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Coleman-Chair-BP-7.jpgMedical advances, improved access to care, prevention initiatives, and our nation's aspiration of an AIDS-free generation are all good signs, but as a culture we will need to shift our perspective to stop the spread of HIV.

Over the last 30 years, where have we failed? We know that HIV is still mostly spread by sexual behavior. Yet, the disease is rather easily preventable through the use of condoms. Condoms are reasonably inexpensive, potentially readily available, easy to use, and highly effective in preventing HIV and other sexually transmitted infections (and unintended pregnancy). What a bargain! So, why are they not used more?

Behavioral HIV prevention strategies and interventions have tried to get people to reduce risky sexual behavior and promote condom use. While reasonably effective, there needs to be continuous implementation of these interventions, and they are costly. Investment in prevention strategies has always been difficult.

New strategies are overdue. In the United States, we continue to experience 50,000 new infections a year, with young people aged 13-29 accounting for 39% of all new HIV infections.* And, there are serious health disparities.  People of color, youth, and sexual minorities are much more likely to become infected than other groups. While 60% of new infections around the world are found in gay and bisexual men, only 2% of the global prevention budget is directed at this group. Also, transgender individuals are an overlooked population at major risk for HIV, due in large part to continued stigma and discrimination. This disparity in funding efforts represents the institutionalized stigmatization, heterosexism, and homophobia that exist in our cultures as well as in our public health systems. If we do not attend to this population as well as other marginalized populations such as sex workers and drug users, we will fail in our efforts to stop the spread of infections.

A fundamental problem remains. We remain a sexually dysfunctional culture. We live in a culture that is still uncomfortable talking about sex and sexuality in a mature and honest fashion. We continue to debate and hold back on providing comprehensive sexuality education. It is very clear that what distinguishes the United States from other developed countries in sexual health indicators is the existence of (or lack thereof) early and sustained comprehensive sexuality education. When kids are educated early they grow up to be more comfortable with talking about sexuality, more likely to be sexually responsible, and have lower rates of sexually transmitted infections and unintended pregnancies. They contribute to a cultural climate that is sexually healthy. That climate then insists on comprehensive sexuality education and thereby creates a cycle of healthiness. In the United States, we are still caught up in a negative and unhealthy vicious cycle. The goal of the Joycelyn Elders Chair in Sexual Health Education is to reverse this negative cycle.

As the current Chair in Sexual Health, I continue to push a sexual health agenda in HIV prevention. I believe in the need for a broad sexual health approach to stem the tide of the HIV epidemic. I envision an approach that goes beyond venereology and on an individual level

• emphasizes a positive and respectful approach to sexuality and sexual expression throughout the lifespan;

• acknowledges sexuality as a basic and fundamental aspect of our humanness and that the pursuit of sexual pleasure is natural and desirable;

• combats sexual coercion, shame, discrimination, and violence;

• promotes positive sexual identity and esteem;

• encourages honest communication and trust between partners;

• supports the possibility of having pleasurable, fulfilling, and satisfying sexual experiences;

• insists that individuals take responsibility of the consequences of their sexual choices and their impact on others; and

• optimizes reproductive capacity and choice


At the community level, it is achieved through

• access to developmentally appropriate, comprehensive, and scientifically accurate sexuality education;

• clinical and preventative sexual health services; and

• respect for individual differences and diversity and a lack of societal prejudice, stigma, and discrimination.

As the Chair in Sexual Health, I will continue to work with our faculty at the Program in Human Sexuality and with partners around the world to promote a sexually healthier culture - not only to address the sexual problems in the world -- but to advance the opportunity for everyone to lead sexually healthier lives which are pleasurable and satisfying.

Eli Coleman, PhD
Professor and Director
Chair in Sexual Health


New HIV Infections in the United States by Centers for Disease Control and Prevention


PAHO-22-BP.jpgEli Coleman, PhD, and Walter Bockting, PhD, joined a meeting convened by the Pan American Health Organization / World Health Organization (PAHO / WHO) from December 19 to 21, 2011.  PAHO gathered representatives of the health sector, academia, and civil society organizations to discuss a series of recommendations for health services on how to address the needs and demands of transgender people in the region of the Americas.

The conclusions of this meeting will become part of a reference document addressing the main problems affecting access to and utilization of health services for and by transgender people. In addition, a plan for the development of a comprehensive strategy for health care provision for this population throughout the region will be designed. Both documents will subsequently form the basis for sub-regional consultations to be held in 2012.

The participants of the meeting, which was held at the headquarters of PAHO/WHO in Washington D.C., decided to adopt the term "trans" to refer to a population whose members are characterized by a variety of gender identities and expressions that differ from their sex assigned at birth. This population faces a number of problems in accessing health services in the countries of the region, many of which are a result of stigma, a lack of appropriate medical protocols and a lack of information on how to deal with certain social situations.

"Trans people have traditionally been stigmatized, marginalized, abused, discriminated against, and even subject to physical and emotional violence. These and other expressions of transphobia have to be considered factors that negatively impact health," said Dr. Gina Tambini, Area Manager of Family and Community Health. "In order for the health sector to be able to adequately respond to the needs of trans persons, we must create and implement policies of non-discrimination, rely on qualified personnel, and ensure that there are environments of respect and quality of care. The presence and active participation of trans persons was a fundamental and indispensable contribution to the success of the meeting.

Trans people as a group have greater vulnerability and exposure to such health problems as HIV, syphilis, gonorrhea, hepatitis, and genital herpes, which create special demands on health services. But in addition, health care providers need to be sensitive to issues of gender identity related to this group.

"The needs, problems, and demands of trans people cannot be defined externally, but must be expressed by them themselves," said Dr. Tambini.

At the PAHO meeting, participants discussed terminology, definitions, and descriptions of this population, as well as epidemiological profiles and health initiatives that have been carried out in the Americas. In addition to reviewing and discussing the content of the reference document, the meeting was intended to promote a multisectoral and multidisciplinary vision on the provision of services, including prevention.

PAHO was established in 1902 and is the world's oldest public health organization. PAHO works with all countries in the Americas to improve the health and quality of life of people of the Americas and serves as the Regional Office for the Americas of WHO.


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Bockting-in-Salzburg-BP.jpgWalter Bockting, PhD, participated in International Partnership for Advancing Transgender Health seminar in Salzburg, Austria, on October 2 - 8, 2011.

The meeting launched a multi-year partnership with international organizations including TIG (lead organization) and Labrys (supporting partner) in Kyrgyzstan, RED TRANS in Peru, Gender DynamiX in South Africa, and The Open Society Public Health Program and the Center of Excellence for Transgender Health at the University of California.

The group aims to establish and implement culturally appropriate guidelines on transgender health care. Ultimately, groups plan to cultivate trained networks of medical care providers who can offer high quality transgender health care and who will participate in the dissemination of best practices regionally.

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FEMESS-BP.jpgOctober 20 - 22, 2011, Eli Coleman, PhD, and Joycelyn Elders, MD, presented at the VIII Congreso Nacional de Educación Sexual y Sexología organized by the Federación Mexicana de Educación Sexual y Sexología, A.C. (FEMESS) in Chiapas, Mexico.

More than 800 individuals attended the conference, including 150 people form the academic sector and health organization and 54 civil servants from the Ambulatory Centers of Prevention and Attention in AIDS and STI (Centros Ambulatorios de Prevención y Atención en SIDA e ITS or CAPACITS).

In a post-conference statement made by FEMESS, the organization thanked the government and university of the state of Chiapas for supporting the conference.  The organization also commended the government for its commitment to reach the United Nations Millennium Development Goals.  The organization also reiterated its support of the 2008 Inter-ministerial Declaration which was adopted by all health and education ministries in Latin American and the Caribbean which advocated for comprehensive sexuality education starting in pre-school to stem the tide of the HIV pandemic.  

FEMESS restated its goal to depathologize transsexualism as a mental disorder.  The organization reaffirms the need for gender expression to be recognized as a fundamental human right of free expression.  Further the group called on mental health professionals to support this position and join in the goal.

Videos from the conference:

Eli Coleman & Youth's Sexual Health in the 21st Century: Get involved!

Joycelyn Elders & Youth's Sexual Health in the 21st Century: Education, Empowerment & Resources

Photo: Joycelyn Elders, MD, Eli Coleman, PhD, with FEMESS conference organizers

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Letter from the Chair

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Eli-Coleman-BP.jpgWe have reached a moment in history with serious global economic challenges and critical and costly sexual health problems. Around the world governments as well as regional and international health agencies are recognizing the importance of having a unified and broad sexual health approach to reduce the burden of disease related to sexual health problems.

There have been several recent, major developments which will certainly have a positive impact on the promotion of sexual health. First, there has been an effort by the Centers for Disease Control and Prevention to consolidate its initiatives in HIV prevention, STI prevention, reproductive health, school-based sexuality education, and sexual violence prevention under a broader and unified effort to promote sexual health as an overarching strategy to deal with the myriad of sexual health problems we face in this country, A Public Health Approach to Advancing Sexual Health in the United States. Second, in July 2010 the White House released a National HIV/AIDS Strategy that acknowledges the importance of addressing sexual health through prevention activities rather than simply more "testing and pills." Third, in March 2011, the Institute of Medicine released its report on The Health of Lesbian, Gay, Bisexual and Transgender People. Finally, in June 2011 the National Prevention, Health Promotion, and Pubic Health Council in the Office of the Surgeon General released a National Prevention Strategy which includes a major section on promoting sexual and reproductive health.

The synergy of these efforts has put sexual health squarely in the center of public health strategies to improve the overall health and wellbeing of all Americans. While PHS has been promoting sexual health for over 40 years, the concept of sexual health has taken root in public policy in a way that represents a revolutionary paradigm shift. It is an exciting time.

We hope that this will translate into improved funding for a strategic approach to change the sexual health climate of this country - using the powerful resources of our government. We hope that this will increase research grants, educational opportunities, and provisions for sexual health care.

During the past decade, it seemed that the leaders in sexual health were in other parts of the world. Now, the US has joined similar international efforts and may be able to assume a leadership role by advancing sexual health through public policy and public health.

PHS is involved in many of these national, regional, and international efforts. Hopefully, through this work, we will truly realize a sexually healthier climate here and around the world. It is an exciting time - a time to "strike while the iron is hot" to consolidate efforts and move the sexual health agenda forward.


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Elders-BP.jpgWith your help, we can work to create a sexually healthy world. Former Surgeon General Joycelyn Elders, MD, is teaming up with the PHS to advance comprehensive science-based sexual health education. Elders and PHS are responding to the current public sexual health crisis by creating the Joycelyn Elders Chair in Sexual Health Education.

We have raised $766,866 of our $2 Million goal. You can help us reach our goal by donating today. Together we will help to change the direction of sexual health in this country and around the world.

By establishing the Elders Chair, PHS will work to create comprehensive life-long sexual education curricula, to increase the number of health care providers trained in sexual health care, and to expand scientific research in sexuality education. Sexual health education is about more than disease and preventing pregnancy, and we will work to promote sexual health throughout every stage of human life, from adolescence through adulthood.

PHS has proven success in educating medical professionals, sexual behavior research, and advocating for science-based public policy. Through the Joycelyn Elders Chair in Sexual Health Education we will build on our strengths to advance sexual health education.

Advancing Science-based Sexual Health Education
The Program in Human Sexuality is positioned to make the next important advances in sexual health and will begin to do so with the creation of the Joycelyn Elders Chair in Sexual Health Education. The faculty member who holds the endowed faculty position at the University of Minnesota Medical School shall focus their efforts on the following:

Improve Education for Health Care Educators and Providers
The Chair holder will improve and expand the Program in Human Sexuality's course for medical professionals that strives to increase the understanding of future healthcare providers on the importance of sexual health and the diverse manifestations of sexuality in their future patients. The Chair holder will seek to create a "template" program that could be modeled by other medical schools and health profession educators.

Creation of Comprehensive Life-long Sexuality Education Curricula
The Chair holder will create age-appropriate sexual health education that will work to promote sexual health throughout every stage of human life, from adolescence through adulthood, creating a sexually "literate" society that is educated about sexuality and able to make informed decisions.

Promote Public Policy Supporting Science-based Sexuality Education
The Chair holder will promote change in public policy through education, community engagement, editorial publication, legislation, and other means to help create an informed sex-positive public and direct government policy towards the creation of a sexually healthy society.

Expand Scientific Research in Sexuality Education
The Chair holder will serve as a catalyst for the creation of new research initiatives that study the effectiveness, efficiency, cost, and goals of sexual health education with the goal of unlocking new scientifically-sound understandings of sexuality and creating more effective teaching methods for disseminating this information.

Get involved
Receive Elders Chair updates and connect to a network of supporters through Facebook and Twitter. You can also contribute your ideas through Facebook discussions or by emailing

Tell 10 friends about the Sexual Health Revolution starting at the U of M

Make a donation of any amount to the Joycelyn Elders Chair in Sexual Health Education

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Alex-Iantaffi-BP.jpgThe US Office of National AIDS Policy (ONAP) has set three primary goals for the US National HIV/AIDS Strategy 1) reduce HIV incidence 2) increase access to care and optimize health outcomes and 3) reduce HIV-related health disparities.  To reach these goals, the Administration has sought input from a broad range of perspectives and stakeholders through the Presidential Advisory Council, national HIV/AIDS community discussions, and an online call to action for community input.  

On October 2, 2009, one of the 14 national HIV/AIDS community discussions was hosted in Minneapolis at the Zurah Shrine Center.  The event started with a brief introduction by Jeffrey Crowley, Director of the Office of National AIDS Policy and Senior Advisor on Disability Policy at the White House followed by a statement from Senator Al Franken.  The discussion was then turned over to community participants including local experts, advocates, care providers, and individuals affected by HIV/AIDS.  Speakers affiliated with PHS included Hale Thompson, research assistant; Andrea Jenkins, AGHO Advisory Board member; Alex Iantaffi, postdoctoral fellow; Sharon Lund, former research assistant; and Fatima Jama, research partner.  Many people spoke of the diverse needs regarding prevention and care throughout Minnesota and the nation.

There are three more community events scheduled this year including Ft. Lauderdale, FL on November 20; New York, NY on December 4; and Caguas, Puerto Rico on December 14.  After that the ONAP will synthesize the input from community discussions, the online Call to Action, and expert meetings to create a more focused HIV/AIDS policy draft.  There will again be an opportunity for community input once the draft is available.

Two related efforts by the White House include reauthorization of the Ryan White Act on October 30, 2009, and new guidelines were released for the global work of the President's Emergency Plan for AIDS Relief, on September 14, 2009.  These guidelines open the door to linking AIDS efforts to family planning.

View the video of the Minnesota community event and learn more about the work of the ONAP.

PHOTO:  Alex Iantaffi

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Letter from the Chair in Sexual Health

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Coleman-Oaxtepec-BP.jpgI recently attended the National Congress of Sexual Education and Sexology sponsored by the Mexican Federation of Sexual Education and Sexology (FEMESS) in Oaxtepec, Mexico.

I talked about the barriers, necessities, and opportunities that are confronting sexuality education now and in the future.  I called for a strategic plan for the next generation of sexuality education programs. 

Education is the basic tool by which we can confront the sexual health problems we face around the world.  We see the HIV pandemic stabilizing overall but growing rapidly among disadvantages groups.  Sexual violence is still at unacceptable levels.  Gender equity remains ideal rather than a reality.  Individuals and couples are struggling to find sexual satisfaction and pleasure.  We have a syndemic - a constellation of epidemics that feed one another.  We are going to need a systematic approach to promote sexual health to address the syndemic.  This is not just a sexual health problem but a public health problem.  Sexual health is essential to overall health and human development.

There are enormous barriers to overcome.  We need to face some fundamental facts. 

● There is the ubiquitous taboo of talking about sex in our cultures and this is not going to go away. 

● Parents, by the nature of parent-child dynamics, are never going to be the most effective sexuality educators. 

● We can not seem to get over the notion that to talk about sex with children means that they are more likely to engage in sexual activity (and irresponsibly).

● Sexual education is a threat to the social order which preserves patriarchy and heteronormativity.

● Science-based sexual education is a threat to certain religious views and beliefs.

● The belief that the state should not interfere in something so private as one's sexuality

● Sexual education by professionals in structured environments is the only way to deal with these barriers.

Despite the barriers, we have tremendous opportunities to overcome them.  The United Nations has declared 8 human development goals for 2015.  Embedded in these goals are a few of them that specifically address sexual and reproductive health.  However, in all of these 8 goals, promotion of sexual health is obviously a means of addressing them.  (See the World Association for Sexual Health's (WAS) Declaration and Technical Document - Sexual Health for the Millennium).  The fundamental premise of this declaration is that it is essential to promote sexual health to enhance overall human development.  Sexual health is on par with the necessity to promote physical and mental health.  The three are like a three-legged stool and without one - the chair will fall.

The fourth point of the WAS Declaration specifically addresses the importance of providing universal access to comprehensive sexuality education.  To achieve sexual health, all individuals, including youth, must have access to comprehensive sexuality education and sexual health information and services throughout the life cycle.  This has been recognized more and more in health promotion strategies as illustrated by the Inter Ministerial Declaration of Health and Education Ministers of Latin America and the Caribbean and the Maputo Plan of Action that was endorsed by the Ministers of Health from 48 African countries and their governments.  So there is openness and opportunity to build upon when public policy officials are recognizing the importance of sexual health education as a general public health policy.

Sexual health has been legitimized in public health policy and science will be needed to guide it.  It is a unique opportunity in history that we must seize.

In order to overcome these barriers and seize these opportunities, we have the following necessary actions.

● Provide mandatory comprehensive sexuality education - that is rights-based, gender sensitive, and culturally appropriate - as an essential component of school curricula at all levels and provide the necessary resources.

● Work with community organizations to reach young people who are not in school or other high-risk populations with comprehensive sexuality education.

● Issue guidelines to ensure that sexuality education programs and services are grounded in the principle of fully informed, autonomous decision-making.

● Ensure that sexuality education programs are evidence-based and include the characteristics that have been shown to contribute to effectiveness. This should be done in a way that allows for creativity and community specific needs in the development and evaluation of innovative programs.

● Promote further research in human sexuality education designed to promote sexual health and responsible sexual behavior.

We only have a few years to show that comprehensive sexuality education can work before the tides can turn and we return to abstinence-only approaches.

We must create a better climate for discussion of sexuality.

We need to ensure access to information and access about sexuality.

We need a society where every child (no matter what their sexual or gender identity) can get basic sexuality information.

We need to ensure that every health care provider is trained to address sexuality as part of their practices. 

And that is the only way that we will achieve sexual health and foster human development. 

African Union Commission.  (2006). Plan of Action on Sexual and Reproductive Health and Rights (Maputo Plan of Action).  Addis Adaba, Ethiopia:  African Union Commission.

Coleman, E. (2002). 'Promoting sexual health and responsible sexual behavior: An introduction'. Journal of Sex Research, 39(1), 3-6.

Coleman, E. (2010).  From sexology to sexual health.  In P. Aggleton, and R. Parker (Eds.), Routledge International Handbook of Sexuality, Health and Rights:.  London:  Routledge.

Ministers of Health and Education in Latin America and the Caribbean (2008).  Ministerial Declaration: 1st Meeting of Ministers of Health and Education to Stop HIV and STIs in Latin America and the Caribbean to Stop HIV and STIs:  Preventing Through Education.   

World Association for Sexual Health (2008).  Sexual Health for the Millennium Declaration.

PHOTO:  Ligia Peralta, Eli Coleman, Luis Perelman

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PAHO-BP.jpgOn July 12-14, 2009, the Pan American Health Organization (PAHO) held an expert consultation in Panama City, Panama, to develop concrete recommendations for a regional multi-component action plan to address health needs and demands of the men who have sex with men (MSM) population.  Eli Coleman PhD, on behalf of PHS, was invited to participate and facilitate part of the meeting.  In addition, PHS postdoctoral fellow, Cesar Gonzales, PhD, was also invited to share his expertise in HIV prevention among MSM and transgender populations.  The objective of the consultation was to analyze factors and situations associated with health problems, social hardship, and poor quality of living among gay and bisexual men, and other MSM in Latin America.  Participants proposed a set of urgently needed interventions to meet the sexual health needs of MSM, including prevention of HIV and other sexually transmitted infections.  Forty participants were invited from all regions of the Americas with particular emphasis on experts from Latin America and the Caribbean including UN agencies in charge of the MSM/sexual diversity; experts in provision of HIV/STI, sexual health, mental health or addiction services to MSM populations; and experts in development of health services for specific target populations.  In order to activate these strategies throughout Latin American and the Caribbean PAHO will outline consultation recommendations technical document that is forthcoming.

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Diaz-BP.jpgPsychologist, activist, and scholar, Armando Diaz, traveled from Mexico City to study at PHS.  Diaz is working on his PhD in sociology at El Colegio de Mexico.  Inspired by Cara a Cara (Face to Face) an HIV prevention training program for community advocates that was created by PHS and conducted in Mexico, Diaz developed the educational program Hombres, conciencia y encuentros (Men, Awareness, and Encounters).  Diaz's training is designed to reduce social and personal vulnerability among gay men and men who have sex with men in urban and rural communities throughout Mexico.  Through presentations, workshops, and small group discussions, trainers focus on sexual diversity, masculinity, history, human rights, HIV/AIDS prevention, and physical and emotional health.  Starting locally in Guadalajara, the program has expanded to reach individuals from many areas of Mexico.  The group is now working with the Sexual Citizenship Network from Jalisco, National Vigilance Council in Sexual Diversity and HIV/AIDS.

Diaz has come to understand the importance of sexual health education and sexual rights.  Although many of the young LGBTI in Mexico are more open about their sexual identity, and there is a growing culture presence with GLBT parades and public gathering places, advocates still have work to do to achieve full integration.  Through their research Diaz and his colleagues found that many individuals young and old are challenged in constructing intimate relationships and many young people do not fully understand the potential impact of HIV.

Diaz believes that an empowered individual has the opportunity to look beyond his own needs to the needs of his community.  Ideally, strengthening a person strengthens the family, the community, the nation, and ultimately, the world.  "The world has been broken through the mistakes of discrimination and injustice.  The social acceptance of sexual diversity will help to align communities and right this history," said Diaz.  It is Diaz's hope that with acceptance an individual can turn his focus to other social issues like homelessness, poverty, and the environment.

While at PHS Diaz spent time consulting with Eli Coleman, PhD, as well as spending some time at a St. Paul clinic (La Clinica) to better understand the options and needs surrounding sexual health and HIV/AIDS for Latinos.   He also made time to explore materials in the Jean-Nickolaus Tretter Collection in Gay, Lesbian, Bisexual and Transgender Studies.  He was excited to find books about the GLBT rights movement in Mexico that he has not been able to locate at home.  Diaz feels that connecting the present to the past is very powerful.  He said, "history shows millennia of violence and discrimination and when one transgender person decides to live as he feels, when one lesbian chooses to love who she loves, and when one gay man decides to assume himself these people are changing the world by breaking the power structure of history.  I am fortunate to work with these individuals and to witness the change."

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