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Hot pillow talk: new and fabulous sex news

Ready for some pillow talk?, the theme of this year’s Sexual and Reproductive Health Awareness Week, couldn’t have arrived at a more opportune time when it comes to HIV and safe sex.

You bet we want to talk! And sexual partners who are serodiscordant – one HIV-positive, the other HIV-negative – have every reason to interject a little celebration with that pillow chat. That’s because the science of HIV transmission is now declaring that with or without a condom, if someone with HIV is on treatment, engaged in care, and has an undetectable viral load, they do not pass HIV to their sex partners!

The “fabulousness” of this news cannot be overstated. We are now at an historical moment, celebrating the most significant development in the HIV world since the advent of effective combination therapy 20 years ago. A person taking antiretroviral treatment who has an ongoing undetectable viral load can declare “I’m not infectious!”

How did we get here?

The research on treatment as prevention has been slowly accumulating for many years. In July 2016, two large studies (PARTNER and HPTN 052) published final results showing that not a single HIV transmission occurred between serodiscordant sexual partners when the person living with HIV was on treatment, had an undetectable viral load and was engaged in care. With these results, “we now have 10,000 person years (of follow-up) with zero transmissions from people who are suppressed,” acknowledged Dr. Myron Cohen (principal investigator of HPTN 052).

Convinced by this body of evidence, CATIE recently endorsed the Consensus Statement of the Prevention Access Campaign, celebrating the fact that “undetectable equals untransmittable”. This revolutionary statement, pushed forward by a dedicated group of people living with HIV, has prompted CATIE to adjust our messaging on this topic. It’s important for all frontline service providers working in HIV to understand the evolution in language so they can convey accurately these new revelations concerning HIV transmission.

In the spirit of ‘starting a conversation’ for the best possible care during Sexual and Reproductive Health Awareness Week, let’s unpack this message of “undetectable equals untransmittable,” or “U=U” in its familiar short-hand.

Can we really say that the risk does not exist?

Yes! We can and we must. While research has reported “zero transmissions,” the idea of “zero risk” is uncomfortable to many because it is impossible for research to ever conclude that a risk is zero. Statistically, we cannot rule out that a very small risk may exist, no matter what the data show us. However, focusing on the possibility of a very rare event can also be misleading. In this case, a large body of evidence is telling us that people with undetectable viral loads do not transmit HIV, and in research jargon we say that the risk is negligible (meaning insignificant or not worth considering).
But what does negligible mean to the average person? It certainly does not convey the excitement that people living with HIV are feeling about this amazing news. Negligible may be an accurate word but it is not a suitable message. If the risk is negligible then we must be willing to accept that it is not important.

HIV- negative and HIV-positive people need to hear this message

HIV-negative people need to know that an HIV-positive person who is on treatment and engaged in care, and maintains an undetectable viral load, is a very safe sexual partner because their HIV is diagnosed and the virus is controlled. This is counter to what prevention messaging said for years, where the HIV-negative partners of people living with HIV were considered to be at highest risk. We now know that the majority of HIV transmissions come from people who are living with HIV and don’t know it (the undiagnosed). This paradigm shift requires us to take up new messages that clearly communicate where the risk actually lies – not with HIV-diagnosed people who have and maintain undetectable viral loads.

It is also important for people living with HIV to hear this message so they can be confident in their ability to have healthy sex lives. People living with HIV continue to face stigma that affects their lives in many ways. By continuing to focus on a risk that is negligible, we do nothing to combat HIV-related stigma. The U=U message can reduce HIV stigma by removing the fear that people living with HIV are “infectious” and “risky” sex partners.
We need to ensure that our HIV prevention messages help, rather than harm, the people to whom we are speaking. With a little creativity and boldness, these messages can be meaningful to the communities we serve while remaining strongly grounded in the science.

More information can be found at the CATIE web site section entitled Undetectable Viral Load and HIV sexual transmission. You can also see prevention resources on catie.ca and add your organization’s name to the Consensus Statement of the Prevention Access Campaign. Let’s get the word out! Get tested, get on treatment, become undetectable and have lots of great sex!
By Camille Arkell, CATIE’s Knowledge Specialist, Biomedical Science of Prevention, and Laurie Edmiston, CATIE’s Executive Director. 

I recently met this great guy and we really hit it off. He says he’s in an open relationship. I’ve always been monogamous and feel completely clueless about this. Help!

co-written by Sadie Villeneuve

First things first, the terms open relationship and consensual non-monogamy (CNM) are often used interchangeably[i], as an umbrella term for various models of relationship.  These relationships like monogamy come with pros and cons, jealousy, the need for safe sex practices and cheating.

When finding out that this guy you hit it off with was in an open relationship, the first couple of thoughts that may have passed through your mind were open relationship? What’s that? Nonmogamwhatttt?!

Open relationships or CNMs are often viewed as out of the ordinary[ii] and illegitimate[iii].  Growing up we are presented with images of princes falling in love with princesses who live happily ever after just the two of them. Hetero-monogamous relationships are often pushed as “the norm” in our society.

Unlike monogamy which comes with what could be called default rules, expectations and social norms[iv], CNM relationships have the opportunity to negotiate an agreement where parameters are set to ensure relationships not only flourish[v], but all parties have their needs and desires met as well as feeling safe[vi]. These relationships are grounded on communication, trust and the ability of all partners to be able to convey their needs, concerns or desires openly at any time. CNM relationships can be nonexclusive sexually, emotionally or a combination of both[vii], depending on the model. The three most common models of CNM are:

  • Swinging: Couples who swing engage in extra-dyadic sex in the presence of their partner in a social setting/party. This form of relationship is strictly sexual in nature, not romantic or emotional [viii].
  • Open relationships: Couples are emotionally and romantically exclusive to each other, while allowing for secondary lovers strictly for sexual relationships[ix]. A large degree of autonomy exists within this type of relationship.
  • Polyamorous: Polyamorous relationships are often regarded more positively than swinging or open relationships; as the relationships are more then just sex – they are romantic and emotional in nature as well[x]. Polyamorous couples may have parallel relationships, with many “one and onlys”[xi].

Individuals in these relationships understand and agree they are non-monogamous.

Jealousy can become the big green monster of any relationship. Many would consider it a certainty in CNM relationships, however it is no more prevalent than in monogamous relationships[xii]. Jealousy can be a healthy relationship experience, bringing a couple closer together. This emotion often speaks to uncertainty an individual may be feeling or the inability to express an emotion, rather than the actions of the partner[xiii]. Jealousy management and communication is useful for CNM and monogamous relationships alike [xiv].

A positive CNM relationship facilitates dialogue and communication among partners to maximize mutual gain[xv]; promoting individual growth[xvi], autonomy, confidence and self-expression[xvii]. Individuals who engage in consensual non-monogamy often report improved lives, a high degree of openness, happiness and overall satisfaction[xviii]. CNM relationships allow for individuals to choose partners that can meet specifics such as sexual variety, instead of relying on one partner.

Like any positive relationship, a positive CNM relationship is based on trust, sharing and communication. Individuals partaking in CNM relationships will often spend a lengthy amount of time discussing STI testing, sexual history and health before engaging in any sexual acts fostering safer sex practices[xix]. Condoms are less likely to be used incorrectly as there is a mutual respect for all parties involved[xx].

Cheating whether in a monogamous or non-monogamous relationship can be defined in a similar manner: disrespecting or breaking implicit or explicit rules of the relationship structure[xxi]. CNM relationships view the transgression from communication, openness, emotional attachment and connection[xxii], as cheating. While individuals in monogamous relationships tend to focus on sexual infidelity and extra dyadic sex with others as cheating.

So, is it for you? That’s the question of the hour!

In order for a CNM relationship to work, you must be willing to communicate what you are looking for, your desires, any concerns you may have as well as being 100% honest. Ask yourself a few tough questions:

  • What are my expectations of a loving relationship?
  • How much security do I need to feel safe?
  • Do I need to be the “one and only” or can I share?
  • What pushes or provokes my jealousy and insecurity[xxiii]?

Don’t be afraid to “this great guy” to clarify any questions/concerns you may have! CNM is all about communication. Just like any relationship, CNM relationships are not always easy but they can be very rewarding. Spark conversation about what your goals, desires and boundaries are, and perhaps you’ll find yourself moving away from the default assumptions we often have about relationships and love[xxiv].

There are lots of great resources aimed at newcomers such as yourself such as www.morethantwo.com, and “The Ethical Slut” by Easton & Hardy as well as a large number of support groups and social networks avaliable to learn more.

No matter your decision, it’s just that – your decision – do what’s right for you!


 

[i] Labriola, K (1999) Models of Open Relationships. Journal of Lesbian Studies (The Hawthrone Press, Inc) Vol. 3, No. ½, 1999, pp.217-225.

[ii] Grunt-Mejer, K,. Campbell, C,. (2015): Around Consenaul Nonmongamies: Assessing Attitudes Toward Non exclusive Relationships, The Journal of Sex Research, DOI: 10.1080/00224499.2015.1010193

[iii] Rubel, A.N., Borgaert, A.F. (2015) Consensual Nonmongamy: Psychological Well-Being and Relationship Quality Correlates. Journal of Sex Research, 52(9), 961-982,.

[iv] Veaux, F. (2012) What is poyamory? (edited by Eve Rickert) Copyright©2012 Franklin Veaux

[v] Rubel, A.N., Borgaert, A.F. (2015) Consensual Nonmongamy: Psychological Well-Being and Relationship Quality Correlates. Journal of Sex Research, 52(9), 961, 982,.

[vi] Grunt-Mejer, K,. Campbell, C,. (2015): Around Consenaul Nonmongamies: Assessing Attitudes Toward Non exclusive Relationships, The Journal of Sex Research, DOI: 10.1080/00224499.2015.1010193

[vii] Conley, T.D., Moors, A.C., Matsick, J.L., Zeigler, A. (2013). The fewer the merrier?: Assessing stigma surrounding consensually non-monogamous romantic relationships. Analysis of Social Issues and Public Policy, 13, 1-30.

[viii] Matsick, J.L., Conley, T.D., Zeigler, A., Moors, A.C., Rubin, J.D., (2014). Love and sex: Polyamorours relationships are perceived more favorably than swinging and open relationships. Psychology & Sexuality, Vol. 5, No.4, 339-348.

[ix] Rubel, A.N., Borgaert, A.F. (2015) Consensual Nonmongamy: Psychological Well-Being and Relationship Quality Correlates. Journal of Sex Research, 52(9), 961-982,.

[x] Grunt-Mejer, K,. Campbell, C,. (2015): Around Consenaul Nonmongamies:  Assessing Attitudes Toward Non exclusive Relationships, The Journal of Sex Research, DOI: 10.1080/00224499.2015.1010193

[xi] Grunt-Mejer, K,. Campbell, C,. (2015): Around Consenaul Nonmongamies: Assessing Attitudes Toward Non exclusive Relationships, The Journal of Sex Research, DOI: 10.1080/00224499.2015.1010193

[xii] Veaux, F. (2012) What is poyamory? (edited by Eve Rickert) Copyright©2012 Franklin Veaux

[xiii] Rubel, A.N., Borgaert, A.F. (2015) Consensual Nonmongamy: Psychological Well-Being and Relationship Quality Correlates. Journal of Sex Research, 52(9), 961-982,.

[xiv] Veaux, F. (2012) What is poyamory? (edited by Eve Rickert) Copyright©2012 Franklin Veaux

[xv] Mellesmoen, G., (2013). Open relationships get a bad rap. UWIRE text: p1.

[xvi] Moors, A., Chopkin, W., Edelstein, R., Conley, T., (2014). Consensual non-monogamy: Table for more then two, please. The inquisitive Mind. Vol. 6, Issue, 21.

[xvii] Rouse, R,. (2011). What is feels like…. to be polyamorous. Sunday Times, London England: p51.

[xviii] Rubel, A.N., Borgaert, A.F. (2015) Consensual Nonmongamy: Psychological Well-Being and Relationship Quality Correlates. Journal of Sex Research, 52(9), 961-982,

[xix] Veaux, F. (2012) What is poyamory? (edited by Eve Rickert) Copyright©2012 Franklin Veaux

[xx] Rubel, A.N., Borgaert, A.F. (2015) Consensual Nonmongamy: Psychological Well-Being and Relationship Quality Correlates. Journal of Sex Research, 52(9), 961-982,.

[xxi] Veaux, F. (2012) What is poyamory? (edited by Eve Rickert) Copyright©2012 Franklin Veaux

[xxii] Mellesmoen, G., (2013). Open relationships get a bad rap. UWIRE text: p1.

[xxiii] Labriola, K (1999) Models of Open Relationships. Journal of Lesbian Studies (The Hawthrone Press, Inc) Vol. 3, No. ½, 1999, pp.217-225.

[xxiv] Veaux, F. (2012) What is poyamory? (edited by Eve Rickert) Copyright©2012 Franklin Veaux

 

I live with a disability. It’s never stopped me from living my life to the fullest – and I have no complaints when it comes to my sex life. I recently started seeing this great girl and we’re totally into each other but when it comes to sex, she gets really nervous about hurting me or doing something wrong. I know my body and tell her constantly that she’s doing fine and what I need from her. What can I do?

co-written by Shaw Chard

Let’s discuss why being sexual with a person with a disability may be novel to your partner and how you both can use this information to grow and learn together.

Time for some background knowledge. Few of us are raised with adequate sexual education, and an oft-excluded factor which contributes to a good (hopefully great!) sex life is communication [1]. At the same time, the dominant discourse of sexuality is not inclusive of people with disabilities, both visible and invisible, and those people are seen as childlike, naïve, and incapable of sexual desire [2]. Sex-ed programs typically don’t include disability or communication in their curricula, and neither do media representations of sexuality. Because it’s never talked about, sexuality among people living with disability is assumed to either be non-existent or fundamentally “different”, which creates a divide between “normal people” and people living with disability [3].

Now, consider how these things may be affecting your partner and your sexual relationship. You’ve made it clear that you enjoy your sex life, that everything between you two in sexual situations is fine, and that you tell her what you need from her. But really, how much of that does she understand? Dominant sexual discourse is so exclusive; nobody talks about pleasure, planning, communication, and alternatives, so it’s no wonder that so many people are lost when it comes to any other idea of what sex can be. Both you and your partner were more than likely taught sexual education through this narrow lens, and although you have been able to find pleasure in tandem with, not despite of, your disability, it may be hard for your partner to get past what she’s learned. Change is not easy, and you can help each other by being as supportive as possible. Try to help her by introducing planning and open communication into your relationship.

When I say open communication, what I mean is that you not only be open with her, but with yourself: you have to be aware of and understand your own desires, as this is crucial to being able to communicate these things to your partner. If you care that she understands what you want, then you need to know what you want beforehand [4]. Even though you say you tell her she’s doing fine, and that you’ve let her know what you need from her, her nervousness could mean that she still doesn’t fully understand. Let your partner know that many people with disabilities, including yourself, don’t see their disabilities as detracting from their sex lives; on the contrary, many feel that their disabilities allow them to get more creative in the bedroom and allow for more open communication in sexual relationships [5]. Further, make sure you are inviting her to explain her wants and needs, and are validating and supportive of them when she opens up. This will facilitate better communication, and you two will likely feel closer, which cycles back to increasing confidence in sharing your desires and your abilities to achieve them in the future [6].

At the same time, you should both make an effort to be understanding of each other’s situations. You both learned that discussing sex is not the norm, but for you two that may simply not work. This is where planning comes into play. Sit down and discuss your respective wants, needs, and how to achieve both in an environment where you can really hear each other. Though the planning may seem like it detracts away from features we associate with good sex like ‘spontaneity’ or ‘immediate, silent understanding’, research has shown that this kind of open communication not only helps in the realm of sexual pleasure, but can also bring more closeness and intimacy into the relationship as a whole [7].

My advice may be starting to sound repetitive; how many times can I say communication? The point of it all is that, in any relationship, partners need to communicate with each other to make sure that everyone involved is getting the most out of their sexual relationship. Sometimes, you just need to be told what to do, and some relationships require more communication than others. There’s no reason that planning and discussion should be an impetus to your sex; on the contrary, it’ll likely make your relationship stronger and the sex better. I’ll dare to assume that most people want to enjoy their sex lives, and the best way to make sure that happens is to talk about your desires, your needs, and the desires and needs of your partner (or partners!). Now go forth, have a discussion with this great girl of yours, and then reap the benefits.


[1] Kaufman, M., Silverberg, C., & Odette, F. (2003). The ultimate guide to sex and disability: For all of us who live with disabilities, chronic pain, and illness (1st ed., pp. 1-345). San Francisco, California: Cleis Press

[2] Katari, S. (2014). Sexuality and Disability. Sexual experiences of adults with physical disabilities: Negotiating with sexual partners, 32, 499-513. doi:10.1007/s11195-014-9379-z

[3] Esmail, S., Darry, K., Walter, A., & Knupp, H. (2010). Attitudes and perceptions towards disability and sexuality. Disability and Rehabilitation, 32(14), 1148-1155. doi:10.3109/09638280903419277

[4] Kaufman, M., Silverberg, C., & Odette, F. (2003). The ultimate guide to sex and disability: For all of us who live with disabilities, chronic pain, and illness (1st ed., pp. 1-345). San Francisco, California: Cleis Press

[5] Katari, S. (2014). Sexuality and Disability. Sexual experiences of adults with physical disabilities: Negotiating with sexual partners, 32, 499-513. doi:10.1007/s11195-014-9379-z

[6] Katari, S. (2014). Sexuality and Disability. Sexual experiences of adults with physical disabilities: Negotiating with sexual partners, 32, 499-513. doi:10.1007/s11195-014-9379-z

 

 

 

 

The Subtle Shift: Transforming Boys into WiseGuyz

The Calgary Sexual Health Centre (CSHC) specializes in helping young people learn about sensitive and emotional topics and more importantly, how these learnings can translate into behavioural change. Typically, education about sexual violence prevention and empowerment has been focused on women and girls, unintentionally ignoring the value of men and boys and their role in helping to create solutions. Research is now pointing to young boys as a key population for which to foster healthy, respectful and non-violent behaviours.

WiseGuyz

In 2010, the CSHC launched WiseGuyz, a school-based program created for junior high boys, who are at a critical point in their gender identity development. The program is voluntary and facilitated by male instructors, helping to create a relaxed and safe environment where the boys can examine their beliefs and assumptions about what it means to be a man in the world today.

WiseGuyz uses a progressive model, with significant attention placed on trust building. In the initial phase of the program, the focus is on creating a safe space and building rapport among participants. WiseGuyz curriculum is comprised of four step-by-step modules: 1) Human Rights; 2) Sexual Health; 3) Gender; and 4) Healthy Relationships

Masculinity and Sexuality are Intrinsically Bound

WiseGuyz encourages boys to be open, curious and not feel shame in asking questions about sex and sexual health. Ensuring boys are developing not only the knowledge about appropriate resources, but also the confidence to access them is critical to their sexual health and engagement in healthy relationships.

The research underscores the fact that masculinity and sexuality are intertwined and that sexual health programming must include education about masculine beliefs and stereotypes, and vice versa. The research explored topics like sexual relationships, safe sex, and sexual health care – and how each intersects with healthy masculinity concepts, such as confidence, self-expression and communication.

Research Findings: There was a 19% improvement in confidence in sexual relations for the participants of WiseGuyz. The increase in confidence indicates that the boys understand the importance of communication, boundary setting and discussing mutual expectations within sexual relationships.

Including sexual health within the curriculum provides students with the tools and resources required to inform and empower positive choices. By implementing this subtle, yet significant, shift in approach to educating young males about their sexual health and emotional literacy, WiseGuyz has earned a reputation for being a promising model for relationship change and a reduction in homophobia, bullying and violence.

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