Sexual Health Conversations: An Essential Ally in Reproductive Health. Douglas Braun-Harvey, MA, MFT, CST, CSTS

Transcription

1 Sexual Health Conversations: An Essential Ally in Reproductive Health Douglas Braun-Harvey, MA, MFT, CST, CSTS

2 Goals and Objectives: Increase provider comfort, confidence and willingness to facilitate client sexual health conversations. Enhance provider skills with sexual health conversations Integration of six sexual health principles within reproductive health services. 2

3 The Harvey Institute: Improving Health Care Through Integration of Sexual Health No Conflict of Interest or Disclosure Douglas Braun-Harvey, MFT, CGP, CST

4 Train the Trainers 4

5 5 Train the I personally received Trainers very helpful sex education information as a youth

6 Train the Trainers 6

7 7 In my personal life as a patient or client, a medical and/or mental health professional has asked me about how satisfied I am with my sexual functioning or sexual pleasure? Train the Trainers

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9 World Health Organization Health Dimensions Spiritual Mental Physical Sexual 9

10 Inextricable element of human health 10

11 Sexual and Reproductive Health Problems Account for 18% of the total global burden of disease

12 32% of the Total Global Burden of Disease Among Reproductive Aged Women is from Sexual and Reproductive Health Problems

13 World Health Organization (2006) What is Sexual Health? 13

14 Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. World Health Organization(2006)

15 Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. World Health Organization(2006)

16 Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled. World Health Organization(2006)

17 Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. sexual rights protected and fulfilled. World Health Organization(2006)

18 Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, the possibility of having sexual experiences, free of coercion, discrimination and violence. sexual rights protected and fulfilled. World Health Organization(2006)

19 World Association for Sexual Health

20 mmmmmmm

21 Sexual health is a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence. and fulfilled. World Health Organization(2006)

22 Sexual Health

23 How do reproductive health services balance safety and pleasure in routine appointments? Sexual Health

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30 Components of a Sexual health conversation? 30

31 Comfort Honest Nonexploitive Consent Shared Values Pleasure Protected from STI s, HIV and unplanned pregnancy Sexual Health 31

32 Comfort Consent Sexual Health 32

33 Comfort Consent: a factor that differentiates mutually enjoyed expressions of sexuality from coercive sexual assault (Pitagora, 2013) Consent Sexual Health 33

34 The ability and desire to engage in a Comfort consensual, rather than a coercive, sexual interaction is a factor that differentiates mainstream from pathological population (Pitagora, 2013) Consent Sexual Health 34

35 Consent is considered a necessary Comfort element in any sexual interaction. Consent is often not discussed at length between partners. Consent (Pitagora, 2013) Sexual Health 35

36 Comfort Consent Nonexploitive Sexual Health 36

37 Non-Consent Exploitation Non-Consent

38 Sexual Response

39 A sequence of physical and emotional changes that occur as a person becomes sexually aroused and participates in sexually stimulating activities Sexual Response

40 Sexual Pleasure

41 Positively valued feelings induced by sexual stimuli Sexual Pleasure

42 Non-Exploitive Sex Smart Films Norway: The Party

43 Comfort Honest Consent Nonexploitive Sexual Health 43

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45 when it comes to sex honesty is not easy

46 Thank you for your honesty

47 Comfort Honest Consent Nonexploitive Shared Values Sexual Health 47

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51 Comfort Honest Nonexploitive Shared Values Protected from STI s, HIV and unplanned pregnancy Consent Sexual Health 51

52 when it comes to sex knowledge about prevention and protection is not always welcome

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54 PrEP (pre-exposure prophylaxis) refers to an antiretroviral (ARV) drug that can be taken by an HIV negative person before potential HIV exposure to reduce risk of HIV infection. Prophylaxis is simply taking medications prior to germ or virus exposure to prevent infection. Taking Malaria pills before travel is an example.

55 Prep is about pleasure

56 Comfort Honest Nonexploitive Consent Shared Values Pleasure Protected from STI s, HIV and unplanned pregnancy Sexual Health

57 Definition of Sexual Health Exploitive CDC/HRSA ADVISORY COMMITTEE ON HIV AND STD PREVENTION AND TREATMENT(2011)

58 Definition of Sexual Health Exploitive Raise your hand when you find the word pleasure in the definition

59 Sexual Health A state of wellbeing in relation to sexuality across lifespan that involves physical, emotional, mental, social, and spiritual dimensions. An inextricable element of human health and is based on a positive, equitable, and respectful approach to sexuality, relationships, and reproduction, that is free of coercion, fear, discrimination, stigma, shame, and violence. Includes ability to understand benefits, risks, and responsibilities of sexual behavior; prevention of disease and other adverse outcomes; and possibility of fulfilling sexual relationships. Impacted by socioeconomic and cultural contexts including policies, practices, and services that support healthy outcomes for individuals and their communities. CDC/HRSA ADVISORY COMMITTEE ON HIV AND STD PREVENTION AND TREATMENT(2011)

60 Number one source of information for teens about sex is their friends (Reznik and Tebb 2008) "one reason for this may be that doctors, parents, and schools don t normally offer teens advice about PLEASURE" (KYLE RAGINS, YALE SCHOOL OF MEDICINE AND ISABEL CHEN, YALE SCHOOL OF PUBLIC HEALTH)

61 "Sexual health promotion programs for all groups, including youth and people with disabilities, should embody the reality that sexual pleasure and intimacy are strong motivating factors for sexual behavior and that sexual pleasure contributes to happiness and well-being."

62 Pleasur e Knowledge of the body related to sexual response and sexual pleasure Valuing sexual pleasure throughout the lifespan Sexual pleasure balanced with respect for rights of others Engage in sex in a safe and responsible manner 62 Dermer, S., & Bachenberg, M. (2015). The importance of training marital, couple, and family therapists in sexual health. Australian and New Zealand Journal of Family Therapy, 36(4),

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64 How do reproductive health services balance safety and pleasure? Sexual Health

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