Girls Like Sex Too

Tsitsi Masvawure of South Africa emphasized that, contrary to what we often see through media representation, the sexuality of young African women is not always subordinate, disinterested or reluctant; that acknowledging that some women actively seek out sex, HIV infection must be looked at in the context of pleasure, rather than danger.

Speakers on the panel, called Reproductive Health: Sexuality, Fertility and Desire, lamented that current prevention programs for women tend to focus on women as victims rather than as agents of their own pleasure. Wendy Knerr, of the Pleasure Project (U.K.), noted that current sex education is fear-based and sex-negative. The Pleasure Project is working to promote sexual health rights through the context of pleasure, and to make sex education more sex positive. Among other programs, the PP works with erotic filmmakers to help them include male and female condoms visibly in their films.

While this panel was decidedly focused on how this relates to women, I think talking about and acknowledging pleasure seeking inprevention applies to everyone and is strangely and conspicuously not done so much. In fact, when Joyce Rivera,of Saint Ann’s Corner of Harm Reduction (New York City) spoke recently at a CHAMP community forum about drug use as pleasure-seeking, it struck me, very surprisingly, as a discourse I don’t often hear.

One speaker at the session on RH spoke on the fertility desires of HIV+ men and women in Cape Town and another spoke on the fertility desires of women in Baltimore. Joanne Mantell, whose study was among Xhosa-speaking people of South Africa, was motivated by the sense that childbearing and parenthood is sidelined in public policy, especially in the case of HIV+ men. Her study found that a large percentage of HIV+ Xhosa-speaking men and women (but considerably more men) of South Africa have strong fertility and reproductive desires.

Likewise, Sarah Kessler, working through Johns Hopkins, found that about half of the participants (HIV+ women in Baltimore, 83% African American, 11% Black African/Caribbean, mean age of 32.4 years) in her study wanted to have a child-- and about 90% of those with that desire intended to do so. Significantly, these women, for the most part, overestimated their risk of mother-to-child transmission (MTCT). 15% of the women had accurate knowledge with regard to MTCT and those, not surprisingly, had had more routine and personalized discussions with their health care providers about fertility plans. In the study, only 31% of the women had had any discussion about their personal fertility plans with providers and 64% of the time, it was the women, not the providers, who initiated that discussion.

In a session called Pursuing Desire, Kevin Osborne of UBBA called for better attitudes among health workers toward RH and parenting for PLWHA. If HIV is to be normalized,providers must be prepared to address reproductive health and parenting. He sees policy gaps in traditional prevention efforts as aimed at negatives and calls for positive prevention to be included as part of primary prevention efforts.

The Pursuing Desire session had a strong start but started to lose my interest after a couple of speakers. I started to leave during the fourth speaker. Almost out the door, I thought I heard her utter the phrase “enhanced pronoun effectiveness and efficiency” among a list of recommendations. Did this just get interesting again? I turned right around and squinted at the screen behind her. No, she said, “enhanced program effectiveness…”