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Modern Sexual Myths

Trevor Stammers Programme Director in Bioethics and Medical Law

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myth 1. Most underage teens are sexually active


Mean Age of First Sex: Do They Know What We Mean?
Jokin de Irala Arch Sex Behav 27th May 2011

UNAIDS usually reports the proportion, among 1519-year-olds, having had sex by age 15 (UNAIDS, 2008) whereas other sources use the mean age at first sexual intercourse

myth 1. Most underage teens are sexually active

the mean age of sexual initiation is 15 years

This does not indicate most 15 year olds are having sex

myth 1. Most underage teens are sexually active

myth 1. Most underage teens are sexually active


The data presented in the table clearly show that the percentage of youth sexually active can be quite low at ages that are close to the mean age of sexual initiation and confirm that the use of this mean can be misleading and that misinterpretation of data is, indeed, quite plausible when using such average ages of sexual initiation.

myth 1. Most underage teens are sexually active


We therefore encourage the use of the percentage of youth at different ages, who have already initiated sexual relationships, instead of the use of averages. This will reduce confusion, help avoid erroneous interpretations, and provide a much needed additional source of support to young people, all of which in turn gives such public health policies a better chance of succeeding.

Myth 2. contraceptives reduce sexual infection risk

HIV and injectables study 2011


3,800 couples in Botswana, Kenya, Rwanda, South Africa, Tanzania, Uganda and Zambia. In each couple, either the man or the woman was already infected with H.I.V. Researchers followed most couples for two years, had them report their contraception methods, and tracked whether the uninfected partner contracted H.I.V.

Myth 2. contraceptives reduce sexual infection risk

The Lancet Infectious Diseases, Early Online Publication, 4 October 2011 doi:10.1016/S1473-3099(11)70254-7

Myth 2. contraceptives reduce sexual infection risk


Dr. Ludo Lavreys, an epidemiologist who led one of the first studies to link injectable contraceptives to increased H.I.V. risk, said intrauterine devices, implants and other methods should be explored and expanded. Before you stop recommending injectables, he said, you have to offer them something else. Belluck P New York Times Oct 3rd 2011

Myth 3. the tps improved sexual health


100 Gillick Ruling 80 60 40 20 0 1975 1980 1985 1990 1995 2000 2005
U16 Family Planning rate U16 conception rate

U16 Family Planning & Conception Rates, England 1975-2005


Health of the Nation

Teenage Pregnancy

Rates

Strategy

Myth 3. the tps improved sexual health


Progress of English Teenage Pregnancy Strategy
160 140 120 100 Rates 80 60 40 20 0 1995 2000
U18 conception rate 2004 target 2010 target

Teenage Pregnancy Strategy starts

2005
U16 conception rate

2010

Myth 3. the tps improved sexual health


Progress of English Teenage Pregnancy Strategy
160 140 120 100 Rates 80 60 40 20 0 1995 2000
U18 conception rate Teenage STI rate 2004 target 2010 target

Teenage Pregnancy Strategy starts

2005
U16 conception rate target18

2010

Myth 3. the tps improved sexual health

3. Teen sex improves mental health

Myth 4. Condoms are 99% effective


Condoms

are highly effective (95%) against HIV transmission in vaginal sex BUT HIV is a very rare STI in the UK and USA

Condoms are effective

sex Condoms have a 2-15% failure rate in preventing conception The lower failure rates are in experienced and motivated couples Risk displacement can increase numbers of unplanned conceptions in population use of condoms

Myth 4. Condoms are 99% effective risky

Richens diagram

Ten-year Decline in National HIV Seroprevalence in Uganda, Based on Data from15 Sentinel Surveillance Sites, 1990-2000
25 20 15 10 5 0

1990

1992

1994

1996

1998

2000

Casual sex distinguishes Uganda compared to other countries


Casual sex
70% 60% Casual sex in last year, age 15-24 50% 40% 30% 20% 14% 10% 0% Uganda Uganda Uganda Zambia 95 (a) 95 89 96 Malawi 96 6% 3%
0%
Data: DHS surveys using same methods
Uganda 89 95(a) are WHO Malawi 96 Uganda 95 and Zambia 96 KABP surveys Casual sex / total population aged 15-24

Condom use
70%

Men

Women

48%

49%

Condom use with last non-regular partner

56%

60% 57% 50% 40% 34% 30% 24% 27% 20% 41% 42%

40%

19% 15%

20%

18%

20%
20%

1 10%

Kenya 98

Kenya

Myth 4. Condoms are 99% effective Single, distinctive factor behind every HIV
prevention success wide social communication leading to declines in casual sex of up to 65% at the population level. If this risk avoidance did not occur, HIV did not decline, even with greater resources, condom use, counseling, education and treatment.
Low-Beer 2003, Going Face to Face with AIDS

Myth 5 Saved sex makes matters worse

Myth 5 Saved sex makes matters worse

www.dh.gov.uk/assetRoot/04/09/03/

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Myth 5 Saved sex makes matters worsesaved

sex works

The abstinence-centred TeenSTAR sex education intervention was effective in the prevention of unintended adolescent pregnancy
Cabezon et al J Ad H 2005 36 64-9

Abstinence only intervention led to later sexual initiation relative to abstinence plus and comprehensive SRE.
Jemmott JB et al Arch of Pediatric Adolescent Medicine, 164(2): 152-159.

Myth 6. Sexual morality is irrelevant


There is no reason to suppose that there is such a thing as sexual morality. There is nothing wrong with sex of any kind including fetishism, bestiality, necrophilia, buggery, incest, paedophilia and the variety approved by missionaries

Myth 6. Sexual morality is irrelevant


I want. to demolish the very tenacious idea that there is something good, or at least morally respectable about things or practices on even inclinations that can be thought of in some sense, natural

Myth 6. Sexual morality is irrelevant

Myth 6. Sexual morality is irrelevant

Love is the fulfilment of desire and love is its telos

Myth 6. Sexual morality is irrelevent


Because love is prone to destruction by jealousy, sexual virtue must try to eliminate and forestall jealousy by cultivating fidelity ..

Myth 6. Sexual morality is irrelevant

Sexual desire is itself inherently nuptial leading through tenderness to the vow of erotic love.

Myth 7. Sex has no meaning or consequences

Sex is about
COMMUNICATION

Myth 8 sex is god


Sexual

pleasure is...in intensity and kind, unique among human pleasures: it has no passable substitute from other realms of life. For ordinary persons orgasmic sex is the only access they have to ecstasy Mohr 1988:113

Myth 8 sex is god

Myth 8 Sex is god

Theres more to sex than skin on skin. Sex is as much a spiritual mystery as physical fact. As written in Scripture The two become one. Since we want to become spiritually one with the Master, we must not pursue the kind of sex that avoids commitment and intimacy leaving us more lonely than ever the kind of sex that can never become one
I Cor 6v16-18 St Paul

Myth 8 sex is god

References
Colman S., T. Joyce and R. Kaestner (2008), Misclassification Bias and the Estimated Effect of Parental Involvement Laws on Adolescents Reproductive Outcomes American Journal of Public Health, 98(10): 1881-5. DiCenso A., G. Gordon, W. Andrew and L. Griffith (2002), Interventions to reduce unintended pregnancies among adolescents: systematic review of randomised controlled trials, British Medical Journal, 324(15, June): 1426-34. Eurydice/NFER (2009), SRE education in other countries /www.inca.org.uk/Sex_and_relationships_education_December_2009_.pdf accessed 19th October 2010. Girma, S and D Paton (2006), Matching Estimates of the Impact of Over-the-Counter Emergency Birth Control on Teenage Pregnancy, Health Economics, 15 (Sept): 1021- 32. Girma, S. and D. Paton. (2011) The Impact of Emergency Birth Control on Teen Pregnancy and STIs, Journal of Health Economics,30: 373-80. Glasier, A, K Fairhurst, S Wyke, S Zirebland, P Seaman, J Walker & F Lakha (2004), Advanced Provision of Emergency Contraception Does not Reduce Abortion Rates, Contraception, 69: 361-6. Henderson M, D Wight, GM Raab, C Abraham, A Parkes, S Scott et al (2007), Impact of a theoretically based sex education programme (SHARE) delivered by teachers on NHS registered conceptions and terminations: final results of cluster randomised trial, BMJ, 334(Jan): 133-137. Jemmott III JB, LS Jemmott and GT Fong (2010), Efficacy of a Theory-Based Abstinence-Only Intervention over 24 Months: a randomized controlled trial with young adolescents, Archives of Pediatric Adolescent Medicine, 164(2): 152-159. Joyce T., R. Kaestner and S. Colman (2006), Changes in Abortions and Births and the Texas Parental Notification Law, New England Journal of Medicine, 354(10, March): 1031-8. Klick J. and T. Stratmann (2008), Abortion access and risky sex among teens: parental involvement laws and sexually transmitted diseases, Journal of Law, Economics and Organization, 24(1, May): 2-21. Kost K., S. Singh, B. Vaughan, J. Trussell and A. Bankole (2008), Estimates of contraceptive failure from the 2002 National Survey of Family Growth, Contraception, 77: 10-21. Levine, PB (2003), Parental involvement laws and fertility behavior,Journal of Health Economics, 22 (5, Sept), 861-78. New, M.J. (2011). Analyzing the effect of anti-abortion U.S. state legislation in the post-Casey era, State Politics and Policy Quarterly, 11 (1, March): 28-47 Paton, D (2002), The Economics of Abortion, Family Planning and Underage Conceptions, Journal of Health Economics, 21 (2, March): 27-45 Paton, D (2006), Random Behaviour or Rational Choice? Family Planning, Teenage Pregnancy and STIs, Sex Education, 6 (3, August): 281-308. Raymond, EG, J Trussell & CB Polis (2007), Population Effect of Increased Access to Emergency Contraceptive Pills: a systematic review, Obstetrics & Gynecology, 109 (1, Jan): 181-8. Raymond E.G. and M.A. Weaver (2008), Effect of an emergency contraceptive pill intervention on pregnancy risk behavior, Contraception, 77: 333-6. Rosenbaum JE (2009), Patient Teenager: A comparison of the sexual behavior of virginity pledgers and matched nonpledgers, Pediatrics, 123 (1, Jan): e110-e120. Stanford J.B. (2008), Emergency Contraception: overestimated effectiveness and questionable expectations, Clinical Pharmacology and Therapeutics, 83(1, Jan): 19-21. Wilkinson P., R. French, R. Kane, K. Lachowycz, J. Stephenson, C. Grundy et al (2006), Teenage conceptions, abortions and births in England: 198942003, and the national teenage pregnancy strategy Lancet, 368(Nov): 1879-86. Zavodny, M (2004), Fertility and parental consent for minors to receive contraceptives, American Journal of Public Health, 94(8): 1347-1351. Zavodny, M (2005), Erratum In: Fertility and Parental Consent for Minors to Receive Contraceptives, American Journal of Public Health, 95(1): 194.

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