Sexual health describes the mental, physical and social wellbeing associated with one’s sexuality. Sexual health, when viewed affirmatively, requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.
According to the WHO, the ability of men and women to achieve sexual health and well-being depends on their:
- access to comprehensive, good-quality information about sex and sexuality;
- knowledge about the risks they may face and their vulnerability to adverse consequences of unprotected sexual activity;
- ability to access sexual health care;
- living in an environment that affirms and promotes sexual health.
When it comes to sexual health, the following three pillars need to be considered:
1. Secured consent
No sexual activity should take place without both people having explicitly expressed their consent. Consent means that all partners engaged in the sexual act agree to the activities that are taking place and must be able to change their minds at any time. Without consent, any sexual activity can be considered sexual assault or rape. It is vital to remember:
- Consent is necessary for every sexual act. The yes of yesterday does not guarantee the yes of today.
- The need for consent applies also to long-term partners.
- Consent can be drawn at any time, even during the sexual act. Everyone has the right to change their minds at any time. Sometimes people are too scared or overwhelmed to say no.
- If someone does not say “no”, they do not necessarily mean “yes”. You should be always mindful of body language.
- How someone is dressed is not linked to consent.
- Consent is not taken for granted if the consenting person is under the effect of alcohol or drugs.
- There is a legally applied minimum age of consent, which varies between countries (usually between 14-18 years). This means that any sexual activity with a person under this age constitutes statutory rape. If you’re in international waters (high seas), the age of consent in your flag state applies.
2. Avoiding Sexually Transmitted Infections (STIs)
STIs are passed through unprotected sexual contact with an infected person. If they are diagnosed early, the infected person can get effective medical treatment. However, if they are left unchecked, they can cause infertility, impotence, cancer, and even death. They may also be spread to other people.
Common symptoms of STIs include warts around the genitals, pain or a burning sensation when urinating, and pain, swelling or itching of the genitals. It is also common for infected persons to have no symptoms at all. However, transmission to other people may still take place.
Among the most serious STIs is HIV or human immunodeficiency virus, which targets the immune system and weakens people’s defence systems against infections. The most advanced stage of HIV infection is AIDS, which can take from 2 to 15 years to develop if not treated. Other common Sexually Transmitted Infections include:
- Chlamydia / Treatment: Antibiotics
- Genital warts/ Treatment: Painting them with a liquid or freezing them with a spray
- Genital herpes/ Treatment: There is no treatment, but antiviral drugs may relieve symptoms
- Gonorrhoea / Treatment: For the early stage, antibiotics
- Syphilis / Treatment: For the early stage, antibiotics
- Hepatitis B / Treatment: It exists but is expensive and debilitating
- Non-specific urethritis / Treatment: Antibiotics
- Trichomoniasis / Treatment: Antibiotics
- Pubic lice / Treatment: Special shampoos, creams or lotions.
While it could be considered that the risk of sexually transmitted infections is equally present on ships as it is in any other environment, ISWAN has earlier identified four factors increasing the risk of STIs specifically for seafarers:
- Working and living away from spouses and partners.
- Single-sex working and living arrangements dominated by men.
- Lack of information about risk and preventive measures.
- Enhanced probability of sex with casual partners due to travelling.
Therefore, it is important that prevention and education on STIs is part of the onboard health program, including regular testing and screening.
3. Protection from unwanted pregnancy
Contraception is the responsibility of everyone who chooses to have sex. Every individual should be responsible and not rely on the other person to take these precautions. For seafarers, pregnancy prevention methods may not be available at any time when the ship is underway, so it is important to make sure that you have secured long-term precaution methods before you go onboard. Key contraception methods include:
- Contraceptive pill
- Contraceptive injection
- Contraceptive implant
- Intra-uterine device (IUD)
Bear in mind that:
- Abortion may be a criminal offence in some countries.
- If you don’t have access to a doctor, you can purchase a pregnancy test in a pharmacy onshore.
- Not all contraceptive methods protect against sexually transmitted diseases.
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