‘Pleasure Audit’: Pleasure-inclusive Comprehensive Sexuality Education in Ghana and Kenya

Written by The Pleasure Project

What is a pleasure-based approach and why is it important?

The Pleasure Project defines a ‘pleasure-based approach’ as one that celebrates sex, sexuality and the joy and wellbeing that can be derived from them. It creates a vision of good sex built on sexual rights, focusing on sensory, mental, physical, and sensual pleasure to enable individuals to understand, consent to, and gain control over their bodies and desires.

Wellbeing, safety, pleasure and joy are the objectives of a programme with a pleasure-based approach. This approach measures empowerment, agency and self-efficiency by whether or not an individual has been enabled to know what they want, can ask for it, and request this of others, in relation to their sexuality, desires and pleasure.

The purpose of sexual health and education programmes is often to transform social and gender norms around sexuality and change behaviours related to gender and sex that are harmful, discriminatory, and non-inclusive. There is a plethora of studies and literature reviews that point to the effectiveness of pleasure-inclusive sexual health programmes. These demonstrate that positive attitudes to sexuality and positive messaging on sex corresponded with improved attitudes and knowledge about sexual health, better partner communication, higher levels of assertion, and increased use of contraception and sexually transmitted infection (STI) prevention, including safer sex behaviours (see The Pleasure Project, 2008; Ford et al., 2019).

How has a pleasure-based approach been applied in programmes?

There is increasing recognition of the importance of pleasure in sexual and reproductive wellbeing. This is evidenced by the many programmes and organisations around the world incorporating sex-positive approaches or pleasure-inclusive messaging.

There are several examples of community-based organisations and local non-governmental organisations (NGOs) across Asia, Africa and Latin America that have adopted pleasure-inclusive messages in their work on HIV prevention, adolescent sexuality, and women’s sexual health:

• SAATHII (Solidarity and Action against the HIV Infection in India), an NGO working on HIV and sexuality, incorporated elements of sensuousness in its behaviour change communication (BCC) material for male-to-male masseurs, to promote making male-to-male sex pleasurable as well as safer.
• In Senegal, the Society for Women and AIDS in Africa (SWAA) likened the rustling sound during sex of a polyurethane first-generation female condom with the seductive rattling of ‘bine-bine’ beads, an erotic accessory that women wear around their hips. SWAA then sold first-generation female condoms with bine bine beads, to promote sales and use of contraception.
• Empowerment Concepts in South Africa advocated with local churches to teach married couples about better sex. Through a programme on positive living, they encouraged both partners to talk openly about what they like and don’t like in sex. They even conducted a ‘build your own dildo’ competition, which required all participants to create a dildo for condom-demonstration purposes out of a variety of materials, and the Catholic nuns won the competition.
• Community Development Services in Sri Lanka trained street-based sex workers to use female condoms in an erotic way and charge more money from clients for it.
• The Love Matters website franchise has established local-expert driven, open and honest websites in local vernacular, that feature user-generated, expert-moderated content on sex, sexuality, relationships, pleasure and love.
• The website Agents of Ishq in India use contextual and historical references and popular culture to promote positive perspectives on sexuality and pleasure.
• The Ghanaian website Adventures from the Bedrooms of African Women provides a space for African women to share experiences of sex and diverse sexualities.

How can sex positivity in programmes be measured?

In comprehensive sexuality education (CSE), there is a lack of evidence on the impacts and outcomes of adopting sex-positive or pleasure-based approaches in contexts that are socio-culturally silent about sex and sexuality and/or have political restrictions on discussion about sex and sexuality with adolescents and young people, even through sexuality education programmes.

Therefore, as part of the Get Up Speak Out (GUSO) project, led by Rutgers, researchers from the Kenya Sexual and Reproductive Health (SRHR) Alliance, the Ghana SRHR Alliance, and the Pleasure Project used a ‘Pleasure-meter’ framework to measure the sex positivity of the CSE provided by local non-governmental organisations (NGOs) in Kenya and Ghana.

This pilot study was done to see how we can measure pleasure-inclusive messaging and whether we can develop a ‘pleasure measure’, i.e. a tool that could be used by organisations and programmes to measure how well they are using a pleasure-based approach and learn how to improve.

What did the study find?

The research teams in Kenya and Ghana reviewed curricula, interviewed CSE facilitators and educators, conducted focus group discussions with learners, and observed CSE sessions being delivered.

The study found that learners wanted to know more about:

• sex and how it feels
• masturbation
• premature ejaculation
• contraception and several myths connected to it
• whether size of penis was related to women’s satisfaction
• what were ‘healthy relationships’
• abortion and several misconceptions related to it
• condom use
• how to find reliable information online about sex
• what to do if a partner refuses sex, among other things.

Learners were accessing information online, stumbling upon porn, or engaging in ‘sexy’ chats with strangers on social media. However, the CSE they were getting was not adequately enabling them to negotiate these risky online encounters.

The study also found some ‘positive deviant’ CSE educators who were sex-positive and willing to acknowledge the reality of their learners’ sexual lives and address these with truthful, explicit and detailed conversations on sexuality and relationships. They were able to navigate the restrictive socio-cultural norms as well as formal restrictions around discussing ‘sensitive’ issues, and found that clear information on condom use, safer sex and different ways to satisfy sexuality, along with giving the learners the skills and the freedom to make the right decisions for themselves, was more effective.

What are some key lessons learned?

Applying sex-positive or pleasure-based approaches does not happen overnight. Sexuality educators, sexual health providers, and others engaged in sexual education, health, and rights programmes need ongoing capacity building and technical support on sex-positivity due to prevalent, underlying socio-cultural norms around sexuality and gender.

The ‘Pleasure-meter’ breaks down the concept of ‘pleasure’ into seven factors that help to create a positive and meaningful sexual experience for an individual, whether with other people or individually:

1. Physical and psychological satisfaction / enjoyment: refers to the level of satisfaction / enjoyment in relationship(s) and/or sexual encounters, and factors that affect this.
2. Self-determination: refers to the level of agency when engaging in sexual relationships or activities.
3. Consent: refers to the ability to arrive at consensual agreements about what you want or don’t want, and how freely consent is given.
4. Safety: refers to aspects of a sexual relationship or encounter that make you feel safe or unsafe, methods of protection against sexually transmitted infections (STIs), (including HIV) and contraception, and use of drugs, alcohol or other substances that affect sexual safety.
5. Privacy: refers to factors that affect privacy during a sexual encounter, control over level of privacy within a relationship or encounter.
6. Confidence: refers to the ability to express yourself in a sexual encounter, thoughts around body image.
7. Communication/negotiation: refers to the ability to talk about what you want, articulate what you find pleasurable and propose new things.

Talking about these seven factors was less confronting for the CSE educators than discussing the topic of sex positivity as a whole, and the researchers experienced no negative reactions when using this approach.

For educators to have the ability to separate personal values from the information to be imparted is essential to providing truly comprehensive sexuality education that addresses the realities of young people. The sex-positive educators had examined and rejected some of the socio-cultural beliefs they were brought up with, including gender bias and expectations. They were also accepting of young people’s sexuality and ready to acknowledge that young people engaged in sexual activity. They accomplished this through repeated trainings, ongoing discussions questioning sociocultural norms around sexuality with like-minded persons, and experience or observation of things like sexual violence, teenage pregnancy and its consequences, sexual desire and fulfilment and engaging in happy relationships.

What are some top tips for someone wanting to introduce a pleasure-based approach in their education or practice?

• Understand the socio-cultural context you are in, and work with young people and local experts on sexuality and history, to understand how pleasure-inclusive messaging can be integrated.
• Work with young people to obtain information about what they already know, and what they want to learn about in a safe and comfortable environment that allows them to discuss sex beyond topics of prevention.
• Plan for continuous training for sexuality educators and sexual health professionals that helps them to question norms around gender and sexuality, and enables them to practice talking about pleasure and build their knowledge, attitudes and confidence to be sex-positive.
• When designing programme goals and objectives, think beyond preventing ill-health or negative consequences, and aim to achieve the ideal sexual experience, in all its diverse glory, for all.

Alongside research, publications and campaigns around pleasure and sex-positive approaches, The Pleasure Project website has a trainer’s toolkit that helps train people for the first time on adopting a pleasure-inclusive and sex-positive approach.

The Pleasure Project

The Pleasure Project was founded in an attempt to make safer sex sexy. The Pleasure Project has built bridges between the public health world and the sex industry, including porn film makers and condom marketers. In this journey, The Pleasure Project has and continues to make strides and build a body of evidence around using pleasure-based messaging to promote safer sex and prevent HIV. The Pleasure Project has also seen the connections between pleasure and gender equity, women’s rights, and overall mental health and wellbeing. The organisation has worked to improve how the global health community communicates safer sex to people of all ages, all over the world.