Vernacular knowledge and critical pedagogy: conceptualising sexual health education for young men who have sex with men

Abstract

Over 30 years after HIV was first recognised in the USA, the epidemic continues to pose a disproportionate threat to vulnerable and marginalised populations. Increasing HIV incidence among young men who have sex with men has spurred debate around the content and approach to HIV prevention interventions directed towards this vulnerable population. A comprehensive model for conceptualising the content of sexual health education is described, which can be tailored to the unique needs and experiences of young men who have sex with men through the application of social theory. Vernacular knowledge is incorporated as a manner of nesting sexual health messages within the shared understandings of young men regarding same-sex sexual practices, gender roles and expectations, community mores and conventions and other shared knowledge of sex and sexuality. Critical pedagogy is then discussed as a way of guiding one’s pedagogical approach during intervention design and implementation that is most conducive to both individual empowerment and community solidarity. The paper concludes with strategies for turning the corner from theory to practice, beginning with formative research that culminates in the design of relevant, community-based sexual health education programmes for young men who have sex with men.

Keywords:

• Sexual health
• education
• HIV
• young men who have sex with men

Acknowledgements

The author would like to thank Patrick A. Wilson, Peter Messeri and Richard Parker for their feedback on earlier versions of this manuscript.

Funding

This manuscript is an original theoretical work that did not receive grant support.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. Over the past two decades, the concept of sexual health has been increasingly used in both health education and health promotion. However, the concept is not without significant critique and debate. Sexual health has emerged from the discipline of sexology, which promotes a broad, sexually affirming and inclusive interpretation of sexual health and well-being across the life course. While useful in many ways, sexual health is also intertwined with issues of authority and control, as well as the implicit reinforcing of societal values and beliefs. A more thorough review of the critiques and debates surrounding sexual health is available in Sandfort and Ehrhardt (2004).

2. In a 2008 review of stigma in the HIV epidemic, Mahajan and colleagues recognise the pervasive and long-lasting effects of stigma with respect to HIV and AIDS. Concluding that approaches to reducing stigma must be multifaceted and multi-level, they propose both structural (in the form of policy) and community-based interventions as the way forward. Without question, policies regarding both HIV and sexual minorities (e.g. same-sex marriage, blood donations, employment non-discrimination and ‘Don’t Ask, Don’t Tell’) have advanced greatly since the time of their publication, and show no signs of slowing in the near future. Less can be said regarding community-level stigma interventions, suggesting that while the lived experiences of young men who have sex with men may be changing rapidly, much remains to be done by way of addressing the root causes of HIV stigma.