Sexuality Matters!
Norad Seminar on Sexuality and HIV Prevention Work
17 April 2008 9 a.m. – 12 noon
Background
During the winter 2007, Norad and Aidsnett identified sexuality as an important issue for discussion for those
working in HIV and AIDS. On 17 April 2008, Norad arranged a seminar on the role of sexuality in development
work and its links with gender issues and HIV prevention. The seminar was led by Jill Lewis.
Jill Lewis has been engaged with gender and sexuality issues since the 1970s. As a researcher and an
educator, she has worked in a large number of countries and regions, including 10 years in Norway. During her
time in Norway, Jill was an active member of Aidsnett and when working at the Nordic Gender Institute (NIKK),
developed training materials for ‘Living for Tomorrow’ - a youth, gender, and HIV/AIDS prevention project. Jill
has also worked with the Norwegian Refugee Council on capacity building around gender and sexuality issues
among staff.
Jill’s presentation drew upon her training workshops in different settings to illustrate her points.
Main message: HIV and AIDS require us to take a critical look at sexuality issues – issues that are usually
shrouded in silence. Sexuality is a gendered arena which raises issues of sexual identify and power. These
need to be examined and addressed in order to develop effective HIV prevention activities.
Sexuality Issues
 Discussing sexuality risks polarising discourse as it disturbs ideas we all have about what we consider
to be ‘normal’ and ‘deviant’.
 Sexuality is embedded in silence which makes related issues even more difficult to address. Despite
the commercialisation of sex, there are vast areas of silence. In Jill’s experience, this silence is
universal from Norway to developing countries. Discussions with girls at two schools in Oslo brought out
the fact that girls did not talk about sex with friends or with parents.
 Taking up sexuality issues requires that we ask questions that often take us beyond our comfort level
and understanding.
 This silence erases knowledge of our sexual body. HIV is spread through body fluids. The importance
of bodily fluids in prevention efforts is largely overlooked and they have different meanings for women
and men.
 Similarly, silence surrounds what is important for sexual pleasure for men and women and their
understanding of what is important for each other. Using an example from Europe, Jill related how
women found it difficult to tell men what they like and men in the same group thought that women
express what they want.
 Examples of exercises for addressing different aspects of sexuality were provided e.g. giving attention
to values; getting separate groups of girls/boys or women/men to reflect not only upon their own
sexuality but also upon how they think the other gender views these issues,1 and reflecting on gender
norms for earlier generations.
 It is important to identify the questions to be asked that get to the fundamental issues related to the
spread of HIV. What are the politics of sexuality? What are the underlying conditions that reproduce
sexual risk? What strategies might become really crucial in response to these? Examples of the kinds
of questions that can be posed to groups are provided in Annex 1 – 3 to this report.
1
Reference to Janet Holland, Caroline Ramazanoglu, Sue Sharpe, and Rachel Thomson, 1998, The Male in the
Head: Young People, Heterosexuality and Power, London: Tufnell Press
1
Sex is a gendered activity
 People have developed sensitivities to sexuality within a gendered situation. Gender norms around sex
are shaped by social, cultural, and historical factors.
 Gender differences are organised around power. Addressing issues of sexuality requires questioning
power relations and understanding how gender systems work.
 Categories of vulnerable groups has ‘erased the heterosexual male off the map’ with little attention
given to how men relate to their sexuality.
 Masculinity - what it means to be a ‘real man’: expectations, vulnerabilities, things that men do or
should not do – (‘boys don’t care’, boys do not take on nursing and caring tasks, men must take risks)
needs to be explored to see how this impacts on HIV prevention. Similarly, when girls’ femininity relates
to a lack of agency, this has implications for their ability to protect themselves from the spread of HIV.
 Sexual identities are not stable but fluid. With transgender and trans-sexual issues coming onto the
agenda, there is a wider spectrum of gender and sexual identities.2
Implications of this for HIV prevention
 The abstinence agenda has added to the silence. If you talk about sex, you are facilitating the thing that
must not happen.
 Current global attention is being directed towards AIDS treatment rather than prevention. Since the
virus is spread through sexual activity, one is again back to addressing issues relating to sexual
behaviour and attitudes.
 We often set up systems to deal with outcomes or symptoms rather than the underlying causes of
gender relations that can be damaging to women and men.
 It is important to address sexual risk more carefully by including an understanding of our sexual body
and gender identities to develop strategies that will more effectively help prevent the spread of HIV.
 The significance of bodily fluids is often overlooked along with the different meanings for women and
men. When asked ‘How do women have pleasure?’ one men’s group responded ‘ When a man’s juices
meet her.’ The HIV risk is apparent to women in this setting but not to men. This is the type of topic that
health education usually misses.
 In the western world, there is often a dependence on technical ‘fixes’ e.g. ARV, the morning after pill.
But, what does the morning after pill offer in the way of protection against HIV?
 Sex information is often medicalised in the name of good health! It should include gender norms,
politics, and the meaning of sex in different settings.
 Condom use brings together a number of the issues discussed throughout the morning: the lack of
direct talk around penetrative sex, the secrecy among sexually active young, gay, heterosexual, and
transsexual people, lack of understanding of body, and wider political constraints around sexuality
issues. Many men not familiar with condoms – they are worried about performance and are clumsy
when using them.
A fragment of a DVD on male voices in Sub-Saharan Africa on sexual realities and condom use was
shown.
Ingunn Klepsvik, Deputy Director, Norad launched the Norad condom
Ingunn welcomed the opportunity this seminar provided to launch the Norad condom. Norad’s Global Health and
AIDS Department has been creative in finding a way that Norad can contribute to taking away the stigma
associated with condoms.
Marilyn Lauglo
Centre for Health and Social Development (HeSo)
Spring 2008
2
Reference to R. W. Connell, 1995, Masculinities, University of California Press
2
Annex 1
Formations of heterosexuality: the binary gendered
sexual scripts






What characteristics do you think are most valued in men where you are living?
What characteristics do you think are most valued in women where you are
living?
What, in your opinion, makes a man a good husband?
What, in your opinion, makes a woman a good wife?
What, in your opinion, makes a man a good lover?
What, in your opinion, makes a woman a good lover?

In general, how important do you think the following aspects of sex are
for men usually in a sexual relationship with a woman? (tick one box for each
aspect).
Very
import
ant
Fairly
import
ant
Uncert
ain
Fairly
Very
unimp unimpo
ortant
rtant
a) feeling intimacy and trust with her
b) strengthening the relationship
c) talking about their feelings
d) touching her sexual areas
e) telling her they love her
f) being touched sexually by her
g) using contraception to avoid pregnancy
h) talking about what they enjoy sexually
i) having sexual intercourse (e.g. putting
penis into vagina)
j) giving physical pleasure to her
k) wearing a condom during sexual intercourse
l) trying out different ways of having sex
m) giving oral sex to her
n) receiving oral sex from her
o) making sure she has pleasure
p) having an orgasm/ejaculating themselves
q) avoiding STIs
r) making her pregnant

What do you think women want most from a sexual relationship with a man?
3

In general, how important do you think the following aspects of sex are for
women usually in a sexual relationship with a man? (tick one box for each aspect)
Very
Fairly Uncert Fairly
Very
import import
ain
unimp unimport
ant
ant
ortant
ant
a) feeling intimacy and trust with him
b) strengthening the relationship
c) talking about feelings
d) touching his sexual areas
e) telling him they love him
f) being touched sexually by him
g) using contraception to avoid pregnancy
i) having sexual intercourse (e.g. receiving
penis into vagina)
j) giving him physical pleasure
k) that he wears a condom during sexual
intercourse
l) trying out different ways of having sex
m) giving oral sex to him
n) receiving oral sex from him
o) making sure their partner has an orgasm
p) having an orgasm/ejaculating themselves
s) avoiding STIs
t) becoming pregnant

Here are some statements about sexual relationships between men and women.
Do you think they are true or false?
Please circle appropriate number for each reply.
definitely
true to
false to
definitely
true
some
some
false
extent
extent
A. Men tend to want sexual intercourse
1
2
3
4
more than women do
B. Sex between a man and woman usually
1
2
3
4
focuses on the woman's sexual pleasure
C. Men know more about sex than women
1
2
3
4
D. Women are more active in sex than men
1
2
3
4
E. Women want to be guided in sex by
1
2
3
4
sexually experienced men
F. Men prefer women who are less assertive
1
2
3
4
and who like men taking the initiative
G. Women are more concerned to please a
1
2
3
4
man during sex, than they are to experience
4
pleasure themselves
H. Sex is something men find it difficult to
talk about with their partners
I. Sex between men and women tends to
stop when a man has had an orgasm /
ejaculated
J. Women tend to feel more uncomfortable
about their bodies during sex than men
K. Men have just as many anxieties about
sex as women
L. Women enjoy the physical side of sex just
as much as men
M. Emotional closeness during sex just as
important to men as it is to women
N. Male violence against women is judged
very negatively by women
O. It is common for men to force women to
have sex with them
P. Women tend to want sexual intercourse
more than men
Q. Men want to be guided in sex by sexually
experienced women
R. Women find it difficult to tell their male
partners what they dislike sexually
S. Men know what they want from sex more
than women do
T. Male sexual violence against women is
judged very negatively by women
U. Women find it difficult to tell their male
partners what they find sexually enjoyable
V. Men's sexual pleasure is considered more
important than women's
W. Sex between a man and a woman often
involves force or violence
X, The most frequent reason people have
sex is to make babies


1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
definitely
true
false to
some
extent
3
definitely
false
1
true to
some
extent
2
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
1
2
3
4
4
What do you think men and women both want in common from sex?
Do you think that sexual relationships between young men and women today are
different from the relationships people had (your parents, grandparents) 30 years
ago?
5
Annex 2
The Beijing Platform for Action (Paragraph 96) states:
The human rights of women include their right to have control over and decide
freely and responsibly on matters related to their sexuality, including sexual and
reproductive health, free of coercion, discrimination and violence. Equal
relationships between men and women in matters of sexual relations and
reproduction, including full respect for the integrity of the person, require mutual
respect, consent and shared responsibility for sexual behaviour and its
consequences.

What do you see as the potential sexual implications for women and girls in relation to
this statement?

What do you see as the potential sexual implications for men and boys in relation to
the statement?

How would you formulate the statement on equivalent sexual rights for men, that could
stand alongside this Beijing Platform for Action statement ?

What could you add to the statement below, or what might you want to change, to make
it more comprehensive about human rights, gender equity and sexual empowerment?

What are some of the challenges or main obstacles you can imagine people may
encounter in attempting to anchor the rights outlined below in their own lives, families or
communities?
 What are some of the issues related to HIV that this statement, and the above questions,
might imply?
6
Annex 3
Sexual rights in sexual situations
An activity to open discussion about challenges of conceptualizing sexual rights and sexual health
Preparation:
* List of related questions to hand to each participant
* List of sexual situations (expand or edit attached list to catch familiar possible situations))
People pair up.
Each participant selects 2 numbers between 1 and 54
Hand out the list
Directions to participants:
Consider your responses to one of the 2 sexual situations that correspond on the list to the
numbers you chose, in response to the listed questions.
First take time to think through and note some of your own responses (5 mins), then
present one of the situations and your responses to a partner (10 mins):
A. What issues of sexual rights are at stake in this sexual situation?
What rights are at stake for all those involved?
Are any rights violated? What is causing any violations of sexual rights?
B. How might this situation be conducive to sexual health?
How might this situation be damaging to sexual health?
C. How might this situation challenge gender inequality?
How might this situation reinforce gender inequality?
D. How would you engage from a human rights/ sexual empowerment/ gender
equity perspective with someone who presented this situation?
Finally participants regroup together and each pair present some of the situations and the
ideas in response to question ‘D’ they came up with, followed by an open discussion about
ways responses to this issue could affect programming (Flip chart and notes taken from this
feedback).
Sexual situations
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
An unmarried man regularly visiting a sex worker
A married woman exchanging sex for food and gifts outside her marriage
A married person frequently having sexual relations outside marriage.
A man assuming he can have sex with his wife whenever he wants
A women refusing to have sex with her husband
A husband refusing to have sex with his wife
A woman having sex with her husband for years without experiencing pleasure.
A married man having sex sometimes with men
A son refusing to marry against family expectations
The re-instatement of compulsory virginity examination of girls before marriage
Requiring obligatory HIV tests before marriage is allowed.
7
12. A married woman insisting on her husband using condoms with her.
13. A married man insisting on using condoms with his wife.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
A man regularly watching pornography
The requirement that women cover certain parts of their bodies
Willingness to have sex being argued as a proof of love
Same sex partners seeking marriage or religious blessing
Non-condom use being argued as a proof of commitment
A girl having older men sponsor her education in exchange for sexual services
A woman demanding more frequent sex from her husband, & more varied ways of making love
A man demanding more frequent sex from his wife, and more varied ways of making love
A young woman performing oral sex on her partner
A young woman, made pregnant by her uncle, having an abortion
A woman compelled to stay living with a violent partner
A man staying abstinent because of fears of having an STI or genital anxieties
A man performing anal sex with his wife
A man performing anal sex with a male partner
A teenage girl who masturbates and is fearful of its consequences
A biological woman wanting to circulate ‘as a man’ & have sexual relations with women
A teenage boy who has regular sex with a woman 10 years older than him
A teenage girl who is in a sexual relationship with a man 20 years older than her
A black young man being ostracized by his family and community for being in a sexual
relationship with a woman of another race
A father who visits a brothel regularly
A girl of 12 who has found out she is pregnant
A mother of four who finds herself pregnant against her desire for any more children.
A man dressing in feminine clothes and having sex with married men.
A girl of 12 getting her period and thinking she is dying
A woman wanting sex to be without a condom with a new partner
A member of staff who is rumoured to be gay and HIV+ being forced to resign
A wife bleeding every time her husband has sex with her.
A woman divorced because of adultery
An HIV positive woman who wants to have a baby with her husband
An HIV positive man who feels under pressure to produce children
An HIV positive man aged 20 who wants to be sexually active
A married HIV positive woman
A married woman holidaying in Gambia with sexual involvement with local man
47. A married man regularly visiting sex workers for more ‘imaginative’ sex than practiced with his wife
48. A married woman with an older husband who has two other regular sexual partners
49. Nordic students going for weekends to Copenhagen or Estonia for weekend sex outings with
Baltic country sex workers
50. A gay man married to a woman, who (he) cruises for sex with men
51. A married man wanting to transition to MTF
52. An orphaned boy selling sex for means to live
53. A teacher who deals in Sexually Transmitted Grades
54. A woman only wanting same-sex relationships being forced by traditions to marry a man
8