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afabulouSEXcitingclasSEXercise. A World AIDS Week event. Goals. Everyone should leave realizing/appreciating: The impact of seeing a visual representation of statistics The value of addressing sexuality as a physician in the clinical setting For their comfort
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afabulouSEXcitingclasSEXercise A World AIDS Week event
Goals • Everyone should leave realizing/appreciating: • The impact of seeing a visual representation of statistics • The value of addressing sexuality as a physician in the clinical setting • For their comfort • For treating the "whole" patient • The diversity and spectrum of sexuality • The value of a behavior rather than identity based sexual history for assessment of HIV/AIDS risk • Having FUN
Clinical Significance of Sexuality • Spinal Cord Disability • how do patients maintain sexual intimacy? • Paxil and other SSRI’s • anxiety disorders worsen delayed orgasms? • MI’s and Angina • when do patients know they can safely have sex after d/c? 2 flights of stairs w/o angina? • Sexually transmitted diseases • frequently discussed when talking about sexuality, but who is actually at risk?
What puts a person at risk for HIV/AIDS? • Exposure to blood, semen, vaginal secretions (including menstrual blood), and breast milk • Possible risk behaviors include: • anal, oral, or vaginal sex (without a condom) • sharing needles (for injectable drugs, for tattoos, piercings, or through accidental needle stick injuries • breastfeeding • It’s not who you are, it’s what you do…
Human Sexuality SurveyOverview • Originally created by Albert Einstein College of Medicine’s Reproductive System Pathology Course • Study: Fall 2002 PennMed MS1, MS2
Human Sexuality SurveyPurpose • Bring statistics to life as a visual representation • Demonstrate the broad variation within human sexuality • Appreciate this spectrum of sexuality as physicians and as peers • Our specific World AIDS Week goal: to think about sexuality, identity, and behavior as risk factors for HIV/AIDS
Discussion – Questions • What trends are worth investing? • What stats are worth evaluating? • What questions should be looked at together or in pairs? • What issues do the questions bring up?
Discussion – Trends • People that have used bondage or sex toys in their sex lives are more likely to be comfortable talking about them with their patients. • People who have sex daily or weekly are more likely to think that sex is a very important part of people’s lives. • Many people who self identify as straight wish there was a place where they could talk about their sexuality.
Discussion – Trends • The number of men who have had unwanted sexual experiences is similar to the number of women. • Women are less likely to tell if they have had an unwanted sexual experience. • People who masturbate less often are more likely to be dissatisfied with their sex lives. • People who have faked orgasms have sex less frequently.
Discussion – Trends • Some people who self identify as straight have either fantasized or had a sexual experience with a member of the same sex. • Men and women fake orgasms with the same frequency.
Summary of Significance Sexuality issues pertinent to physicians that this survey raises: • Physician Comfort Level with Sexuality • Spectrum of Sexual Practice • Variations in Human Sexuality • Sex Values and Myths • Sexual Orientation vs. Behavior • Sexual Orientation vs. Sexual Behavior • sexual behavior varies widely both across and within sexual orientation groups • it’s not safe to assume a level of HIV risk without asking about specific behaviors • it’s not who you are, it’s what you do
Summary of Significance Sexuality issues pertinent to physicians that this survey raises: • Women’s & Men’s Health • Rape/Abuse – Overcoming Silence • Sexual Dysfunction • Need for Sexual Counseling in Medicine • Validity of Survey/Stigma of Sex
Acknowledgements • Special thanks to AMSA’s Committee on Gender and Sexuality • Thanks to Albert Einstein College of Medicine’s Reproductive System Pathology Course for assistance with the original survey • Thanks to Dr. David Chu, for providing background for this presentation and survey
Human Sexuality SurveyQuestions • Identification • Question #1,2 • Comfort Level • Question #3,4 • Physician/Sexual Hx • Question #6 • Personal Practice • Question #7,8,9,10 Q#4:MS1 = 51 MS2 = 75 Q#6:MS1 = 42 MS2 = 58 Q#8:MS1 = 45 MS2 = 87 Q#9:MS1 = 89 MS2 = 90 Q#10:MS1 = 45 MS2 = 26
Human Sexuality SurveyQuestions Q#13:MS1 = 49 MS2 = 71 Q#16:MS1 = 14 MS2 = 38 • Sex Values/Myths • Question #12,13,14 • Sexual Orientation vs. Behavior • Question #16,17,18,19 • Rape/Abuse • Question #21,22,23,24 Q#17:MS1 = 19 MS2 = 72 Q#19:MS1 = 43 MS2 = 72 Q#21:MS1 = 21 MS2 = 47 Q#22:MS1 = 17 MS2 = 22 Q#23:MS1 = 15 MS2 = 13 Q#24:MS1 = 1 MS2 = 5
Human Sexuality SurveyQuestions • Sexual Dysfunction • Question #25,26,27 • Need for Sexual Counseling in Medicine • Question #29 • Validity of Survey/Stigma of Sex • Question #30 Q#25:MS1 = 1 MS2 = 5 Q#26:MS1 = 1 MS2 = 5 Q#27:MS1 = 49 MS2 = 71 Q#29:MS1 = 19 MS2 = 72 Q#30:MS1 = 43 MS2 = 72