Newspapers, in addition to news, also cover topics of permanent interest to their readers. One such topic is sexuality. The appearance of the incurable sexually transmitted disease AIDS obliges a reconsideration of the complex and contradictory concept of sexuality. Sexuality is not often spoken of openly; rather, it is secret, hidden, and referred to obliquely. Sexuality is the manifestation and satisfaction of the sexual impulses common to all individuals. Sexuality is determined by anatomic and physiologic aspects and also by the knowledge, experiences, values, and norms internalized by the individual living in a social group. Messages about sexual conduct are constantly being received. This social part of sexuality supported by customs and morals is the part that is directly influenced by communications media. An important objective of the media is to create awareness and mold opinions. Mexico's large national circulation newspapers present different points of view about sexuality. Newspapers that continually critique homosexual practices and those that demonstrate implicit approval of pornographic videos by advertising them both present attitudes without providing opportunities to reason, compare, or support opinions. Sexuality is usually referred to indirectly and superficially in the press. Sex education may be mentioned but not the erotic implications of sexuality, and acceptance or opposition to use of condoms may be discussed without mention of psychological barriers to their use. The national press is not prepared to propose new attitudes toward sexuality in the age of AIDS. Only 1 national newspaper in Mexico regularly provides information on AIDS including aspects related to sexual pleasure and responsibility and safer sex. The majority continue with their pre-AIDS coverage of sexuality, using it to arouse interest but providing little depth. Newspapers should provide more extensive coverage on sexuality and its modifications due to AIDS, a reality threatening every person to some extent.
Women have generally assumed responsibility for contraception since the appearance of oral contraceptives and IUDs. But AIDS prevention programs are now asking women to assume responsibility for safer sex through use of condoms, a male method. Women are being asked to carry condoms, to negotiate their use each time they have sex, and to insist if the partner resists. The problem with this strategy is that frequently it is the male partner who makes sexual decisions, and women have less negotiating power. Women are considered feminine if they assume a passive role in sexual activity. This work suggests strategies to improve the negotiating power of women. Options and problems of speaking about safer sex vary in accordance with the nature of the relationship. A woman with a new partner can try to ascertain his sexual history, but may gain no information on his probable health even if he tells her the truth. It may be easier to convince him to use a condom at least in the beginning of the romance. Women working in the sex industry often have greater trouble convincing their friends and lovers to use a condom than their clients. Some family planning workers have begun to speak of safer sex with all their clients. Role playing and workshops or discussions with small groups of women having similar problems may help women overcome their reticence about discussing sexual topics. Some general suggestions to help women negotiate safer sex include choosing an opportune moment and planning in advance what to say; daring to speak directly without beating around the bush (the partner may also be gathering courage to speak); practicing placing condoms on objects and if necessary placing one on the partner without speaking; being honest with the partner about sex, love, and fidelity; and remembering that protection from condoms is mutual given that it is not possible to know who is infected. Until now, programs to help women practice safer sex have concentrated on sex industry workers or family planning clients. Adolescents are a particularly vulnerable group because of their usual lack of knowledge when the initiate their sex lives. Some sex education classes are beginning to include materials instructing young girls in how to negotiate with boys seeking sexual favors. Printed materials such as simple pamphlets made available by family planning programs to young people can help to raise the topics of HIV infection and safer sex. Greater societal awareness of the problem and improvements in the opportunities for women to exercise their basic rights will be needed to ensure all women the power to protect their own health.
The origin of the term condom is not known, but it may have been derived from the Latin word condus meaning receptacle. Or it may have been names for an English physician named Condom, although there is no proof of this. Potential users should not be put off by a misperception of the word condom as vulgar. The 1st condoms were made of animal intestines and were designed to prevent spread of sexually transmitted diseases. They decreased sensitivity and could not be mass produced. The 1839 discovery of a process for vulcanizing rubber permitted widescale production of condoms for the 'st time in the later 1800s. Although condoms are not completely safe wither as a contraceptive or a preventive measure, they offer more advantages than disadvantages. They reduce sensitivity and interrupt lovemaking, but their use can be converted into an element of erotic play. The condom should be placed on the erect penis and carefully unrolled to the base. The condom should be carefully removed after ejaculation to ensure that no liquid escapes. Condoms offer protection against the life threatening AIDS virus and against unwanted pregnancy. They have the further advantage of requiring male participation and thus of fostering greater egalitarianism in family planning and contraception. Condom use is slowly gaining ground. 10 years ago a person seeking condoms in a Mexican pharmacy had to request them, but today they are sold in supermarkets and on pharmacy display racks. Channels for free distribution of condoms should be increased to remove the financial constraint on their acceptance.
AIDS in a single decade has affected life and assumptions on the societal and individual level more than any other illness or epidemic in history. The most important aspect of the HIV pandemic is that it is still in an early stage of development. The pandemic will continue to be volatile and dynamic; its greatest impact has not yet been felt. There is still great potential to influence its future course. HIV infection is spreading rapidly in some already affected populations in Africa, Latin America, and the Caribbean, and is penetrating deeply into new areas such as Eastern Europe, the Middle East, and Southeast Asia. Thailand and India are symbols of its rapid spread. The more than 100 million new cases of sexually transmitted diseases diagnosed in the world each year demonstrate the potential for sexual transmission of HIV. On the global level, the foundations have been laid for preventing the spread of HIV infection. But in many countries information is still inadequate or incorrect, needed social and health services are nonexistent, and punitive and discriminatory attitudes persist toward the infected. The gap between rich and poor within and between countries is widening. 2/3 of AIDS cases and 3/4 of seropositive individuals are in developing countries. The cost of drugs and treatment implies that "early intervention" is a meaningless concept for developing countries. The developed world contributes $200 million or less to combat AIDS in developing countries. Some of the revolutionary ideas prompted by the advent of AIDS included the immediate attention given to behavior as a preventive measure, the eradication of complacency about the condition of health and social services, the insistence of AIDS patients and the HIV infected on being included in the total process of prevention, treatment, and research, and the unexpected flowering of a dialogue on dignity, human rights, and social justice. AIDS is now leading to a new vision of health promotion in which individual and collective behavior is recognized as the greatest challenge for future health. Solidarity is a central aspect of the emerging perspective on health prompted by AIDS. The disease has revealed the inherent limitations of 2 alternatives to solidarity: coercion and discrimination.
AIDS and the economic crisis in Mexico are threatening the epidemiologic transition in which infectious diseases ceased to be the only major cause of death and chronic degenerative diseases began to account for a growing proportion of deaths. Many factors combined to produce the sexual, gay, and women's liberation movements beginning in the 1970s. At the beginning of the feminist movement, women proposed different kinds of interpersonal relations both between women and with men. Women together realized their rights to control their own bodies, to sexual enjoyment, to abortion, and to free themselves of feelings of shame and guilt. The weight of moral pressures was lessened and the personal desires of the woman assumed a greater role in selection of sexual partners. Conservative forces grew stronger in the 1980s, and the proliferation of sexually transmitted diseases began to imperil the sexual revolution. But these setbacks were minor compared to AIDS. Now, 10 years after its appearance, it is clear that AIDS is not limited to homosexual men. The number of cases in Mexico increased from none 10 years ago to some 10,000 estimated cases reported and unreported today. 1/6 of the cases are in women. Many women and heterosexuals felt immune from AIDS in the beginning, and some still do, but many more have become aware of the danger. Women now fear contracting AIDS, but they also fear confronting their partners to suggest that they use condoms. Denial may play a role, but deeply rooted cultural factors that women may recognize but fee powerless to change may also be at play. Many women over 30 have difficulty taking the initiative in sexual matters. They are embarrassed to buy condoms and even more embarrassed to propose their use. They imagine that men will consider them "loose" if they carry condoms. Mexican women are poorly prepared to tell their men explicitly what they want sexually, and Mexican men are also poorly equipped to ask what women want, accustomed as they are to exercising sexuality exclusively to satisfy their own needs. The entire problem of condom use is related to ethical-moral and ideological factors and to broader attitudes toward knowledge. Those with more rational orientations see AIDS as a disease rather than a divine punishment and can more easily accept condom use as a preventive.
