Part 1. What is sexual health? Part 2. Why have Priority Population Groups for Sexual Health Services? Part 3. The framework of a phone call. Part 4. Managing difficult calls. Triage Course Overview
Part 1What is Sexual Health? “If the average person knew as little about eating as he does about sex, he would quickly starve to death.” Dr. David Reuben
Part 1. What is sexual health? Learning objectives: At the end of this session you will be able to: Understand how people learn about sexand why people might have sex. Identify the barriers to communicating about sex. Define that sexual health is not merely the absence of disease. Define and maintain healthy personal and professional sexual health boundaries.
Learning about sex People learn about sex in many different ways, such as through school education, friends and family, magazines, books, internet multi-media and/or through experience with sexual partners. As a result people have varying levels of knowledge about sex and sexually transmissible infection (STI) risks.
Reasons people have sex People may have sex for different reasons – for example - pleasure, relaxation, pregnancy, money or other forms of exchange, power, commitment or love. Sex is generally considered a personal and a private matter and is usually not communicated about openly or explicitly.
Some people may consider sex to mean any form of interaction occurring within a sexual context, whereas others may view sex to only refer to the process required for pregnancy to result or where insertive activity has occurred.
Sex is also confined by norms, which are considered acceptable or not acceptable. The interpretations of this can vary between individuals and groups.
Stigma Stigma is the mark of disgrace associated with a particular circumstance, quality or person.1 Erving Goffmandefined stigma as the process by which normal identity is spoiled by the reactions of others (1963).2 A person may be reluctant to admit to certain sexual behaviours because of the stigma associated with them. The Sex in Australia study (2003) reported a range of sexual behaviours which varied from the norm.3 Reference 1http://oxforddictionaries.com/definition/stigma accessed 17 Dec 2010. 2Goffman E., (1963) Stigma: Notes on the Management of Spoiled Identity, Prentice-Hall, 1963 3Richters,J. Grulich, A., de Vissler R.O. Smith, A., & Rissel, C.E. Sex in Australia: Autoerotic and other sexual practices engaged in by a representative sample of adults. Australian and New Zealand Journal of Public Health Vol 27, Issue 2, p 180-190, April 2003.
For these reasons people may not be able to communicate effectively about sex for fear of being misunderstood or judged.
Consequently people may not receive the right information, support and help. It is important to be aware of these barriers and how your own beliefs may effect communication when triaging.
Part 1. What is Sexual Health? 5 myths that stigmatise Sexually Transmissible Infections (STIs) Only people who are ‘promiscuous’ / people with ‘no morals’ get STIs Married people don’t have STIs You can get STIs from toilet seats You can’t get an STI through oral sex People usually know if they are infected
More Myths about STIs 4 more myths that stigmatise STIs Sex workers have lots of STIs Only gay men have HIV People who have an STI are ‘dirty’ You can’t get an STI if you only have one partner
World Health Organisation’s Definition of Sexual Health 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, as well as 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 (WHO 2002). WHO (2002) Defining Sexual Health Report on a technical consultation on sexual health 28-31 January 2002 Geneva
Fundamental to this concept is the right to sexual information and the right to pleasure.
The purpose of sexual health care should therefore be the enhancement of life and personal relationships and not merely counselling and care related to procreation or STI prevention.
Personal and Professional Boundaries A common misconception is that when a person talks about sex, it means they may be personally interested. At work when you first start talking about sex (particularly with strangers), it is not unusual to feel a little anxious and unsure.
Personal and Professional Boundaries In sexual health, it is not voyeuristic to ask certain questions as long as there is a clear professional reason for asking them. There is a clear distinction between personal and professional boundaries. For your professional development, it is helpful to be aware of your personal boundaries and how they may impact on your professional life.
Personal and Professional Boundaries Please take a moment to read: Principles for Effectively Maintaining Professional Boundaries as a Service Provider Why Are Boundaries Important?
Where would you go to for information and help?
Online Resources on Personal Boundaries Why are boundaries important? Overcoming the disease to please: How to Recognize Collapsed, Inflexible, Unhealthy Boundaries Tools for enforcing personal boundaries