It’s 2018, but young men still don’t want to talk about contraception – here’s why

2018-05-23

It’s a Friday night in a midsize university town in the Western US, and for many students, this means one thing: it’s time to party. University students head out for a night of drinking, dancing and often, sex. For many students attending large US universities, it’s more or less expected that they will have casual sex on a night out. But while attitudes toward casual sex have become more liberal, there’s been significantly less change when it comes to attitudes toward contraception.

Since the 1960s, when the birth control pill became widely available in the United States, research and development has focused on generating contraceptive methods for women to use. The feminist movement celebrated female contraceptives for giving women the power to control if and when they become pregnant. But somewhere along the way, a woman’s right to use birth control translated into a woman’s responsibility to use birth control.

Our research, recently published in Culture, Health & Sexuality, found that young men have a difficult time reconciling the idea that women should have control over their own bodies with the ideal that men should play an equal role in making decisions about contraception – especially since most forms of contraception alter women’s bodies to prevent pregnancy, rather than men’s.

A conflict of ideas

For our study, we held in-depth interviews with 44 young men at a large public university in the western United States to understand how they make decisions about contraception during their sexual relationships with women. The men we interviewed clearly articulated two sets of expectations: they thought that men should participate equally in decisions about contraceptive use, but that women should have the final say, since women bear much of the physical and social responsibility if they get pregnant.

Some men were worried that they might disrespect women’s bodily autonomy by bringing up the issue of contraceptives. Women were expected to request that men use a condom or otherwise communicate to men that they were not using a hormonal contraceptive. By deferring to women, men were attempting to be mindful of power dynamics that still privilege them.

We found that being confused about these competing ideas can prevent men from communicating clearly about contraceptives with their partners. As a result, men ultimately tasked women with initiating all communication about contraception, leaving their sexual partners with greater responsibility, work and financial costs related to getting contraception, and preventing pregnancy.

Bringing up birth control

In a culture where almost all forms of contraception are designed for women, most men couldn’t come to a satisfactory resolution between sharing equal responsibility for contraception and respecting a woman’s right to control her own body. What’s more, they said that this conflict contributed to their general reluctance to engage with the issue of contraception at all.

Our findings suggest that sexual health education aimed at young men must go beyond simply telling them to use condoms. Recent efforts to normalise “affirmative consent” and encourage men and women to communicate clearly about sex might also help raise the issue of contraception.

How researchers and sexual health practitioners can help to reconcile these opposing ideas is up for debate. New efforts to develop a birth control pill for men are promising, and would help to reduce the gender disparities in available methods. But the male pill is still in development and won’t be widely available for some time.

In the meantime, when in doubt, men should simply wear a condom. Men shouldn’t just assume that if women don’t say anything about contraception, it means they’re protected. It’s necessary to have the conversation – even if it’s uncomfortable. Men also can also learn more about female forms of contraception, so that they can understand the impact they have on women’s bodies and be more sensitive to women’s needs during these conversations.

Men should never assume that any woman is using a contraceptive method. If you don’t want to discuss contraception, then simply use a condom – and relieve women of the responsibility for requesting one.

In this, and other ways, we must cultivate an understanding of sexual relationships that goes beyond a battle of the sexes approach, in which men’s and women’s needs and desires are seemingly at odds. In this study, men lacked the tools they needed to engage in sex responsibly, which ended up placing greater responsibility on women.

http://theconversation.com/its-2018-but-young-men-still-dont-want-to-talk-about-contraception-heres-why-96951

Why STDs Like Gonorrhea and Syphilis Are on the Rise

2018-05-18

People have blamed dating apps for the rise of gonorrhea and syphilis. But there are a few sneakier factors at play here.

As if dating weren’t hard enough, singles in California have one more thing to worry about: the rise of sexually transmitted infections (STIs).

According to the California Department of Health, more than 300,000 cases of chlamydia, gonorrhea, or syphilis were reported in the state in 2017 alone. Overall, the transmission rate of these three STIs has spiked by a staggering 45 percent over the past five years.

But the rise of STIs isn’t just a concern in the Golden State. Figures from the Centers for Disease Control and Prevention (CDC) show that STIs are rising everywhere. From 2015 to 2016 alone, gonorrhea rates in men increased by 22 percent nationwide, while syphilis rates increased by 14.7 percent.

The biggest problem? Many men might not even know they’re infected with these STIs. About half of men don’t exhibit any symptoms of chlamydia, while many men with gonorrhea are similarly asymptomatic. The early signs of syphilis — small, painless sores around the mouth, genitals, or rectum — also tend to be subtle, and can easily be explained away as an ingrown hair.

The massive spike in STI rates is particularly concerning, given that just a decade ago, STI rates were on the decline. But “progress has since unraveled,” the CDC wrote in a 2016 report.

So what’s to blame for this unraveling? The answer is more complicated than you might think.

Over the past few years, many media outlets have published alarmist stories linking Tinder and Grindr to the rise in STIs. As recently as May 15, the Los Angeles Timesreported that some health experts partially attribute the spike to people having “more sexual partners linked to dating apps.”

But Matthew Prior of the National Coalition of STD Directors says we shouldn’t be so quick to point the finger at Tinder and Grindr. Most experts “don’t think it’s a primary reason that STDs are spreading,” he told MensHealth.com.

Instead, Prior and other public health experts attribute the nationwide spike in STIs to a confluence of different factors.

While STI rates have risen across the board, cases of syphilis in particular are on the rise among men who have sex with other men (MSMs, according to CDC lingo), who accounted for 80.6% of the new syphilis diagnoses between 2000 and 2016. That’s in part because MSMs are more likely to have receptive anal sex, which ups their risk of contracting STIs: the anus is narrow, doesn’t offer natural lubrication, and the skin tears easily, which means that STIs can easily enter the bloodstream.

Dr. Hunter Handsfield, Professor Emeritus of Medicine at the University of Washington Center for AIDS and STD, believes an additional reason why men who have sex with men may have gotten more lax about using condoms is because of PrEP, a daily medication taken to prevent HIV infection.

“Because HIV is now less of a worry, there’s less condom use,” Handsfield tells MensHealth.com. “That’s the biggest single change.”

According to the California data, half of chlamydia cases and a third of gonorrhea cases were among people under 25, indicating that young people in particular are at heightened risk. That’s in part because they simply don’t know that many of the most common STIs are asymptomatic, Heidi Bauer, the chief of the California Department of Public Health, told BuzzFeed News.

“I hear it all the time — they think, Well, if I have something, I will know it and I will just go in and get it treated. But the reality is the vast majority of these infections don’t cause any symptoms at all,” she said. “So people just pass them around without realizing it.”

Over the past decade, federal budget cuts have led to the closure of STI clinics across the country, making it harder for people to get tested and treated. In a 2016 report, for example, the CDC reported that more than 20 health department STI clinics had been shuttered in 2012 alone.

Why doesn’t your husband want to have sex?

2018-05-14

Men’s desire for sex can be as tricky as women’s, according to ­researchers at the University of Kentucky. Men often lose interest when they feel insecure, when they worry they are losing autonomy in a relationship, or when physical changes cause embarrassment. Pressure to be the ­initiator compounds the stress.

“We expect male desire to ­always be high and to be simple, like an on and off switch, while we expect women’s desire to be a complicated switchboard, but they are both complex,” says Kristen P. Mark, associate professor of health promotion and director of the Sexual Health Promotion Lab at the University of Kentucky and the lead researcher on the project, a broad look at men and women that analysed 64 studies on sexual ­desire conducted since the 1950s.

Psychologists say desire in both sexes ebbs and flows. And it’s ­natural for it to decline after the heady honeymoon period, which typi­cally lasts about 18 months to two years. Still, almost 80 per cent of married couples have sex a few times a month or more: 32 per cent reported having sex two to three times a week; 47 per cent ­reported having sex a few times a month, according to The Social ­Organisation of Sexuality: Sexual Practices in the United States, a 1994 University of Chicago study considered the most comprehensive in the field.

Women do lose desire more often than men: research shows that about one in three women — regardless of age — reports a lack of interest in sex for at least several months in the past year, compared with one in five men, ­according to Edward Laumann, a professor of sociology at the University of Chicago, who has studied sexual desire and dysfunction for 25 years. But experts say that men are often reluctant to talk about sexual troubles, so the problem may be more prevalent.

Mark’s research, published in March in the Journal of Sex ­Research, found that the reasons for a drop in desire generally fitted into three main categories — individual, interpersonal and societal. Some issues, such as stress, a drop in self-esteem or changes in their attraction to their partner, affect both men and women.

But men’s desire also wanes for different reasons. Men have ­trouble when they expect their ­desire to always remain high and it does not, or when they fail to make their relationship a priority. Sometimes men’s desire drops when a couple has sex for negative reasons — to avoid a fight, for example — rather than positive ones, such as to increase intimacy. Men also feel pressure to always be ready for sex and to initiate it.

There are often physical issues, as well. A man’s less-efficient bloodflow as he ages, diseases such as depression or medicines for issues such as high blood pressure or mood disorders can all hurt a man’s sex drive.

And these physical changes can cause emotional distress. Embarrassment is a big issue for men who have trouble getting or maintaining an erection, and so they may stop initiating sex. “For the guys who don’t like to do what they don’t do well, there will be avoidance, because they feel ashamed,” says Michael A. Perelman, co-­director of Weill Cornell Medicine’s Human Sexuality Program.

Unlike women, men often lose interest in sex when they are ­unhappy or insecure, Laumann says. Stress about a promotion, worry about a child, the transition to retirement “all undercut a man’s sense of his abilities and prowess”, he says.

And sometimes the problem does stem from the relationship. Sex can become routine in a long-term marriage, or partners grow apart. A man may harbour resentments, often about money. Or he may de-eroticise his wife. “He sees her as a good person, mother, supporter, but not as an exciting lover,” says Barry McCarthy, a psychology professor at American University.

Is the relationship doomed when a man — or a woman, for that matter — loses interest in sex? Not necessarily. But it’s definitely a signal that you need to evaluate what is going on. And there is the possibility that a decrease in desire for your partner may indicate that the person is no longer right for you, says Gurit Birnbaum, a social psychologist and associate professor of psychology at the Interdisciplinary Centre, a private university in Herzliya, Israel. You may have grown too far apart, or your goals, values or interests may have changed. “Your body may be telling you something,” she says.

But often the problems can be solved. This will require talking, the experts say, and it’s important to do that before it is too late. “A ­relationship becomes more fragile when it loses its sex aspect,” says Birnbaum.

Start by having a conversation outside of a sexual situation — go for a walk or have a glass of wine. Tell your spouse you miss having sex rather than criticising. Both partners should ease pressure by accepting that men, not just women, don’t want sex all the time. “Approaching hard conversations by being vulnerable ­upfront automatically creates a safer environment for a tough talk,” says Mark.

The Wall Street Journal

https://www.theaustralian.com.au/life/why-doesnt-your-husband-want-to-have-sex/news-story/4252b40db44be354e483bd7cab3dff85

Seven sexual health myths you should ignore

2018-05-10

1. You can’t get pregnant during menstruation

Menstruation is the process of the womb’s wall lining shedding off after unsuccessful fertilisation of an egg. While it is not common that pregnancy occurs during menstruation, it is still scientifically possible that intercourse during the period a woman sheds blood can lead to conception.

Sperm once shed into the birth canal can remain alive and viable between three to five days. During this time ovulation may take place followed by successful fertilisation.

2. You can get an STI from a toilet seat

Venereal diseases are primarily passed from one infected person to the next through sexual contact. Some STIs, such as pubic lice, can also be spread through skin-to-skin contact or sharing clothes, towels or bedding.

In many cases direct contact of skin or genitals or other bodily fluids with infected people is required for successful infection to occur. Urine usually cannot carry STI, so toilet seats are safe on that count. Besides, most STI agents cannot survive outside the human body for a long time.

3. You need a big penis to orgasm

A recent study shows that the average human penis is 13.12 cm long and 11.66 cm in circumference. The idea that a big penis automatically means satisfactory sexual experience for a woman is a fallacy.

Most women orgasm by stimulation to clitoris rather than inside the vagina. A woman can either experience clitoral orgasm or G-spot orgasm. A deep-penetrating penis is irrelevant to clitoral orgasms.

4. You can’t get an STI from oral sex

You are more likely to get infected with an STI through sexual intercourse than through oral sex. However, some infections are spread much easily through oral sex. The most commonly passed on are herpes simplex, gonorrhoea and syphilis.

The best way to help protect yourself during oral sex is to use a male or female condom or a dam to cover your genital area or anus.

5. Menopause kills a woman’s sex drive

Menopause, the age when a woman loses reproductive vigour, is often accompanied by symptoms such as hot flushes. However, losing the ability to procreate does not affect one’s sex drive. A woman well past menopause can experience good libido and also have a fulfilling sexual life.

6. Birth control pills make you gain (or lose) weight

Tens of studies covering this subject have been conducted all over the world but none of them is yet to prove a correlation between oral contraceptives and weight gain, this is still a common belief among women of all ages.

Specifically, a review article published in 2006 analysed 44 previous trials and found that while some participants did gain weight during their studies, there was no evidence that their birth control was to blame.

7. You have to use a cleaning agent to clean the vagina effectively

It is common behaviour that a proper bath is often accompanied by use of soap or shower gels. This has led to the belief that the vagina (especially internal walls) need to be cleaned with a cleaning agent like soap. It is from this belief that practices such as douching started being practiced.

On College Campuses, Students Push For Free Condoms

Only about 13 percent of colleges have condom dispensers or vending machines that allow young people privacy and better access, says one researcher.

When Boston College student Connor Kratz came out as a freshman, he realized he didn’t have any tools available on campus to learn more about sexual health and staying safe.

“I didn’t have the resources to have those discussions on my campus,” he explained. He then joined Students for Sexual Health, a group that had previously received pushback for handing out contraceptives on the Catholic campus.

That experience “helped me realize this is what I wanted to share with other people, these resources. Everyone deserves and has a right to sexual and reproductive health care.”

Kratz is one of 1,000 college students participating in the Great American Condom Campaign (GACC), an Advocates for Youth project providing each student with a box of 500 condoms to hand out in their community during a semester. The GACC has existed for several years—but now many students are advocating for their schools to be the ones handing out condoms instead.

ecause young people are a population with relatively high sexually transmitted infection (STI) rates, and contraceptives are a right like any other form of health care, these students are pushing their campuses to put up free condom dispensers as part of the campaign.

Young people have the right to lead healthy lives and make their own choices about their futures. There are proven links between a person’s ability to decide if and when to become pregnant and their academic achievement and rates of attending and completing college.

Of the estimated 20 million new STIs infections reported in the United States each year, people between the ages of 15 and 24 make up more than 50 percent of new gonorrhea cases and more than 60 percent of new chlamydia cases. When Kratz and his group surveyed nearly 400 Boston College students about condom use, they found 80 percent of students on campus were sexually active, yet 60 percent of those surveyed did not always use protection during sex. Demonstrating how useful it would be if the school provided condoms, more than 70 percent of respondents said they would use resources if they were provided by a student group or the university. Almost 45 percent didn’t know where to find sexual health resources and treatment near campus.

A majority of colleges do make condoms available. But where condoms are available, they’re often not used as much as expected, given the sexual health needs of college students, said Scott Butler, assistant director of the School of Health and Human Performance at Georgia College.

Butler is one of a few academics who has done studies about condom availability in colleges, and according to his research, 85 percent of colleges in the United States distribute free condoms somewhere on campus. Butler said that “most colleges that give out condoms—about 96 percent—do so at their college health center.” But one reason this isn’t effective is because “people associate going to the health center with when they are sick or ill. You need to make condoms available in different places within the student’s environment, so they have them when they need them.”

As Butler explained, “colleges only give out an average of 1 condom per student per year. It’s clear that that’s not enough to meet the sexual health-care needs of students.” But Butler is not sure that colleges have “realized that the number they were giving out was low in comparison to the student population.”

This makes sense to me: I manage the Great American Condom Campaign, and thousands of students apply to hand out 500 condoms themselves in their free time without any compensation or additional incentives, aside from knowing that people on their campus really need these sexual health resources and a desire to help people have the reproductive care they deserve.

Stephon Camp, a junior at Indiana University Southeast and a leader in an LGBTQ group on campus, is collecting petition signatures for his school to put free condom dispensers in public places. “Not everybody always knows where these resources they can get are, and some people are still going through embarrassment to even go to the store and buy them, or think it’s not important until something happens,” he said. “We’re trying to get a condom dispenser … and figure out if we can possibly have them in bathrooms.”

While distributing condoms with the GACC, Camp has noticed a high demand while giving out condoms at his school. “Outside our club office, people can grab condoms, and that’s been going really well since I’ve had to fill that up numerous times,” said Camp.

Camp noticed a lot of shame around needing condoms while handing them out at Indiana University Southeast. “With the free condom dispenser that we are working on, I know that would help with the privacy part because people do get really hesitant, especially with it being a small campus. We’ve got paper bags if people want privacy,” said Camp, as he’s overheard groups of students making snarky comments about others who are grabbing condoms.

Some of the stigma around condom distribution also concerns ideas about youth and sexual activity. Opponents of condom distribution often claim that giving people free condoms will make them have more sex than they already do. On the other side, the American Academy of Pediatrics has statedthat condoms should be made widely available in schools and to teens. There is no evidence that increased access to condoms or contraceptives increases young people’s sexual risk taking.

Having free condom dispensers in campus bathrooms would also normalize condom use and safer sex, as well as reduce the stigma around the need for condoms.

Only about 13 percent of colleges have condom dispensers or vending machines, added Butler.

Free condom dispensers have been a success at American University in Washington, D.C., where they were installed last year. Those machines cost $75 to $100 each (condoms are provided free from the local health department)—definitely a worthy and inexpensive investment in young people’s health and safety.

Mickey Irizarry, the director of the Wellness Center at American University, realized that the 9-to-5 hours of her office, which provided condoms, were a barrier for students. “We had heard, especially from students that live on campus, that they were frustrated that they couldn’t get condoms in their residence halls.”

With help from students, she began exploring location options. They wanted “somewhere that was easily accessible, and public space in the halls, but that wasn’t so in your face, in case some students who aren’t sexually active were not going to be comfortable with it, but also not so private that it would be hard to get to or that they wouldn’t know where it is.” They ultimately ended up placing them in three residence halls, where they “were having to fill up the dispensers about every week or two.” The campus plans to put up more free dispensers in residence halls.

Although the movement for free condoms is a new and growing one—and faces uphill battles on some religious campuses—some students have succeeded in getting their schools to give out free condoms. Jasmine Wilson, who’s a part of Advocates For Youth’s Student Organizing team, advocated for her school, Kenyon College in Ohio, to provide free internal condoms (sometimes called female condoms) last semester.

“I began organizing for free condoms on my college campus because I believe that people should not be restricted [from] living a safe and healthy life. Condoms are a form of protection and safety,” said Wilson.

She added another reason: economic equity. Cost is a major barrier to condom access for some young people.

Free condom distribution “would eliminate the large income gap, where affluent students can afford better health care and therefore afford things like contraception …. I know all too many people who do not use condoms because they could not afford to purchase them, and that should not be the case. Condoms should be available for free to everyone.”

Interested in joining the movement for free condom dispensers on college campuses? Email kinjo@advocatesforyouth.org to learn more. Students can apply here.