Sexuality...Let's Talk About It!

What is the Program?

Sexuality...Let’s Talk About It! is a community-based program that aims to increase awareness and improve attitudes about sexual health among First Nations and Inuit youth (referred to collectively here as Aboriginal youth) who are between the ages of 10 and 29 and who live outside of their communities of origin, in order to reduce risky behavior and prevent unplanned pregnancies, STIs and HIV, and intimate partner violence. Given the considerable disparity in age, education and awareness of issues related to sexuality among the target clientele, the program consists of a series of short exercises that are accessible to youth from a wide range of backgrounds and experiences presented over the course of two short workshops. Lunch can be served between the two workshops.

The short exercises use arts-based projects, role-playing and discussions around written and filmed scenarios to encourage participants to explore topics related to sexuality that can have an important impact on their life experience. This largely participatory approach is culturally relevant to Aboriginal youth living in an urban setting. The workshops provide participants with an opportunity for asking questions about sexuality in a safe environment. Though the workshops focus predominantly on heterosexual relationships, resources on same-sex and/or same-gender relationships are included in the supporting literature presented to participants.

Why Was the Program Developed?

In some Aboriginal communities in Quebec, including some of the rural communities that Aboriginal youth involved in Sexuality…Let’s Talk about it! come from, sexual abuse, drug and alcohol use and violence are disproportionately prevalent. Bearing this in mind, the theory behind the program is that, to adopt healthy sexual behavior, youth need to discuss sexuality and partner violence and gain access to general information on STIs and sexual health in a safe, non-judgmental environment where they can be themselves and share cultural values they have in common.

In this context, the Sexuality…Let’s Talk About It! program was developed to present information on HIV, STIs and intimate partner violence. The program was inspired by the SEXEplorer program of the Centre des R.O.S.É.S., which introduces youth in the Abitibi-Témiscamingue region to information on STIs and violence.

Though the program is based on the general topics and casual, fun approach from the SEXEplorer program, the specific content and resources for Sexuality…Let’s Talk About It! were developed from scratch to specifically address the cultural needs of the Aboriginal participants.

In the current program, sensitive topics are addressed through artistic and role-playing activities to given the fact that sex remains a taboo subject among many Aboriginal youth and to show respect for participants’ comfort and community norms regarding discussing sexuality. This more discreet approach is critical to the program’s success, given the existing stigma related to STIs, HIV and hepatitis C in some Aboriginal communities.

How Does the Program Work?

Location

Sexuality…Let’s Talk About It! consists of two two-hour workshops comprised of various activities lasting from five to 20 minutes each. The short duration of each activity ensures that facilitators are able to keep participants engaged throughout the workshop.

Each workshop requires a quiet, comfortable space where participants can feel free to reflect, speak openly and hear each other. Most workshops are currently offered at the eight Native Friendship Centres in towns and cities in Quebec, which exist to “improve the quality of life of urban Aboriginals, promote [their] culture and build bridges” among the various First Nations people. (It is important to note that “urban” is defined by the Native Friendship Centres as anywhere outside of a rural Aboriginal community, whether in the city of Montreal or in smaller towns, such as Val d’Or or Senneterre.)

Recruitment and Engagement

The program recruits participants by contacting each of the eight Native Friendship Centres with information on the program and a proposal to present the program to youth who visit the centre. The Program Officer follows up with each Native Friendship Centre to explain the program in more detail and answer any questions. So far, the Officer has conducted workshops multiple times at certain centres serving larger communities, while other centres have yet to schedule a first workshop. Much depends on the frequency with which youth visit a specific centre.

The Program Officer works with Native Friendship Centres to be flexible in scheduling workshops when youth are likely to be present. It is often possible to take advantage of participants’ presence by giving both workshops on the same day and providing lunch as both an incentive for the youth to participate and as an encouragement for them to stay for the entire program.

The number of participants can vary, requiring the direction of a highly versatile facilitator.

Workshops

The first workshop deals with pregnancy and STI prevention, while the second addresses the issue of violence within intimate and sexual relationships. The sessions complement each other, and it is important to begin with the session on STIs, as it addresses general questions about sexuality, which youth are usually very interested in. The session on relationships draws heavily on participants’ understanding of the material from session one. The activities rely heavily on engaging participants in role-playing scenarios, which allows them to present feelings and questions in relationship to the characters they are playing, granting them a certain license to be outspoken on culturally taboo topics they may otherwise be uncomfortable speaking openly about.

Session One: STIs and Contraception: How do you deal with it?!?

1. Welcome: Participants are given a folder with activities, a lexicon that explains certain terms used when speaking about sex, a list of resources with contact information and brochures on STIs, HIV/AIDS, hepatitis C, homosexuality, contraceptive methods, pregnancy, puberty and condom use. Please see Program Materials for examples of these resources.
2. Introductions: Each participant introduces him/herself and describes how talking about sex makes him/her feel. This breaks the ice and allows the facilitator to assess the level of comfort of participants while establishing an atmosphere for freedom of expression in the group.
3. Ground Rules: The facilitator engages participants in establishing the ground rules to assure a respectful, confidential and judgment-free environment.
4. Pre-Test: Participants take a short quiz to assess their knowledge of STIs and contraception prior to taking the workshop. Please see Program Materials for a copy of the pre-test.
5. Risk: The group is divided into teams to record reactions to a scenario in an educational poster about risks associated with sex (see Program Materials). Speaking about the people in the poster rather than themselves provides a certain license for testing out their thoughts and feelings. Afterwards, the facilitator asks the teams to share some of their reactions and dispels any misconceptions.
6. STIs: As a group, participants try to list the different STIs they are aware of. The facilitator provides details about the symptoms and modes of transmission for each.
7. Contraception and STI Prevention: Participants brainstorm ways to avoid unwanted pregnancies and STIs. A PowerPoint presentation on contraceptive methods shows the efficacy of each in preventing pregnancy and STIs. The condom is highlighted as an effective tool for preventing both. The risks associated with condom usage are discussed along with the option of using a second method of contraception as a backup plan. Please see Program Materials for a copy of the PowerPoint on STIs and Contraception.
8. Negotiating Condom Use: Participants are divided into teams of three in this 20-minute exercise. On each team, one member plays the partner who wants to use a condom for sex, and one plays the partner who doesn’t want to use one, while the remaining person records the arguments of both partners. Afterwards, teams share their findings with the group and discuss strategies for negotiating condom usage. (See www.jcapote.com for examples of rebuttals to arguments against condom usage.)
9. Sex and Drugs: Participants think of reasons why people use drugs and/or alcohol before having sex and discuss the ways they can influence sexual behaviour.
10. Overcoming Anxiety: In small groups, participants simulate anxieties related to the use of condoms and other contraception during first sexual encounters. A video on the correct technique for using condoms is shown. Next, the facilitator responds to questions from the participants.
11. The Condom: Each participant receives a packaged condom and is invited to unwrap it, look at it, touch it, smell it, taste it and express their observations.
12. Conclusion: The facilitator concludes the workshop by reminding participants that the objective is not to scare them away from a healthy sex life but rather to inform them about the realities—both positive and negative—of having sex, so they are able to make informed choices about protecting themselves against STIs and unplanned pregnancies.
13. Post-Test and Training Evaluation: Participants repeat the quiz they took at the beginning of the workshop; then they fill out a form providing their feedback on the workshop. Please see Program Materials for a copy of the post-test.

Session Two: Intimate Relationships: The love and sexual relationships of youth

1. Welcome: Participants are given a folder with additional activities and support materials, including support resources for intimate partner violence.
2. Introductions: Each participant introduces him/herself and names a quality that they possess that begins with the first letter of his/her first name. This serves as a warm-up and introduces the concept of the unique value of each person.
3. Ground Rules: The facilitator engages participants in establishing the ground rules to assure a respectful, confidential and judgment-free environment.
4. Pre-Test: Participants take a short quiz to assess their knowledge of sexuality and intimate relationships. Please see Program Materials for a copy of the pre-test.
5. What is Sexuality?: Participants say what the word “sexuality” means to them and the facilitator follows up by stressing that sexuality involves a wide range of human experiences and emotions as well as physical interaction.
6. Love: Participants are separated into two groups—male and female. Each group divides into smaller groups. The male participants respond to questions about how girls behave and feel (e.g., “What kind of partner do girls generally look for?”), while the female participants respond to questions about how boys behave and feel (e.g., “How do boys act with their partners when they are in love?”). After sharing their responses with the larger groups, the girls have the opportunity to respond to the boys’ perceptions, and vice versa. Collectively they discuss the implications of the exercise and how both boys and girls can learn to understand each other better.

   Note: This exercise is focused on heterosexual relationships, but throughout the workshops, the term “partner” is used instead of “boyfriend” or “girlfriend.” Confronting homosexuality directly within the role-playing exercise is not only difficult given time constraints and the very general scope of the workshop materials, but it can be a highly taboo subject for youth from certain communities.

7. Sex: In small groups, participants respond to different questions related to a scenario in which two people are thinking about having their first sexual encounter. Next, they must draw a cartoon to illustrate their responses. Each team is given paperboard and crayons as well as a list of questions the team’s comic strip must address. Collectively, the groups share their cartoons and discuss how, based on the scenario, being prepared for sex can help reduce the risk of STI/HIV transmission, pregnancies and intimate partner violence.
8. Violence: Participants name and define different types of violence then watch four short video scenes illustrating jealousy and psychological, sexual and physical violence. They discuss who is capable of committing and/or being subjected to violence, then discuss different ways of responding to and overcoming it. Participants are directed to resources in their handouts that provide support for those who are victims of or affected by violence.
9. Respect: In groups, participants take turns exploring their own sense of physical boundaries by standing in the middle of a circle formed by their fellow teammates. As the teammates move in, the person in the centre must tell the others to stop as soon as he or she feels uncomfortable. Participants discuss how to listen to their bodies to learn when to say no.
10. Conclusion: Participants are reminded that the discovery of sexuality happens at each person’s individual pace and that it is important to affirm one’s desires and boundaries to ensure the most positive and pleasurable experiences possible.
11. Post-Test and Training Evaluation: Participants repeat the quiz they took at the beginning of the workshop; then they fill out a form providing their feedback on the workshop. Please see Program Materials for a copy of the post-test.

Required Resources

Human resources

One enthusiastic and personable facilitator experienced working with Aboriginal youth, who understands their reality is essential to the success of the workshops. A co-facilitator meeting the same criteria can also be beneficial. Facilitators must be aware that youth from several communities may be present in the same workshop and should be prepared to tailor material to meet the different needs of youth from communities with very different levels of awareness of the topics covered.

To date, the program has been administered by the Program Officer, but anyone who is qualified and understands Aboriginal realities and ways of life is encouraged to facilitate the workshops using FNQLHSSC’s detailed guides (see Program Materials for a copy of the facilitator guides).

Material resources

• Computer and projector for PowerPoint and video presentations
• A folder for each participant with brochures, support documents, training evaluation, lexicon, resources, brochures and registration forms
• Art supplies such as cardboard, crayons, paper and pencils
• Food and refreshments

Please see Program Materials for copies of support materials.

Financial resources

Total expenses for the two-part workshop series can range from as little as $50 to thousands, depending on the number of participants recruited, travel expenses and whether facilitators are recruited on a volunteer or paid basis. Expenses include:

• Equipment and supplies
• Food and refreshments (if applicable)
• Additional travel expenses (if applicable)

Challenges

• Because this program targets Aboriginal youth living outside of their communities, where their housing may be unstable, it can be difficult to reach them.
• The complexity of presenting this content to youth may make recruiting facilitators difficult.
• Due to socio-economic instability among the youth served, it can be difficult to follow up with workshop participants.

Evaluation

Comparing participants’ pre- and post-test scores revealed an increase in knowledge about STIs, safer sex, intimate relationships and intimate partner violence as a result of their participation in the workshops.

Additionally, during the program’s one-year “breaking-in” period (April 2009 to March 2010), a discussion was held after each workshop to gather participants’ comments and evaluate the quality of the work accomplished.

According to the Program Officer, Christine Godbout-Sioui, “Participants didn’t know that there were so many STIs, and they were unaware of the risks of contracting them. They asked a lot of questions during and after the workshops. They say it’s fun to be able to talk about sex here because they don’t have anywhere else where they can talk about it and get the answers they need.”

Participants also became more aware of the dangers of falling into violent behaviours within their intimate relationships. “After these workshops they appear to be better equipped to realize that violence prevention has a positive impact on STI prevention,” Godbout-Sioui says.

Workshops are adapted regularly based on the answers provided during evaluations. Based on the youths’ responses, for example, the program has been expanded to allow more room for discussions on STIs and pregnancy, and the terms used in the workshops have been revised to include language that is readily understood by the youths.

Lessons Learned

• Aboriginal youth living outside their home communities in urban centres in Quebec can be reached when they drop in to Native Friendship Centres in the province.
• Short participatory workshops that can be given on the spot whenever youth drop in are ideal for ensuring participation on short notice.
• Providing lunch between a series of two sessions provides an incentive for youth to attend fully scheduled workshops.
• Role-playing and other creative exercises dramatizing issues of sex, sexuality and the negotiation of condom use help demystify these and other taboo topics.
• Incorporating informational videos can help youth find words to discuss situations they may encounter in their daily lives.

Program Materials

• Sexuality...Let's Talk About It! Facilitator guide: Love & Sexual Relationships of Youth
• Sexuality...Let's Talk About It! Love and Sexual Relationships of Youth Workshop Tools
• Sexuality...Let's Talk About It! Workshop Facilitator Guide: STIs and Contraception
• Sexuality...Let's Talk About It! STI and Contraception Workshop Tools
• Sexuality...Let's Talk About It! Worksheet on Violence, Glossary of Terms and Other Resources
• Oh oui! Oh oui! [Affiche]

Contact Information

For more information about the FNQLHSSC program Sexuality... Let’s Talk About It! please contact:

Christine Godbout-Sioui
Agente de programme
VIH/sida, hépatite C en milieu urbain
CSSSPNQL
Tel.: (418) 842-1540 poste 270
Fax: (418) 842-7045
cgsioui@cssspnql.com