggers have taken this a stage further by reflecting on their relationships adventures. But this year I think we’ll see the idea of self reflection and sexual diary keeping become more of a mainstream phenomena. We might be using these for erotic entertainment, to communicate with a partner, or to identify particular problems we wish to tackle. Susie Bright has helpfully paved the way with her Sex Journal (which gives you pointers about what to write and space to share your reflections). Numerous magazine features are set to follow. You can easily join in by writing about and reflecting on your intimate life/lives online or in private. I’ll share more tips on how you might do this later in the year.

What’s definitely happening
There are some things I don’t need to predict as we already know they’re taking place. In February the Natural History museum delves into Sexual Nature with a fascinating exhibition on animal sex – easy tiger! Sex work is back on the political agenda (see here and here) and sex workers are particularly encouraged to get involved with consultation and lobbying on this issue (see here for more on how to do this). Debates are taking place around age of consent in Ireland (as is the topic of policing prostitution). In the UK the future of sex education will be debated in the early part of 2011 but we’re still uncertain what will happen.

So there you have it. Not perhaps a particularly cheery year to look forward to financially, but that doesn’t mean there’s not a lot of interesting things happening in sex and relationships research, education and activism in 2011. And plenty of work to be getting on with! On that note join me later this week when I’ll be outlining my plans for this blog for the next 12 months. I’m changing approach and format somewhat so I’m hoping it’ll be more useful and interesting for you.

Here’s wishing you a fantastic New Year!

This year seems to have just flown by, and what a busy one it was for research and stories about sex. From philandering footballers to STI statistics we certainly got to hear a lot about relationships.

Here are some of the main stories I think made up the year in media, sex and science.

The year began with the launch of the Home Office’s report on Sexualisation of Young People a problematic review which received lots of media coverage but very little critical attention from the press. It sadly overshadowed a far more detailed and useful similar report that came out just beforehand on Sexualised Goods, Commissioned by the Scottish Parliament. (You can find discussions critiquing the Home Office review here and here with a history of sexualisation reviews from other countries and open access tools to evaluate them here)

January was also noteworthy for being the month all our G spots went missing. Who knew?

Did you know Facebook caused syphilis? No, well nor did I until in March the press went crazy for the ‘Facebook linked to a rise in syphilis’ story. This was based on some opinions from a public health practitioner who should have known better, but who press released speculations about sexual health and social media. Cue plenty of irresponsible media coverage.

It provided an opportunity for sex educators to challenge these claims and also to promote health advice about syphilis, STIs and safer sex. Worryingly many sexual health charities and public health organisations failed to engage with the story in a timely fashion, completely missing the opportunity to share information with the public. An account of how this story unfolded, the heroes and villains of the piece can be found here.

The BBC produced a groundbreaking and sensitive drama ‘Five Daughters’ in April, based on the tragic story of five women from Ipswich who were victims of a serial killer in 2006. It retold the stories of Anneli Alderton, Paula Clennell, Gemma Adams, Tania Nicol and Annette Nicholls, plus the role of the police and support agencies. It was praised for its accuracy, respectful approach and depicting the female characters in a humane way, particularly focusing on their friendships and families. A discussion of why and how the series was made can be found here.

April also saw the bizarre case of Clitoraid unfold. What began as a request via twitter and facebook to ‘adopt a clitoris’ soon was a more complex case involving a cult, unclear activities in Burkina Faso, and the support of sex educators and a sex store. A summary of the story can be found here, hereand here. Many questions about Clitoraid still remain unanswered, and have caused rifts between sex educators, activists and health/development practitioners. This bad feeling was distressing, particularly since many involved were highly respected within the field of sex education and activism – and because basic respectful approaches to international practice were ignored.

What do you do if your girlfriend ditches you and goes out with someone else? Mope? Call up your mates and hit the town? Go visit your mum? Listen to sad music? Or cut your girlfriend’s face so nobody else would ever want to date her? If it’s the latter then you’ve clearly been taking your relationship advice from actor Danny Dyer and Zoo magazine. In May Dyer’s advice column contained this shocking suggestion, which was noticed by @sarahditum and quickly spread across twitter. Dyer blamed Zoo, Zoo blamed Dyer. Nobody took any responsibility for anything. But action did get taken, primarily when people stopped complaining to the magazine and editor and started targeting advertisers with the magazine. Dyer was sacked. Zoo was forced to write an apology and feature about domestic violence. The whole sorry saga is summarised here and here.

The same month saw Project Prevention gain notoriety in the UK with largely uncritical media reports like this. Through countless chat shows, broadcast and print news the organisation suggested drug/alcohol and reproductive health services (plus other support services) were failing to manage drug/alcohol users getting pregnant. And suggested cash incentivised sterilisation programmes were the answer. (Project Prevention are only focused on sterilisation or adoption of long acting hormonal contraception. They are not interested in supporting drug/alcohol users after this – in terms of sorting out any addiction, housing/family issues, or safer sex concerns. Moreover they fail to address repeat pregnancies can be a sign of domestic abuse. Their focus is solely on preventing drug/alcohol users getting pregnant).

The media provided no real discussion of what services already exist, what they offer, how they work, where they could be improved. Without this, discussions on Project Prevention were meaningless but this didn’t stop media approaching the issue of drug/alcohol abuse and incentivised sterilisation as though this were a necessary and beneficial option, required because of gaps in existing services. Since no services were seemingly assessed it would be difficult to draw these conclusions but it didn’t stop the media. Who also ignored the concerns of drug/alcohol charities, human rights groups, and healthcare practitioners.

Nor was much investigation carried out into Project Prevention, or their previous incarnation CRACK (Children Requiring a Caring Kommunity) despite numerous publications on them in health/legal journals (see here, here, here, here, here and here)

Blogger Stuart Sorensen emerged in this debate as a voice of sanity and tireless campaigner against Project Prevention. Inviting the UK representative of Project Prevention to explain their plans for the programme in the UK then creating resources for practitioners and the public around how to tackle the organisation (all his writing about Project Prevention can be found here and on twitter)

Despite some journalists and bloggers writing about Project Prevention as though it were an established and worthwhile UK organisation, in fact it is not. Ethically in the UK practitioners cannot sterilise people who’ve been financially incentivised or who are drug/alcohol dependent. They can, with the person’s consent, suggest long acting reversible contraception (LARC), although Project Prevention do not appear linked with any existing drug/alcohol or reproductive health services. Currently they are requesting monetary donations to fund getting people onto LARC which can already be freely offered via the NHS. But the media and uncritical bloggers haven’t really considered the ramifications of this at all. The project and messages behind it are popular with media and some quarters so it continues to require vocal opposition. Not least because its focus on the poor, vulnerable and socially excluded feels like eugenics to many people. Rather than giving Project Prevention a platform we would do better to explore complex cases around reproductive health and drug/alcohol abuse, and ways to ensure services can better support addicts and their families.

In the midst of this we had a general election. Labour lost. The conservatives and liberal democrats formed a coalition. Many long term labour supporters, myself included, had become disenchanted with many of the actions of the labour party. Particularly around its use and neglect of scientific evidence to inform policy and law. (I wrote about my direct experiences of this here). The Liberal Democrats were eager during electioneering to persuade scientists to focus on ‘geeking the vote’ and made many promises around healthcare, education, academic funding, university fees and supporting science. Perhaps unsurprisingly many working in academia and science were persuaded to vote for them on this basis (I certainly was, something I am still regretting – and you’ll understand exactly why when you read this – the most personal post I’ve ever shared on this blog). For some the subsequent backtracking and u-turns of the Liberal Democrats have come as no surprise, to others of us it has come as a dreadful shock. And a sad let down not only to see the behaviour of the Liberal Democrats since they became part of the coalition, but also to note many of those who so actively courted the academic and science vote have dropped contact with us. Leaving us feeling cheated on many levels. A truly depressing turn of events.

June saw the FDA reject the drug Flibanserin – the female ‘desire drug’ despite months of media hype about this being the next ‘female viagra’ (as the media consistently and incorrectly described it). Shortly after drug development was discontinued, while later in the year Ray Moynihan’s fantastic book Sex, Lies and Pharmaceuticals highlighted further the problem of medicalisation of female sexual functioning by the pharmaceutical industry.

Also over the summer we saw a scandal break around off label use of the drug dexamethasone given to pregnant women to prevent congenital adrenal hyperplasia (CAH) in girls. CAH is a disorder that affects the adrenal glands, so a person will not make enough of the hormones aldosterone and cortisol, but will make too much androgen. One of the results of this can be girls with CAH having ‘ambiguous genitals’. Using dexamethasone to prevent CAH (and particularly to prevent girls developing male genitals) is a standard practice for some clinicians, as is offering genetic testing to parents with a history of CAH. Many endocrinologists and medics have argued prescribing dexamethasone should only happen within a controlled, supervised, trial programme (which is currently not the case). The real scandal around CAH came from a clinican who was prescribing ‘dex’ to not only prevent CAH but also to prevent lesbianism.

This case was broken by Alice Dreger and colleagues and quickly spread to the media who focused on the need for using dex to treat CAH and the circumstances under which it might be used (see here and here for examples). The media, while expressing dismay, were not as critical about the use of dex to ‘treat’ both gender and sexuality as bloggers were. The blogosphere (particularly writings from trans and intersex people) took a more politicised, critical and wide ranging approach to this story (see for example this post from Mark Simpson assisted by @quietriot_girl, which links to other discussions about dex, sexuality and CAH).

Around the same time, a separate story was broken by Dan Savage which also involved Alice Dreger and colleagues. This time alerting practitioners and the public to research being undertaken at Cornell University by Dr Dix Poppas. Poppas’ research focused on ‘treating’ young girls judged to have oversized clitorises by performing clitoral reduction surgery on them. And testing for post operative sensitivity with manual stimulation and the use of a vibrator. Unsuprisingly this led to an outcry, primarily from bloggers (rather than the mainstream media who didn’t give it as much attention). Bloggers and activists saw the research as child abuse and female genital mutilation/cutting (examples here, here and here). It also led to wider discussions around surgical interventions and intersexuality within forums and on twitter – some of which became pretty heated but were definitely of interest. Sadly even within these discussions some intersex people felt they were (as so often happens) being spoken for or spoken over. The CAH and particularly Cornell case showed us we still have a long way to go around open and respectful dialogues in this area.

While it was right to focus on both the CAH/dex/lesbianism and the Cornell /cutting stories, what proved interesting about both was they recieved far more attention and debate across the blogosphere than within the mainstream media. But both these cases still received masses more attention in both blogs and the mainstream media than the clitoraid case. Despite the Clitoraid case being equally troubling on many levels. Those of us involved in challenging Clitoraid were left wondering whether it was simply the case that when it came to the rights of African women the press and bloggers just weren’t as interested. Not a comfortable feeling.

The media tend to view the summer months as ‘silly season’ and they certainly didn’t disappoint in August, with a spectacular misunderstanding of public health data and wild claims that not only were dramatic numbers of 11 year olds on the pill, but the belief they were all using hormonal contraception because they were sexually active. In reflecting on the story health practitioners began to realise just how little journalists covering stories like this understand about young people, puberty and hormonal contraception. Or that very few young women are prescribed the pill – and if they are it’s usually for things like acne or heavy periods. A rundown of the story in its full ridiculous glory can be found here

Not to be outdone by the press, MP for Peterborough Stewart Jackson decided the best use of twitter was to insult his followers who questioned his anti sex education statements. By calling them ‘sex obsessed leftie weirdos’ and other choice insults. Accounts of which can be found here and here .

In the US a spate of suicides of teens bullied over their sexuality led to Dan Savage establishing the It Gets Better project aimed at providing messages to young LGBTI people that things can improve. Numerous celebrities, politicians, activists and members of the public have posted their stories to the project in an attempt to highlight for many young people suffering homo/transphobic bullying that life can change and is worth living. There are too many to share here but the notable and moving contributions (in my view) to discussing how ‘it gets better’ came from Councilman Joel Burns

and the staff at Pixar

This programme was unusual as it took a slightly different approach to the usual anti bullying approaches, by taking a positive and hopeful view. Perhaps unsurprisingly some critics felt it oversimplified problems, suggested that things always worked out okay, and that adulthood is an automatic escape from homo/transphobia. In particular the message that it was worth enduring hardship/distress now because a brighter future awaited proved problematic for many. (This is explored in more depth here). Debates began about whether the project was a good idea. Blogger Furrygirl robustly responded to feminist critics of the scheme. While thoughtful writer Tania Glyde took a different view, thinking around why sometimes things don’t get better – and why that happens. And how often this may not be under your control. Her amazing and moving post on this is here.

It Gets Better still requires discussion and evaluation – it would be interesting to see what a difference this grassroots project may make. But it also reminds us of the lessons many working in sexuality, sex and relationships health/education already know. Which is that we can’t give blanket messages. It is important to have positive goals, but telling people what to do rather than how to get there may not be enough. And that anti bullying messages based on oversimplistic ‘it’ll be okay’ or ‘it’s dreadful’ are unhelpful. Instead we need more tailored approaches to tackling homo/transphobia for young people, adults and families. Across schools, the legal system, media and beyond. It Gets Better may have its fans and critics, but it has reminded us many young people are at risk of bullying within the school or other spaces and we all need to take action to empower and safeguard them. Now and in the future.

During the year it became apparent that science funding and other provision for education were under threat and in October UCL scientist (and all round fabulous woman) Jenny Rohn decided to take a stand. She gathered together a merry band of scientists and practitioners and got them to back the Science is Vital campaign which resulted in a petition, plenty of blog posts on the topic, extensive media coverage, and defended science against the cuts. Oh and some really questionable singing

Oh, and this woman turned up too

November saw the 40th anniversary of Page Three – but was this a cause for celebration? Nobody seemed sure. It also marked the closure of the Teenage Pregnancy Independent Advisory Group (TPIAG) who had overseen the (then) government’s Teenage Pregnancy Strategy over the past decade. Their final report can be found here, with TPIAG warning that not taking action on teen pregnancy (and supporting teen parents) will cause problems in the future. While the Teenage Pregnancy Strategy was not without its critics (from various sources) it did commit to supporting teen mothers and identifying causes of teen pregnancy. What will happen under the Coalition in relation to support for young people, and particularly teenage parents, remains to be seen.

This month also saw the Geek Calendar project go into overdrive, with plenty of coverage, advanced orders and the opportunity to raise funds and awareness for libel reform. I was delighted to participate and hope many of you are now a proud owner of a Geek Calendar of your own!

At the close of the year the government have revisited the issue of prostitution, calling for a review into best practice in managing the issue, echoed by ACPO who have also called for a review of legal and health approaches to sex work. Media coverage on this so far has been positive, but focused more on women, not addressed male and trans workers.

The year has also ended on a similar note to how it began, with a return to reviewing sexualisation and commercialisation, this time led by Reg Bailey (chair of the Mothers’ Union) who will be looking at existing reviews in this area and deciding what else needs addressing for children and young people. Critics have already questioned why a ‘review of reviews’ need completing, and whether Bailey is the appropriate person to oversee this process.

Linked to this was the government suggestion that Internet Service Providers block access to porn which has had a mixed reception. However, debates about sexualisation continue to be a media favourite and are for the most part not based on sound research. Indeed much of it seems to just be speculation – like this claim that cheating footballers are normalising adultery. This sadly seems to be the way Bailey and others are trying to bring boys into this debate. Not exactly helpful.

During the year we’ve had to say goodbye to several people who’ve been trailblaizers in the areas of sex, education and health. Including
Claire Rayner
Professor Otto Wolff (a hero of mine who was the first and pretty much only senior health practitioner to recognise the work of agony aunts as having a relevant health role)
Actress and model Pamela Green
Cory Silverberg also pays respect to others who have passed during the year over at his blog.

Join me on New Year’s Eve when I’ll be looking back over my Sex and Relationships Predictions for 2010 and seeing how many of them came true, or where I was completely off track. And in the new year I’ll be giving you a new list of predictions for 2011.

Thanks to @bishtraining @mngreenall @SexEdUKation for their help with this blog – and checking I’d managed to remember all that’s happened this year! And for @quietriot_girl and many others who emailed me to remind me about things I’d forgotten and needed to add.

It’s nearly Christmas and you may have already got gifts for friends and family. But if you’re still wondering what last minute goodies to buy, or can stretch to one more present, then here’s a few suggestions for charities and organisations who could do with your support.

These are all programmes I feel are often not given much publicity and may not fit in the usual ‘good gift’ type Christmas promotions, but nevertheless do amazing work all year round and deserve our support.

I’ve picked 6 charities/groups who represent various different activities around sex, relationships and health. Some are faith based, some secular. Some are specifically focused to one region or country, others are international. You may want to support the one you feel most impressed by – or perhaps give a small amount to several of these very good causes.

As well as financial support there are also other ways to help these organisations so do read up on any that interest you and see if you can help them as a volunteer in the new year.

Hesperian Foundation
Hesperian is a non-profit publisher of books and newsletters for community-based health care. It produces free resources in various different languages on topics such as Where There Is No Doctor, Disabled Village Children and Helping Health Workers Learn.

Here are ways you can get involved, which don’t just involve financial donations – you can also volunteer, translate and review books, and let other people know about the work Hesperian are doing.

Jabulani Rural Health Foundation
Jabulani is a non-profit organisation that supports Zithulele Hospital and its surrounding community. Zithulele Village is situated in a remote part of the Wild Coast (Eastern Cape Province, SA). Founded in 2007 by four Christian doctors, our focus is on healthcare, education, poverty relief, environmental issues and care for those affected by HIV/AIDS.

Practitioners at Zithulele have introduced a number of innovative programmes for rural health which have been reported in The Lancet and SAMJ and include nutrition, maternal health, occupational therapy and education projects.

A short film about the hospital can be found here:

Donation information can be found here
Become a friend of Zithulele here

Scarleteen
Scarleteen is an independent, grassroots sexuality education and support organization and website. Founded in 1998, Scarleteen.com is visited by around three-quarters of a million diverse people each month worldwide, most between the ages of 15 and 25. It is the highest-ranked website for sex education and sexuality advice online and has held that rank through most of its tenure.

More info here

Donate here

Outsiders
Outsiders is a community for people with physical and social disabilities that enables people to meet, make friends, overcome isolation and form relationships. It coordinates local meet ups, provides advice and hosts numerous events to raise funds for greater advocacy for people with disabilities. It also operates a peer support network, lobbies for greater rights for disabled people, and informs health and social care practice around sex, relationships and disability.

As well as providing financial assistance there are other ways you can help Outsiders including lobbying on issues around disability rights, and assisting the organisation with research, advocacy and resources. More information on how to give here

Education for Choice
Education For Choice is the only UK-based educational charity dedicated to enabling young people to make informed choices about pregnancy and abortion.

When young people have opportunities to explore the decisions that can lead to and result from pregnancy they are better able to:
Protect themselves from sexually transmitted infections and unintended pregnancy
Make informed choices
Access appropriate services to support their choices.
Education For Choice’s work is focused on the word choice. Whilst we concentrate on the issue of abortion, as it is the issue that receives least attention, we believe that work with young people should value all pregnancy choices equally.
Our ethos is that the best outcomes of unintended pregnancy occur when the woman involved has been able to make her own informed choice.

Donate here

The New View Campaign
The New View Campaign was formed in 2000 as a grassroots network to challenge the distorted and oversimplified messages about sexuality that the pharmaceutical industry relies on to sell its new drugs.
The pharmaceutical industry wants people to think that sexual problems are simple medical matters, and it offers drugs as expensive magic fixes. But sexual problems are complicated, sexuality is diverse, and no drug is without side effects.

The goal of the New View Campaign is to expose biased research and promotional methods that serve corporate profit rather than people’s pleasure and satisfaction. The Campaign challenges all views that reduce sexual experience to genital biology and thereby ignore the many dimensions of real life.

The New View Campaign is devoted to education, activism, and empowerment. We invite you to benefit from the information on this website, and we invite your support and participation.

More information on donating and volunteering for the New View, as well as implementing its ideas into policy and practice can be found here

I hope you are able to support one or more of these charities/organisations financially or in some other way.

Thanks for your continued support for this blog. Your feedback, suggestions and ideas for content (and how to improve the blog) is always very welcome.

Wishing you a very Merry Christmas and all the best for a happy and healthy New Year.

To get people in the Christmas spirit – and the mood for giving, I’ll be sharing carols, seasonal songs and a few sketches on twitter between 1-4pm on 22nd December (GMT) on the hashtag #PsXmasCharityConcert.

If you missed it, here’s the concert in full – please consider giving to one or more of the charities/organisations listed above while you tune in!

We opened with Mariah Carey’s All I Want For Christmas Is You

Followed by Meryn Cadell’s The Cat Carol which you can listen to here. [Not really suitable for young children, anyone who feels a bit hormonal, or people who like cats]

Then it was time for a bit of reading, with the fabulous Joyce Grenfell’s Nursery School Nativity Play And George, Wise Men never do that…

I bet you’ve never heard a better (or madder) version of The Little Drummer Boy than this one by The Klezmonauts.

It’s a Christmas tradition in our house that my dad reads King John’s Christmas as part of our family concert (he does it beautifully). So it felt apt to include it in my virtual Christmas Concert.

Next it was time for some Christmas kitsch – and it doesn’t get much kitscher than Eddie Dunstedter and his organ. I feel like I need a pair of heels, a cocktail and a Christmas pinny to really get into this one…

And if that wasn’t camp enough, it was time for some innuendo with Larry Grayson asking ‘Who’s stuffing your turkey this Christmas?’ (Go on, you can tell me!)

Do you believe in reindeer and the magic of Christmas? Of course you do! It’s only those pesky physicists who try and spoil things with all their logical explanations. Bah humbug!

Another song due after that, and it was over to Si Cranstoun and a very jolly Miss Santa Claus (he’s part of the Dualers – who are fab!)

What could be more seasonal than a song about an Angel Gabriel by LAMB?
I can fly
But I want his wings
I can shine even in the darkness
But I crave the light that he brings

Hoping you have someone in your life who make you feel this way.

On a lighter note I asked if people were familiar with the term Camp As Christmas? You will be after watching Bearforce 1 and ‘Christmas is here’ (which frankly ought to be the Christmas number one IMHO)

Next it was time for an activity for all the family – and kids of all ages. The Santa Application form (which I use in teaching questionnaire design – only at Christmas obviously). Still time to get your application written!

Obviously it wouldn’t be Christmas without a bit of Judy Garland, and the tearjerker anthem Have yourself a merry little Christmas

Last up in the virtual concert was my favourite carol In The Bleak Mid Winter which has the most beautiful words written by Christina Rossetti. I have a bad habit of ruining carol services by blubbing my way through the final verse of this.

Thanks for joining in my charity concert – either here or on twitter, and remember this was all for the good causes listed above, so please give them your money or your time if you are able.

Merry Christmas!

Today is World AIDS Day with events taking place globally around the theme of Universal Access and Human Rights. You can follow discussions about the day with links to activities and organisations involved on twitter using the hashtags #WAD2010 and #PreventionRevolution

Access is an important but often overlooked issue within this area. Getting education to help people protect themselves from HIV or making care available for people with HIV/AIDS are both still major problems being faced worldwide. Particularly in resource poor communities. Women, children, sex workers, LGBT communities may find it more difficult to reach basic educational and health services, particularly in countries with gender inequalities or where homosexuality is illegal. A lack of critical reflection on the meanings of masculinity within research and care around HIV/AIDS can often mean mens’ health needs or problems can be overlooked or only focused on in negative terms.

Aside from funding and staffing issues, access to HIV services can center around transport and roads, availability of aid, poverty, housing, and education generally (particularly literacy programmes). Not to mention problems of rape and sexual violence, domestic abuse and availability of medication.

Access isn’t just about treatment services for those living with HIV/AIDS but also around prevention and treatment programmes. Which can often be blocked by moral or political opposition or apathy. Which is why access and human rights are interlinked. People deserve the right to have accurate information to help them protect themselves from HIV or gain appropriate care and support if they are positive.

The theme of access for the coming year is an important one and hopefully will be an opportunity for health care staff, educators and researchers to focus on a broader definition of the term. Access also applies to the education, training and support of staff working in health and social care in HIV/AIDS. We still have problems with a lack of open access for many academic journals covering issues staff need to be aware of and that should be something we all press for in the next twelve months.

Easily available and high quality education programmes for staff also need to be based on the specific needs of communities, encourage capacity building and are constructivist in nature – using the lived experiences and local contexts of staff to inform their teaching. Currently much teaching, while well intentioned, is delivered in a context-free, top down and short term fashion. Illustrated here with these wonderfully reflective pieces by Matt Greenall here and here. This can result in programmes that tell people what they ought to do, but not how to achieve this – and how to amend messages if they don’t fit people’s personal or local needs. A lack of sustainability and support within programmes can also often leave communities disempowered and distrustful of research, education or health initiatives.

There can also be a problem around applying what we know. All too often funding for HIV programmes can lead to people deciding to do more research (a survey or focus group) without consulting the existing evidence base on this area which could well inform practice and save time. This is not to say there’s no place for research in HIV/AIDS. Just for practitioners to think carefully about what they are doing and why they are doing it. Critical reflection on both our research and teaching in this area is essential if we wish to improve upon current care and outcomes for the communities we serve.

Health educators and researchers working in this area often struggle themselves with limitations of time, money and demands of funders and local/national politics. Not to mention barriers caused by internalising homophobic, sex negative and gender/class/tribal judgements. With a call to consider access it is important we focus more critically about the teaching we offer and how this work can have meaningful outcomes that include and work with communities.

A couple of examples of this in action can be found in the recent Distance Learning for Health conference which brought together health educators who shared examples of good practice and reflected on ways to improve their work internationally. A review of the event and access to presentations given can be found here. While Contestations provides space for practitioners, activists and educators to debate and think critically around topics related to healthcare that often are oversimplified or overlooked. And, as you can see from Matt Greenall’s posts above are crucial to reflect upon if we’re to improve our understanding of health and human rights.

Finding ways to share knowledge and educational resources can be a powerful approach to tackling HIV/AIDS, but equally importantly allows us to remember that HIV is not the only health problem the world is facing. Thinking about access to education and creative ways of providing this can also allow us to consider additional issues that are impacted upon by HIV but can also be ignored because of a focus on HIV/AIDS. Things like maternity services, mental health, disability, tackling poverty, or managing non communicable diseases, or infections such as TB or malaria.

I will share more on the blog about programmes I hear about in expanding access to education and prevention and would be keen to hear from bloggers, institutions or organisations who are finding creative ways to introduce empowering, critical and reflexive educational programmes with health care staff on HIV (and related issues).

In the meantime if you are thinking these are interesting issues but ones you cannot contribute to directly, here are 10 things you can do in the fight against HIV/AIDS.

Over the past few months, geeks, scientists, writers and presenters have been mulling over how to raise more funds and awareness for libel reform. This follows a number of recent high profile libel cases in the UK which have been seen as attempts to silence debate – particularly in areas of health and science.

While the Libel Reform Campaign has been involved in a number of activities to boost awareness, those of the geekier persuasion wondered if there might be something they could also contribute. After some discussion a charity calendar was hit upon as a way of uniting and celebrating geekiness in all its guises – while celebrating a good cause.

A number of high profile scientists, writers, artists, performers and broadcasters were invited to take part – including Simon Singh, Gia Milinovich, Jonathan Ross, Brian Cox, Chris Addison, Ben Goldacre and Evan Harris.

I was particularly glad to see several of my favourite journalists, artists and performers featured including Aleks Krotoski, Hannah Devlin, Adam Rutherford, Mark Henderson, Ed Yong, and Matt Parker.

The calendar was put together by a team of enthusiastic volunteers including
Alice Bell, Louise Crane, Mun-Keat Looi with photographers Ben Gilbert and Greg Funnell. Each ‘geek’ had a photo depicting different aspects of their lives, work or hobbies. Everyone involved with the calendar gave up their time for free.

Given this stellar line up I was massively surprised and extremely flattered to be asked to feature in the calendar. Although I’d deny it if you asked me, it’s fair to say I am a geek. I’m fascinated with research methods, the whole process of research and how it works, and deconstructing how we study people in the health and social sciences. I’m obsessed with critical appraisal and applying evidence to practice and evaluating our health and educational activities. I’m driven to improve research practice internationally, along with increasing our understanding of research ethics, and the safety and wellbeing of researchers. Clearly when your interests are that dull you need to liven them up – and I do that through adding sex to the mix. You’d be amazed how much more understanding research governance becomes if you’re considering the ethics of studying our intimate lives.

Once I’d agreed to take part the dilemma of what we’d do for my photo shoot began. I was offered the choice of how I’d like to be photographed, with ideas from shoots already undertaken provided for inspiration. With that encouragement my first choice was to recreate this shot of Josephine Baker with her cheetah Chiquita*

Ms Baker is my hero and has been since I first saw a photo of her when I was six. I thought she was the most glamorous woman I’d ever seen. I still think that. Having a pet cheetah was the icing on the cake. In true geek style over the years I’ve been obsessed with La Baker, her career, her values, her trials and tribulations and her achievements. (If you’d like to know more about her this book is a great introduction).

However, I wasn’t sure my fandom of Baker would be clearly conveyed within the calendar, and anyway I couldn’t find a co-operative cheetah for love nor money. So that idea was out.

Because my research involves talking to people about sensitive issues photographing me actually doing any research or training introduced ethical problems around consent which made that kind of photo shoot inappropriate for a calendar.

Since sex research and education is so important to me I really wanted to have a photo shoot that captured that passion, as well as indicating how varied sexology is – and why it’s important.

So we eventually settled on a shoot at Crossbones Graveyard in Southwark. If you’ve never heard of it you wouldn’t be alone. It’s a pretty much forgotten part of London where ‘single women’ (aka prostitutes) were buried, along with paupers (male and female), and infants. Although it’s part of old, hidden London people clearly haven’t lost touch with their history as the gates of the old graveyard remain adorned with ribbons, mementos and messages to ancestors and those who have passed more recently.

I thought it would be an excellent choice of venue because history is vital to sex research – you can’t understand your present situation without understanding what has come before. Given the histories of the poor, the oppressed and particularly sex workers is so often airbrushed from our cultural memories, the idea of commemorating those who lie buried at Crossbones was a privilege. It also drew together for me the core aspects of sex research – understanding history, geography, anthropology, plus documenting and interrogating people’s lived experiences. I hoped including it in the calendar would encourage people to think more about those we often ignore and overlook, those whose sexualities or sexual lives differ from our own.

Knowing those buried there included sex workers, unmarried mothers, impoverished fathers and infants drew upon my commitment to researching and educating in sexual health. It reminded me why this work is so important – and how gender and health inequalities have harmed and oppressed in the past and continue to do so today in many parts of the world. The tributes to infants who’ve died that are still lovingly placed at the memorial also serve as a poignant reminder for any of those working in reproductive and maternal health (and more personally for those of us who have lost a baby through miscarriage, stillbirth or cot death).

As you can see I didn’t make this choice lightly. One of the core criticisms made by sex workers regarding how they’re represented by research revolves around being misrepresented, patronised, sidelined or spoken for. The frequently made criticism that (some) academics work ‘off the backs’ of sex workers and benefit (while workers may not) always needs remembering – even if those being represented in this case have long departed. In choosing Crossbones as a venue I didn’t want it to seem we were ignoring those who lay there, nor that we were glossing over or in any way making light of their histories.

This extended to how we’d photograph the gates of Crossbones. Among the ribbons and adornments include many messages, including names and personal details of people’s relatives – many of which are deeply moving. Some of which speak of very recent losses. All of those involved in the calendar felt it wasn’t appropriate focus on this identifying information and so we used the gates as a backdrop to avoid this.

Aside from the wish to link with sex worker history there were additional reasons for me wanting to be photographed south of the river. Apart from being proud of my South London roots (I was born in Lewisham), other members from my family on my father’s side come from Southwark. I have also worked with healthcare practitioners and young people across many South London boroughs, as well as conducting research (with colleagues) on modernising sexual health services there.

You can see an additional write up on the actual process of the photo shoot here and background photos here.

UK libel laws currently restrict our ability to raise questions about many social and health issues. The fear many journalists, bloggers, academics and activists have around being sued for asking questions or highlighting inequalities or poor practice has a potentially devastating chilling effect. We can all do our bit to challenge this problem but you can do something right now by ordering a calendar (you can buy one here).

And to give you a little more inspiration here’s a trailer of the calendar showing the geeks in all their glory….

* most accounts of Baker refer to her having a leopard although I’m told on good authority she actually owned a cheetah.

Today sees the launch of FPA’s Sexual Health Week 2010, with the focus of this year’s event aimed at the over 50s. Entitled ‘Middle Aged Spread’ it’s the first dedicated sexual health campaign aimed at this age group with the message for people in the 50+ bracket who are starting new relationships that they can get an STI “as easily as someone in their 20s”.

This may come as a surprise to those more used to associating sexual health problems with younger people. Indeed we’re only too aware of the prevalence of sexually transmitted infections in the under 25s - partly due to a lack of sex education and other negative factors, and partly due to better detection and treatment of infections.

However, we are also aware those in the over 50s are an important group to target as they may well have missed out on sex education in their youth, may not have been part of a generation who particularly worried about condoms and safer sex (although certainly were sexually active), and who may mistakenly believe they are not at risk from STIs because they’re older. And of course being older doesn’t stop it being difficult to ask a potential partner to use a condom – particularly if you’ve not had sex with a new partner for some time. For women who’ve not passed the menopause pregnancy is still an issue and guys can still get someone pregnant although this may not always be something that’s considered as much in the over 50s. Tessera blogs in more depth about reaching baby boomer’s sexual health needs here.

While this campaign is focused more towards condom use and older people, sexual health week also addresses wider issues around sexual wellbeing. Events will be run across the UK on managing your own sexual health, negotiating condom use (and carrying condoms), confidence in relationships, accessing sexual health services and when to seek help for an STI. If you’re hosting something let me know what you did and how it went and I’ll feature it on a future post. And if you’re a journalist do find out what’s going on across the UK and report on what’s going on – it’s a great opportunity to focus on empowerment and positive messages around managing our sexual wellbeing and relationships health. All of which is important given recent research findings suggesting while people are aware of STIs and the need for testing and treatment 1 in 3 remain too embarrassed to seek help.

Thinking about contraception is also a part of sexual health week, and there’s an exciting new tool designed for practitioners and the public to assess their contraception needs – and find the right contraceptive for them. My Contraception Tool is a project shared between the Family Planning Association and Brook, in collaboration with Maldaba Ltd, and the London School of Hygiene and Tropical Medicine.

Sexual Health Week isn’t just happening in schools, colleges and healthcare settings across the UK, it’s also part of online advice giving (see above). Which has had a boost in the past week by new research from Julia Bailey and colleagues from UCL who reviewed the evidence on interactive computer based interventions for sexual health promotion which suggests these can play an important role in sexual health promotion. This didn’t come as particularly surprising news to those of us engaged in sexual health advice giving online and across social media, although it is heartening to hear initiatives being reviewed in this way. Future research on this issue also needs to focus on how such interventions/initiatives are established, evaluated and sustained as there’s an ongoing problem of work being reinvented, a lack of coordinated approaches and a problem of initiatives being measured on audience figures rather than any other impact factor. This will certainly be a topic worth returning to in future sexual health promotional campaigns and research.

All too often sexual health campaigns tend to be depressing, overly medicalised or focused solely on infection control – little can be heard about pleasure, desire, communication or assertiveness. They’re also characterised by being serious and worthy. There’s no real fun to be had in the campaigning world of sexual health – and perhaps that explains why people don’t engage with campaigns or find it very difficult to cope if they are diagnosed with an infection.

So I was pleasantly surprised to see one initiative around trying to liven up sexual health education, from Science Matters. They’ve created a series of soft toy microbes which can be used to talk about sexual health. So far these have been used in school lessons, for training educators, and in projects with young offenders (who have to pick different infections out of a grab bag). I’m hoping to report more on the use of these little critters in youth and adult education. In the meantime you might want to celebrate sexual health week with
Chlamydia
Gonorrhoea
Hepatitis
Herpes
HIV
Kissing Disease
Syphilis
Or perhaps a little egg or some sperm?

And I’ll leave you with one of my favourite reminders about condom use (poss NSFW) – and remember sexual health isn’t just an issue for the over 50s, or for one week a year Sexual wellbeing is something for all of us to promote, as much as we can, and as often as we are able.

Fans of the movie Anchorman will no doubt be familiar with the men’s fragrance ‘Sex Panther’. If you hadn’t heard of it before, here’s your introduction…

The fantastic line ‘they’ve done studies you know. 60% of the time it works every time’ has become a well known catchphrase. But I think it deserves far wider use and so I’ve appropriated it to highlight dubious sex research claims.

Last week a Dallas TV station didn’t disappoint with an amazing Sex Panther statistic of their own, claiming ’80% of women have an enlarged labia’. You can see the coverage of the story here.

Even with my dubious maths skills this doesn’t make sense. Because if such a large majority of women report large labia then presumably this becomes ‘the norm’ rather than ‘a problem’.

Using a standard Sex Panther approach we’re told nothing about the origins of this statistic. Merely an assumption that science has shown us 80% of women have larger labia. So we don’t know how many women were studied to make up this figure, who they were, when they were studied, or whether they actually considered themselves to have a problem. We don’t know who did the research, or whether it was even published. We’re given no clue about how ‘enlarged’ labia must be before they become unwieldy. The statistic becomes even more ludicrous if we’re assuming ‘enlarged’ to mean ‘larger than average’. In which case we seem to be being told that 80% of women have larger than average labia.

And that’s before we get on to the problem of the programme makers not being able to differentiate between the vagina and labia.

Of course the piece is really only an advertorial for a “misses only makeover” and sadly amidst the coy references from the anchorwomen we see absolutely no investigative journalism to assess whether cosmetic surgery for well women is needed or to interrogate the concept of ‘enlarged labia’ and who is problematising our vulva shapes and sizes.

Had any research been undertaken the journalists may have learned there is no clear evidence for the effectiveness of cosmetic genital surgery in well women, but there is a growing trend within the cosmetic surgery industry to pathologise the female body as a means to creating a wider market in ‘enhancement’.

Although uncritical media reporting on genital surgery is not unusual there is fortunately an antidote.

THE NEW VIEW CAMPAIGN announces its THIRD Conference, to be held at the University of Nevada, Las Vegas, on Sunday, September 26, 2010.

FRAMING THE VULVA: GENITAL COSMETIC SURGERY AND GENITAL DIVERSITY

While the vulva surgeons are holding a conference on the Las Vegas strip, the New View, in collaboration with the UNLV Women’s Studies Department and Petals, will hold a counter-conference to examine the
personal and political complexities of the new female genital cosmetic surgeries.

Our one-day event will include a morning plenary session on the emerging issues in genital scholarship, activism, and art, and an afternoon of experiential and discussion workshops for participants to share strategies and build connections. The event will conclude with an evening reception, photography and craft exhibition, and film showing at the Erotic Heritage Museum.

Areas covered will include:
• Cosmetogynecology and the new genital perfectability industries
• The rhetoric vs. the realities of Western genital surgeries vs. “FGM”
• Collaborative models of activism
• The revival of “cunt art” in craft, film, photography and painting
• Sex education and feminist-owned sex shops
• The latest body modification trends, from Vajazzling to Vatooing
• Disease-mongering, marketing, and body surveillance
• Critical health studies perspectives on cosmetic genital surgery

Confirmed plenary speakers include:
• Virginia Braun, University of Auckland, New Zealand
• Leonore Tiefer, NYU Medical School, NYC
• Vanessa Schick, Indiana University, Bloomington
• Lynn Comella, UNLV, Las Vegas

Full registration, hotel, and contact information here.

Please share information widely and if you’re a health worker, activist, therapist or sex educator do try and support the event if you can – either by attending the conference or donating to the New View Campaign. Journalists may particularly want to attend to learn more about celebrating women’s bodies and accurate reporting on the growing trend for medicalisation.

In the meantime go on – love your labia! Or love someone else’s. And if a journalist tells you there’s something wrong with your genitals without explaining the science behind their statements be assured they’re simply selling you Sex Panther Statistics.

The e-journal Contestations is a cross cultural and cross disciplinary publication which tackles diverse issues around women’s health internationally. It seeks to create a platform to explore and discuss core issues around development, politics and health.

The current issue debates the statement ‘Sexual pleasure empowers women!’ and opens with an outline of core issues relating to women, development, health and empowerment in relation to sexual pleasure, written by the awesome Susie Jolly. Jolly provides a very helpful overview of sexual and reproductive health and human rights, highlighting how often well intentioned programmes to tackle women’s problems and gender inequality have either ignored the idea of pleasure, or only focused on sex negative or victim/pity models.

This opening essay is expanded upon with an interview with Hania Sholkamay who talks about her views on the concepts of sexual empowerment within a development context.

The remaining part of the issue includes short responses from key practitioners working within International Health and/or Sexual/Reproductive/Rights based programmes. Drawing on work, experience and practice from different cultural settings (and subject positions) these essays discuss and expand upon the ideas set out in Jolly’s original piece. These include essays from
Sylvia Tamale from Makerere University in Uganda
Li Yinhe from the Chinese Academy of Social Sciences
Sonia Correa from ABIA AIDS and Sexuality Policy Watch in Brazil
Pinar llkkacaran from Women for Women’s Rights, Turkey
Shivananda Khan director of the Naz Foundation in India
Each contributor has a different interpretation on what pleasure means and how important the concept of sexual pleasure is within the wider arena of women’s health, human rights and international development.

I was proud to be asked to join the discussion, my contribution can be found here. It hinges around my acceptance of the importance of pleasure but my anxiety over how concepts like sexual pleasure and sex positivity may be understood and applied within an international health context, given my awareness of how critical and evidence based practices within this area are often absent or overlooked. I drew upon my experience as a Social Psychologist working within International Sex and Relationships health – both as an academic teaching and supervising healthcare professionals in their postgraduate studies, and as a practitioner educating healthcare and journalism colleagues worldwide to appraise and deliver sexual health programmes. I also wrote the piece during the Clitoraid debacle that took place earlier this year – which was divisive and unpleasant but served as a chilling reminder of how good intentions around sex positivity can often fail if introduced in a top down fashion in developing country settings.

Hopefully you’ll find all the essays provocative, interesting and useful. They will be particularly helpful to you if you work within sex research, education, development and health. While they take a global view the messages within this special issue are relevant to women in many country settings – not just in the Global South.

I’d particularly encourage the sharing of this open access resource to those working internationally within sexual and reproductive health where critical thinking and considering concepts like pleasure often doesn’t get talked about – not least because people aren’t sure where to begin. These essays give a great opportunity to begin dialogue about the importance and meaning of pleasure, as well as encouraging us to review existing research to inform better practice, and to evaluate activities we’re currently involved in.

Enjoy!

What’s the difference between sexual, reproductive, psychosexual and relationship health?

Sexual health refers to dealing with either sexually transmitted infections, or physical or psychological sexual problems (also called sexual dysfunctions).

Reproductive health refers to your fertility – either advice on getting pregnant, information on contraception, supplying contraception (to prevent pregnancy), or helping you deal with an unplanned pregnancy.

Some clinics specialise in sexual health, sexual problems or reproductive health, other services will offer treatment or advice for any of these issues.

Psychosexual health services tackle deep-seated sexual problems that could be caused by psychological and/or physical factors.

Relationship counselling services help with problems ranging from sexual communication difficulties, to jealousy and coping with arguments or life after infidelity or divorce.

These services are dependent on your location – there may be more services available in certain countries/states. The politics or religion of different countries/states may affect service delivery or approach. Many clinics offer free support and advice, some private clinics do charge a fee, as do some doctors in certain countries – if you live outside the UK check your health care policies for more information.

Many sexual health services particularly those for sexually transmitted infections are often overwhelmed by patient demand. Part of the reason for this is that people pick the wrong service for their needs – so consult the list below to ensure you get the right help at the right time. And tell your friends so they get it right too!

Your Doctor (GP/Family Practitioner)
What can they offer?
• Advice about contraception and prescribe (and sometimes provide) contraceptives for you
• Advice on sexual problems (dysfunctions)
• Health checks relating to sexual problems (e.g. pain during/after sex, loss of erections)
• Information about menstruation, menopause, fertility (getting pregnant), pregnancy and abortion (termination), pregnancy testing
• Physical examinations of your genitals (including smear tests for women or testicular exams for men)
• Referrals to counsellors or other specialists in the case of sexually transmitted infections, sexual dysfunctions, previous or current sexual abuse, genital cancers
• Assessment and testing/treatment for STIs
• Advice about pregnancy/fertility, antenatal and postnatal support
• Advice and referrals for termination of pregnancy (in countries where abortion is legal)

Your doctor or practice nurse can perform external and internal genital checks, swabs and blood tests. They can test and treat you for STIs, or related infections. Depending on your location they may be able to provide you with condoms or refer you to a condom clinic. In many countries, GPs are the main providers of contraceptive services, so they’re not shy about talking about sex. Some people do feel embarrassed discussing sexual health with their doctor, particularly if they’ve known their doctor for a long while – or in cases where they may have an STI through an extra-marital affair or unprotected sex. If you would prefer to see someone you don’t know as well, you can either speak to a different doctor at the practice or go to a Genito Urinary Clinic for STIs or Family Planning/Reproductive Health Clinic for contraception/fertility advice (see below).

Useful links
NHS Choices has a dedicated section on sexual health
Patient.co.uk (links, resources and helpsheets on a variety of health issues)

Genito Urinary Clinic/Sexually Transmitted Infections Clinic
What can they offer?
• Tests and treatment for sexually transmitted infections.
• Advice about contraception (some clinics also prescribe contraceptives and provide condoms – at some clinics these are free).
• Information about safer sex.
• Advice on how to tell a partner you have an STI – some clinics will notify your partner(s) for you.

These clinics (also sometimes known as ‘sexual health clinics or centres’) will test and treat you for STIs, and provide safer sex advice and information. Some clinics work on an appointment basis, others on a ‘drop-in’ system, or a ‘first come, first served’ basis. Some have set times for teenagers, women or men to attend. You may want to telephone first to check appointment times and whether there’s a waiting list for treatment. You shouldn’t have to wait long to get an appointment, but in many countries where there is high demand for services the wait could be longer. You can get condoms from Genito Urinary Clinics.

Useful links
NHS Choices: Sex, worth talking about includes guides to sexually transmitted infections, including locate your nearest clinic and symptoms and signs of STIs
Planned parenthood’s guide to STIs (also available in Spanish)
Go ask alice! (your sexual health questions answered)
STIQ answers common questions about STIs, testing and treatment

Family Planning/Reproductive Health Clinic
What can they offer?
• They can advise you about contraception and give you contraceptives
• Information about how to get pregnant, or options if you have an unplanned pregnancy
• Pregnancy testing and referrals for termination of pregnancy (abortion) if you require it
• Smear tests for women

These clinics can perform smear tests (internal exams for women), and offer contraception and pregnancy advice. They can provide contraception such as birth control pills or injections, or condoms. If you want contraception only, then make an appointment at one of these clinics. If you think you have an STI, it’s better to see your GP or Genito Urinary Clinic.

Useful links
Family Planning Association guide to contraception, pregnancy and STIs
Brook sex advice for under 25s
Planned Parenthood advice on contraception, STIs and sexual and reproductive health – in English and Spanish
Marie Stopes global reproductive health advice source

Your Pharmacist
What can they offer?
• Home pregnancy testing kits (some pharmacies will do the tests for you)
• Over the counter treatments for cystitis, thrush, period pains (menstrual pains), folic acid (for those planning to get pregnant or during pregnancy and breastfeeding)
• Condoms and lubricant
• Give you contraceptives as prescribed by your doctor

In some countries, community pharmacists are taking a more active role in health care. For problems such as thrush or cystitis you can get confidential advice from your pharmacist. You can also get condoms, the morning after pill (emergency oral contraception), and lubricant from many pharmacies. In parts of the UK, US and Europe, you may also be able to be tested and treated for certain STIs by your pharmacist. If you think you have Chlamydia or Gonorrhoea, the pharmacist can provide you with a urine kit, which you return to them or post to a local laboratory. Results are returned in a few days and you’ll be given the all clear, provided with antibiotics by the pharmacist, or referred on to a Genito Urinary Clinic or your doctor if further tests or treatment are required. Not every pharmacy can offer this service, those that do will usually advertise testing with posters or leaflets. All pharmacies should be able to signpost you to your local Genito Urinary Clinic who will be able to help.

Psychosexual Therapy (Also known as sex therapy)
What can they offer?
• Identification and treatment of psychosexual problems (e.g. erectile dysfunction, loss of desire)
• Overcoming sexual problems due to past or present sexual abuse
• Dealing with sexual problems due to worries about sexuality
• Sexually compulsive behaviour
• Referrals to other healthcare services (e.g. urology, gyneacology) if needed

Many countries offer psychosexual advice and services. In some cases, they are free to patients with severe sexual problems, although have to be referred through a medical doctor, and can have a long waiting list. In countries where psychosexual services are free, patients can also book to see therapists privately. This cuts down the waiting time, and will cost money, but allows the client choices who they get therapy from (e.g. a religious person may prefer to have sex therapy from someone who understand and respects their religion; a lesbian or gay client may prefer a ‘pink shrink’). In other countries, psychosexual services are entirely private, and have to be paid for. These services may not be covered by medical insurance, check your policy. Some countries do not offer any services, or a limited number of therapists.

Useful resources
Overcoming sexual problems by Vicki Ford (Constable and Robinson)
Women who love sex: an inquiry into the expanding spirit of women’s erotic experiences by Gina Ogden (Womanspirit Press)
Our bodies ourselves: a new edition for a new era by Boston Women’s Health Book Collective (Touchstone Books)
Sexual health for men by Phillip Kell and Vanessa Griffiths (Class Publishing)
The new male sexuality by Bernie Zilbergeld (Bantam Doubleday)

Basrt (British Association for Sex and Relationship Therapy)
Sexual Dysfunction Association includes advice and support on male and female sexual problems
Women’s Health gynaecological and other women’s health advice
Male health information from the men’s health forum

The above organisations cater to gay or straight couples – however if you’d prefer to see a gay or lesbian-friendly counsellor you can contact:
Pink Therapy
Pace

Relationship Therapy/Counselling (also known as couples counselling)
What can they offer?
Counselling for individuals and couples for issues like…
• Communication skills
• Increasing sexual confidence
• Overcoming common sexual problems
• Dealing with jealousy
• Coping with infidelity
• Reducing arguments
• Planning for parenthood

Relationship therapy is offered in different forms in different countries. In most cases the service is paid for by the client – but is often means-tested, meaning those on a low income may pay less. Medical and psychosexual services can refer clients to relationship therapists, and clients can refer themselves. Many religious groups or other support networks offer relationship therapy – again this may be free or paid for and evidence underpinning advice may be patchy. Medical insurance may not cover costs for relationship therapy – check your policy. Some therapists will tackle domestic violence and reputable therapists will not see a couple together while one party is being violent. If domestic violence is a problem within your relationship you need to alert your therapist to this as soon as you can.

Useful resources
Overcoming relationship problems: a self-help guide using cognitive behavioural techniques by Michael Crowe (Constable and Robinson)
Loving yourself, loving another: the importance of self esteem for successful relationships by Julia Cole (Relate Guides)
Gay relationships: how to find them, how to improve them, how to make them last by Tina Tessina (Jeremy P Tarcher)
Relate
British Association of Counselling and Psychotherapy
Couple counselling Scotland
Relationships Australia
American association of sexuality educators, counsellors and therapists (AASECT)
BBC Relationships has a collection of resources and referrals addressing domestic violence

The above organisations cater to gay or straight couples – however if you’d prefer to see a gay or lesbian-friendly counsellor you can contact:
Pink Therapy
Pace

Hopefully you can work out from the list above what service suits your needs best. If in doubt call the service/clinic and ask if they can help you. If they can’t they should be able to explain a source of support.

Where to get advice about your sexual, reproductive or relationship health by Dr Petra Boynton is licensed under a Creative Commons Attribution-Noncommercial 3.0 Unported License

1. Get educated – then share the knowledge
There are many ways to learn about sexual health and wellbeing. You can bring yourself up to speed with information about HIV/AIDS here (contains links to quizzes, resources, forums and advice sheets). Or you can test your knowledge with Avert’s Quizzes (on sex, pregnancy, HIV/AIDS, contraception). Teen site Scarleteen includes loads of frank and helpful information, as does Go Ask Alice!, Kinsey Confidential and Cory Silverberg at About.com’s Sexuality section.
You can also make use of Planned Parenthood’s toolkits and resources, while All About My Vagina explains how anyone can become a sex educator (with links to resource materials).

2. Bust those myths!
Despite education and advice, many people are still confused about HIV and AIDS. You might want to check out some mythbusting courtesy of About.com; questions, answers and papers about areas of confusion about AIDS from The Body while New Scientist lists the top 5 myths about HIV.

3. Don’t just focus on sex
HIV can be transmitted through sexual contact, but it is also passed on from mother to baby through breast milk, through blood transfusion (if infected blood is transfused – this is less common nowadays), by sharing needles, needlestick injury, or unsterilized/unhygienic needles or other sharps used routinely in healthcare. Further information on transmission can be found here. The problem with messaging around sex is we tend to focus on confusing or mixed messages, or advice that’s difficult to put into practice (for example asking people to be faithful in countries with massive gender inequalities). Instructing people they must abstain without discussing the contexts for why abstinence may happen, considering delay messages or thinking about when abstinence is not possible or wanted does not empower communities. It certainly does not protect those who are subject to sexual abuse and rape. Equally dangerous is instructing against condom use. Or telling people not to have sex, to be faithful or always use a condom without giving them any life skills to put these choices into action. Simplistic approaches that assume all people need is instructions to have HIV tests or simply ‘use a condom’ without addressing their wider social, economic, healthcare or personal needs is unhelpful and frequently counterproductive. Discussing sex only in the context of intercourse (vaginal or anal) leaves out wider contexts around relationships, desire, and coercion. We need to focus on clear messaging around sexual transmission of HIV (with actionable solutions and life skills offered), but not forget there are other means of getting the virus. This is of particular concern given a recent study from Swaziland that suggests 1:5 babies are infected with HIV through dirty needles or other clinical equipment.

4. Challenge and tackle inequalities
HIV is more prevalent in countries or communities where there are high levels of gender inequality, restricted access to healthcare, poverty, discrimination over sexuality (including transsexuality), and high levels of illiteracy. Challenging transphobia, homophobia, gender inequality, and discrimination against male, female and trans sex workers can help – for example in the views you hear from other people (particularly those working in health and social care or law enforcement), biased media coverage, or discriminatory practices expressed by organisations. You can also support campaigns that address poverty and literacy along with wider access to healthcare. You might even decide to become an activist – here’s an example toolkit for just this purpose.

5. Volunteer and/or fundraise
There are many ways of getting involved in tackling HIV, inequalities and poverty. You might want to volunteer on a sexual health helpline, or help out at an HIV/reproductive health clinic – on reception, as a health advisor/advocate, or interpreter (either using signing or different languages). Or you could always donate toys or magazines to clinics.

Unwanted clothing, shoes, blankets, toys can be donated to charities supporting those affected by HIV (particularly orphanages worldwide and clinics supporting the homeless, refugees or those fleeing domestic abuse).

You could give of your time locally – for example seeing if your local health or educational authority needs any support (which may include administrative duties that free up healthcare providers to see patients). You might want to prepare nutritious meals for people living with HIV, or if you’re currently breastfeeding you may want to donate some of your milk to feed babies whose mothers are HIV positive. Not all mothers have the option of donated milk or formula, more information for them can be found here.

Spare cash? Well, the recession’s still on, but as the saying goes ‘every little helps’. Financial donations can be made nationally and internationally. If you do wish to donate I’m always happy to recommend trustworthy charities and healthcare providers working to treat and prevent HIV (and other health issues). The Terrence Higgins Trust are always worth supporting, or you might want to help the Jabulani Foundation whose innovative approach to healthcare was recently reported in The Lancet (sadly not open access).

You can save your pennies in a jar, or raise money through car boot or jumble sales, or even sell stuff on ebay and put your profits to a good cause.

Donating materials can also help – old computers, digital cameras, access to educational materials are always welcome in resource poor communities. Offering to help with fundraising (including creating advertising, designing and maintaining websites) is also welcome. Here’s an example of what one charity needs. Search on the web to find more you could contribute to.

Maybe you’re not able to contribute cash but have other skills you might share? Gardening, cooking, sewing/needlework, knitting or craft can be applied to help those affected by HIV/AIDS, raise funds, teach new skills, or generally raise awareness. Knitted items (hats, booties and baby clothing) are always welcomed by orphanages – although don’t forget clothing for toddlers and older kids (particularly shoes, kids do get through a lot of shoes!). You can donate your children’s unwanted items, with the added opportunity of raising their awareness about HIV.

Maybe you’re a drama buff, artist, musician or film maker – in which case those talents can be used to help people find new ways to share messages around HIV/AIDS, safer sex, communication skills, and desire.

If you’re good with words or numbers then why not volunteer to help people who might be struggling with HIV alongside other disadvantages related to literacy/numeracy. Help may well be appreciated with filling in forms, applying for benefits, balancing budgets, or following medical advice.

6. Target problematic practices
There are well meaning campaigns that promote abstinence only as a response to HIV. While it is appropriate to recommend delaying sex until someone is ready (and has sorted contraception/condom use), many abstinence campaigns focus on simply telling people not to have sex – with no additional information about relationships, pleasure, confidence, or negotiating skills. In particular suggesting adults abstain from sex until marriage without any additional sex education, and recommending this approach in countries/communities with major gender inequalities, does little to reduce the spread of HIV. For a balanced view about abstinence based educational approaches see Avert’s review, plus this systematic review from the Cochrane Collaboration indicating abstinence only approaches are not effective. Speak out against those who promote HIV programmes that are only focused on abstinence because it doesn’t reduce the prevalence of HIV.

Linked to some abstinence campaigns is anti-condom propaganda, promoted by some faith based organisations, governments and NGOs. This includes misinformation such as ‘condoms don’t work’, which is untrue. Of course no barrier method is 100% effective, if used correctly then condoms are 80-97% effective in preventing HIV transmission. Other claims include condoms usually break – again untrue if used correctly (in such cases condoms are 98% effective). Or that there are minute holes in condoms that the HIV virus is small enough to pass through. This is false. Condoms are a barrier method and the HIV virus cannot pass through latex or polyurethane condoms. More information about condoms and how to use them can be found courtesy of Planned Parenthood.

Here’s how to use the male condom


And the female condom

Use this awareness of what condoms do and how they are an effective method of preventing HIV transmission, and support educational campaigns that not only distribute condoms but also give people the life skills to know how to use them correctly and negotiate using them with a partner.

Remember, though, that just repeating ‘always use a condom’ mantra, handing out condoms or expecting people just to use condoms without addressing their individual needs is unlikely to be effective. Indeed where people are facing stigma, inequalities and violence handing them condoms and expecting them to use them is deeply disempowering. If you are working as an activist, educator, healthcare provider or are a client using sexual health services speak out against simplistic approaches that promote condom use or HIV testing in an uncritical way.

Unfortunately sexual health – particularly around HIV/AIDS – is often based on good ideas from well intentioned people, but not necessarily practices based on the latest evidence. To find out what’s going on you can use PubMed and Google Scholar to search for research papers, or organisations like MedFash or BASSH. The amazing Magnus Hirschfeld Archive (a multi language resouce) has lots of free tools to help improve your sexual health knowledge – including an online course about understanding STIs. Toolkits to help are also available via the WHO. If you work in education or healthcare ensure your staff are supported to learn about effective ways of promoting clear messages around HIV prevention or how to manage if you are HIV positive. Ask for additional training if you are a staff member or volunteer in this field and ensure you’re obtaining (and attending) continued professional development (and not just for the per diems or certificates – you need to show clear outcomes in your practice and benefits for your clients).

Added to this is the problem of staff who are working in the field of HIV/AIDS but may lack basic training, be unsupported or require more intensive supervision – particularly around reflecting on current evidence and how that might underpin their practice. Without this we see staff giving advice that goes outside their area, not referring to medical specialists when they should, or being highly negative/judgemental. You can do your bit, wherever you are in the world, by campaigning for open access to journals and free or low cost training and support for healthcare practitioners on how to find, appraise, synthesise and apply evidence. All of us who work in health research, activists, clients and academics can and should be pushing for high quality research that does not reinvent the wheel, drain or divert resources from healthcare provision, and can demonstrate practical results that build capacity and sustain communities. Which I appreciate is often difficult to do – that very fact should shame us into trying far harder to achieve it.

In many cultures there’s a mix of a lack of sex education, often a negative cultural attitude to sex, alongside sexual messages within the mainstream media – often with different messages for women and men (so men are expected to be hypersexual, women less so). So often people are not sure about HIV, what it is, how to prevent transmission, or what to do if you’re positive. Creating educational and awareness campaigns that aim at diverse audiences (teens, parents, LGBT, sex workers) and allow people to discuss any areas of confusion can really help. If you want to assess the effectiveness of an HIV intervention, this free toolkit by eminent researcher Doug Kirby is invaluable.

It’s no surprise that HIV is rising in countries where governments have not taken enough appropriate action against HIV or poverty, or to promote balanced sex education. Where politicians are opposed to/negative about pre-marital sex, homosexuality, drug users, or sex workers and do not invest in healthcare and education, then it’s not surprising their electorate suffer. Lobbying, protesting and drawing attention to how government’s do not tackle HIV effectively is one way forward – as is making the treatment and prevention of HIV an election issue. Make politicians accountable – and expose those who are not willing to tackle HIV. Remember HIV is an issue globally, it is easy to assume it happens to people who’re not like us in terms of where they live, their sexuality, gender and so on. In fact focusing on HIV as something that happens somewhere else, or to other people can mean we avoid tackling real inequalities on our doorstep, patronise those in other communities, or assume we’re not likely to become HIV positive or contract other STIs.

We can all find out our HIV status and practice safer sex.

Many people struggle with accessing services that provide education, prevention advice or treatment for HIV due to access to or availability of services. This may be simply because they cannot afford medications, or the cost of travel to get to clinics. Or it may be that services are available but clinic opening times and directions are unclear – or are not available at the time when you need to go (for example early afternoon or weekend for teenagers, evenings for adults). Alert clinics that aren’t making their availability clear. Offer to distribute leaflets or display adverts showing opening times. And campaign for low cost or free access to healthcare, drugs, education, baby milk (for infants who can’t have breast milk) and condoms. Practical campaigning on affordable healthcare, transport and road links, and joined up healthcare that addresses concurrent conditions is also vital (but again, frequently politically difficult, another alarm bell that we really can and should be doing more).

We’re all fighting to prevent HIV/AIDS but that doesn’t mean you shouldn’t question fundraisers that claim to make a difference. There are those who exploit this area, and even where there are well meaning campaigns they may be more about fashion than fundraising/awareness/empowerment. If you want to make a difference then the Buy Less campaign may be more appropriate

7. Healthcare practitioners and teachers – speak out!
As well as promoting more evidence based practices (see above), tackling colleagues who are judgemental about HIV/AIDS (or related areas – for example prejudiced towards homosexuals, transsexuals, sex workers or drug users), then work towards better training and support for them – and if this fails then complain to management and ensure they are not harming others with their views.

Challenge NGOs and funding bodies promoting that only promote abstinence only/anti condom messaging (see above), or who will only fund HIV programmes that don’t mention safer sex or other sex positive/educational messages. Or who simply push for condom use and testing with no other resources given. Where possible ensure your services do not take this approach and link with colleagues to ensure you offer a balanced service based on the latest evidence. If you are working in a resource poor country you may find making links with established academics/practitioners in other countries can help you access materials you need for your work (please email me if you’d like me to put you in touch with some).

If you are struggling to access drugs, medical supplies, sterile clinical products and syringes, or basic supplies like bedding or clothing, then again you may find making links with colleagues in other countries can help. Western medical students, for example, are often keen to fundraise, volunteer and access/share sterile items.

We’ve already heard about the political barriers to sorting HIV, but if you are experiencing this as a healthcare provider, educator, parent or volunteer then expose it – to local papers, through a blog (which can be anonymous if necessary), or through the HIV research/practitioner community. That might be discussing a school or health authority promoting negative or mixed messages, or denying access to condoms. Or national blocks on sex education, or politicians openly supporting AIDS denialism, being trans/homophobic, or harassing those with HIV.

If you don’t feel able to speak out yourself, then alert people like me and we can try and help you find ways to share your story anonymously.

8. Empower people to protect themselves
As well as becoming a sex educator (see point 1 above), encouraging peer to peer education initiatives can make a real difference to young people, although adult to adult peer support schemes work well too (for example to raise awareness among m/f/t sex workers, or gay men). The 15 and Counting Campaign provides a wide range of resources for setting up sex education activities – and to help people campaign within their communities for better access to HIV/sex education.

Alternatively, you may want to support existing HIV initiatives aimed at teaching skills and raising money for people who are affected by HIV. For example the Positive Beadwork Project.

You could encourage clubs and pubs to provide condoms, or work with HIV charities or health authorities to hand out condoms in social spaces. (Remember it’s not just about dishing out the condoms, it’s also about giving people the chance to ask about safer sex and relationships, pleasure and communication).

Supporting open access organisations like the (wonderful) Hesperian Foundation helps people learn more about their health and HIV – including how to prevent, treat, and live with the virus. Their books are free to those in resource poor communities (the rest of us quite rightly pay). Titles worth sharing are listed below (and many come in languages including Bengali, Chinese, Indonesian, Urdu, French and Spanish).

HIV, Health and Your Community
Helping Health Workers Learn
Where there is no doctor: a village care handbook
Where women have no doctor
Where there is no dentist

9. Question bad science
Sadly there’s a lot of misinformation in the name of HIV/AIDS, and often this comes from science – or people pretending to be scientists. The worst offenders are the AIDS denialists, who not only promote their views across the internet, they’re also active within the media (see this recent report on the inclusion of an AIDS denialist movie at a cultural festival).

It is important to tackle AIDS denialists, and there’s a particularly useful list of resources here about spotting pseudoscience relating to this issue.

Added to this are those who (usually well meaningly) offer alternative treatments to those affected by HIV. There is no evidence that homeopathic remedies ‘cure’ or ‘prevent’ HIV, and those who promote such treatments – particularly when encouraging standard medical treatments for HIV (antiretrovirals) are discontinued – are extremely dangerous. Unfortunately there are some who are not averse to maliciously exploiting this virus and will offer a variety of cures, spells, amulets, or other products with the promise of curing or preventing HIV – but in fact simply a means of parting people with their money. We need to do more to stamp out quackery in this area and educate people to use established treatments and methods of prevention.

One of the major criticisms raised at the HIV/AIDS research community is about ensuring studies are focused, relate to/develop existing findings (rather than replicate them), and have measurable benefits to communities. Critics have argued that research in HIV may build academics careers but do little to enable people in ‘real life’ settings, or the focus on HIV detracts from other equally important issues within healthcare. While some of these accusations are often unfounded, there are questions to be asked about the quality of some studies on HIV/AIDS, and the ethical conduct of researchers. We should question any research on HIV/AIDS that doesn’t appear to have ethical approval, or does have approval but still seems to be putting participants at risk. Two examples of this come from sex workers in Cambodia and a Canadian study taking part on prostitutes in Nairobi. If you have concerns about ethical and governance issues in research then you should speak to the ethics committee overseeing the work. Established scientists can help if you need support with this (I can refer you to some if this is an issue for you).

We also need to be wary of research that doesn’t fit with the wider body of evidence (or contradicts it). Particularly in the case of studies that seem to be detracting from general HIV messages, or appear to promote anti-condom messages.

Studies and interventions that do not involve communities, sustain development or empower people are also a major problem. Particularly when they involve resource poor communities, or where literacy is an issue, or where access to wider healthcare and education is limited. More information on how this can have a devastating impact on communities (and how researchers, practitioners, activists and communities can resist this) can be found here.

Those of us working within research in sexual health/HIV need to do more to explain our methods, make evidence more accessible and directly applicable, and link carefully with communities where we’ll be working. It is important to work ethically and transparently, but also nurture community relationships as it is unfortunate that some studies are scuppered not because researchers were unprofessional, but the negative reputation of science resulted in opposition to research. PLRI are a good example of practitioners trying to achieve this.

10. Don’t forget, there are 365 World AIDS Days a year
It’s easy to think about HIV/AIDS on World AIDS Day, but not always so easy to remember it all year round. Hopefully the list of ideas above may give you some pointers for things you can do throughout the year that will make a difference. Setting aside time to regularly engage in an activity (like fundraising, volunteering or community education) means you don’t forget about HIV and you help those affected by it.

If you’ve found these tips helpful then please feel free to circulate widely.

I’ll leave you with a link to the official World AIDS Day site, and this short film from 2010 that reminds us why we cannot stop fighting HIV and supporting those affected

Posters for World AIDS Day 2011 can be downloaded here.