Health-e News: Placing pleasure at the heart of safe sex

“I want to talk about this sex toy. It’s this great sex toy. It’s small and convenient, you can carry it in your bag with you so it’s ready for you to use whenever you’re ready to ‘get it on’,” said Arushi Singh, with a cheeky smile, to a packed auditorium at the 2016 Women Deliver global conference on the rights and well-being of women and girls.

“You can use it by yourself or with a partner and you can, you know, insert it on your own and get ready, get into the mood,” she added. The tension in the audience was intense. People, on the edge of their seats, were straining to see what innovative sex toy Singh was about to take out of her little purse.

“It’s got these two rings so there’s an inner ring, it’s nicely lubricated as well,” she said as she removed the mysterious object from her purse – and as she did so the audience erupted with laughter. What Singh held up was none other than the female condom.

“It’s convenient to put in and then the inner ring you just hold that and put it through the vagina and it goes in and sticks itself to the cervix… it’s really quite popular. That’s the sex toy we love promoting at The Pleasure Project,” Singh said.

The Pleasure Project (TPP), an organisation “putting the sexy back into safe sex”, launched in 2004 with the aim of eroticising safe sex. TPP uses a pleasure-based approach – as demonstrated by Singh’s presentation of the female condom as an “erotic accessory”.

The female condom, made of polyurethane or Nitrile, can be inserted up to three hours before sex and is considered to contribute towards correcting the gender imbalance that sometimes exists around negotiating condom usage and decision-making power.

Yet, the female condom has been plagued by a negative stigma – some complain that it’s difficult to insert, that it causes weird noises during intercourse, or that its sheer size makes it seem unsexy.

Central to TTP’s sex-positive message is that safe sex doesn’t have to mean a lack of pleasure. “We also work with porn filmmakers to include condoms in porn films in a sexy way – so we try to bridge the public health world and the sexy world,” Singh told Health-e News.

TPP is critical of sexual education that speaks about safe sex solely in terms of avoiding disease and infection, instead of in pursuit of pleasure and good health. The organisation argues that we need to rethink the approach to sexual and reproductive health and rights – and move beyond scare tactics to put “pleasure” on the public health agenda.

Anne Philpott, the founder of TPP wrote in a journal article, When good sex is safer sex, that eroticising male and female condoms is key to increasing condom use. “Making condoms more comfortable and pleasurable transforms them from being strictly disease-prevention tools into erotic accessories,” she wrote.

This necessity for a reformulated approach rings true in South Africa. Inter-generational sex or the “blesser” and sugar daddy phenomenon – where sex is exchanged for “stuff” such as cars, hairdresser appointments or fancy clothes – has seen some young women become infected with HIV. A pleasure-based approach to the use of the female condom could yield a much-needed increase in this form of contraception and HIV-prevention. “If we’re talking about pleasure and public health and women’s health, it’s really about enabling agency,” explained Singh.

The government recognises this, which is why South Africa’s National Strategic Plan on HIV, STIs and TB for 2012-2016 aims to increase its distribution of female condoms from about 5-million in 2010/2011 to 25-million by the end of this year.

Increasing availability of condoms is only half the battle. The other half is getting people to use them. The Human Sciences Research Council (HSRC) found that while knowledge of female condoms among sexually active young women over 15 years old was high, at almost 78%, usage was incredibly low, at just over 7%.

A further 2014 study by the HSRC, the National HIV Prevalence, Incidence and Behaviour Survey, painted a similarly bleak picture. It found that overall rates of condom usage in the country are falling. In contrast, the HIV infection rate is on the rise. According to the study, the HIV infection rate rose from 10.6% in 2008 to 12.2% in 2012. The incidence rate among females aged 15 to 24 was found to be more than four times higher than the rate found in males in this age group. A country with statistics like this can’t afford decreases in condom uptake.

According to Health Minister Dr Aaron Motsoaledi, there are about 2,500 new HIV infections a week among 15- to 24-year-olds in South Africa. The Department of Health needed a plan to make condoms seem funkier so it introduced purple, grape-scented Choice condoms in 2015.

“I hope you find this condom more appealing and will use them,” Minister Motsoaledi said at the launch. Perhaps the department needs to change the way condoms are “pitched”’ to young people – having a more effective, youth-oriented sexual education approach.

What would happen if pleasure was given a prominent platform – as a pulling power to increase condom usage? The pleasure approach requires a re-branding of male and female condoms, removing the mindset that they’re a necessary evil and a hindrance to sexual desire, replacing it with sex-positive language that paints condoms as pleasure enhancers.

TPP investigated how widely the mode was used globally. In Senegal the Society for Women and Aids in Africa noticed that concerns around the noise the polyurethane female condom made during sex had contributed to a low uptake. In a clever marketing move, the society compared the noise to the sound made during the rattling of bine-bine beads – a traditionally erotic accessory that men present to their female lovers to wear around their hips. After this association, the noise made by the condom was considered evocative and the female condom gained positive connotations as an erotic tool.

South Africa should follow Senegal’s lead in forging a strong association between condoms and pleasure-driven sex. Condoms need to be given authentic positive messaging that resonates with youth and addresses their needs and desires – perhaps beyond simply changing the colour and the flavour. Minister Motsoaledi would do well to poke around in Singh’s bag of sex toy tricks for ideas on how to spread the pleasure message. DM

Photo: The Pleasure Project website's home page.