Sponsored by:
 
 
Dr. P. Ganesan Adaikan, PhD, DSc, ACS ( USA ).
 
OVERVIEW OF MALE AND FEMALE SEXUAL DYSFUNCTION
 
Some degree of erectile dysfunction (ED) affects around half of all men over 40 years. The common complaint in this group of patients is difficulty with either getting an erection or maintaining it long enough to allow for satisfactory sexual activity. There are a number of causes for ED which includes physical / medical problems affecting the blood supply and neurological function in addition to psychological aspects such as stress, fatigue, anxiety, partner conflicts and unresolved family issues. Sexual dysfunctions could also be due to the side effect of prescription medications such as treatments for high blood pressure or depression. Both alcohol and cigarette smoking have deleterious effects on sexual performance by complex mechanisms. Obesity and high cholesterol levels affect the blood circulation as well as the hormonal status of testosterone which is needed for libido and sexual arousal. In the process of restoring intimacy, ED and related sexual problems need to be understood and addressed from time to time. Impotence can lead to secondary infertility, as afflicted individuals tend to avoid marital relationship, become depressed and lack normal desire and frequency of sexual intercourse. Hence, w ith holistic approach of counselling and couple therapy, the success rate in the treatment of ED can reach its full potential. The other types of male sexual dysfunctions include ejaculatory and orgasmic disorders and impairments of libido / desire. Ejaculatory problems may be clinically classified according to the presence or absence of the sensation of orgasm. Orgasmic ejaculatory disorders include premature ejaculation , r etrograde ejaculation , a spermia, retarded, weak or painful ejaculation . Anorgasmic ejaculatory disorders are less common and comprise primary and secondary anejaculation.
 
Fundamental scientific research in female sexual dysfunction (FSD) is an important area of sexual medicine that has been neglected over the decades at the expense of worldwide research and treatment interest for male sexual dysfunction (MSD). However, during the last 4 - 5 years, it is heartening to note that scientists have shifted part of their attention from MSD and have generated tremendous research interest in understanding the female sexual physiology and treatment options for FSD. Irrespective of the age, a commonly encountered FSD is the sexual desire disorder, a component of which is sexual aversion. This disorder may be aggravated by subjective lack of lubrication and vasocongestion of the genitalia during the peri- and post-menopausal period. Currently, arousal disorder is the main area of pharmaceutical interest and drug development. Other manifestations of FSD include orgasmic delays with aging and sexual pain disorder, which could also result from vaginal dryness and atrophic changes in this age group. With the holistic management of male and female complaints, couple satisfaction and sexual intimacy could be satisfactorily revived leading to improvements in quality of life.
 
Dr. Eli Coleman, Ph.D.
 
What is " Normal "?: Paraphilias, Sexual Obsessions, Compulsions, and Addictions.
 
Individuals with compulsive sexual behavior (CSB) are often unable to control their sexual behavior, act out impulsively and/or are often plagued by intrusive obsessive thoughts and driven behaviors. They often find their behavior to excessive experience serious consequences. CSB has been referred to as sexual impulse disorders, compulsive sexuality, sexual addiction, hyperphilia, hypersexuality, and paraphilias. This paper will discuss these various terms and the criteria being used for normal, problematic and the clinical syndrome. The associated symptoms or consequences of the clinical syndrome might often be seen in the physician's office in the form of anxiety, depression, somatic complaints, alcohol or drug abuse or dependency, exposure to HIV or other sexually transmitted infections (STIs), unwanted pregnancies, relationship discord, domestic violence, sexual dysfunction and or child abuse. The clinical syndrome may also lead to ethical, social and legal problems and a great deal of emotional suffering. These are all serious problems and should alert the physician to address the mental and sexual health issues and to particularly assess for CSB.
 
Dr. Sol Gordon, Ph.D.
 

Askable Parents Raise Sexually Responsible Children.

 
Don't operate on the assumption that nowadays young people know everything about sex. Where are they receiving their knowledge.from parents, schools, or religious institutions? No, most of what young people "know" they get from one another or pornographic videos, films, magazines or television. And most of it is just plain wrong!
 
Parents could be the best sex educators of their own children. I believe that the public will applaud the real sexual revolution - when one's sexual behavior is private, moral, responsible and pleasurable. When people will respect each other, it will come. The question is: What do parents do in the meantime? It is useless to give messages like "just say no."
 
Five critical things parent need to know:
 
» Parents are the main sex educators of their children, whether they like it or not.
» Parents, if they want to be "askable," must be prepared for any question or incident that involves their children's sexuality. The best first response: "That's a good question."
» Parents must convey to their children that nothing that ever happens to the child will be made worse by talking about it to the parents. The best first response: "I'm so glad that you are able to talk to me about this."
» Children are not perfect and parents are not perfect. Young people make mistakes. It is up to the parents to turn kids' mistakes into opportunities for learning and growth.
» Failure is an event - it is never a person. Children who are loved and are guided by limits, grow into adults who like themselves and like others. They don't exploit others and are much less likely to let themselves be exploited.
» What to do now? Current reality obligates parents to have frank and knowledge-based discussions on issues such as: Where babies come from; penile erections; "wet dreams"; menstruation; penis and breast size; and using the correct names and language for intimate body parts. And masturbation needs to be discussed as normal and private.
 
Young people need direct advice from their parents on how to respond when someone says to you: "If you really love me you'll have sex with me." They need to know that this is always a seductive line used to trick and exploit a partner. They also need to know that if someone really loves you, he or she would never try to manipulate you in this way.
 
Dr. Cynthia Graham, Ph.D.
 

Contraception and Sexuality

 

Freedom from the fear of pregnancy, resulting from modern methods of contraception, has enhanced sexual enjoyment for vast numbers of people, especially women. However, the consequences of using contraception are complex and varied. One important issue is the significance of fertility for a given individual or couple. For example, for some individuals for sex to be enjoyable there must be at least the possibility of conception. Most commonly this is because of moral or religious reasons, but sometimes the prevention of pregnancy may affect an individual's sense of masculinity or femininity. For such individuals the use of an effective method of contraception may lead to decreased sexual interest or satisfaction. The question of which partner takes responsibility for contraception in a sexual relationship is also important. The consequences of using an effective contraceptive method are not always positive. For example, a woman, once free from concern about pregnancy, may become more sexually interested and responsive and her partner anxious about being able to meet her sexual needs. On the other hand, the elimination of risk of pregnancy may result in the man putting increased demands on the woman for sexual activity.
 
In addition to these more general aspects of fertility regulation, there are also the consequences of each specific method to consider. Despite the fact that contraception and sexuality are inextricably linked, there has been very little research into the effects of specific contraceptive methods on sexuality. This presentation will focus on the effects of oral contraceptives and condoms on sexual interest and enjoyment in men and women.
 
Dr. Debby Herbenick, Ph.D., M.P.H.
 

Talking and Teaching About Female Sexuality: What You Must Know to Educate Others.
 
In 1953, Dr. Alfred Kinsey and his research team published Sexual Behavior in the Human Female in the United States, a controversial book that shed light on American women's experience of sexuality. In the decades since Dr. Kinsey's ground-breaking research, scientists world-wide have continued to study the taboo topic of female sexuality. This presentation will review some of the key findings related to normative female sexuality, and how these findings relate to common questions asked by women and men. These topics include female anatomy (e.g., the clitoris, vagina and g spot), sexual desire, arousal, orgasm, pain during intercourse, female masturbation, the use of sexual enhancement aids (i.e., "sex toys"), sexual behaviors within and outside of marriage, and age-related changes. In addition, new data relating to men's and women's attitudes toward women's genitals (and how these attitudes relate to women's experience of sexuality) will be presented. Printed materials that provide information and additional resources will be available to those in attendance.
 
Dr. Prakash Kothari, Ph.D.
 

Common Sexual Problems - A utilitarian approach.
 
This is an approach which I follow in my clinical practice at KEM hospital. The model has been applied with more than 40,000 patients and has been found to be extremely effective, especially for this part of the world. The approach includes education, counseling, clearing of myths and misconceptions and understanding of the problem leading to positive transference. In addition there is an integration of modern psychological and medical techniques and practices with Ayurvedic, Yoga, and other traditional Indian knowledge in the therapy.
 
Manish Kumar, MSW.
 

Use of Interactive methodologies like board games, puzzles and magic tricks for sexuality education.
Adolescence (10-19 years), a vital stage of growth and development, marks the period of transition from childhood to adulthood. Adolescents are full of energy, enthusiasm and new ideas. During this period, adolescents tend to indulge in experimentation and risk-taking, of giving in to negative peer pressure, of taking uninformed decisions on crucial issues, especially relating to their bodies and their sexuality. In fact, adolescent sexuality, masculinity and femininity as concepts are inadequately understood and, due to social taboos, rarely discussed. As a result, distorted information often leads to exploitation, abuse, mental health problems and heightens the risk of HIV and other sexually transmitted infections.
Adolescents have specific needs and concern which have to be timely and appropriately addressed and that also in a very efficient, interesting and innovative manner. The methodologies and the tools being used for creating awareness on adolescent issues should be full of fun. As per our experience of working with adolescents in the last 14 years, we have found that entertainment education can play an important role in creating awareness on adolescent issues including sexuality education.
Since 1993, we have adopted and developed various methodologies for creating awareness on adolescent issues including sexuality education which are as follows:
 
» Magic
» Puppetry
» Activity games
» Board games
» Game shows
» Puzzles
» Mobile exhibitions
» Ventriloquism and dolls
» By claiming records in various record books like Guinness Book of World Records, Limca Book of Records.
 
All these methodologies have been developed by us with the active involvement of participants, especially young people. Due to the fun loving nature of these methodologies they have been very helpful in creating a discussion around sexuality. But while using these methodologies we have to be very careful about cultural beliefs and practices. The beauty of these methodologies is that they can be adopted by any community after making few changes.
 
Note: Author will provide a display and demonstration of all entertainment education materials which are approximately 150 in number at the conference. (if he will get permission from organizers).
 
Dr. Michael Lewis, Ph.D.
 
Shame, Guilt and Sexuality Education
 
The development of shame and individual differences in the self-conscious emotions will be presented.  Shame is an emotion that involves self attributions about ones failure vis-à-vis a societal rule or goal.  Children's temperaments (physiological reactions) and the social environment both determine the degree of shame they feel.  High shame children have difficulty with their sexuality especially as it relates to their feelings of disgust.  This perspective suggests that shame, disgust and sexuality are related and that individual differences exist early in life.  Its implication for sex education will be considered.
 
Prof. Dr. D Narayana Reddy, Ph.D.
 
Sex and the Ageing Indian
 
Sex plays an important role in our lives and sexual intercourse is an integral part of human physiology. Not only in the lives of the youngsters but also in the elderly. In spite of its significant role, the scientific study about the sexuality of the aging population has been neglected until very recently due to social taboos. But the wheels of change ushered in an era of much needed and awaited openness where social mores started to change and hence so did sexual norms. This has lead people to change with respect to their practices. Unfortunately this change was restricted to their private lives. It is believed that Indians have not changed with respect to their public sexual behavior and continue to languish in the shackles of conservatism.
 
The average life expectancy of Indians has increased many folds since the 1950s due to advancements in the medical sciences and greater availability of Medicare. In the next ten years India will have a huge chunk of aged and aging population. Unless the health needs ( both sexual and nonsexual )are understood and appropriate health care is rendered, the country will be burdened with an ailing population which may have a bearing on the growth of the community.
 
A lot of misconceptions are prevalent in the community regarding sexual behavior of the aging Indians. It is assumed by all segments, from the scientific fraternity to the media, that the aged are asexual and are not bothered about sex. And sexual behavior shrouded in conformist restraints. But the last twenty-five years of exclusive Sexology clinical practice by researchers have proved how grossly unfounded the above-mentioned assumptions are.
 
The authors have made an attempt to document the sexual behavior and problems of about 2000 persons between the age groups of 50 – 91.
 
The objective is to essay the actual sexual practices of the aging population and the problems faced by them, so that the researchers in India need not have presumptions. This data will be useful for all those involved in the planning of sexual health programmes keeping in mind the needs of the aged and the sexual health care fraternity in general.
 
This study is not intended or meant to be judgmental. While it may not reflect the sexual behavior and problems of the entire aged Indian population, it is by far and most probably the only study of its kind. The study subjects belonged to 15 states of India . Hence it is a good indicator of the sexual behavior, sexual health and concerns of the community. Further, large scale and truly representative study has to be undertaken if a definitive picture is to be obtained.
 
It was observed by the authors that contrary to popular belief the aged are interested in active sex lives. Unfortunately they do not have access to non-judgmental healthcare agencies to discuss and address their needs and concerns. This study highlights their sexual practices like coital frequency, masturbation, extra-marital sex, fantasies, sexual problems and their sexual apprehensions.
 
Dr. Liu Dalin, Ph..D.
 
Modern Chinese Sex Education and the role of the China Sex Museum in Tongli
 
The China Sex Museum was established in 1995 in the suburbs of Shanghai . In 1999, it opened for the public in downtown Shanghai and then in 2004 the Museum moved to its permanent home in a heritage mansion and gardens in Tongli with a satellite exhibition in Shanghai . The collection includes more than 4000 pieces of Chinese sex-related antiques -- the oldest piece is 9000 years old. The main purpose of the China Sex Museum is sexuality education and the role of sexuality in Chinese culture and history. Since sex education, sex research and erotica were not acceptable during the past era there is widespread ignorance regarding sexuality in China . The Museum's goals are to: Educate people about China's sexual history; to reveal the naturalness of human sexuality; to reveal the role of sexuality in traditional culture; to show the richness and individuality of the private lives of individuals during the long history of China as illustrated through the materials in the collection; and to demonstrate that there is nothing new in sexual behavior. There is now strong public and private support for the museum and its mission.
 
Dr. Vickie Mays, Ph.D., M.P.H.
 
Human Sexuality Education as a Tool Against HIV/STI
 
There have long been debates about who is responsible for teaching children about human sexuality, parents or the government in various venues such as the school curriculum.  The result of this debate has been that governments find themselves in the position of needing to launch disease prevention educational campaigns to control Sexually Transmitted Infections and HIV. The goal of this talk is to examine the benefits of the teaching of human sexuality throughout the lifespan as a tool to not only prevent disease but also to enhance overall sexual health for both
men and women.
 
Dr. Walter Meyer, M.D.
 
Sexual and Psychosexual Development.
 
Sexual development and psychosexual development are determined by a variety of biological, social and psychological factors. The biological determinants begin with conception and continue though until the completion of adolescence; the psychological and social factors are also influential though out the entire period. The normal biochemical and hormonal events in this process will be summarized to give an impression of their complexity. Normal psychosocial development including gender identity, sexual role and sexual orientation and its interaction with the child's physical development through early childhood, latency and adolescence will be reviewed. The important role of hormonal changes in this process will be emphasized.
 
A lot of insight into normal psychosexual development can be gathered by examining these issues in patients with a variety of intersex problems. Specifically, female pseudohermaphrodites (such as congenital adrenal hyperplasia), male pseudohermaphrodites (such as androgen insensitivity and 5 a reductase deficiency), individuals with sex chromosome variants, and individuals with choacal exstrophy will be discussed. The controversy concerning sex and gender of rearing of a child with ambiguous genitalia will be explored. Their long term psychological, endocrine and surgical treatment needs will be examined. What is known about the role of psychology and endocrinology in the development and treatment of gender identity disorder will also be reviewed. Lastly, data concerning the relationship between testosterone and sex offending behavior will be discussed.
 
Dr. Swayam Prakash, M.D.
 
S.V. Clinic and Research Centre,
 
Hyderabad , India
 
Enhancing sexual life and satisfaction through Ayurveda, Anangaranga and Kamasutra.
 
The earliest named teachers of Ayurveda are a treya and Dhanwantary. Their disciples Agnivesa and s usruta wrote treatises on Ayurveda. Even though their exact date is disputed, they are said to have lived as early as 1500 B.C The works of these two disciples were systematized and edited time to time, Caraka edited Agnivesa's work,which became the c araka s amhita (samhita means collection). The date of Caraka is disputed.Historians put him between 600 B.C. and 100 A.D. (Ray,1965). Susruta junior edited the Susruta Samhita. It also was systematized and edited from time to time. The edition of Nagarjuna, still available today, is said to have originated between the third and fourth centuries A.D. (Ray et al., 1980). Both Caraka Samhita and Susruta Samhita constitute the basis of present day Ayurveda. The former deals mainly with medicine and the latter mainly,with surgery.
 
Ayurveda literally means knowledge of life,( a yu=life; v eda = knowledge). There are eight branches of Ayurveda. One branch is v ajikarana which translates as making a man stallion-like in performing sexually. To achieve the goal of maintaining an erection and postponing ejaculation, v ajikarana recommended various psychological and pharmacologic preparations. All are for males. Females are neglected. For males, an exhilarating woman is recommended as the best aphrodiasiac.
 
The aphorodiasiacs mentioned in c araka s amhita can be classified in to three groups, food recipes; pharmacologic prescriptions, and psychological stimuli.
 
Food Recipes
 
In the dietary prescriptions, a unifying principle may be discerned, namely, to supplement the intake of protein. For example, eggs or powdered black lentil, mixed with milk and ghee, would be taken morning and evening. The Ayurvedic menu is not exclusively vegetarian; thus soups made from various animal meats are also prescribed.
 
Pharmacologic Prescriptions
 
The Ayurvedic herbal pharmacopoeia of the Caraka has been augmented successively since the thirteenth century. Approximately 100 herbs were recommended as Vajikaranas. s ome of these herbs are known to contain a pharmacologically active principle, among which are Cannabis sativa (Indian hemp, bangh, or hashish), Papaver somnifera (opium), and s trychnos nuxvomica (strychnine).
 
Psychological stimuli
 
v arious psychological stimuli can influence sexual function. The following are said to decrease interest in the sexual act (Sharma,1983,p.51).
 
Old age, anxiety, diseases, fasting and excessive sexual indulgence, wasting, fear,want of confidence,grief,finding fault with the woman,ignorance of enjoyment with women, lack of determination and interest, because potency is based on(sexual) exhilaration which again depends on the strength of body and mind.
 
Various psycholocigal stimuli are said to augment sexual power;(Sharma R.K and Dash, Bhagwan, 2005.
 
A person who takes ghee and milk, who is free from fear complexion and diseases, who indulges in sex everyday, who is youthful, and who has determination, gets sex vigour with women,
 
Persons who have friends with similar profession, who are accomplished in their objectives, who are attached to each other, who are skillful in arts, who are similar in mind and age, who have noble lineage, expertise, good conduct and purity, who regularly indulge in sex acts, who are excited, who are free from grief and pain, who have similar conduct, who have lovable and pleasant disposition as well as speech - friendship with such good companions promotes virility of a person.
 
A man gets sexually excited by massage, unction, bath use of scents, garlands and ornaments, comfortable home, bed and seat, happiness, wearing of clothes which are not worn out and to the liking of the person, pleasing sound of the birds, sounds of the ornaments of women and samvahana (kneading) by beautiful women.
 
Kama Sutra
 
Kama Sutra consists of teachings of great antiquity that were compiled and edited by Vatsyayana. The precise age of Vatsyayana's compilation is uncertain. Attributions range from 200 B.C. (Haeberle, 1978) to the fourth century A.D.(Anand, 1958; Kothari & Brahmbhatt,1985).
 
Vatsyayana departs from Caraka in giving consideration to the erotic pleasure of the woman as well as of the man, and to the reciprocal dependence of the pleasure of each on the pleasure of the other.
 
In the kama sutra there are five categories of loveplay: embraces and caresses, the kiss, scratches and marks made with the fingers, love bites, and hitting and the accompanying sounds. Within each of these classes there are as many as eight varieties, each with its own name.
 
Kama sutra in translation has long been a model for European and American sexology. For well over a century, it was the only completely explicit celebration of erotic teachnique in Western sexological literature. Its influence can be recognized in, for example, Van de Velde's immensely influential and revolutionary Ideal Marriage(published in England in 1928), with its greater attention to the tactile stimulation of forepaly and coital positioning than to preparatory visual stimulation and imagery.
 
Anangaranga:
 
Anangaranga of Kalyanamalla explained "Poornachandra n adi" , the same being explained as G-spot. Clitoris is described as “above the vagina there is organ like nose, which is known as “Manmadhachatra”. Here is a network of various nerves and an expert of Kamasastra should know to rub this organ with phallus.”
 
Poornachandra n adi is situated inside the vagina which is full of excitement . When fluid is discharged from this orgon it is known as fulfillment and complete sexual satisfaction.
 
Ayurveda, Anangaranga and Kama Sutra suggested various ways to enhance sexual pleasure and satisfaction.
 
Reading List
 
»
Money, J., Leal, J. and Gonzalez-Heydric, J. Aphrodisiology; History, folklore and efficacy. In Hanbook of sexology, vol. 6: p harmacology and Endocrinology of sexual Function" (J.Money and H. Musaph, serieseds; J.M A. Sitsen, vol.ed.). Amsterdam , Elsevier, 1988.
»
Murthy, K.R.S (Eng.Trans.) s arangadhara s amhita t reatise on (Ayurveda) by s arangadhara." Varanasi , c haukhambha o rientalia, 1984.
»
Ray, p. and Gupta, H. c araka s amhita: A scientific synopsis. New Delhi, Indian, National Institute of Sciences of India , 1965.
» Ray p ., Gupta, H. and Roy M." Susruta Samhita: (A Scientific synopsis)." New Delhi , Indian National Science Academy , 1980.
»
Sharma, P.V." Ayurveda ka vaiganika itihas." Varanasi , Chaukhambha Orientalia, 1975.
»
Sharma, P.V. ( Eng. Trans.) Caraka samhita; Agnivesa's treatise refined and annotated by Caraka and redacted by Dridhabala. Varanasi , c haukhambha Orientalia,1983.
»
Anand, M.R. Kama Kala: Some notes on the philosophical basis of Hindu erotic sculpture. Geneva : Editions Nagel 1958.
»
Hoernle, A.f.r.(Ed). The Bower manuscript: Facsimile leaves. Nagari transcript, Romanised transliteration and English translation with notes (3 vols., facsimile of 1893 ed.). New Delhi : Aditya Prakashan, 1978
» Kothari, P., & Brahmbhatt, r. Kama Sutra: Ancient and yet modern. In Proceedings of the World congress of Sexology, Bombay : Kothari Prakash, (1985).
»
Sharma, R.K., Dash, Bhagawan. Caraka Samhita (Text with English Translation & Critical Exposition based on Cakrapani Datta's Ayurveda Dipika, Varanasi, Chowkhamba Sanskrit Series Office, 2005.
» Burton , R.F. The Kama Sutra, Penguin popular Classics 1994.
 
Dr. June M. Reinisch, Ph.D.
 
Sexuality Education and the Elimination of Sexual Myths
 
Despite the general feeling that society is being bombarded by sexual images and information, when individuals are faced with issues relating to their personal sexuality they often resort to half-truths, myths, and old-wives tales. This is primarily the result of the lack of comprehensive sex education in primary and secondary schools, the shame and embarrassment of parents who were not appropriately educated themselves, and the flawed information of older siblings and school-yard peers all of whom are left to provide the "facts of life." Data have shown that the average medical student in the United States receives approximately four hours of training in human sexuality during medical school and so it should not be surprising that the average physician is not prepared to deal with sexual issues.
 
Thus, myths about sex, gender and reproduction that are handed down from generation to generation take on the authority of scientific fact. Not only do they misinform about important issues in the lives of individuals but they also can cause emotional, physical and psychological harm. It is the responsibility of health and sex education professionals to be aware of the sexual myths in their cultures and to carefully debunk them for their patients, clients and students. It is essential not to wait for these powerful wrong ideas to emerge but to seek them out and correct them with current scientific knowledge. In this presentation, I will use both science and art to illustrate some of the most prevalent sexual myths that still plague modern societies including those on masturbation, sexual orientation, fantasy, anal intercourse, erection, and sexuality education.
 
Dr. Leonard A. Rosenblum, Ph.D.
 
Sexuality and Evolution: What primates can teach us.
 
Studies in nonhuman primates can teach us much about the origins of human behavior. Examination of factors that would be either unethical or impossible to carry out in unbiased fashion with humans can be systematically studied in controlled fashion on our evolutionary forebearers. As a consequence, identifying environmental, physiological and individual behavioral factors that influence both normal and abnormal sexual expression in our closest evolutionary relatives can offer both insights into human sexual behavior, and the generation of hypotheses of clinical relevance that can be directly assessed at the human level. This lecture will focus on our understanding of selected aspects of the sexual functioning of monkeys and apes that bear directly upon significant concerns in humans, including such issues as the development of sex differences, the influence of the environment and individual experience on sexual performance and the role pf particular neurophysiological factors in regulating sexual interactions.
 
 
Dr Michael Ross, MA MS PhD
 
Sexuality and HIV/AIDS
 
We discuss patterns of HIV transmission in India 1985-2005, including regional and urban-rural variation, and transmission sexual risks, including vaginal, oral and anal sex (in both males and females), and including physical cofactors in HIV transmission: STIs, genital infections, disease status. More attention is given to psychosocial factors in HIV transmission prevention, specifically gender and power issues and relationship and family dynamics, and stigma and HIV and its impact on disclosure and prevention. We consider special groups of interest in India with high HIV infection rates, including commercial sex workers and their clients, men who have sex with men, and truck drivers. Sexuality education and HIV, including basic education needs and common myths are addressed, including individual HIV counseling and prevention models with HIV-infected clients, and community-based HIV prevention models that have been successful in India.
 
 
Dr. Stephanie A. Sanders, Ph.D.
 
Sexual Orientation/Preference: What is it? Why should you care?
 
What do we know about why people feel attracted to one gender or the other or both? Are homosexuality and heterosexuality opposite ends of a spectrum of sexual orientations? What is the relationship of sexual orientation and gender identity and gender role conformity? Why might sexual behavior patterns not be accurately reflected in self-labeling of sexual orientation? Is sexual orientation fixed early in life or may it emerge across a lifespan? How do people's beliefs about sexual orientation affect their comfort with their own attractions, their self-concept, their interaction with others, and their well-being? These are some of the questions I will address.
 
Scientific knowledge and concepts are evolving and challenging long-held views on this topic. It is important for sexuality educators and those in the health care professions to understand these advances so that they may better assist their clients/patients. For example, isn't it important for a physician to know if a man who considers himself to be heterosexual is having sex with men? People may be reluctant to seek advice or help if they feel they will be negatively judged for their behavior or if they think they are protected from certain medical conditions because they think it only happens to "gays" or heterosexuals. By promoting better understanding of sexual orientation we can enhance the health and well-being of the population.
 
 
Dr. Saroj Gumaste, MD, OBGYN,
 
Why Focus on Adolescent Sexuality Education
 
Adolescents are young boys and girls in the age group of 10-19 years which constitute 230 million people in India . Adolescence is the period of human life when most people emerge as individuals from the family unit. This is a very critical stage and requires appropriate inputs to address various issues which cause stress and emotional turbulence. They are also vulnerable to peer- pressure and may be subject to the risk of substance abuse.
 
Therefore, the adolescents require help from all stakeholders to develop a clear perspective on the process of growing up, development of skills to cope and manage reproductive and sexual health concerns including overcoming elements of risky behavior, awareness and understanding of HIV/AIDS and other forms of abuse. The need is to provide the right environment for the young adolescents to realize their potential and dreams. Adolescents have to be empowered to make informed choices in their personal and public life promoting creative and responsible behavior through information, education and services.
 
Adolescents constitute nearly 22% of the total population according to 2001 census of India . Of the total adolescent population female adolescents are almost 47% and male adolescents are 53%. Out of every 3 adolescents in the age group of 15-19 one is working resulting in high dropouts rate for education. 24% of the drug users are in the age group of 12 -18 years. One in eight people living with HIV resides in India.
 
Sexual drives are strongest during years between the mid-teens and the early twenties. Sexual expression does not entirely depend on biological factors. Factors such as parents, school, peer group, culture/religion and various media like books and movies play a role in shaping the sexual expression. These factors also form the base for sexual grounding and hence later continue to be life long influences in the sexual behavior of the individual.
 
Boys during this stage are going through the peak period of their pubertal psycho-sexual drive. Wherein the emotions are turbulent and physical needs are strong and hence they are more affected during this time period than Girls. Erotic impulses, particularly in boys are common, hence there is more interest in the opposite sex which culminates in the viewing of nude pictures, pornography, women's underwear etc. Therefore on the whole male fantasies are largely bio-oriented.
 
Girls have early pubertal start whereby they understand and come to terms with their body changes easily. Fantasy is an important part of sexual development for girls. Hence Girls develop a hunger for passionate love stories, romantic movies and love songs. Female more inclined to emphasize love and romance. This is the reason why expectations of boys and girls differ during the phase of heterosexual attraction when teenagers begin to go out with one another.
 
Each sex assumes that the opposite sex feels the same way about love romance and sex. Boys yearn for sexual satisfaction while girls long for romance, tenderness and attention. There are other issues though non-sexual but still affect adolescents. That is, fluctuating interest in school work which is noticeable during the Class IX –X level, when the average age of he/she student is between 15 and 17 years.
 
At this stage information on sexuality is not complete as they do not know whom to talk to. The Books and Media act as a source of information however they may prove to be more damaging than beneficial because of the following reasons:
 
» It is inadequate
» It is incorrect
» It is sensational, entertaining
» It is without values
» It does not consider the realistic social aspect
» It does not address feelings or relations.
 
Actually adolescents develop their own perceptions about sex before sex education is given!
 
“Why and how should we educate adolescents?”
 
The answer is very clear. Since adolescents invariably enter in to hetero-sexual and homo-sexual relationships and there is growing incidence of premarital pregnancies, un-wed mothers adolescent sex crimes, the adolescents should be imparted with knowledge about sex and sexuality, so that they can practice safe sex and develop assertive skills to say ‘No' to sex.
 
We should know that whether inside or outside their homes, with known or unknown, small or big, children are at risk of being sexually exploited. They do not talk about it (sexual exploitation) but develop guilt. Young children should be able to recognize the abuse and try to protect themselves. Ignorant children do not understand what is happening or what they must do when they are being sexually abused in addition to understanding sexual advances of others.
 

Sex urges are strong and sometimes young people cannot or do not control them. Adolescents must be able to assert themselves whereby they can determine when to stop and when to say no. Unacceptable sexual behavior and obscene language is not due to education but due to the lack of it. It is due to exposure to the language, gender roles and attitudes existing in society.
 
How Education can help and develop responsible behavior.
 
Effective sex education provides young people with an opportunity to explore the reasons why people have sex, and to think about how it involves emotions, respect for one self and other people and their feelings, decisions and bodies. Young people should have the chance to explore gender differences and how ethnicity and sexuality can influence people's feelings and options. They should be able to decide for themselves what the positive qualities of relationships are. It is important that they understand how bullying, stereotyping, abuse and exploitation can negatively influence relationships.
 
They need to have information about the physical and emotional changes associated with puberty and sexual reproduction, including fertilization and conception and about sexually transmitted diseases, including HIV/AIDS. They also need to know about contraception and birth control including what contraceptives are available, how they work, how people use them, how they decide what to use or not, and how they can be obtained. In terms of information about relationships they need to know about what kinds of relationships are there, about love and commitment, marriage and partnership and the law relating to sexual behavior and relationships as well as the range of religious and cultural views on sex and sexuality and sexual diversity. In addition, young people should be provided with information about abortion, sexuality, and confidentiality, as well as about the range of sources of advice and support that is available in the community and nationally.
 
To be effective, Sex education must be imparted at an early age. That is before young people reach puberty, and before they have developed established patterns of behavior. This is the age at which information that is provided depends on the physical, emotional and intellectual development of the individual as well as his/her level of understanding.
 
There are certain dimensions which need to be examined before the information is imparted.
 
These are:
 
» What is the subject matter covered
» How is this subject matter covered
» Who is providing the subject matter
» When is it being provided
» In what context is the subject matter taught.
» What are the individual's perceptions about the subject matter.
 
One must remember that it is important not to delay in providing information to young people but to begin providing it early. Providing basic information lays the foundation on which more complex knowledge can be built up over time.
 
This brings us to an understanding that sex education has to be sustained. For example, children can be informed about how people grow and change over time and how babies become children and then adults. This provides the foundation on which they will be able to understand more detailed information about puberty in the pre-teenage years. In addition, they can be provided with information about viruses and bacteria that attack the body. Later on discussions can be held about infections that can be caught through sexual contact.
 
At times parents and educators are concerned about providing information about sex and sexuality. This arouses curiosity and can lead to sexual experimentation among adolescents. One can not be certain that this happens for the whole population. However it is important to remember that young people can store up information provided at any time, for a time when they need it later on. Therefore it is also important not to defer dealing with a question or issue for too long as it can suggest that one is unwilling to talk about it.
 
In India specifically, adolescent girls are confronted with hazards of early child bearing. About 17% of total fertility in India is still attributed to young women within the 15 to 19 age group, exposing them and their children to greater health risks. The problem of violence against adolescents and particularly females in India is a major concern. According to the report of the national crimes bureau, the incidence of reported rape cases in the 10 to 16 age group went up by 26.2% in the years between 1991 and 1995.
 
The socio-economic profile of Indian adolescents is also far from satisfactory. Despite the crucial place that adolescents have in the population as the most important resource for the future, their needs and concerns, especially their reproductive health needs have been ignored. In view of all of the above, it is necessary to pay attention to our adolescents. The current generation of adolescents is more than a Billion and will be the largest generation in the history to make the transition to adulthood.
 

Currently there is a nationwide education program instituted by the Ministry of Human Resources, Ministry of Education and National Aids control Program for adolescents. The objective of this program is to empower adolescents and to build up a healthy strong nation.
 
Recommended Books and Articles:
 
»
Meyrick, J. and Swann, C. (1998) "Reducing the rate of teenage conceptions an overview of effectiveness of interventions and programmes aimed at reducing unintended conceptions in young people". London : Health Education Authority.
» Wellings, K., Wadsworth , J., Johnson, A.M., Field, J., Whitaker, L.B. (1995) Provision of sex education and early sexual experience: the relation examined, British Medical Journal 311 pp. 417-420.
» Wellings, K., Wadsworth , J., Johnson, A.M., Field, J., Whitaker, L.B. (1995) Provision of sex education and early sexual experience: the relation examined, British Medical Journal 311 pp. 417-420.
 
 
Dr. Pepper Schwartz, Ph.D.
 
Sexuality and Intimacy in Committed Couples
 
This paper will look at five major areas of sexuality in married and cohabiting gay, lesbian and homosexual couples.  The literature and topics to be explored are: The intersection of health and sexuality in long term couples satisfaction, desire  and sexuality in intimate couples communication and sexuality in long term couples clinical perspectives and debates on long term sexual functioning (issues on orgasm in women, erectile dysfunction in men) sexual fidelity and sequela of non- monogamy in committed couples.
 
Dr. William R. Stayton, Th.D., Ph.D.
 
What Sexuality Educators Should Know About : Religion and Sexuality.
 
Sexual value systems that students bring into the sexuality education classroom can greatly affect their learning and practice. Many religious sexual values are based on the actual "acts of sex", such as masturbation, homosexual behaviors, non-marital sex, and alternative sexual lifestyles, as being acceptable or non-acceptable, moral or immoral. Other religious sexual values are based on the nature of relationships and how the motives and consequences of the variety of sexual acts impact acceptability and morality. India is regarded as the country where sexuality education began. The majority of major religious faiths are found in this great country, which makes it a very appropriate venue for presenting what sexuality educators should know about religion and sexuality. This presentation will illustrate how the variety of sexual values systems found in major religious systems, such as Hindu, Muslim, Hebrew, Christian, Sikh, Buddhist, and Jains impact the best of science in sexuality education and practice.
 
Dr. Terry Tafoya, Ph.D.
 
When "Ok" doesn't mean "Yes"-What are the cross-cultural issues in communication that can enhance or impede the delivery of services?
 
Even when providers and clients speak the same language fluently, culturally based issues of discussing topics directly or indirectly, assumptions about how such foundational definitions of what is "sex" and what is "gender," can create confusion. In those cultures that have a concept of more than two genders, how does someone even definite homosexuality? How does a provider work with someone who has many ways of saying "no" without ever saying "no?" This presentation will examine in detail the pragmatic aspects of how "the question determines the answer," and how asking for information in different formats can result in different responses from the same individual.
 
Dr. Mitchell Tepper, Ph.D.
 
SexeLearning: The Internet as a Source of Sexual Health Information and Education
 
With nearly 713 million people using the Internet globally, the World Wide Web offers heretofore unparalleled access to sexual health information. Sex and health have emerged as two of the Internet's most critical components due to the accessibility, anonymity and affordability offered by the medium. According to the Pew Internet report, Health Information Online, eight in ten Internet users have looked online for information on at least one of 16 health topics; 11% of those users specifically sought out sexual health information, which roughly translates into 63 million people from all walks of life. This presentation will survey the evolution of sex on the net from content and commerce to personalization services and software diagnostic solutions.  Different ways for clients and clinicians to utilize the Internet including peer support, specific information, e-learning, e-commerce, and e-counseling will be discussed as well as how clinicians can utilize the Internet to better serve their clients.
 
Dr. Gorm Wagner, M,D., Ph.D.
 
Male Sexuality: Physiological Responses To Sexual Stimulation In The Male.
 
PURPOSE: To present the essential parts of male sexual function from the eye of a medical physiologist and to describe the existing knowledge regarding how the mechanisms behind these events work.
 
METHOD: E xperimental and clinical studies from literature, our own observations from a survey of the physiological responses to sexual stimulation, as well as the changes due to aging and diseases will be presented.
 
TOPICS:
 
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