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Congrès Virtuel WAS 2021

Dr Arnaud ZELER  -  le  7 septembre 2021

Le 25e congrès de l’Association mondiale pour la santé sexuelle (WAS 2021) est organisé par l’Association mondiale pour la santé sexuelle (WAS) en association avec la Southern African Sexual Health Association (SASHA).

Cette année congrès aura lieu en ligne, du 9 au 12 septembre 2021, sur le thème “Leave No One Behind

Au programme, plus de 100 conférences et symposiums sur la santé sexuelle !

L’AIUS est membre de la WAS et organise un symposium (en anglais) sur le thème “Sexologie française : contributions et spécificités” coordonné par Brice GOUVERNET (Voir plus bas)

SESSIONS EN LIGNE EN DIRECT

2 jours de conférences en direct les 11 et 12 septembre

ATELIERS THÉMATIQUES

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French sexology: contributions and specificities (2021, septembre) 25th Congress of the World Association for Sexual Health

Coordination : B. Gouvernet (CRFDP, Université de Rouen Normandie)

Ce symposium a pour objectif de présenter les apports, spécificités et originalités de la sexologie française. Celle-ci se caractérise par une vision intégrative, contextualisée et globale. Multiréférencée, elle se situe aux croisements des compétences de champs disciplinaires distincts. Elle prend en compte les vécus et les expériences tout autant que les comportements. Elle aborde par ailleurs des thématiques encore relativement délaissées par la communauté scientifique.

Le symposium se structure en deux parties : l’une souligne l’importance d’une approche interrogeant les vécus et expériences des sexualités. La seconde met en valeur l’importance d’une approche intégrative dans les accompagnements proposés. La première communication se veut une introduction contextualisée. Partant de la situation sanitaire actuelle, liée au confinement et au covid19, B. Gouvernet et J. Corruble soulignent l’importance, dans l’approche française des sexualités, de la prise en considération des expériences vécues en s’intéressant aux impacts des confinements sur les fantasmes. P. Martin élargit se point de vue aux consultations en médecine sexuelle, mettant en évidence l’importance des dynamiques émotionnelles et dyadiques dans les accompagnements individuels et de couples. La communication de M. Chollier vient faire transition théorico-clinique et souligne l’apport des modèles multiréférencés dans la prise en charge sexologiques de personnes souffrant de troubles mentaux. C. burté présente l’efficacité d’une approche intégrative dans l’accompagnement des patients souffrant de cancer et présente à cette fin l’originalité de la formation en oncosexologie française. Pierre Bondil aborde la spécificité des prises en charge des troubles priapiformes et leurs modalités de traitement. Le symposium se conclut par une communication d’A. Giami sur un état des lieux des professionnels exerçant dans le champ des sexualités en France, et des mutations qu’a connu la profession ces dernières années.

Part I : The importance of the living experience of sexuality

During covid19 lockdown, my sexual fantasies were not the same

Brice Gouvernet (WAS, Rouen Normandy University, France) & Juliette Corruble. (Rouen Normandy University, France)
Objectives: Studies dealing with the effect of covid19 lockdown on sexual fantasies (SF) are rare, or even, in France, non-existent. We question the repercussions of lockdown on SF based on the responses of 336 French participants (women: 70%) to an online study conducted between the 15 and 21 April 2021.
Method: We studied SF using the questionnaire of Cossette and Joyal (2011). A global analysis focuses on the proportion of subjects who experienced changes in their SF. A second level of analysis investigates the type of SF impacted. The results are crossed with data related to gender at birth, the fact of having been confined with sexual partner, and with levels of anxiety and depression, assessed using the Hospital Anxiety Depression Scale (HADS).
Main results: 10 categories of SF were identified. 88.4% of participants were affected in their SF during lockdown. The impact of lockdown on SF was more pronounced for men-at-birth (AOR: 1,595, p<.05), for those confined alone (AOR: 1,92, p<.01) or for those with depressive disorders (AOR: 1,888, p<.01). The main SF affected concerned the actual partner (70.4%), submissive fantasies (51.9%) or extramarital relationships (sex with acquaintance : 45.1% ; sex with stranger : 50.3%) . The SF least affected by lockdown were urophilia (9%) or those related to non-consensual intercourse. However, the latter increased for 12% of participants. This increase concerns more men-at-birth (23.7%) than women-at-birth (7%).
Discussion: Results are discussed in reference (i) to the literature about the effects of the covid19 health situation on both sexuality and psychological functioning; (ii) to sexual social scripts theories.
Conclusion: The covid19 health situation had an impact on sexual behavior but also on SF. The inter-individual variabilities of these repercussions underlines the importance of a biopsychosocial perspective in understanding the effects of lockdown.
Keywords : covid19 lockdown ; sexual fantasies, France, change

Doctor, could you please take care of my emotional and sexual life as well?

Dr Pierre MARTIN-VAUZOUR*, sexologist. AIUS. Head of the pedagogic committee of the sexology course unit at the university of Bordeau, France
During chronic diseases, both pathology and treatments can provide potential emotional and sexual impairments: pain, tiredness, nerve damages, body image distortions or incontinence can be found as the result of the illness by or as the consequences of the therapies applied. More than just affecting the patient, those troubles negatively interact with the partner as well, sometimes putting at stake the couple.
Usually, as physicians, we are trained to focus on the pathology regarding our specialty and to provide our patients with the most up-to-date treatments, with, generally, quite good results on the initial pathology.
But then, what about the emotional and sexual life of the patients and their partners? At best, and essentially regarding men, our response is to offer them some pharmacological drugs in order to improve their erectile capabilities. But is that good enough? Is giving pills or alprostadil injections good enough to give them back the sexual and emotional spontaneity they lost? And what about women, for whom we know a great lack of sexually active drugs?
Some recent studies tend to demonstrate that a psychologic supporting care, specifically focused on emotional and sexual troubles, alongside specific primary cares and sexually active drugs when available, can improve the quality of the intimate life, for both the patient and the partner.
But we have to remember that the first and most powerful tool at our disposal in this area is to inquire about the emotional and sexual life of our patients and their partners, because they are generally waiting for us to make the first step in this private domain. If the specific supporting care required is beyond out competencies, we can purposefully direct them to a trained sexologist.

Part II : Integrative perspectives

Why do we need integration? Trauma-informed sexology in mental health services

Dr Marie Chollier (PhD)
AIUS, France ; University of Chester

Mental health services encompass a wide spectrum of organisations (e.g. NGOs, hospital), institutional specialties (i.e. primary or specialised), and treatment modalities. Condition- based guidelines provide standards of care and good practices that are usually based on pharmacological and behavioural interventions. The sexuality and sexual quality of life of people with mental ill health (chronic or acute) has been a growing area of interest, as pharmacological treatment impact on sexual quality of life and behavioural treatment do not systematically investigate it. Mental health service users are a socially vulnerable and highly stigmatised group; studies reported higher rates of adverse childhood events and abuse and sexual dysfunctions, sketching an impaired sexual quality of life, when considered.
Embedding sexology and trauma-informed practice in a primary mental health services can be part of a global integrative approach to care, focusing on screening and prevention strategy related to sexual quality of life. Trauma-informed sexology in mental health will be exemplified by two case studies.
Integrated care has shown effectiveness for several conditions. Integrating sexology in mental health services daily practice in both manualised interventions and person-centred approaches will support a holistic, global sexual/mental health approach, taking service users’ sexual quality of life into consideration to improve their relational and sexual well-being. Such efforts should be paired with comprehensive research on integration using appropriate transtheoretical models and tools.
The last decade saw the rise of professionals’ concerns for mental health service users’ sexual health. This is prolonged in this presentation advocating for access to and availability of sexological integrative care in mental health services, the acknowledgment of human rights related to sexuality, and empowering strategies for people experiencing or living with mental ill health.

French perspectives on oncosexology

Dr Carol Burté (MD)
AIUS, Université de Nice, France

Today, cancer is being treated more effectively, recovery and remission rates are increasing. Given the improvement in life expectancy, cancer is increasingly considered as a chronic disease for which it is legitimate to pay attention to the quality of life.
One of the aims of the French national “cancer plan” is to improve the quality of life of patients treated or cured. As sexual health is an integral part of quality of life, it must be taken into account since for a majority of patients and couples, satisfactory sexual life is highly important. Patients are seeking care in this matter, but health professionals rarely satisfy this demand. The reasons for this are the prohibitions and taboos associated with sex life, false beliefs and, above all, the lack of knowledge and know-how in this area, as health professionals are scarcely trained in sexual health.
In this context, an inter-university course in oncosexology was created in 2015. It brings together 4 universities: Toulouse, Paris, Bordeaux and Nice. It aims to strengthen the knowledge of cancer care professionals in the field of sexology in order to make them able to inform, advise and refer patients towards specific care when necessary.
At the initiative of the National Cancer Institute, a group of national experts met to issue recommendations for good practice in this field, and released a document published in 2021 under the title “Preservation of sexual health and cancer”.
The purpose of this presentation is to describe this specific teaching and briefly present these guidelines.
Keywords: oncosexology ; teaching ; care

Priapiform erections: what should know and do the sexologist?

Dr Pierre Bondil, MD urologist, oncologist, sexologist; president of the AIUS, France

In 2021, priapism and its care pathways are still poorly understood by almost all stakeholders in sexual health. This fact led a French working group (including urologists, emergency physicians and sexologists) to propose a simplified temporal definition as well as a new algorithm for the acute venous form (> 95% of cases). Although rarely confronted, the sexologist must be aware that a “priapiform” erection, i.e., conscious, up to 15 minutes outside any sexual context, is abnormal and may become potentially dangerous after one hour. Until proven otherwise, any priapiform erection is a potential therapeutic emergency due to the risk of ischemic erectile sequelae (if not treated before the 24th hour) specific to the acute venous type. The three key points of treatment are to precise the duration, the pathophysiological mechanism and the etiology. In the majority of cases, the clinic and, if necessary, the blood gas easily distinguish the chronic, subacute or acute (the most dangerous) venous type from the exceptional arterial type. The treatment is always adapted to the arterial or venous type and to hypoxic suffering (blood gas role). Medical treatment is almost always effective before the 24th hour for the acute venous type. Surgery is only indicated if medical treatment has failed or cases seen after 24th hour. The sexologist may be in the first care line in case of chronic venous priapism or especially, iatrogenic one caused by an intracavernous injection of proerectile drugs. After evaluating the emergency degree, he/she should not hesitate to start first-line medical treatment before referring, if necessary, to the emergency room or to the urologist. In fact, the best prevention of post-priapism erectile sequelae involves educating all both concerned health professionals and at-risk subjects about these dangers as well as prompt treatment of priapiform erections.
Keywords: priapism, definition, diagnosis, treatment, prevention, care-pathway

Conclusion : Transformations in contemporary French sexology

Alain Giami. INSERM, Paris, France; AIUS, Sexologies, European Journal of sexology and sexual health

The renewal of French sexology started in the early 70 and it was impulse by a group of young medical practitioners all male. During the first decades of its development, French sexology was organized in 2 major organisations and included more than 70% physicians and 70% males. This situation was the opposite as compared to the one that was observed in other Western European countries in which the majority of sexologists were females and belonging to non-medical health professionals. 3 national surveys were carried in France, in 1999, 2009 and 2019 based on similar approaches. The results of the 2019 study show a significant change in the population of sexologists (compared to the 1999 data) with, in particular, the inversion of the sex ratio (83% of women) and the relative proportion of doctors and non-physicians (67% of non-physicians). The majority of participants have a degree in sexology or sexual health (62%). More than 60% of the participants do not devote more than 50% to sexology as part of their overall professional activity.
The 2019 survey has revealed a change in the profile of persons working in the field of sexology and sexual health as well as a change in the missions assigned to sexologists and to all persons who intervene in matters related to sexuality and sexual health. This evolution is parallel to the creation of new sexology associations focusing on specific themes.
Keywords: History of Sexuality / Sexology ; Human and Sexual Rights ; Sexual Medicine

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