Tuesday, July 5, 2011

Isn't sex the same in Nairobi or New York?

Sex thrusts itself into every aspect of modern life so blatantly - advertisers use it to sell us everything from cars to coffee and no Hollywood film is complete without a little light nudity - that it's easy to forget that in real life, many of us are nowhere near progressive in our sexual behaviour.

Around the planet, people have sex when they'd rather not, pretend that STDs happen to other people, and don't use condoms when they know they should.

Health experts are going to be thinking about sex and condoms a lot over the next few weeks. July 11th is World Population Day, and while fertility rates are plummeting in developed countries, populations are set to spiral in Africa and Asia. At the International AIDS Society conference in Rome this month, HIV experts are going to be talking about how to improve HIV prevention efforts. Slowing population growth and stopping HIV both rely on people using condoms more often (let's face it, abstinence is never really going to work), and figuring out how to do this is perplexing policymakers and researchers.

Many scientists study these issues in countries in Asia and Africa to figure out how to solve the conundrum, but too often the studies are predicated on the notion that people in poor countries behave or think differently in sexual relationships than they do in the West. This seems to be a major stumbling block in improving sexual and reproductive health in these countries.

Sexual and reproductive health programmes aimed at the developing world are always mindful of local cultural and social traditions – the idea being that if we import programmes designed with Western sexual attitudes in mind, they would hold little traction in conservative societies where men still tend to dominate.

Clearly, social mores affect sexual attitudes, and it would be ludicrous to take a one-size-fits-all approach to sexual health programmes irrespective of local religious beliefs or cultural approaches to sex before marriage, say. Yet cultural norms often operate at a macro, societal level; on an individual level, however, sexual relationships tend to operate similarly wherever you are in the world. Negotiating something as fundamental and intimate as sex is as delicate and complicated in Nairobi as it might be in New York.

A quick scan of research articles on increasing condom use in developing nations shows that almost all talk about how to empower women to better negotiate it. This not only puts the onus on women to take care of the sexual health of both herself and her partner, it assumes that men are not capable of taking any responsibility, and even suggests to them that they shouldn’t try to. It also ignores an obvious point: if empowering women is the answer, why doesn’t it work in the West, where many women are about as empowered as they can be?

One paper encourages women in developing countries to negotiate condom use well before they have sex. Could you really imagine even the most educated, independent, feminist woman in a city like London leaning over to their potential sexual partner over dinner, in between the main course and dessert, say, and telling them that they better stock up on condoms?

Women should always be encouraged to stand up for their sexual rights, and empowering women is a commendable goal. But if privileged women in rich countries find negotiating the balance of power in sexual relationships difficult, it seems a double standard to expect it of women in the developing world. Experts working to improve sexual health in developing countries should instead focus on bringing men into the picture. Sexual health isn’t just a woman’s problem, and it’s time we stopped pretending that men don’t also have a role to play.

Image: Condom superhero costumes at Cabbages and Condoms, Bangkok, an NGO that promotes safe sex

Photo credit: Shane R/flickr


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