Sexual interventions – WHO guidelines addressing big questions

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Practicing self-care (even self-care that involves sexual intervention) may sound like something that has nothing to do with health, but it’s not something that has emerged solely because of mindfulness or the various health fads that come and go.

In fact, people around the world have been practicing self-care for thousands of years. The position of “doctor” has not always existed. Communities large and small have had to learn how to take care of themselves. This includes making medicines, ways to stay healthy, and preventing disease.

As the coronavirus pandemic upends life, WHO is peering out from its digital offices to remind the world we need to get back to basics – including contraceptives and testing for sexually transmitted infections.

New WHO guidelines

The first thing to remember is that this whole thing is labeled a “guide to living.” That’s just a fancy way of saying that things change as research brings new ideas—and those ideas have to be vetted.

Still, even with the changing guidelines, it’s still a better resource than what some countries are dealing with. This is even more important considering some people’s primary care may be closed without notice based on random COVID rules.

“We still need further data and rigorous research to ensure there is a strong evidence base to drive the introduction, use and scale-up of self-care interventions,” said Dr Soumya Swaminathan, Deputy Director-General of WHO.

What are the exact guidelines?

Here’s a mix of old and new self-care advice *copied directly from the WHO website…

• Pregnancy self-tests available over the counter
• Emergency contraception pills available at pharmacies
• Providing lubricants to help individuals improve their sexual health and pleasure
• Self-supplementation with iron and folic acid before, during, and after pregnancy
• Self-monitoring of blood sugar during pregnancy
• Self-monitoring of blood pressure during pregnancy

After these examples, the document goes on to say that all recommendations need to be accompanied by…

1. Human rights and gender equality *

2. Financial considerations (and economics)

3. Training of key staff/professionals

4. Different factors need to be considered for different groups of people

5. Digital health interventions

6. Environmental considerations.

* “Reproductive rights include certain human rights that have been recognized in national laws, international human rights documents and other consensus documents. These rights are based on the recognition of the fundamental right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children, and to have access to the information and means to do so, and to the highest attainable standard of sexual and reproductive health. It also includes their right to make decisions about reproduction free from discrimination, coercion and violence, as expressed in human rights documents ([32]paragraph 7.3).

Several big questions

There are also some interesting passages devoted to holistic and life course approaches. However, two highlights were surprising – “self-sampling for human papillomavirus (HPV) testing to improve cervical cancer screening, and self-injectable contraceptive injections.”

These two ideas, especially the second, are the key to sexual activity.

However…

With these international guidelines, What does this mean for governments that are sending mixed messages? Sexual self-care (and even self-wellness in general) is a wonderful thing, but what if it leaves you broke?

For example, the U.S. healthcare system is notoriously bad. Families are rationing medications like cancer drugs and diabetes injections. These drugs are essential for survival and are already unaffordably priced—unless you’re lucky enough to have a job that provides good health insurance.

How much does it cost to buy a self-administered HPV test kit and self-administered contraceptive injections?

So what about states’ regulation of sexuality, from sex change to the availability of contraception? The World Health Organization can make all the recommendations it wants, but that doesn’t mean everyone will act on them.

Then, there’s the fact that some areas of the developing world don’t have the infrastructure to get any of these self-care pathways (even taking into account the economic and demographic factors the WHO mentioned earlier). And let’s not even mention the “rumor” that they get all the expired drugs so that big pharma can make extra money.

Conclusions of sexual intervention

While this isn’t a crazy conspiracy theory, we can’t ignore the fact that all of these sexual interventions (especially sexual health interventions) are like putting a bandaid on a broken leg. At the end of the day, does it really work?

what do you think?