1. society
2. sex

The power of pleasure: How to talk about desire and
make sex education sexier
(A lesson learned from the 8th ICAAP)
by
Mr. Sakesan Siriphadung
One of the most fascinating and stimulating programs on
the third day of the 8th ICAAP was the Skills-building workshop
entitled “The power of pleasure: How to talk about desire and
make sex education sexier” hosted by an organization called The
Pleasure Project. The workshop drew considerable attention
among the participants with the use of sexy, provocative, and
eye-catching flyers distributed to the participants a day before
the session was commenced.
The workshop’s facilitators introduced three activities
based on The Pleasure Project's training materials. The first was
on naming sexual pleasure in which participants from different
countries were asked to respond to the questions of how ‘sexual
pleasure’ was called and how it was written in their native
languages. This was followed by another activity called
Identifying areas of Pleasure. The participants were divided into
small groups by gender, and each group was asked to identify
'areas of pleasure' by drawing an outline of a body of the
opposite sex and indicating the areas on the outline of the body
that, the group members thought, could potentially receive
sexual pleasure (figure 1 and 2).
Figure 1: identify 'areas of pleasure'
Figure 2: identify 'areas of pleasure'
Each group then presented its 'pleasure body map' to the
other groups, and the groups of the other gender were asked to
comment (figure 3).
Figure 3: Presenting ' the pleasure body map'
Subsequently, participants were split up into two groups in
the last activity, and each group was asked to market or sell
either male or female condom to the other group by attempting
to associate the messages used in the marketing with pleasure.
For instance, “using male condom is very pleasurable because it
delays ejaculation and can be used as a tool during foreplay”; or
“female condom gives pleasure and excitement to both men and
women, since its outer ring rubs against the clitoris and its
texture gives warmth on the penis” (figure 4).
Figure 4: Group members were trying to come up with
messages based on pleasure to sell male condoms.
The important lesson learned from the workshop is that
positive and pleasure-related benefits of condom use along side
safer sex messages should be emphasized in the promotion and
education campaign for consistent as well as effective use of
condoms. This intriguing and slightly controversial lesson is in
keeping with the research findings stating that the limited effect,
so far, of public health campaigns to promote effective and
consistent use of both male and female condoms might be
attributable, in part, to scare tactics which overwhelmingly focus
on adverse consequences of unsafe sexual intercourse such as
diseases, death, risk and fear (1).
The
lesson
carries
crucial
implications
for
the
sustainability of the public condom-promotion campaign,
particularly the high-profile and successful 100% condom use
promotion program in Thailand, which significantly contributed
to the slashing of Thailand’s HIV infection rate from over
140,000 cases in 1991 to approximately 20,000 cases in 2003.
Furthermore, the evidence of the success of Thailand’s 100%
condom use promotion program from The 2006 National Sexual
Behavior Survey of Thailand conducted by The Institute for
Population and Social Research, Mahidol University has also
been found among 94% of Thai males aged 18 to 59 years old in
Bangkok and other 14 provinces, who report that they always
use condom with sex workers (2).
This findings are, on the other hands, contrary to the
information in AIDS Epidemic Report by UNAIDS and WHO
that highlights the erratic condom use found among female sex
workers in Thailand. It states that women selling sex in
Bangkok, Chang Mai and Mae Hon Son in the northern part of
Thailand reported using condoms in just over one half of
commercial sex encounters. Similarly, fewer than one third of
young men surveyed in the north of the country said they always
used condoms with sex workers (3).
Despite the tremendous success of Thailand’s 100%
condom use promotion program, the HIV epidemic has now
transformed from one that plagues among only the vulnerable
and high-risk people to the generalized epidemic which occurs
in general population, intensifying the gravity of the epidemic
(4). The situation is further complicated by a major shift in
Thailand sexual culture from sex with sex workers towards
premarital sex or casual sex within relationship. This newly
found sexual culture, reinforced by the association of sex
workers with HIV, is a reflection of the trend in gender
liberalization which ushers in premarital sex as a socially
acceptable behavior for both males and females (5).
Among the overriding concerns in light of the condom use
in casual sex is the evidence that over a quarter of respondents
in the survey report that they never use condom in casual sex.
One of the major reasons for not using condom during casual
sex is the prevailing dislike to the use of condom due to
perceived reduced sensation (6). These multifaceted and
interrelated factors could potentially put HIV situation in
Thailand on the verge of a large scale re-emerging epidemic. As
a result, the study suggests that Thailand is in a great need to
reinvigorate its safer sex campaigns, including its highly
renowned 100% condom use promotion program.
The survey suggests that the perceived loss of sensation
from condom uses needs to be set off against the personal
disaster of becoming HIV positive as a means to encourage the
consistent use of condom (6). However, the use of positive and
pleasure-related benefits of condom use along side safer sex
messages might have revolutionary implications and offer bright
prospects to profoundly enhance the effectiveness of the 100%
condom use promotion program to be in line with Thailand’s
current and predominant trend in sexual culture.
Since pursuit of pleasure is one of the main reasons that
people have sex, this factor must be addressed when there is an
attempt to motivate people to use condoms and participate in
safer sexual behavior. Although enjoyment as well as sex itself
has been noticeably absent from much of the dialogue
surrounding STI and the spread of HIV, increasing evidence in
several research-based examples shows the importance of
condom promotion that includes a combination of pleasurebased and safer sex messages.
The following evidence-based advantages of positive
pleasure-related and erotic aspects of condom use are excerpted
from the supplementary documents of the Pleasure project
organization entitled “Promoting protection and pleasure:
amplifying the effectiveness of barriers against sexually
transmitted infections and pregnancy” distributed at the end of
the Skills-building workshop.
Eroticizing male condoms
To decrease HIV transmission in female sex workers and
their clients, and in men who have sex with men, Population
Services International, Cambodia, introduces a water-based
lubricant sachet packaged with two condoms. The product is
called Number One Plus and is marketed by emphasizing its
pleasure-enhancement and safety benefits. Key messages are
that it increases pleasure for the penetrator, diminishes vaginal
and anal friction for the receptor, and reduces the risk of
condom breakage. When using condoms, sex workers who
undertake several sex acts per night with different clients, and
men who have sex with men, often report discomfort and
sometimes pain due to no lubrication. Both groups say they
often avoid condoms because of this soreness. Qualitative
research shows that reduction of displeasure and discomfort
when using condom is essential to boost condom use. Although
lubricant cannot be used to prevent HIV infection and it should
always be promoted as a supplement to condoms, decreasing
friction by means of lubricants during vaginal and anal
intercourse with condoms lowers the likelihood of tissue
irritation and condom breakage. In this way, Population Services
International in Cambodia has addressed the discomfort issue
while marketing its product with positive, pleasure-focused, and
safety messages. According to this organization, since the
launch of Number One Plus in 2003, sales have steadily risen.
Marie Stopes International has been socially marketing
textured male condoms in Uganda with huge success. Studded
condoms are sold as pleasure-promoting, and the brand has had
huge sales, with 12 million sold in Uganda every year. Although
the causal relation between the characteristic and sales has not
been established, sales are certainly higher than originally
expected.
Other work has shown that pleasure in using male
condoms derives not only from the perception that they can
enhance enjoyment but also from the knowledge that the sex is
not risky, and the use of condom shows respect for the partner.
Participants in a study in Mexico and the Dominican Republic
say that the security of using condoms makes them feel relaxed
and enjoy sex more. Furthermore, promotion of pleasure as a
motivator for condom use could focus on the advantages of
delayed ejaculation that can happen with condoms. For example,
in India, The Kohinoor Xtra Time brand of condom is coated
with a lubricant containing local anesthetic, which is marketed
as enabling long-lasting intercourse.
Eroticizing female condoms
Research has shown that one of the factors that increases
the success of programs promoting female condoms is taking the
opportunity to promote the female condoms as an erotic
accessory. Users of the female condoms report that the outer
ring rubs against the clitoris and the inner ring against the penis,
creating pleasurable friction. The female condom is made from
polyurethane, a strong, thin material that conducts heat well, and
is lubricated internally and externally, and can enhance
physically enjoyment. There is also a new version made from
nitrile. Couples have reported that use of female condoms does
not interfere with pleasure.
Female sex workers in Colombo, Sri Lanka, encouraged
their male clients to insert the female condom as a means to
increase pleasure for both people. Sexual excitement was used
as a negotiation technique, with clients finding the process very
arousing and perceiving the female condom as a sex toy and
enhancement to the sex act. In an acceptability study, more than
90% of condom users claimed that they liked the female
condom very much, with nearly 60% saying that their clients
like it and were excited to watch its insertion. In Madagascar,
women using female condoms became aroused and, as a result,
had an increase in vaginal lubrication, sometimes for the first
time in their lives. In Senegal, the society for women and AIDS
in Africa promotes female condoms alongside local erotic
accessories, such as incense, frilly underskirts, and bine-bine
beads, which are worn on women’s hips during sex. The noise
that the female condom makes during intercourse is similar to
that made by bine-bine beads: thus it was associated with erotic
activity. Similarly, in Andhra Pradesh, India, the noise of the
female condom was eroticized when female sex workers told
clients that it only made that sound when they were “doing it
right”.
In conclusion, the practical application of pleasure-related
and erotic aspects of condoms as one of the motivators for the
consistent use of condom in public program appears restricted
due to the fact that an overt dialogue about sexual pleasure is
still, to some certain extent, not wholly embraced in Asian
culture. A well-rounded strategy, however, could be formulated
to appropriately convey the right messages for the right
audience, rendering it seamlessly in alignment with this
relatively deep-seated, cultural taboo.
References
1) Philpott A, Knerr W, Maher D. Promoting protection and
pleasure: amplifying the effectiveness of barriers against
sexually transmitted infections and pregnancy. The Lancet
2006 Dec; 368: 2028-31
2) Chamratrithirong A, Kittisuksathit S, Podhisita C,
Isarabhakdi P, Sabaiying M. National Sexual Behavior
Survey of Thailand 2006. Nakornpathom: Institute for
Population and Social Research, Mahidol University;
2007. p.59-68, p.99-106
3) UNAIDS, World Health Organization. AIDS epidemic
update. Geneva: UNAIDS;2006. p.32-3
4) The Global Fund To Fight AIDS, Tuberculosis, and
Malaria. Annual Report 2006. New York: The Global
Fund; 2006. p.58-9
5) Chamratrithirong A, Kittisuksathit S, Podhisita C,
Isarabhakdi P, Sabaiying M. National Sexual Behavior
Survey of Thailand 2006. Nakornpathom: Institute for
Population and Social Research, Mahidol University;
2007. p.106-7
6) Chamratrithirong A, Kittisuksathit S, Podhisita C,
Isarabhakdi P, Sabaiying M. National Sexual Behavior
Survey of Thailand 2006. Nakornpathom: Institute for
Population and Social Research, Mahidol University;
2007. p.107-11