To reach youth with contraceptive information, could sexual pleasure be the game changer?
By: Christine Odour, Digital Health Program Manager, PSI/Kenya and Emma Beck, Associate Communications Manager, PSI
Whether it’s business as usual, or even now – as we respond to COVID-19 –young people need the sexual and reproductive health (SRH) tools and knowledge to own their health and life choices.
But with persistent barriers to SRH services, we know that to truly understand what it takes to meet youth SRH needs, we need to widen the lens from which we reach and serve our youngest consumers.
Sexual pleasure as an entry point, our early research has found, could be the game changer – and digital platforms could offer the medium to meet young people’s needs, all from the palm of their hands.
After all, neither sex nor the desire for pleasure pauses for a pandemic.
Pleasure-Forward… from the Palm of Consumers’ Hands
While the literature remains limited on sex-positive messaging across low- and middle-income countries (LMIC), research with young people in high-income countries indicates that pleasure-forward content can lead to positive sexual and reproductive health (SRH) outcomes. And with existing evidence proving the efficacy of digital services in linking young people to SRH resources and care…. well, we knew the framing warranted further focus.
We convened 84 Kenyan university students aged 18-29 from rural, peri-urban and urban backgrounds. Through a variety of gender-segmented focus groups, we sought to understand the nuances of sexual pleasure (from perception to comfort level) and identify how we could integrate digital platforms to reach young people with the information they said wanted, on their own terms.
We outline below what we’ve learned and where we see opportunity as we look ahead.
Defining the Terms
The International Planned Parenthood Federation defines sex-positivity as:
“…an attitude that celebrates sexuality as a part of life that can enhance happiness, bringing energy and celebration. Sex-positive approaches strive to achieve ideal experiences, rather than solely working to prevent negative experiences. At the same time, sex-positive approaches acknowledge and tackle the various risks associated with sexuality, without reinforcing fear, shame or taboo surrounding the sexualities of young people.”
The Pleasure Project adds:
“A pleasure-based approach measures empowerment, agency, and self-efficacy by whether or not an individual has been enabled to know what they want, and can ask for it, and request this of others, in relation to their sexuality, desires and pleasure.”
Based on these frameworks, we dove into our research to understand young people’s comfort with conversations around desire, their ability to negotiate consensual and pleasurable sex and their know-how when it comes to protecting their SRH.
What We Found
1. For young Kenyans, prevention is not top-of-mind. They will go to a clinic, but only once extreme health risks arise.
2. Google > Providers. Why? Simply, Google is non-judgmental. Young people Google to self-diagnose and treat. But it’s fear that drives young people to turn to Google, rather than proactive measures to make healthy choices well before symptoms present.
3. Confidentiality is key, and time efficiency is valued. Young people want SRH information at their fingertips, without others knowing what they’re searching for.
“Google is my 1st go to place whenever I experience signs and symptoms that could be STI related. I also google possible treatment options from the diagnosis I get online and will only go to hospital to see a doctor should the symptoms get worse”
R5, Nairobi Kenya
“I don’t talk to my parents, siblings or friends…. that’s the last thing on my mind, it’s like confirming to my parents or older siblings that I am having sex. Doctors are quite judgemental even when we go to ask for contraceptives, how can we go to ask for a service that s STI related? The internet is the best option. It’s quick and you are not subjected to questions to make you feel guilty. The only problem is the information we get is sometimes alarming, you are either diagnosed with HIV or cancer even when that may not be the case.”
R8, Machakos Kenya
Sex, Pleasure and Social media
1. Looking for content on pleasure? Kenyan youth say they want to engage with sex-positive content but don’t have access to curated content from credible sources. They turn to porn sites to learn about sex and encrypted social media platforms like Telegram to share X-rated content.
2. Gay young women feel most comfortable seeking sexual pleasure in partnership. In contrast, heterosexual females view pleasure in sex as reserved for men – and use sex toys to please themselves, albeit in private.
3. Straight men want to seem “informed” about sex.They felt that failing to please a woman, would result in women finding another man.
“Women know how to pleasure fellow women better…it is also very comfortable talking to my girlfriend about these things, we are very open with each other and I think I’m doing a good job taking care of her needs as she does the same for me. When you express your pleasure desires to a male partner, you are viewed as a hoe* or domineering, something the male partners don’t like”
R2, Nairobi Kenya
“I get pleasure content from porn hub…you know I can’t appear not to know what I’m doing should my girlfriend accept to have sex with me…I have to be on top of my game or another man may give it to her and take her away from you”
R7, Nairobi Kenya
To reach young people, the convergence of sexual pleasure and digital platforms is promising – and, as our early research suggests, the opportunity could be right at our fingertips.
1. When young people seek SRH information once an issue presents – rather than as a proactive measure taken in advance – they miss the opportunity to talk to a provider to get the right diagnosis or advice. In doing so, we’re missing an opportunity to build a lifetime of users.
2. According to young people: Facebook is “dead.” Youth-driven channels offer a viable alternative. Most participants had inactive Facebook accounts, or expressed disinterest with the platform given its wide use among Kenyan parents. With Facebook no longer viewed as a safe space to engage, young Kenyans have increasingly turned to youth-driven social media channels, including Instagram, Snapchat, Telegram, TikTok, Viskit and WhatsApp.
3. Could a sex-bot—an SRH chatbot that layers in sex-positive messaging – be the answer? Kenyan youth would rather talk to private chatbots over humans for SRH questions (with the caveat: our target audience is, predominantly, digitally literate and would have internet access). Our focus group preferred structured chatbots with predefined algorithms, over chatbots that function via Artificial Intelligent chatbots. The latter – developed using “American” English –didn’t recognize slang common among Kenyan youth. This frustrated users, resulting in decreased engagement. The focus group preferred engaging with a chatbot on a website over Facebook messenger given the sense that a website offered greater anonymity.
4. A chatbot could make the link between information and services… for instance pairing users to the closest clinics with youth-friendly providers or offering the ability to buy products online (i.e. HIV self-testing, pills, condoms, emergency contraception).
5. An automated system would offer insight into consumers’ pathway to care. The real-time data would give us sharper understanding of young people’s pain points in accessing information, and how we can pivot, in response.
Eager to learn more? Email Christine Oduor (firstname.lastname@example.org).