MINISTRY OF HEALTH

PSYCHOSOCIAL COUNSELLING
SKILLS COURSE

Human Sexuality
(Source: Psychosocial Counselling Training Manual)
 Introduction
• The role that Culture and Traditions play in
the epidemiology of any disease can not be
overemphasized. Certain cultural practices
have contributed to the prevalence of HIV
infections in Sub-Saharan Africa
• Since HIV is mainly transmitted through
sexual contact, it is imperative to discuss the
sexual issues that relate to counselling from a
cultural perspective.
 Learning objectives
• To learn about the common sexual
practices in Zambia
• To gain knowledge on specific sexual
and cultural practices that affect the
prevention of HIV/AIDS in Zambia
• To enhance knowledge on safe sex
practices
 Common reasons why humans
indulge in sex
• For Pleasure (sex is very nice)
• To make babies
• Curiosity (peer influence, experimenting e.t.c.)
• Matrimonial duty
• To reduce stress
• Business
• Customary obligations
• To maintain a relationship
• To relieve sex tension resulting from
caressing, abstinence, watching sex movies &
use of sex potency drugs
 Sexual orientations
• Heterosexual: Male to female sexual
attraction (normal)
• Homosexual: Male to male or female
to female sexual attraction
• Bisexual: Heterosexual and
homosexual at the same time
 Common sex practices
• Vaginal sex
• Anal sex
• Oral sex (blow job)
• Caressing
• Fondling
• Giving a sexy look
• Rubbing
• Talking sex (hot talk)
• Masturbating
• Looking at each other’s nakedness
• Watching others in sex act
 Puberty and adolescence
• Puberty is the process of body maturation to
a level of sexual reproduction. During
puberty, physical and emotional changes
take place
• Adolescence is the transition period between
puberty and adulthood
• An adolescent is no longer a child and not
yet an adult
• It is the period from approximately 10-19
years
 Stages of adolescence
1. Early adolescence (10-13 years)
2. Mid-adolescence (14-16 years)
3. Late adolescence ( >17 years)

8
 Areas of adolescence changes

• Physical changes
• Social changes
• Psychological changes

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 General characteristics
• Developing autonomy (independence)

• Establishing satisfying relationships

• Developing an identity

• Developing moral reasoning

10
 Group discussion(30 mins)

In three groups discuss the adolescence

changes that happen in the following areas:
1.Group 1: physical changes
2.Group 2: social changes
3.Group 3: psychological changes

11
 Physical Changes
• Increased hormone flow
• Growth of hairs on pubis, arm pits and chin
• Enlarged genitals
• Profuse sweating
• Body odor
• Acne (pimples) on the face.
• Physical attraction to opposite sex

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 Boys
• Deepening of voice
• Muscle development
• Growing taller
• Enlargement of scrotum and penis
• Wet dreams
• Development of beards

13
 Girls
• Enlargement of breasts
• Enlarged labias and clitoris
• Menstruation begins (menarche)
• Widening of hips

14
 Social Changes
• Friendship formation
• Attraction to opposite sex
• Formation of peer groups
• Fashion conscious
• Easily influenced by peers
• Seeking recognition
• Need for adventure

15
 Psychological changes
• Emotional and moody
• Rebellion
• Egocentric
• Increased sexual feelings
• Curious and inquisitive
• Sense of independence
• Creative and innovative.
• Seeking and doubting the meaning of life.
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 Sex and Gender
• Sex is being male or female.
• Gender is the social perception of males and
females.
• Gender issues are those social and cultural
concerns of males and females regarding how
they regard each other (gender perceptions).

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 What is Sexuality?
• Sexuality is the overall attributes of male and
female animals and includes: sexual behaviours,
feelings, attitudes, intercourse, pregnancy,
relationships, marriages, sex attraction, gender
issues, sexual orientation, sexual preference,
menstruation e.t.c.)
• Sexuality can be simplified to mean maleness or
femaleness.
 Factors that influence sex and
sexuality in adolescents
Social status of girls and women
• In many African societies, a girl’s status is
only recognized when she enters into a
sexual relationship and demonstrates the
ability to have a baby
• Older men seek younger sexual partners. In
such a relationship the girl is vulnerable
because she is not able to negotiate for safe
sex with the older man who has a greater risk
of infection.
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 Brainstorming (5mins)

How do adolescents in your area obtain

information on sex and sexuality?

20
 Cultural aspects of sexuality
• Culture is a set of customs, beliefs and mind set of
a given society or ethnic entity. Culture is also a way
in which a people express their values and
civilization and is often expressed within the
parameters of their social and ethnic boundaries.
• Tradition refers to the practices that a group of
people do as part of normal life such as dress code,
traditional ceremonies, important observations, code
of conduct and leadership etiquette.
• The following cultural and traditional practices are
sexual in nature and as such do have a bearing on
the prevalence of HIV infection:
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
Dry sex: Removal of • To Increase friction
natural vaginal • To please a man
secretions before or • To enhance a man’s
during a sexual act performance
using herbs, drugs or a
cloth. • For maximum pleasure
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
Sperm bath: Smearing To strengthen the baby
semen on the baby, a and protect him/her
practice that is done on from communicable
the first sexual diseases
encounter following
birth of the baby
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
Marital shave: The • Mutual hygiene
shaving of pubic hair • To enhance
from each other by trust/faithfulness
married spouses • Monitoring the
(usually followed by a reproductive health of
sexual act). spouse (STIs???)
• Stimulant for coitus
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
Post coitus wiping: A • To demonstrate
practice of wiping a affection for the man.
man’s penis with bare • To strengthen the
hands and then marriage bond
smearing semen on her • Semen is believed to
thighs after a sexual make a woman’s skin
act. smooth.
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
Sexual cleansing: A To free the widow from
customary practice the dead spouse’s
where a widow is forced ghost
to have sexual relations
with the dead spouse’s
sibling.
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
• Tattoos: Stylish cuts on the • Medicinal
skin made deliberately with • To boost Fertility
a sharp instrument e.g. • Family bonding or budding
razor which may be shared • Ethnic identification
among close family
members. Some do suck
blood or even rub tattoos
with each other
• Beauty
• Beauty tattoos: Tiny scars • Identification
made on the woman’s • Stimulant for coitus, To
forehead, thighs, belly and enhance coitus (when man
around the waist touches/feels the scars)
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
• Breast milk related: • To clean the urethral
Apart from meatus
breastfeeding, women • To “sweeten” the sex
squeeze breast milk organs
onto a baby’s genitalia • To treat eye infections
and into the eyes
• To neutralize poison
• Wet nursing: A Antidote for vermin for
breastfeeding mother spitting cobra
breastfeeding a dead
woman’s baby • Nutrition
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
• Initiation ceremonies: that • Traditional education to
include circumcision (male prepare adolescents for
and female) adulthood responsibilities
• Enlargement of penis and • Preparation for conjugal
elongation of labias using duties
herbs or pulling

• *sexual intercourse with a • *To get rid of (cure) HIV

child or an old woman infection
• Purification to chase evil
spirits
• To enhance business
prowess
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
The wife assistant: A • To relieve pressure
young sister or cousin from an aging wife
is appointed, with • To maintain the man
blessings/consent from within the family
the parents and the • To have more children
current wife, to become from the same man
the second wife and
assist the elder one • To retain wealth within
with house chores and the family
other marital
responsibilities
 Cultural aspects of sexuality
Cultural Practice Purpose/belief
Cutting fire wood: • To provide family
Traditionally done by support with heat
the men or husband’s energy
male relative in his • To sustain evening
absence. Fire wood entertainment within the
keeps the family warm. family
• To provide protection
against outsiders
 BENEFITS OF SEX
Research now confirms that a good sex life
has a number of benefits. During sex the
sexual excitement makes the body to release
natural chemical compounds that are good
for the body.
 BENEFITS OF SEX
• Sex reduces stress: Orgasm is a tranquilizer. During
arousal, your muscles tense: during orgasm they twitch, then
relax completely. This may explain the findings of the Institute
for Advanced Study of Human Sexuality: People with fulfilling
sex lives are less anxious, violent and hostile.
• Sex burns calories: Vigorous sex gives you a mini work out.
Dr Alfred Franger, professor of Obstetrics and Gynecology at
the Medical College of Wisconsin, estimates that a 119lb
woman burns 4.2 calories per minute during sex, compared
to 4 calories per minute playing tennis.
• Sex boosts your immune system: Orgasm improves
immunity. Dr. Dudley Chapman, a gynecologist, monitored 24
breast cancer patients and found that those who regularly
reached orgasm fared better than those who did not. Orgasm
boosts infection fighting cells by up to 20 percent.
 BENEFITS OF SEX
• Sex improves health and happiness: “Sexually active
people take fewer sick days, are more gregarious and enjoy
life more” says Dr. Ted McIlvenna, of San Francisco’s
Institute for Advanced Study of Human Sexuality. And sex
guru Alex Comfort observed 20 years ago, sexually active
people outlive their inactive counterpants.
• Sex regulates your hormones: Dr, Winnifred Cutler,
director of the Athena Institute for women’s Wellness in
Pennsylvania, has shown that due to prolonged exposure to
male pheromones, women who have intercourse at least
once a week are more likely to have normal length menstrual
cycles than women who are celibate or who take a “feast or
famine” approach.
• Sex boosts estrogen: Cutler also found that women who
enjoyed regular weekly intercourse had significantly higher
levels of estrogen in their blood. Estrogen keeps the
cardiovascular system healthy, lowers bad cholesterol, raises
good cholesterol, maintains bone density, helps the skin to
stay supple and prevents depression.
 BENEFITS OF SEX
• Sex relieves menstrual cramps: Uterine contractions
during orgasm may help reduce premenstrual fluid build up
in the pelvic area by forcing blood to flow back into the
general circulation, relieving bloating and tightness. Orgasm
helps lower prostaglandin levels and reducing pain.
• Sex relieves pain: Orgasm acts as a natural analgesic.
Beverly Whipple and Barry Komisaruk of Rutgers University
have found that women with conditions such as arthritis and
whiplash gain higher pain thresholds through regular
orgasms. Midwives advise women to masturbate to orgasm
to relieve labour pains.
• Sex strengthens pelvic muscles: “Regular sex can tone
the muscles of the pelvic floor” says Giovanna Ciccarelli, a
trainer at NYC’s Equinox Fitness Centre. Gripping a penis
with the vagina plus the vigorous contractions during orgasm
strengthen the pelvic muscles.
 BENEFITS OF SEX
• Did you know that we can determine if a person
is sexually active or not by looking at her skin?
• Sex is a beauty treatment. Scientific tests have
shown that a woman who has sexual relations
produces big amounts of estrogen which makes
hair shiny and soft.
• The more we make love, the more we have the
capacity to do more. A body sexually active
releases a higher amount of pheromone. This
subtle aroma excites the opposite sex !
 BENEFITS OF SEX
• Sex relieves headaches. Each time we
make love, it releases the tension in brain
veins.
• Making love can heal a nasal congestion.
Sex is a natural antihistaminic. It helps
fight asthma and spring allergies.
• Sex is not always about penetrating
someone. It is mainly about how you feel
when you are with that someone special
 BENEFITS OF SEX
• To make love allows to burn all the calories
accumulate is this romantic love scene
• Sex relieves headaches. Each time we make
love, it releases the tension in brain veins
• Sex is one of the safest sports. It strengthens
and tonifies all body muscles. It is more
enjoyabel than doing 20 lapses in the pool.
And you don’t need special shoes!
 BENEFITS OF SEX
• Sex is an instantaneous cure against depression. It
frees endorphines in the blood flow, creating a state
of euphoria and leaves us with a feeling of well-being
• The more we make love, the more we have the
capacity to do more. A body sexually active releases
a higher amount of pheromone. This subtle aroma
excites the opposite sex !
• Sex is the safest tranquiliser in the world. IT IS 10
TIMES MORE EFFICIENT THAN VALIUM.
• To kiss everyday allows to avoid the dentist. Kisses
aid saliva in cleaning teeths and lower the quantity
of acids causing enamel weakening.
BENEFITS OF SEX
Sex is a gift from
our creator. It
should be enjoyed
in marriage for as
long as you live
 Common sex problems
• General lack of interest in sex due to fear,
anxiety, depression etc
• Impotence: Failure by the man to have and
maintain an erection
• Frigidity: Lack of interest in sex by the woman
and failure to experience sexual arousal
• Premature ejaculation: Man reaching orgasm
before full penetration is achieved
• Sadism: Man experiencing sexual arousal only
when he inflicts pain and humiliation on a woman
• Masochism: Woman experiencing sexual arousal
only when she has been exposed to physical pain,
torture and humiliation
 Common sex problems cont”
• Peeping Tom: Person who experiences sexual
arousal by watching others making love
• Exhibitionist: Man or woman who attains sexual
gratification by exposing his/her nakedness to
others.
• Fetishism: Experiencing sexual arousal through
touching or watching garments worn by the
opposite sex e.g. knickers, belt, neck tie, bra etc
• Trans-sexual: These are men or women who
wear clothes for the opposite sex, behave like they
are from the opposite sex because they feel
“trapped” in the wrong body.
 Safe sex
• Unsafe sex: Sex practices that offer no
protection for either partners e.g. “skin to
skin sex”
• Safer sex: Sex practices that offer
some protection for either partner e.g.
use of condoms
• Safe sex: Sex practices that offer
absolute protection for either partner
e.g. caressing, masturbating, hot talk
e.t.c.
 COMFORT LEVELS - Exercise

GROUP 1
• Describe the customary practices that
done on both the male child and
female child to prepare for their future
sex roles
• Describe these practices according
to the following age groups: 0 –1
year, 1 – 3 years, 3 – 6 years, 6 – 9
years, 9 – 13 years, 13 – 16 years
 COMFORT LEVELS Exercise
GROUP 2
Mention the following body parts in
your local languages (Nyanja, lozi,
Tonga, Bemba, Namwanga, Kaonde,
Tumbuka):
Breasts, Sexual intercourse,
Penis, Vagina, Clitoris, Glans,
Labias, Buttocks, Scrotum,
pubis, semen, vaginal fluids
 END OF LESSON-3&4

“WE LEAD TO PROMOTE SKILLS AND SELF-RELIANCE IN ZAMBIA”

THANK YOU!!!!!!