One thing that has marked this election is the growing focus on science issues. This has partly been down to the interest of some politicians in the subject, and mostly due to the activism of a number of scientists (natural and social), science journalists and bloggers.

The focus of these discussions has been around tackling key issues around science (funding, support, listening to expertise etc). And while it is really important these topics are being debated, I’d invite a step back to think a little bit more about the way politicians understand and use ‘evidence’ from science and healthcare in practice. Otherwise we may miss opportunities to work with politicians and inform political thinking – and in turn help the public on key issues around health, education, innovation and technology.

In order to explore some of these core issues I’d like to reflect on my experiences of working with the Department of Health (DH) on their sexual health campaigns, where I had the chance to see where there are major barriers to using, applying and understanding good approaches to sound science. Which results in misleading information and a lot of money wasted.

I began volunteering on the DH campaigns in 2001 and between then and 2008 I increased the work I was doing, eventually becoming both a consultant and spokesperson on the public sexual health campaigns RUThinking, Playing Safely, Want Respect? Use A Condom (see also their great ad campaign), and Condom Essential Wear. Most of which have now been updated for Sex and Young People and Sex, worth talking about (where I currently volunteer for NHS Choices answering questions on psychosexual health topics).

This work involved identifying core evidence to underpin key messaging and liaising with civil servants, ministers and PR companies to ensure accurate, accessible and engaging messages were shared at a variety of different audiences in diverse formats (print, online and broadcast media as well as live events like music festivals).

I came to this work through my background as an academic who teaches healthcare practitioners and policymakers internationally how to access, critically appraise and understand evidence. And through my research which has focused on the sex and relationships health topics of education, service improvement of reproductive health, and addressing psychosexual problems, with a particular interest in media and public health campaigning. All of which I apply via advice giving through educational events, practitioner training and the media.

I was honoured to be part of the campaigning work and believe there were a number of key areas where major achievements were made around getting sex talked about within the media, and particularly with young people. There were some great examples of innovative practice and in the activities I was involved in we ensured work was ethical, based on sound evidence, while still being engaging.

However, during the seven years of working on the campaigns I noticed a number of core problems. I don’t know if these are repeated within other government departments, but it would be worth investigating whether the issues outlined below are happening elsewhere. My hunch is they’re not unique to health.

It was for that reason I asked the Guardian’s Science Test of politicians (by Martin Robbins) to clarify how political parties intended to oversee and manage public health campaigns and associated PR companies.

Here are the key areas I noticed problems around the application and interpretation of research and evidence:

Bidding for contracts
The majority of public engagement activity run by the government (and via political parties) is organised through PR companies. That in itself is not problematic, PR companies are experts in ensuring messages reach the right people in a timely fashion. What is problematic is for health, education and other campaigns there seems to be frequent bidding process orchestrated by different government departments. Meaning several months on any contract will be spent preparing to bid to renew it (in competition with other PR companies). And until any bids have been renewed no new activity can take place. Which restricts the amount of work you can do to reach the public.

There is also the difficulty posed when a PR company is replaced. Where the company who has held the contract has built up their own contacts, messages, experience in delivering information and goodwill among the media. Because they are a commercial organisation this information remains with them if they lose the contract. Meaning the incoming agency has to begin from scratch building up these contacts, there is no organisational memory, and a lot of time lost in repeating activities. It also means experience built up on campaigns can be lost.

Uncertainty of messaging
During the time I worked on the DH campaigns there were periods where ministers were unsure about the direction in which they intended to go. That was not because they were engaged in a systematic review of the evidence which might help them decide, but because they were anxious about media and public responses to their messages. Particularly relating to sensitive issues like contraception, teenage pregnancy and STIs. It took three years to move the more fragmented ’sex lottery’ campaign of 2003 into the national media run ‘Condom Essential Wear’ launched in 2006. [This was the first widespread government-backed public media campaign on STIs since the HIV/AIDS one of the 1980s]. Fear over how the press/public will respond led to haphazard delivery of messaging, also hampered by a limited budget.

It has also led more recently to overlooking evidence of good practice – which is about easier access to services, accessibility of testing and treatment, combined with prevention messaging. Instead the government has opted far more towards promoting testing, and has moved away from their 2006 approach which suggested prevention based messaging/normalising condom use. This appears to be based around cost decisions and attempts to deal with rising STI rates. While it is right that we alter messages depending on new information from research and evaluation, it is problematic if politicians and civil servants do not understand this process, or ignore it in favour of activity that is based around anticipated public opposition or healthcare spending cuts. And equally worrying given it muddles the public and healthcare staff around what they should be doing.

Reinventing the wheel
In the past decade our public sexual health campaigns have begun with the Sex Lottery, which became Playing Safely, which morphed into Condom Essential Wear and is currently Sex, worth talking about. And that’s just the campaign aimed at young adults. Teen campaigns for sexual health, general health and pregnancy have also morphed in similar ways. This has included new websites, logos, branding and core messaging for each iteration of the campaign. And within each development an additional range of agencies working on digital, creative, and marketing tasks. While material written for the web has been reused for some of these campaigns, in many cases new content has had to be created although again not always based on core evidence. It results in confusion to the public who are presented with different names, brands, and websites to find. Individual NHS trusts paying for their own sexual health websites that replicate content found on government ones wastes additional money. All of which results in a lot of activity, a lot of money spent, but no real sense of outcomes – the impact such campaigns have had. Sadly the focus of evaluation is often reduced simply to mentions within the media or visits to the campaign websites. Again indicating a lack of awareness of how to fully assess activity undertaken.

Flashy, gimmicky, but has it worked?
One aspect of the public sexual health campaigns has been a focus on getting young people involved. That has included viral videos, myspace pages, interviews with celebrities and texting services. More recently England’s Sexual Health Quiz was launched. Critics have questioned why this uses a kids vs parents approach (given evidence indicates competitive based education in this area is rarely successful). Other concerns have been expressed about the accuracy of the questions (particularly relating to cancer) and whether knowing how much water a condom holds really tells you anything about your ‘knowledge’ of sex and relationships, or your sexual health needs.

All of these activities are clearly costly, and most of them are focused online, which excludes large numbers of the population. We also have no idea how much they have cost, or what impact they have had. When asked, the Department of Health’s response to me was the latest quiz encourages ‘friendly conversation’ between parents and teens and provides right and wrong information. They had no information about whether this approach had been successfully piloted or was working to increase communication between parents and young people.

We have no idea whether, post election, the current quiz will still exist, or whether the data will be used to inform public health campaigning in the future.

Activity that doesn’t make the headlines
While we may be concerned over the quality of public engagement activity, there is the additional problem of campaigns that are paid for, but fail to reach the public or make much impact. For example one survey called ‘pulling pants’ was carried out for the DH by Tickbox which was to identify whether people chose ‘lucky pant’s to go out in. The survey indicated people spent time thinking about what underwear to wear – and clearly did have special undies they wore in the hope of pulling. But they did not put the same focus on taking condoms with them. This was a playful message, but actually quite important if you think about intentions to have sex. However, despite the survey being designed, run, data collected and the PR and polling company paid, it never made it to the media as ministers and civil servants were worried about the underlying messages. While I have a copy of the data, I do not have the costs for this particular project, but it would be equivalent to a standard public survey of 1000 participants spread across the UK.

Another activity that did make the headlines, but not in any great way, was the Alesha Dixon photospread run in 2008. It produced a series of gorgeous photos, but hardly any media outlets picked up on it (if memory serves only a couple of online editions of tabloid papers ran it). Which again represents a lot of money spent for very little return. [This is not a criticism of Ms Dixon who showed a genuine commitment to a campaign on a topic very few celebrities will be associated with]

It is not unusual within mainstream research or any public engagement activity for ideas to change, for messages to occasionally fail, or for problems to arise. But in relation to the cost of these campaigns – particularly when front line services are being cut – this is a worry. Not least when you add it to the fees for the more online activities, surveys run and time lost while rebidding for contracts.

Part of the problem of messaging being ineffective is the timing of them – Valentine’s Day, for example, is such a busy period to get any media pickup. But it’s also not a particularly good time to run public sexual health messaging – a better time would be around Christmas/New Year when people are more likely to have unprotected sex.

Policy/public health education and the role of the PR Company
By far the biggest problem around evidence-based approaches to public messaging is related to PR companies. In 2008 the Telegraph reported the government were spending approximately £1million per week on polls and focus groups and it may be the figure is far higher if you factor in consultations, and other public facing activity such as websites run by different government departments.

This issue has not really been fully explored and I think a canny journalists might be able to identify a far larger spend than already suggested.

These surveys and focus groups are not run to identify people’s key problems or needs, nor to improve services or our wellbeing. Instead they are run to collect information that will be used to inform media activity. Because nowadays most journalists won’t cover stories unless they can pin them to a survey or similar.

This wastes time and money on a number of levels. It firstly overlooks existing evidence on health, education or business that may well be useful to help us understand or deal with an issue. Peer reviewed research is rarely consulted or used to underpin such activity. Instead we see a number of leading questions used to get answers that in turn will generate headlines and discussions points for radio. Which can work if you have a spokesperson allied to a campaign that can translate that information into accurate and contemporary advice. But this is sadly not often the case given the use of PR companies of spokespeople who may not be the best qualified within an area to interpret and share information.

Research to inform public health is led by PR companies, not academics/practitioners
Over the years there has been a shift within public health campaigns where instead of being informed by key academics/practitioners about current evidence of best practice there is now the approach that the PR Company comes up with the idea for an activity as well as being responsible for promoting it.

A key example, and one that led me to resign from supporting the Department of Health’s sexual and reproductive campaign, came from the new PR agency they appointed. They had heard about some research covered in the Daily Mail where researchers counted the number of mentions of alcohol in the media. They suggested the same approach be used, but focusing on condoms.

Their recommendation was for someone (an academic) to observe the media over an unspecified period, and from that they could indicate how little condoms were mentioned in the media, and flag this up as a problem. They also incorrectly claimed no similar research had ever been conducted on this before (because they had not found any in searches they had undertaken).

Civil servants at the Department of Health seemed impressed with this idea. My opposition to it ran as follows. Such an activity if carried out correctly is very time consuming and costly. It would require very clear parameters around what media would be studied over what period. Given that we already know condoms are not mentioned much within mainstream media there is probably little point in doing such an in depth activity. But given we also know that integrating safer sex messages into mainstream media works see here and here and here and here, perhaps using that knowledge might allow us to bypass the research and focus instead on working directly with journalists – particularly in television where often plot lines in soap operas can be requested to focus on core issues (e.g. sexuality, bullying, teenage pregnancy). My advice was ignored.

On 20 February the Department of Health announced they had commissioned research that looked at media coverage of condoms in a report called ‘Mis Selling Sex’. The report still has not been publicly launched, and there is no clear information on who did the analysis, how it was conducted, and how much the activity cost. Moreover, there is no clear information on how the findings would be implemented outside of talking to television companies, which, as we already have seen, could have been done without having to do a full-scale study.

It is sadly a common problem within health research where people repeat studies, but in the case of a government department being advised they did not need to do this research – and could have used their money elsewhere – it is worrying such advice was ignored. If we do not see particular changes within mainstream media, this work will have been wasted. And even if we do see such messages in media they need to be sustained and supported.

What did I learn from my time in the field?
It would be wrong of me to imply those working on various government health campaigns are not doing their best or lack good intentions. My experience of working with ministers, civil servants and the PR companies behind the campaigns suggested a lot of well meaning people. There were also a few practitioners like me who volunteered our time and skills to inform campaigns and improve sexual health.

However, high staff turnover, fear of the response of the Daily Mail, a reliance on ‘desk based’ research and the focus towards ‘policy based evidence making’ rather than ‘evidence based policy making’ meant many good ideas were blocked, and weaker activities green lit.

Given sexual and reproductive health services are so underfunded, and yet given our equally worrying rising STI rates, it is vital any activity we undertake is cost effective, appropriate, built on evidence and evaluated. And that it directs people to the services they need. Spending money on campaigns that do not achieve this means people won’t go for help and while services continue to struggle with lack of funding.

I wonder how much better we may have done if money simply had been spent on improving services, and telling people where they could find them?

As mentioned I cannot speak for the rest of the activities run in different government departments but it is my belief that money and time has been wasted elsewhere. It is also my belief that politicians and civil servants will continue to struggle after the election because they are not supported by the public or by scientists/practitioners to use evidence to inform policies and services.

While we debate science and how important it is, we need to be aware of the real life problems encountered on the ground that means very often poor practice is allowed to continue because nobody is adequately checking what is being done, and few practitioners volunteer to ensure good services can be offered.

Please, while you’re campaigning for science, think about offering your services and scrutiny to ensure we can stop wasting time and money in the name of government backed health research and education.

Why is there all this fuss about sex education? Is it really a problem?
In the UK we clearly have issues that need addressing through sex education. The ones you are most likely to have heard about are high rates of teenage pregnancy, rising rates of Sexually Transmitted Infections (STIs), and problems around coercion and sexual violence among young people. However there are also wider problems you may not be aware of. Young people have complained existing sex education focuses too much on the biological aspect of reproduction and not enough attention has been paid to tackling feelings, emotions and negotiation – and the practicalities of enjoying a relationship.

The needs of lesbian, gay, bi and trans teenagers have not always been adequately met although homophobic bullying is recognised as a problem within schools. Teachers have complained they don’t always feel supported to confidently deliver sex education, particularly once it moves past the biological basics. Parents, generally, are in favour of sex education (despite what you may have read in the media) but worry they don’t know how to adequately deliver this in what they perceive to be a highly sexualised modern culture. And there’s been an ongoing concern that sex education has been delivered in a haphazard manner with different schools offering different approaches. Meaning some young people get excellent sex education, others get patchy advice, and some get nothing at all.

As a result there are problems around what is being taught, the quality of teaching and issues about the underlying messages of sex education which often remain negative and are based on warning youth against pregnancy or infection rather than preparing them to anticipate sex as something pleasurable to enjoy when they are older.

For these reasons it’s been recognised that sex education needs to change and be delivered in a far more effective manner.

What’s actually happened with sex education in the UK?
Over the past few years there’s been an ongoing consultation about sex education. This has involved contributions from the public (particularly parents and young people), faith groups, teaching and healthcare organisations and academics involved in researching sex education and youth culture. It has also involved expert input from a core group of professionals involved in researching or delivering sex education within schools.

This has fed into the Children, Schools and Families Bill 2009-2010 which seeks to make sex and relationships education (SRE) a statutory part of the school curriculum. You can see the progress of the bill here and here and view the actual bill here. The parts you should focus on in relation to sex education are sections 11-14 of The Curriculum. In particular point 13 which details the provision of SRE and 14 which outlines exemption from SRE.

This week the bill passed its first reading in the House of Lords where it was agreed that sex education would be compulsory for all schools. Faith schools will have the right to explain their view on key issues (although they’ll still have to teach all aspects of the SRE curriculum), and parents will have the right to withdraw their child from sex education up until the age of 15.

There are additional readings of the bill to follow over the coming months so it is not completely guaranteed these suggestions for SRE will be upheld.

Is sex education now compulsory in schools?
At this time all schools in the UK are required to teach SRE within the context of biology (basic reproduction). They are able to opt out of teaching topics they may not agree – homosexuality, abortion, contraception for example. School governors can also restrict what can be covered, who delivers sex education and what they talk about. Many schools do already offer good quality sex education.

I heard Catholic schools will be able to teach abortion, homosexuality and contraception are wrong. Is that correct?
There has been some controversy this week where Minister Ed Balls was seen as backtracking when he explained faith based schools would be allowed to teach SRE “in a way that reflects the school’s religious character”. Mr Balls stated “There is no opt-out for any faith school from teaching the full, broad, balanced curriculum on sex and relationship education and that is a huge step forward…Every school will have to teach the full curriculum in a balanced way that respects equality and is not discriminatory, but of course what we are saying is they can explain the views of their faith…Catholic schools can say to their pupils that, as a religion, we believe contraception is wrong, but what they can’t do is therefore say they are not going to teach about contraception.”

Secular groups have been understandably upset by what they feel is a climb down over sex education, while sexual health and LBGT groups have expressed concern this will lead to schools being able to promote homophobia or incorrect messages over abortion or contraception.

It is disappointing this decision was taken, but it is my understanding it was made after considerable pressure was made by faith groups (particularly the Catholic Church) against the proposed bill. There was a fear that this might derail the bill completely. So although this is a compromise it may have been made to ensure that compulsory SRE could still be assured.

Before we panic over this issue, it’s worth noting that whether this compromise had been made or not, there is no guarantee that teachers at faith or non faith schools would deliver SRE effectively – even if it was mandatory. After all ‘compulsory’ is not a byword for ‘good’. There are plenty of teachers delivering compulsory subjects on the curriculum in substandard ways. Even if a school delivers sex education well, a child will also be exposed to negative messages from their peers, parents, or their Church, Mosque or Synagogue.

And let’s not forget the media here. While the press was shouting against Ed Balls it seemed to escape everyone’s attention that by far the biggest voice against SRE in the UK is the press. So even if schools are delivering sex education well, the media are likely to continue in their efforts to scupper it.

My hunch is rather than faith based schools delivering a class on abortion or homosexuality as prescribed, following it up with ‘well that’s bad’, we’re more likely to see these topics covered but in a lacklustre or inaccurate manner. And sadly that may apply in non faith schools too. The challenge will be to identify where poor practice is happening and work to rectify that when the time comes.

Given we live in a multicultural society with different faiths and views about relationships it’s not unreasonable to have this reflected in our teaching of SRE. That is not, however, the same thing as allowing faith groups to decide what can and cannot be taught, nor to undermine basic teaching that is essential to the psychological and physical wellbeing of young people.

If I don’t want my child to have sex education, will I have the right to stop them going to lessons?
Once sex education becomes compulsory you will be able to withdraw your child from lessons up until they are aged 15, after that you will not be able to do so. This age seems very late to many educators as many of our most vulnerable youth are sexually active much younger than this age and they need help far earlier. However, currently parents will be able to opt out up until this age.

I hope that parents won’t want to do this. Here’s why. School sex education is an additional source of information for your child. Sometimes hearing someone other than a parent talk about a topic can help a child appreciate an issue. It also means if you and the school are talking about sex and relationships then the likelihood of your child picking up misinformation from peers or the media is reduced. We must remember that for many vulnerable children it is not possible to talk to a parent, or that often very well meaning parents simply do not feel able to talk about sex with confidence. Sadly sometimes parents, with the best intentions, provide misinformation about sex.

Most schools show parents what they will be delivering to young people in SRE before the children see it, giving parents the chance to ask questions and be aware what their child will want to know about. Organisations like the Family Planning Association and Parentline Plus offer additional support and classes to parents, as do many Primary Care Trusts. So the aim should be for schools and parents to work in tandem. If that isn’t happening currently you should speak to your head teacher about it.

Parents I talk to worry that schools will teach too much too soon or be explicit or rude. It’s easy to believe this from the media, but this should not happen in SRE. Young children are not going to be taught about using condoms or sexuality, but they will be told how to name their body parts, how a baby is made and introduced to gender differences and ideas about friendship and respecting others. As they grow information will be added to suit their developmental needs.

So rather than seeing the school as undermining you it’s better to think of them as an ally in raising your child.

Whether parents or teachers talk to young people about sex and relationships, kids are definitely talking to each other about it. So to ensure they’re on the right track we need to be there to answer their questions and explain what positive relationships look like.

If sex education isn’t compulsory yet, will there be any classes covering sex education issues?
Yes. Schools are already covering SRE to varying degrees and this will continue. You may expect to see some schools working to improve what they are already delivering in the run up to SRE becoming compulsory (anticipated in September 2011).

What’s actually going to be taught in sex education?
At this point the SRE curriculum is still being debated. It will definitely include topics like contraception, STIs (including HIV), coercion and abuse, and pregnancy. But it is also expected to cover sexuality, pleasure, delaying sex, confidence, communication and positive relationships. The consultation on the curriculum is open until 19 April 2010 and you are invited to have your say on what may be covered. If you are interested in SRE do please take the time to read and respond.

Why has sex education failed in England?
It’s wrong to say sex education as ‘failed’, or that it is taught badly. The problem we have in the UK is our sex education has never been valued or well funded. There’s never been an effort to deliver it in a compulsory manner and so what has been taught and the standard of teaching has varied widely. Unfortunately because we provide some sex education the media and some faith groups claim this causes teenage pregnancy and STIs. In truth we have problems with teen pregnancy and STIs for numerous complex and often interrelated reasons – poverty, poor education overall, the exclusion of young people, barriers in accessing contraception and healthcare services, lack of family support, aspirational limitations.

There are plenty of dedicated practitioners, teachers, parents and researchers all working to ensure young people learn more about sex and relationships. Young people themselves are not passive in this process and also usually seek out information. Simply providing SRE is not going to tackle wider social issues so we also need to invest in tackling those. However, not providing SRE (or delivering inadequate messages) is not going to help young people manage a commercialised sexual culture which they may not always know how to negotiate.

Often when we hear the sex education has failed mantra it’s a precursor to ‘so we should stop it completely’. The answer to our problems with SRE is not to ban it, but to ensure it is delivered to a high standard to all young people.

My husband thinks if we teach sex education it encourages young people to experiment or take risks, is that true?
This isn’t true, but it’s again something the media and some faith groups claim is a by product of SRE. If you simply tell young people not to have sex, or that they must wait until marriage for sex (but provide no other SRE information) then often young people do have sex – and are less likely to use contraception. If you talk to young people about sex as something to look forward to in the future and provide them with information about contraception, talk about negotiation and safer sex, confidence and delaying until they feel ready, then yes they may have sex but they are more likely to use contraception – and wait until they are older.

Young people do ‘experiment’ – I’m sure we can all remember lustful teenage feelings even if we didn’t act on them. And while we as parents often worry that teenager are all involved in sexual activity it is worth remembering the majority do not have sex until they are over 16 and most do think about contraception and safer sex.

As parents we want our children to grow up to enjoy positive relationships and pleasure. We want them to be confident and able to avoid coercive situations and toxic relationships. We don’t want them to be abusers or victims of domestic violence. We don’t want our children to have sexual problems when they were adults because they were not given enough information about sex or taught it was dirty or shameful. Young people have the right to know about sex and relationships and we have the responsibility to deliver that information in supportive ways.

If we introduce compulsory sex education, what difference will that make – and how soon will we notice it?
It is hoped that sex education, if delivered uniformly and to a high standard, will:
Reduce STI and teenage pregnancy rates
Reduce the number of terminations young people are having, and in the future prevent rising levels of infertility
Increase young people’s uptake of contraception services
Reduce coercion, abuse and exploitation
Tackle homophobic bullying and reassure young people about sexuality
Improve young people’s confidence to talk about sex and negotiate relationships
Highlight the importance of positive relationships

The difficulty with some of these issues is we won’t notice any changes for a long while (for example tackling future infertility). And sometimes if you do introduce more education you see a rise in the uptake of services so it could be likely we see a rise in STI rates for a while.

Even if we do introduce really great SRE across the UK it will take time to bed down and we will need a period of support for teachers and parents. We will be learning throughout this introductory process and undoubtedly there will be some quick wins and stumbling blocks. But SRE is only one part of the puzzle and we will only see benefits if we also tackle other issues around access to reproductive healthcare, reducing poverty and dealing with other inequalities.

What is the biggest barrier you see to SRE provision?
The media. We’ve had endless negative coverage about how dreadful we are at tackling teen pregnancy, STIs and other anti social behaviour among young people. The media has for the most part stood in the way of every initiative to try and improve SRE when they could have supported ventures. Instead we’ve had judgemental pieces most of which end up in girl blaming and hysterical misrepresentations (shag bands, anyone?). Specific editorial decisions are made to be unsupportive and we must not lose sight of this.

Journalists frequently cite the Netherlands as a gold standard of good practice, complaining how we fail in comparison. Never noting the reason the Netherlands do so well is partly cultural, partly about education, but mostly because their media are supportive of SRE.

What’s going to happen next?
The bill is still going through the Lords so there will be more discussions. I will update on those as they happen. In the meantime we can expect to see more efforts in training the trainers activities and support for parents.

Hopefully that’s answered your questions about SRE in the UK, but if you do have any more please let me know.

I’ll be returning to some of the issues raised here in future blogs, particularly around training for sex education teachers and nurses and what parents can do to talk effectively about sex and relationships.

This week’s national condom week, and in case you hadn’t been thinking about male or female condoms it’s a good time to reflect about what they can bring to your sex lives.

Long gone are the days where condoms are thick, smelly and come with the spermicidal pessary that bleaches your boyfriends carpet (yes I’m talking personal experience here).

Nowadays condom manufacturers have caught on to the opportunities offered by making condoms sexy so not only do we have a huge range of size/shape combos, we also get ones with different textures, colours, flavours and lubes to go with them that can increase sensitivity or prolong sex. In short, condoms are the new sex toys. Even adverts for condoms and lube have got good

So hopefully you’ll join in the celebrations this week and think about using condoms and what that can do to enhance your sexual health – and pleasure. Even if you don’t usually use them for contraception, give a flavoured or textured one a go – it all adds to the fun.

And to keep us in the mood Logan Levkoff’s written an Ode to Condoms. While here’s my guide for busting those ‘condoms don’t fit me’ type excuses. Seriously, don’t make me come over and spank you for not gloving up.

You could send someone you fancy a naughty condom e card. Or check out this podcast from the BMJ on the importance of condoms fitting.

Finally Scarleteen asks us to celebrate your ‘condomversary’ – the number of years you’ve been using condoms.

What’s your number?

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). Telling people to abstain only, or even instructing against condom use is very dangerous. 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 homophobia, gender inequality, and discrimination against sex workers can help – for example in the views you hear from other people, 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 – and if you do Global AIDS Alliance has created a free 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 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.

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.

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. 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.

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.

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.

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, prostitutes 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. 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 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 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 http://www.hesperian.org 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.

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.

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 that reminds us why we cannot stop fighting HIV and supporting those affected

Without further ado, let’s find out the answers to the questions I posed as part of the Science Late evening of sex event on Wednesday. How did you score?

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

Correct answer = C

The most commonly used methods in contemporary sex research globally are surveys or interviews/focus groups. Brain scans, heat sensors or blood tests can be used, as can observational studies (where people have sex within laboratory settings). However, these latter two methods are used less as they’re often more difficult to recruit representative participants for studies. With the internet the opportunity for people to film their sexual activities and share those with researchers, and methods where participants film or document their own lives may become increasingly popular in the future. One thing we don’t do, but which people often assume happens, is have sex with the people we’re studying and then write about it. This would be considered unprofessional and unethical in research nowadays, and would focus the study on the researcher rather than a wide range of participants.

Want to find out more?
Check out the Kinsey Institute and the Magnus Hirschfeld Archive for Sexology who provide information about sex research being undertaken and provide answers to your frequently asked questions about sexual behaviour.

You might also find these guides helpful too:
Want to be in a sex study? Tells you about how sex research is conducted and how you can get involved

Sex research since Kinsey’s day – explains the different methodological approaches that can be used to study human sexual behaviour.

What’s it like to be a sex researcher? answers the frequently asked questions I’ve received about studying sex.

How to run a sex study outlines the steps you’d undertake to carry out a scientific study.

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

Correct answer = C

Robust and reliable research indicates that younger people do have more sexual encounters annually than older people. You can see links to research where frequency has been addressed here. The UK Natsal study found the average for heterosexual sexual activity per month was around 6 times. If you account for sexual behaviour over a wide range of ages the average is once a week or less. However, reputable sex research focuses more on quality rather than quantity. We would usually ask people for a range of sexual behaviours they engage in (masturbation, oral sex, intercourse) and whether they enjoyed them. That way you might find someone doesn’t report much ‘sex’ (as in intercourse) but they enjoy masturbation on a regular basis and are happy with this.

This contrasts with the media’s description of sex where ‘sex’ is usually only considered in terms of intercourse and quantity is taken as a measure of ‘great sex’.

Want to find out more?
Set yourself an experiment. Look at magazine or newspaper coverage of sex/relationships over the next month and see how ‘great sex’ is described. Is it written about in terms of exploration, variety and pleasure, or described in terms of quantity and penetration.

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

Correct answer = B

Many studies do give the average erect penis length as 5 inches. However, there are numerous problems with studies on penis size as they vary in the methods used to collect data. Some studies relied on self report, others on a researcher either measuring an erect or flaccid penis. Critical reflection on penis size studies suggest there are problems with the inconsistency of measuring penis size (summarized here). Interestingly research in this area suggests men (gay and straight) are more worried about length than girth, although women seem to be more interested in girth. And partners of men (male or female) are usually most bothered about their partner’s technique and the way they treat them. With anecdotal evidence suggesting men with larger penises don’t try so hard to please their lovers.

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

Correct answer = A

Women and men are just as likely to be turned on by visual images of sex. This may run counter to common knowledge of this issue, particularly since the media often repeats the idea that men are visual creatures and provide various evolutionary and biological explanations for this. What science is now discovering is that women, like men, do get aroused by sexual imagery. There is a diverse range of what turns women on – as with men. There is often the myth that women prefer erotica and men like porn, or women need their sexual imagery served up with a warm slice of romance. Yet studies where women have been asked about or shown sexual imagery suggest they do respond to a variety of arousing stimuli.

Interestingly many of the studies assessing response to visual images of sex (usually done through showing a series of images or sexual film clips and measuring genital response) did not include women. These were conducted on male participants (often undergraduate students) who were tested in response to viewing sexual images to see if exposure to said imagery had led to them feeling more hostile towards women.

More recent studies of women show they report enjoying a range of sexual imagery but do often worry more than men about the content of materials and how they’re made. Debates around the impact of porn, and whether the content is sexist, can often make women feel guilty for looking at/enjoying sexual imagery. Interestingly we’ve focused more on asking women critical questions about how they respond to porn than we have inviting men to reflect on their porn use.

Want to learn more?
Violet Blue’s written a fascinating book called The Ultimate Guide to Adult Videos which discusses how to pick porn to view, and answers some of the common concerns people have about content.

Alternatively there is a vigorous debate about porn/sexual imagery that’s ongoing. Some view porn as innately sexist and degrading to women, others feel it’s a symptom of a sexist culture but not a direct contributor to sexism/abuse. While some believe porn could help improve relationships, or at least has no harmful effects. You can find debates ongoing across different websites (particularly those with a feminist/political focus). Read up on the issues and see where you fit in.

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

Correct answer = A

Men can, and do, fake orgasm. We don’t know exactly how many do this, but therapists and educators are increasingly hearing from men who are worried about faking orgasm. Reasons for doing so include being tired, sore, wanting to bring sex to an end, and not wanting to let a partner down. Men report feeling the need to fake because of pressure to perform sexually. It is unclear whether this pressure is experienced more or less acutely by straight or gay men. Interestingly, we tend to respond to women faking orgasm as being an inevitable (partly linked to the stereotype of women being less sexual). We tend to respond to the idea of men faking with disbelief or humour. This does little to help either gender if they feel the need to fake.

Want to find out more?
Comedian Richard Herring has written a great book called Talking Cock which although based on humour is a useful survey on male sexual behaviour and includes some discussion about faking orgasm.

If you’re a man and find it consistently difficult to orgasm it might be you have delayed (or retarded) ejaculation. More information about this condition and treatment options available here.

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

Correct answer = B

Although this is often quoted in the media it doesn’t make sense in social research terms. The data seems to have come from surveys in the first half of the 20th century on sex where young men could record an interest in sex, but young women couldn’t. Culturally young women weren’t supposed to be sexual (particularly before marriage) and so either were unable to report on sexual behaviour, or were too afraid to disclose what they may have done. Older women who were married and had experienced sex were in a stronger position to report on their experiences. So early surveys measured behaviour and found younger men were able to report sex positively, as were older women. This is not the same as hitting a sexual peak during lifespan.

Although studies do still about that reinforce this myth or suggest particular ‘peak’ times for sex, reliable research suggests that rather than their being specific peak times for sex, there will be times when people enjoy, desire, and have sex more or less. This will be influenced by many factors including health, parenthood, financial security, relationship quality, and lifestyle factors (such as work stress).

Sexual activity may reduce as people age, and certainly we do see young people reporting having more sexual encounters. However, this does not mean the same thing as pleasure or desire or exploration. Older people do also report they may not have as much sex as in their youth, but the sex they have remains important and pleasurable.

Part of the misrepresentation of sexual behaviour across lifespan as having one off peaks is linked to the quantity over quality. A more accurate way of looking at this issue would be to see sex intertwined with other factors (listed above) and to expect points in your life when you’ll have no sex (with a partner), lots of sex, and occasional sex – with quality differing also.

Want to find out more?
Keep a diary for the next year and record when you had sex. Note periods when you enjoyed different sexual activities (masturbation alone, oral sex, intercourse), who you were intimate with, and when you were or were not enjoying sex to identify what else was happening. It might be something negative like being made redundant, or something positive like starting a new job where you put your energy into that activity.

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

Correct answer = A

Homosexuality has been observed in numerous species from dolphins to monkeys, dogs to sheep. We have only recently begun to learn more about this topic as science has in the past often misrepresented homosexuality in animals, describing it as ‘immature sexual behaviour’ or reporting it as something that only happens because no other sexual partners are available. Or simply not discussing it at all.

Want to find out more?
The question of sexuality is one that fascinates people – and can be a reason for concern or celebration. If you want to find out more about your own sexuality why not try the Kinsey scale which gives you a score from heterosexual through to entirely homosexual. You can even get a t-shirt to proudly display your rating.

Within the scientific community we’re still debating homosexuality and for two differing takes on this issue you might consider Queer Theory which sees sexuality largely as a social construct or contrast this with Qazi Rahman and Glenn Wilson’s excellent book Born Gay.

There’s also widespread discussion about whether homosexuality can be ‘cured’. Evidence shows it cannot (because it’s not a disease or dysfunction). You might find these papers interesting – they feature interviews with psychiatrists and patients who were part of treatment programmes to ‘cure’ them of homosexuality.

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

Correct answer = D

Most people do use the media, and particularly the internet (where available to learn more about sex). Friends can be highly influential, although more for young people than older adults. The self help/sexpert market (which often influences media content) is worrying given that many sex experts are not adequately qualified to discuss sex and relationships issues. Porn is not the first place people look for information, however evidence suggests it is somewhere people will turn to if they can’t find answers elsewhere.

Want to learn more?
If you want to find useful places to get quality sex information (aside from the links above), I’d recommend:
Paul Joannides – author of Guide to Getting it On
Cory Silverberg – who writes Sexuality About
Good Vibrations magazine
Dodson and Ross – sex tips, advice and information
DIY sex education from All About My Vagina
Susie Bright gives great sex advice over at Jezebel

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

Correct answer = B

The most funded and most prolific research globally focuses currently on sexual problems. That’s things like sexual dysfunctions and sexually transmitted infections (particularly HIV). While these are issues requiring investigation, there are problems about other issues such as love and romance, desire and pleasure receiving far less attention. In particular concerns have been expressed about the ‘medicalisation of sex’ (for women and men) and the way sex research has been influenced by pharmaceutical funding.

Campaigners working within sex research are working to try and broaden the range of topics studied in this area, but limitations around funding and academic priorities do still influence what gets studied. This is a problem since many members of the public have many unanswered questions about sex which are currently not being addressed.

Interestingly, the area of sex addiction is hyped up a lot in the press but is not being researched to the same degree within academia/therapy. That’s because the concept is not agreed upon by practitioners. You can find out more in this great discussion between Susie Bright and Leonore Tiefer on the topic, or see just how problematic the diagnosis of sex addiction is in my blog ‘Help! I’m a sex addict and I didn’t even know it’.

10. Why do sex researchers study sex?
There are numerous reasons why we study sex. To find out more about human sexual behaviour, to get people answers to questions they have. To reduce problems – STIs, anxieties, fears. To promote sexual pleasure. Or to encourage abstinence (not all sex researchers are sex positive). Some sex researchers are motivated to research sex because they want to offer help, to share pleasure, or to learn more about themselves. Some may have had a personal experience (positive or negative) that’s motivated them to study a particular area of sex.

As part of the Science Museum event I asked guests to share why they thought we studied sex and I’ll blog all their ideas next week – along with some updates from real life sex researchers about their motivations.

So, are you a sexpert? You may have scored well or badly on this test. It doesn’t really matter. Many of the questions were deliberately tricky. Hopefully what the test has revealed to you is that there’s a lot more to sex research than you may have imagined, it’s an area that spans many academic areas (science, medicine, history, anthropology and zoology to name a few). It’s a growing subject area and one with a real application to human life. By continuing to read up on sex (using some of the links above) and ask questions about all the sex stories you read in the press (and anyone who calls themselves a ‘sexpert’) you’ll be well on the way to sexpertise.

If you work in science communication, sex research or sexual health you are welcome to use this quiz (and answers) in your own activities (with acknolwedgement). Please do research all answers before presenting to ensure you fully understand topics, and perhaps you can bring in questions and resources of your own to add to the quiz.