PSI is Bringing Sexy Back

This piece was originally featured on the Medium blog.

By Andrea Novella, Social Business Global Digital Advisor and Arzo Kaderi, Social Business Associate Project Manager, PSI

Why Pleasure-Positive Content Might Just be the Key to Safer Sex

Let’s talk about Sex.

Talking about sex — specifically how we talk about it — is one of the most powerful ways we can impact health programming for youth.

Although pleasure is one of the main drivers of sexual behavior, when it comes to the majority of health programs, the approach is the opposite. Too often, sexual and reproductive health (SRH) programming is solely focused on preventing negative outcomes such as unwanted pregnancy or sexually transmitted infections, resorting to fear tactics– a blind spot which ignores the potentially positive aspects of sex as an entry point for encouraging healthy sexual behaviors.

So why aren’t we seeing more sex-positive, pleasure-forward programming? The evidence base demonstrating a positive impact on healthy behaviors and outcomes in relation to adolescents and young people in low- and middle-income countries is limited. This lack of evidence, in combination with deeply rooted social norms and taboos around sexual pleasure, is, in part, to blame.

Shifting the Narrative Around Sexual Health

Thanks to global advocacy efforts led by organizations such as The Pleasure Project, The Case for Her and the World Association for Sexual Health, among others, the global discourse has begun to shift. Sexual pleasure is being recognized as both a universal human right as well as a component of good health and well-being, as recognized by the World Association for Sexual Health (WAS) in the Declaration of Pleasure in 2021.

Population Services International (PSI), with the help of the Foreign, Commonwealth & Development Office (FCDO), is helping to support this transformational evolution in the sexual health narrative.

PSI is bringing sexy back to sexual health by incorporating pleasure-forward content into its programming and taking it one step further by conducting quantitative and qualitative research to contribute to the growing body of evidence on the impact of sex-positive content.

With the support of FCDO in 2019, PSI developed NENA, a sex-positive chatbot in Kenya providing on-demand sexual health information using popular social media channels and gamification principles. The original NENA bot helped young people navigate sex and sexiness while an additional sprint with FCDO added a layer of pleasure-forward content that turns the bot into a platform we can use to better understand how pleasure-forward content can potentially influence sexual and reproductive health-seeking behaviors among Kenyan youth. To test the hypothesis, PSI invited chatbot users to participate in a mixed methods study to assess changes in sexual pleasure and reproductive health attitudes and behaviors. We also captured and analyzed social media analytics to measure whether pleasure-forward content was a cost-effective and socially acceptable way to meaningfully engage with youth.

“[In] our culture, when we were growing up no one really wanted to tell you how sex is…”

As a part of the initial diagnostic phase of the program, PSI conducted qualitative interviews to understand the needs and expectations of potential users and guide the design of novel sex-positive content. These interviews revealed that although young Kenyans wanted sex-positive content, they didn’t feel they had confidential, credible and curated sources and spaces for sexual health questions and care. Without options, they turned to porn sites to learn about sex and encrypted social media platforms like Telegram to share X-rated content. As a result, they only went to clinics when dire health-risks presented, otherwise opting for Google to self-diagnose.

A Chatbot to Change Your Life?

Building on previous design sprints and formative work among young Kenyan adults, NENA was designed to deliver novel sex-positive content related to genital health, health communication with sexual partners, sexual pleasure, and pleasure-focused practices such as orgasms and masturbation. This content was added to a menu of more traditional SRH content deployed by PSI, which includes an algorithm designed to provide information around STIs as well as contraceptive counseling and method information.

[The chatbot] helped me to know how to communicate with my partner when it comes to sex. It helped me so much. I can now talk with her. I [also now] know what I’m supposed to do when it comes to use of contraceptives. What I’m supposed to do so that we don’t get unwanted pregnancies. Who to contact and where to go when I have a problem. Yeah, it has impacted my life in a way. It has changed the amount of pleasure. I can’t say it has changed it in a bad way. It has changed it in a better way. Nowadays I can access the sex without fear. I can say [the chatbot] has increased [the amount of pleasure experienced]. I don’t know how you can explain it there but I can tell you that it has increased it. [Young Kenyan Man, 18–24]

It was good because it tackled like every question there is to know about sexual education, I liked how it was broken down in terms of contraception and pleasure and things like those it helps one have a broader idea of like sex and topics like those that we feel like are normally a taboo especially in our culture, because when you look at it our culture when we were growing up no one really wanted to tell you how sex is what sex is like, how to you know prevent yourself from getting pregnant or getting an STI’s situation like those you find we learn on our own and Nena has created a platform where at list our questions can be answered. [Young Kenyan Woman, 25–29]

Though preliminary data supports PSI and FCDO’s belief that pleasure-forward content is an integral part of a positive, supportive and more holistic health ecosystem, research is still ongoing and PSI will produce a publication of results upon completion. Still, initial insights are promising as we are seeing pleasure-forward content as not only acceptable to Kenyan youth but even strongly preferred. There is an opportunity to disrupt the narrative around SRH, leading to more meaningful engagement and better health outcomes.

While analysis is ongoing, initial observations about pleasure-forward content include:

  • It’s engaging: Pleasure-forward content may serve as a “hook” to lead to sexual health information. Analyzing early chatbot interactions, PSI is finding that sexual pleasure content serves as an important access point for bot interactions with follow through to more traditional SRH content.
  • It’s impactful: Pleasure-forward content was nearly five times more effective at driving demand generation when compared to standard pregnancy and STI prevention focused messaging.
  • It’s effective: In A/B testing of social media ads, layering pleasure with SRH content outperformed SRH-only advertising, proving to be more cost-effective by having higher traffic for the same cost. This creates opportunities to leverage efficiencies in funding and increase the impact of our programming. In some instances, the cost effectiveness measured up to 85%.

We’re Going ALL THE WAY!

PSI will continue analyzing and exploring pathways to and through this chatbot, and the links to intention formation and utilization of SRH services, to continue to meet young people’s SRH needs through pleasure-forward and SRH content.

Moving forward, PSI aims to catalyze the initial investment from donors, including FCDO, in the “pleasure bot” project in Kenya and scale-up its impact across other markets. Leveraging learnings from Nena, PSI has launched Viya — its new global lifestyle brand — in South Africa, with additional countries to follow. Viya builds on the existing PSI offer and expands it to a comprehensive, digitally enabled platform that brings together information, products and services and provides a safe space for women to connect on topics around SRH all the while building on the foundation of social marketing and sustainability. The goal is for Viya to support women through their entire lifecycle, across every stage of the SRH journey by equipping women with the tools needed to make the right choices for their bodies, health and future. Nena is part of this overall vision and the learnings from this bot will support PSI in delivering Viya around the world.

Expanding into new markets will enable PSI to continue gathering evidence around this topic, but further research and development, as well as support from partners and donors, will be required to help go “all the way” in developing acceptable and effective pleasure-forward SRH programming and growing the body of evidence around the impact of sex positive content.

For further reading on the Pleasure Bot, please click here.

Banner photo credit: Evelyn Hockstein.

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Let's Talk About Sex