WH_MH_article

ORIGINAL PAPER
Promotion of Sexual Health and Sexual Responsibility
in Women’s Health and Men’s Health Magazines
P. Cougar Hall • Joshua H. West •
Brianna Magnusson • Abigail Cox
Ó Springer Science+Business Media New York 2014
Abstract This study analyzed the promotion of sexual health and sexual
responsibility in Women’s Health and Men’s Health magazines as characterized by
the Surgeon General’s Call to Action along with sexual health objectives targeted by
Healthy People 2020 and sexual healthy behavior outcomes established by the
Centers for Disease Control and Prevention. This study also identiﬁed the most
frequently addressed sexual health topics included in Women’s Health and Men’s
Health. Two coders conducted a content analysis of a total of 599 articles from 64
issues (32 Women’s Health and 32 Men’s Health) published between January 2009
and November 2012. More than half of all articles addressing sexual health were
found to promote sexual health (57 %). Promotion of sexual responsibility was rare
with variables such as ensuring that pregnancy occurs only when desired, recog-
nition and tolerance for diversity, limiting the number of sexual partners, and using
birth control consistently each mentioned in 3 % of articles in this study sample.
Among topics coded, improving sex life (29 %), what men like (19 %), and what
women like (18 %) were the most common in Women’s Health while What women
like (46 %), improving sex life (27 %), and other men’s sexual health (16 %) were
the most frequent topics in Men’s Health. Among the least common topics men-
tioned were homosexuality (0.16 %) and HIV/AIDS (0.33 %). No articles addressed
rape or dating violence.
P. C. Hall (&)
Brigham Young University, RB 229-E, Provo, UT 84602, USA
e-mail: cougar_hall@byu.edu
J. H. West
Brigham Young University, RB 229-D, Provo, UT 84602, USA
B. Magnusson
Brigham Young University, RB 229-B, Provo, UT 84602, USA
A. Cox
Brigham Young University, RB 221, Provo, UT 84602, USA
123
Sexuality & Culture
DOI 10.1007/s12119-014-9239-0

Keywords Sexual health Á Sexual responsibility Á Magazines Á Women’s health Á
Men’s health
Introduction
Sexual health and sexual responsibility are primary concerns of government
agencies charged with promoting public health. For three decades the United States
Department of Health and Human Services (USDHHS) has collaborated with a
variety of other federal agencies in establishing the Healthy People objectives and
benchmarks for improving the health of all Americans. Included in the Healthy
People 2020 objectives are goals related to the promotion of sexual health and
sexual responsibility. As the leading spokesperson on matters of public health in the
Unites States, the Surgeon General reports directly to the USDHHS on public health
and scientific issues related to sexual health. The Centers for Disease Control and
Prevention (CDC) likewise works to promote sexual health and have established
desired healthy behavior outcomes related to sexual health.
Sexual health is a state of physical, mental and social well-being in relation to
sexuality (USDHHS 2001). It 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 (World Health
Organization 2006). Personal sexual responsibility is an essential component of sexual
health at both the individual and community level. The US Surgeon General’s 2001
report entitled The Surgeon General’s Call to Action to Promote Sexual Health and
Responsible Sexual Behavior, identifies five components of personal sexual respon-
sibility: (1) understanding and awareness of one’s sexuality and sexual development;
(2) respect for oneself and ones’ partner; (3) avoidance of physical or emotional harm
to either oneself or one’s partner; (4) ensuring that pregnancy occurs only when
welcomed; (5) recognition and tolerance of diversity in sexual values within any
community (USDHHS). The Call to Action recommends increasing public awareness
as a key strategy in promoting sexual health and responsible sexual behavior.
One potential source for disseminating information and raising awareness
presented in the Call to Action is mass media, including magazines. Magazines are a
frequent and trusted source of general health and sexual health information among
both adults and adolescents (Hesse et al. 2005). Health and lifestyle magazines, in
particular, represent a popular publication genre where sexual health issues are
frequently presented. Women’s Health (WH) and Men’s Health (MH) magazines
published by Rodale Press Inc. are two of the most popular magazines in this genre
providing readers with content related to fitness, nutrition, sexuality, fashion, travel,
technology, and finance. WH magazine is among the most circulated women’s
health and lifestyle magazines in the world. WH has 17 editions in 27 countries,
reaches 15 million readers per month, enjoys a US circulation of 1.5 million, and
ranks among the top 20 of all US magazines for single-copy sales (Rodale Inc
2013a). Each issue of WH includes columns such as Ask the Guy Next Door, Sex
Scoop, Health Dose, Sex and Love, and Kiss and Tell. MH is the most circulated
P. Cougar Hall et al.
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men’s health and lifestyle magazine in the world. As of 2013, MH had 40 editions in
47 countries and a US circulation of 1.8 million—the highest among all health and
fitness magazines. MH ranked in the top 15 for single-copy sales making it the best-
selling men’s magazine on US newsstands in 2012 (Rodale Inc 2013b). With regular
columns such as Sex Bulletin, Sex & Relationships, Ask the Girl Next Door, and The
Best Life, promotion of sexual health is a primary focus of MH each month.
A body of research has examined sexual health messages in popular magazines.
Batchelor et al. (2004) examined messages related to sexual health in media outlets,
including magazines, popular with adolescents in the UK. The authors reported that
the frequency of messages promoting personal decision making related to sexual
activity for females was mostly encouraging. However, content specifically directed
at males, addressing diversity in sexual orientation, or addressing sexual respon-
sibility was largely absent. Hust et al. (2008) conducted a similar content analysis of
adolescent media consumption in the US and concluded that the overwhelming
majority of sexual content did not promote sexual health. Furthermore, the authors
concluded that the few sexual health promotion messages identified were largely
inaccurate, ambiguous, and reinforced inequitable gender stereotypes related to
sexual responsibility. Larry and Grabe (2005) conducted a content analysis of sexual
health promotion messages related to sexually transmitted diseases in popular men’s
and women’s magazines. This study identified comparatively fewer messages in
men’s magazines related to sexual health promotion and prevention of sexually
transmitted disease. Walsh-Childers (1997) conducted an extensive review of sexual
health coverage in women’s, men’s, and teen’s magazines. HIV/AIDS was the most
common sexual health topic, appearing in 14 % of men’s magazine articles
addressing sexual health. By comparison, topics coded as ‘‘non-sexual health’’ such
as sexual activity, enhancing sex appeal, and sexual fantasies were present in 47 %
of articles coded. Stibbe (2004) conducted a critical discourse analysis of
masculinity as presented by six MH magazines. A key characteristic of the ideal
man as constructed in MH is sexual prowess, or as Stibbe states, ‘‘a sexual
champion’’ (p. 46). Stibbe concluded that while sexual content, essentially in the
form of sexual tips, tricks, and techniques is abundant in MH, its pages are void of
messages promoting sexual health and sexual responsibility. As analyzed by Stibbe,
instead of promoting a sexual health goal, MH merely reinforces a form of
hegemonic masculinity which turns a blind eye to safe sex practices, equitable
relationships, and non-heterosexual expression. Studies of sexual health topics in
magazines to this point have not utilized federal guidelines for assessing the
inclusion and frequency of sexual health and sexual responsibility content. The use
of such guidelines may be important insomuch as they represent the standards by
which public health agencies develop sexual health interventions. The purpose of
this study was to analyze the promotion of sexual health and sexual responsibility in
MH magazine as characterized by the Surgeon General’s Call to Action along with
sexual health objectives targeted by Healthy People 2020 and sexual health
behavior outcomes established by CDC (2008). In addition, this study sought to
broadly identify the most frequently addressed sexual health messages in WH and
MH.
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Methods
Sample
The study sample was comprised of 599 articles from a total of 64 issues of WH and
MH (32 each) published between January 2009 and November 2012.
Procedure
Following initial training related to each study measure, two coders, the principal
investigator (PCH) and a research assistant, independently analyzed 15 articles from
three randomly selected WH and MH issues included in the study sample.
Concordance between the two coders was 88 %, exceeding inter-rater reliability
standards established in the literature (Landis and Koch 1977). Thirty-two issues of
WH and 32 issues of MH included in the study sample were then randomly assigned
to each coder. Coders searched each of issue for articles addressing sexual health
topics. Articles identified as addressing topics related to sexual health were then
analyzed using the study code book. Coding results for each individual article were
entered into an electronic coding sheet that captured and stored data for each article.
When both coders had completed an analysis of each assigned issue, 15 articles
were again randomly selected for analysis by both coders to check for rater-drift.
Coder agreement was 86 %, again exceeding reliability standards.
Measures
Articles were coded for article length, type and topic. Length of the article was
coded as small, medium, or large. Articles consisting of one paragraph or less were
coded as small, those 2–5 paragraphs in length were coded as medium and articles
with six or more paragraphs were coded as large. Article type was defined as (1)
feature/cover story or (2) a general information article. Feature/cover story articles
were limited to those included in the first page of the table of contents. General
information articles were those listed on subsequent table of contents pages, often
labeled ‘‘Departments’’ with regularly occurring columns of the magazine. These
general information articles were coded by column title (e.g., Sex Bulletin, The Best
Life). Together with article length, this is an important distinction in differentiating
passing reports of sexual research, facts and figures from detailed writing related to
sexuality and sexual health.
Articles were coded for sexual health and sexual responsibility according to
guidelines defined by the WHO, Surgeon General’s Call to Action, and Healthy
People 2020/CDC.
Promotion of Sexual Health
Articles were coded as either promoting sexual health or not promoting sexual health
based upon the following definition of sexual health: state of physical, mental and
social well-being in relation to sexuality; requires a positive and respectful approach
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to sexuality and sexual relationships, as well as the possibility of having pleasurable
and safe sexual experiences, free of coercion, discrimination and violence.
Surgeon General’s Call to Action
Articles were coded for inclusion of the goals and objectives included in the
Surgeon General’s Call to Action, specifically: (1) understanding and awareness of
one’s sexuality and sexual development (e.g., sexual attitudes, beliefs, body
changes, evolving beliefs, changes in desire and thoughts, questions about other
lifestyles and orientations); (2) respect for oneself and one’s partner (e.g., sexual
dignity, meeting a sexual partner’s needs, selflessness); (3) avoidance of physical or
emotional harm to either oneself or one’s partner (e.g., not hurting self or partner
during sexual activity, avoidance of emotional harm from sexual activity, avoiding
harm caused by cheating or infidelity); (4) ensuring that pregnancy occurs only
when welcomed (e.g., contraception, family planning); and (5) recognition and
tolerance of diversity in sexual values within any community (e.g., recognition of
sexual minorities, tolerance for diverse sexual attitudes, cultures, and orientations).
Healthy People 2020/Centers for Disease Control and Prevention
Articles were coded for inclusion of the following sexual health goals and sexual
healthy behavior outcomes representative of both Healthy People 2020 and CDC
objectives: (1) Avoid pressuring others to engage in sexual behaviors; (2) Seek
health care professionals to promote sexual health; (3) Limit the number of sexual
partners if sexually active; (4) Use condoms consistently and correctly if sexually
active; and (5) Use birth control consistently and correctly if sexually active
In addition, articles were coded for inclusion of the following 18 sexual health
topics: improving sex life, what women like, what men like, improving a woman’s
orgasm, improving a man’s orgasm, sexual satisfaction, HIV/AIDS, STDs, rape/
dating violence, pregnancy, condoms, other contraception, other women’s sexual
health, other men’s sexual health, gay men, lesbians, drugs/alcohol, and other.
Detailed topic descriptions and examples are provided Table 1.
Analysis
Descriptive statistics were calculated for each of the study variables. Separate rates
were calculated for WH and MH. Chi square test statistics were computed to
compare articles from WH and MH on variables included within the categories of
article topic, promoting sexual health, Surgeon General’s Call to Action, and
Healthy People 2020/CDC.
Results
Table 2 includes descriptive information related to article length, article type, article
topic, and promotion of sexual health. The majority (62 %) of coded articles were
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less than one paragraph in length (‘‘small’’) and fewer than 1/3 of sexual health
articles (29 %) contained 6 or more paragraphs (‘‘large’’). Most articles were
general information (79 %) as opposed to feature or cover stores (17 %). For
general information articles published in WH, the most common columns
addressing sexual health were Sex Scoop (22 %) and Ask the Guy Next Door
(13 %). Similarly, for articles published in MH the most common columns
Table 1 Coding topics with descriptions or examples
Topic Descriptions or examples
Improving sex life Strategies for getting more sex
Achieving better sex or sex more consistent with the potential reader’s
perceived desires and interests
What women like Preferences, likes and dislikes, relative to sex or sexual relationships
Sexual techniques that women enjoy or endorse
Physical or personality traits of a preferred or potential sex partner
What men like Preferences, likes and dislikes, relative to sex or sexual relationships
Sexual techniques that men enjoy or endorse
Physical or personality traits of a preferred or potential sex partner
Improving a woman’s
orgasm
Information or techniques for improving a woman’s orgasm quality, strength,
duration or frequency
Improving a man’s
orgasm
Information or techniques for improving a man’s orgasm quality, strength,
duration or frequency
Sexual satisfaction Information related to personal contentment of current sexual experiences and
sex life (as opposed to advice on how to improve one’s sex life
HIV/AIDS Any mention
STDs Any mention
Rape/dating violence date rape or acquaintance rape
Sexual harassment
Sexual cyber-bullying
Date rape drugs other than alcohol
Pregnancy Any mention
Condoms Any mention
Other contraception Any mention (e.g. vasectomy, tubal ligation, birth control pill, natural family
planning)
Other women’s sexual
health
Female reproductive health (e.g. sexuality during or just following pregnancy,
cervical cancer, poly-cystic ovarian syndrome, female genital cutting, breast
cancer, vaginal dryness, sexual dysfunction, abortion)
Other men’s sexual
health
Male reproductive health (e.g. testicular cancer, prostate health, erectile
dysfunction)
Gay men Any mention of male non-heterosexual orientation or behavior
Lesbians Any mention of female non-heterosexual orientation or behavior
Drugs/alcohol Content connecting drugs and alcohol to sexual behaviors and outcomes (e.g.
bars and clubs as locations for ﬁnding sexual partners, alcohol and sexual
performance)
Other Sexual information not coded in the categories listed above
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Table 2 Article characteristics and content for a sample of articles discussing sexual health published in
Men’s Health and Women’s Health January 2009–November 2012
Variable Category Men’s Health Magazine
(n = 279)
Women’s Health
Magazine (n = 320)
n % n %
Article length Small 168 60.22 206 64.38
Medium 29 10.39 22 6.88
Large 82 29.39 92 28.75
Type of article General information 226 81.00 246 76.88
Feature 41 14.7 58 18.12
Ask 21 7.53 9 2.81
Ask guy next door 0 0 42 13.12
Ask girl next door 64 22.93 0 0
Sex scoop 0 0 71 22.19
Bulletin 80 28.67 0 0
The best life 15 5.38 0 0
Health dose 0 0 15 4.69
Sex ? love 0 0 37 11.56
Your 2 cents 0 0 7 2.19
On our radar 4 1.43 0 0
How to do everything better 3 1.08 0 0
Love and life 0 0 4 1.25
Kiss and tell 0 0 21 6.56
Sex secrets 0 0 2 0.63
Other 50 17.92 68 21.25
Article topic Improving sex life 75 26.88 94 29.38
What women like*** 129 46.24 57 17.81
What men like* 35 12.54 62 19.38
Improving woman’s orgasm 22 7.89 20 6.25
Improving man’s orgasm 9 3.23 5 1.56
Sexual satisfaction 13 4.66 10 3.12
HIV/AIDS 1 0.36 1 0.31
STDs 9 3.23 12 3.75
Rape 0 0 0 0
Pregnancy* 4 1.43 14 4.38
Condoms 13 4.66 10 3.12
Other contraception* 5 1.79 17 5.31
Other women’s sexual health*** 10 3.58 80 25
Other men’s sexual health*** 44 15.77 17 5.31
Gay men 1 0.36 0 0
Lesbians 2 0.72 0 0
Drugs/Alcohol 5 1.79 7 2.19
Other 22 7.89 26 8.12
* P .05; *** P .001
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addressing sexual health were Sex Bulletin (29 %) and Ask the Girl Next Door
(23 %).
Table 3 includes sexual health and sexual responsibility variables derived from
the Surgeon General’s Call to Action, and Healthy People 2020/CDC objectives.
Following the Surgeon General guidelines, understanding and awareness of one’s
own sexuality was present in 26 % of WH articles compared to 20 % of MH
articles, respect for oneself and one’s partner was less common in WH (16 %) than
MH (25 %) (P .01), and avoidance of physical or emotional harm were
approximately the same for both (17 %). Ensuring that pregnancy occurs only when
desired (WH—2 %; MH—0.72 %) and recognition and tolerance for diversity
(WH—3 %; MH—2 %) were infrequent article topics in both magazines. Among
measures of Healthy People 2020/CDC objectives for sexual health, seeking a
healthcare professional (WH—11 %; MH—9 %) was the most common topic
mentioned. Of the remaining Healthy People 2020/CDC objectives, none exceeded
4 %. Most notably, limiting the number of sexual partners and using birth control
consistently were both mentioned in 1 % of articles in this study sample.
The most common article topics for WH were improving sex life (29 %), what
men like (19 %), and what women like (18 %). Conversely, what women like
Table 3 Proportion of sexual health articles containing sexual health promotion content as deﬁned by
the U.S. Surgeon General’s Call to Action and Healthy People 2020/CDC objectives for articles published
in Men’s Health and Women’s Health January 2009–November 2012
Variable Category Men’s
Health
Magazine
(n = 279)
Women’s
Health
Magazine
(n = 320)
n % n %
Promotes Sexual Health (yes): 161 57.71 185 57.81
Surgeon General’s Call to Action-
Does the article promote (yes):
Understanding and awareness of
one’s sexuality/sexual
development
55 19.71 83 25.94
Respect for oneself and one’s
partner**
70 25.09 52 16.25
Avoidance of physical or emotional
harm
48 17.20 54 16.88
Ensuring that pregnancy occurs only
when desired
2 0.72 7 2.19
Recognition and tolerance of
diversity
5 1.79 9 2.81
Healthy People 2020/CDC
objectives-Does the article
promote (yes):
Avoid pressuring others to engage in
sexual behaviors
5 1.79 2 0.62
Seek health care professional 26 9.32 34 10.62
Limit the number of sexual partners 2 0.72 1 0.31
Using condoms consistently 10 3.58 11 3.44
Using birth control consistently 1 0.36 2 0.62
** P .01
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(46 %), improving sex life (27 %), and other men’s sexual health (16 %) were the
most common article topics in MH. Improving women’s orgasm was more common
than improving men’s orgasm, independent of whether the article was published in
WH or MH. Among the least common article topics were those that mentioned
homosexuality (0.16 %) and HIV/AIDS (0.33 %). No articles addressed rape or
dating violence. More than half of all articles mentioning sexual health were found
to promote sexual health (57 %). When comparing article topics between the two
magazines, what women like (P .001) and other men’s sexual health (P .001)
were more common in MH, compared to WH. What men like (P .05), pregnancy
(P .05), other contraception (P .05), and other women’s sexual health
(P .001) were all more common in WH, compared to MH.
Discussion
Magazines represent a popular medium for presenting and promoting sexual health
messages. Sexual health topics were common in both the WH and MH magazine
issues analyzed in this study. Articles mentioning sexual health in both magazines
frequently focus on improving one’s sex life. Improving one’s sex life is an
important health promotion topic as sexual satisfaction is related to relationship
quality, marital stability, and overall quality of health (Rosen and Bachman 2008;
Sprecher 2002; Yeh et al. 2006). Both what women like and what men like are also
frequent topics in WH and MH magazines. In particular, nearly half of all MH
articles addressing sexual health focus on what women like. Helping MH readers
better meet a woman’s sexual needs is largely consistent with the goal to establish
respect for oneself and one’s partner outlined in the Surgeon General’s Call to
Action. With articles such as Say This, Have Sex (Men’s Health, Jan/Feb, 2009),
however, the argument can be made that such a focus in MH has less to do with
meeting a female partner’s needs as it does attracting a female partner to meet a
man’s needs. By comparison, only one-ﬁfth of WH articles addressing sexual health
focus on what men like. Of particular note is a greater focus in WH than MH on
sexual satisfaction, or getting more sex, better sex, or sex more consistent with
one’s desires and interests. In MH what men like is an infrequent topic mentioned
approximately once for every four mentions of what women like. Sexual
satisfaction, although a topic in more than one-quarter of MH articles coded in
this study, was less common in MH than in WH. The comparatively heightened
focus in WH on improving sex life, what women want, and sexual satisfaction can
be viewed as encouraging and liberating in the promotion of women’s sexual health.
Similarly, more than one-quarter of articles addressing sexual health in WH include
information directed at understanding and awareness of one’s sexuality and sexual
development.
Both WH and MH magazines analyzed in this study fall short in addressing many
relevant sexual health topics. Very few articles in either magazine address critical
topics included in the Surgeon General’s Call to Action, and Healthy People 2020/
CDC objectives for sexual health such as HIV/AIDS, STDs, rape or dating violence,
pregnancy, and issues related to LGBT sexual health.
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About 1.1 million people in the United States and 34 million in the world are
currently living with HIV, with approximately 50,000 and 2.5 million new cases
respectively each year (CDC 2013). AIDS is responsible for approximately 50,000
deaths in the U.S. and 17 million deaths globally each year. The CDC estimates that
20 million new STD infections occur annually, with a total of $16 billion in medical
costs in the U.S. (CDC). Walsh-Childers (1997) reported 14 % of sexual health
articles included information about HIV/AIDS. Only 21 of the 599 articles reviewed
in the current study mentioned STDs in general, and just two articles discussed HIV/
AIDS in particular. One notable exception was When Did Unsafe Sex Stop Being
Scary (Women’s Health, January/February, 2010) which targets the danger of a
‘‘mating-without-dating’’ multiple sex partner lifestyle and subsequent STD risks.
While such articles are rare in WH, they are even harder to find in MH. In the
current study STDs were discussed in approximately 3 % of sexual health articles in
both WH and MH, yet there were 25 % more STD mentions in WH overall.
Comparing STD content in men’s and women’s magazines, Larry and Grabe (2005)
identified comparatively fewer messages targeted at men. Similar to Stibbe’s (2004)
conclusion that MH has turned a blind eye to important issues such as safe sex, the
findings from the current study show both WH and MH fail to take advantage of the
opportunity to promote sexual health by addressing STDs, including HIV/AIDS.
Rape and dating violence continue to be primary public health concerns in the US
where one in six women and one in 33 men have experienced an attempted or
completed rape in their lifetime (Elliot et al. 2004). Rates of unplanned pregnancies
have increased for young adults over the age of 20 in recent years (Palmetto et al.
2013). Not a single mention of rape or dating violence was identified among the 599
articles analyzed in the current study. It is possible that readers of WH and MH may
identify topics such as bedroom boredom, weak orgasm, and erectile dysfunction as
greater threats to sexual health than rape or dating violence based upon findings
from this study.
Similar to the analysis by Batchelor et al. (2004) in the UK, the current study
identified a void of information related to diversity in sexual orientation and sexual
responsibility. Sexual health risks are highest among sexual minorities, who along
with the threat of STDs and sexual violence, often face additional mental,
emotional, and social challenges related to discrimination. In accordance with the
Surgeon General’s Call to Action, a great need for increased attention and focus on
recognition and tolerance for sexual diversity exists. There was no mention of
homosexuality among the 35 issues and 320 articles coded in WH. The sole mention
of male homosexuality in MH in this study sample was the following question for
Jimmy the Bartender in The Best Life section of the March 2012 issue: ‘‘I’m certain
my friend is gay, but hasn’t come out yet. Do I bring it up?’’ Jimmy’s response was:
What makes you so sure? Is it the way he talks or dresses? Is it the things he
talks about or the people he hangs out with? Maybe your hunch is dead-on, but
maybe (have you considered this?) it’s not. Either way, unless you think he’s
going through a tough time and you want to show support, why bring it up? If
he has something to say to you, he will. Until that time, his business is none of
yours. (p. 70)
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The two coded incidents of female homosexualilty in MH were mentions of
heterosexual or non-lesbian women enjoying ‘‘girl-on-girl’’ action, and a declaration
that a man’s ‘‘threesome fantasy may not be so far-fetched’’ (Men’s Health, June,
2011, p. 42). In his review of MH, Stibbe (2004) highlighted the magazine’s
singular focus on heterosexual expression. Granted both WH and MH target a
heterosexual audience, yet with its large and growing circulation in the US and
globally, both magazines have an opportunity to address sexual diversity in more
meaningful ways and increase tolerance and understanding while promoting sexual
responsibility for all.
Fifty-eight percent of articles in this study sample from both WH and MH were
coded as promoting sexual health. In their analysis of sexual health messages in
young adolescents’ media, Hust et al. (2008) found little promotion of sexual health.
While sexual content in media was common, it was rarely discussed in a way that
would promote sexual health. The conceptualization used by Hust et al. was based
upon national guidelines developed for sexuality education in the 1990s by the
Sexuality Information and Education Council of the United States and focused on
taking responsibility for sexual health, contraception, prevention of unwanted
pregnancy, and prevention of STDs. The current study used a considerably broader
definition of sexual health based upon the WHO and the Surgeon General’s Call to
Action which may explain its discrepancy with the Hust et al. findings. It is
noteworthy that coders of the current study were largely dissatisfied with the broad
definition of sexual health promotion used in analyzing the WH and MH issues in
this study sample. The consensus among coders following the analysis was that both
WH and MH consistently missed out on opportunities to promote sexual health in
meaningful ways. Coders’ perceptions of missed opportunities in promoting safer
sexual practices, including the correct and consistent use of condoms to prevent
unwanted pregnancies and STDs is largely supported by the results of coding for
specific sexual health topics which demonstrate that these key sexual health
promotion topics occur infrequently in WH and MH.
Promotion of sexual responsibility in WH and MH is infrequent as measured
using the Surgeon General’s Call to Action and Healthy People 2020/CDC
objectives. The most infrequent measures of sexual responsibility identified in this
study were using birth control consistently, ensuring that pregnancy occurs only
when desired, and limiting the number of sexual partners. These findings are similar
to previous research including Batchelor et al. (2004) and Walsh-Childers (1997). It
is very clear that while WH and MH both commonly address sexuality and sexual
health, the intent of these magazines is not to promote sexual responsibility as
defined by the Call to Action or Healthy People 2020/CDC objectives. Messages
related to limiting the number of sexual partners or tips on how to avoid pressuring
others to engage in sexual behaviors may not sell magazines in quite the same way
that Sex So Good…the Neighbors will Complain (Men’s Health, July/August, 2010)
and Have Electric Sex Tonight (Women’s Health, September, 2012) can. Perhaps
the Surgeon General’s expectation for promotion of sexual responsibility through
the mass media is incongruent with a publisher’s expectation to produce a profit and
provide readership with content it desires.
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Limitations
This study has several key limitations. First, while pre- and post-measures of
acceptable inter-rater reliability were established in this study, content analysis is a
limited research methodology prone to rater bias. Second, the validity of a key
coding variable used in this study, promotion of sexual health, may be limited.
Despite a high rater-reliability, questions of validity arise given the broad definition
of sexual health used in study. While more than half of all articles coded in this
study were found to promote sexual health, very few addressed key components of
sexual health promotion such as safe sexual experiences, and freedom from
coercion, discrimination, or violence. Many articles included in this study sample
were coded as promoting sexual health despite these important omissions because
they generally met at least one part of the definition for sexual health. Coders were
obligated to indicate an article promoted sexual health based upon codebook
instructions and descriptions in instances where both WH and MH likely fell short
in fully promoting key aspects of sexual health. This limitation was minimized by
coding for a large number of individual article topics revealing that both WH and
MH could improve their promotion of sexual health topics. Finally, this study is
limited by a largely descriptive methodology of articles coded for inclusion of key
topics, rather than the quality and accuracy of which those topics were presented.
Future studies should explore the quality and accuracy of the sexual health
promotion messages and topics addressed in WH and MH.
Conclusion
While sexuality and sexual health are frequently included in WH and MH, few
articles fully address sexual health and sexual responsibility as defined by leading
health authorities in the US. Moving forward, public health may consider ways to
partner with the publisher of WH and MH in such ways that both parties’ interests
are addressed, whereby WH and MH can increase promotion of sexual health and
sexual responsibility while continuing to be leading magazines for readers interested
in health and fitness. Future research may address the extent to which magazine
editors view such efforts as compatible with the magazines’ publishing objectives.
Additionally, researchers may explore the extent to which readers would be
accepting of this type of sexual health and sexual responsibility content.
References
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