Latinos and sexual health: last week, we offered insight into the disparities faced by the Latino community as seen by higher rates of reproductive cancers, unintended pregnancies and sexually transmitted infections, all of which boil down to the greater conversation of lack of access or barriers to care for this community.

But sometimes it's more than just numbers or statistics.

This week, we hope to offer additional insight on this topic.

Not only will we talk about the cultural significance of sexuality in the Latino community, but we'll also delve into Covid-19 and how that's impacted relationships across the board.

Welcome to A Su Salud: Cheers to Good Health.

I'm your host, Genesis Ortega.

We're broadcasting inside the PPL Public Media Center in Bethlehem, Pennsylvania.

Let's introduce our first guest.

You may recognize her because we spoke with her last week, but we're bringing her back in hopes to offer some cultural insight.

And I'm hoping to break down a few stereotypes today.

This will, in fact, be a deep dive.

Now, Dr.

Bianca Laureano is an award winning educator, curriculum writer, facilitator and sexologist.

Thanks for joining us today, Dr.

Laureano.

- Thanks for having me back.

- So let's set a baseline here.

When it comes to Latinos and sex, what can you tell us?

- Well, Latinos and sexuality, we are a very sensual community.

If we look at the way that we are singing and dancing and the ways that we incorporate ritual into everything we do from cooking to bathing, we definitely value our sexual lives and our sexual selves.

And sometimes it's difficult for us to find common ground and how to live our best, fullest and most joyful experiences with the realities that sexuality does have certain consequences at the end of the day as well.

So I think one of the first things to remind ourselves is that as Latinos, we enjoy life.

We are very sensual, and it's really a part of our full experiences as members of our communities to really value life and to experience it fully.

- Now, from a male and female perspective, I imagine things are very different on this conversation.

But when talking about Latina sexuality, where does that conversation begin?

Does that begin with sex positivity?

- It can begin with sex positivity.

And sometimes that language may resonate more with people who have lived in the United States for one or two generations longer.

For people who have newly arrived to the United States or who are understanding the language for the first time and learning English, sex positivity may feel really not common for what they're experiencing.

And so I just want to acknowledge that the language of sex positivity, sometimes it lands well for many people and sometimes it still feels really odd and uncomfortable.

And so I think some of the things that show up for Latinos when it comes to being sex positive is reminding ourselves that there is no wrong way to have a body, that there is no wrong way to experience our own pleasure as long as we're not harming other people.

And to remember that it is our gift.

It's a gift that we've been given.

Our bodies are a gift that we are responsible for.

And it is a lot of responsibility, but there is a lot of joy, a lot of pleasure in much of what we do.

And so oftentimes when people think about pleasure and Latinos, there's a really narrow idea of what we enjoy.

And so I want to encourage people to remember that what you enjoy is yours, your pleasure is yours, and that we have body autonomy, which means we get to have the right to say what happens to our bodies and who gets to touch our bodies and who cannot touch our bodies.

And those are really important pieces, I think, for all of us to keep in mind, not just for young people and children to be told, but this is something for adults to understand as well.

- Now, would you say that Latina sexuality has been - criminalized?

- Absolutely.

It totally has been criminalized.

If we think about the language of how, you know, conservative community members have used terms such as anchor baby to talk about people who are pregnant, who are coming into the United States to birth children that will then have U.S.

citizenship, these are some of the ways that we're experiencing criminalization of Latina sexuality.

When we also think about the ways that people who are trans gender or non binary or people who are gay or lesbian, those individuals have also experienced criminalization maybe in their home countries, but also here in the United States, where protections to individuals who are different, whose sexual expression is also different, those protections are really being chipped away at for all people in this country, but especially for Latinos, for many of us who are living in communities where we're more surveilled, which means we're being watched a little bit more closely than other people in other communities.

And sometimes it's our neighbors who are doing that, unfortunately, and it's really connected to this expectation that people have for us, which sometimes is fair and sometimes it's not fair.

And so it's really about being clear about who we want to be in our communities, why it is we want to show up in a particular way and to be guided by some really radical ideas of love, acceptance and representation I think is really, really important to remember.

How do we want to be seen?

- Now, the University of Washington did a study recently and they found that black women are hyper sexualized in media.

And so for women of color, for Latinas and maybe more specifically Afro Latinas, how can one be in control of their sexuality despite this?

- Yeah, you know, it's one of those hard spaces where we really have to negotiate and also be clear about who we want to be and what we're comfortable with.

So one of the first things that I usually tell black Latinas, Afro Latinas, whatever term they use to identify with, is that you deserve privacy and you get to decide who has access to you.

And you also get to decide who you want to share information with and who you want to reach out to.

This can also be a contradictory message when you look and you say, oh, Latinas have these stereotypes of being overly sexualized or always ready for sex, and then add that with the same layer of racialized beliefs of black women.

So here there's like this double form of stereotyping that exists.

And so one of the things that I usually encourage people to remember is that being Afro Latina is not new.

We've always been here.

We've been here since, you know, chattel slavery and the transatlantic slave trade.

A lot of those boats stopped in the Caribbean and in Brazil and in other parts of Central and South America.

And so when we think about black people in the West, a lot of us are in Brazil and a lot of us are in the Caribbean.

And, you know, we celebrate in ways that people from the US may not fully understand.

So I think about Carnival, I think about festivals that may be happening.

And those are the pieces where art shows up in our lives or music shows up in our lives, and we really get to be expressive outside these very rigid ideas of what's possible.

And so some of the things that I remind people of is our power and the power that we already have, the power that we've been birthed with, and that that's a type of power that other people may try to take away because they don't understand it.

But it's also the power that will never leave us.

And so it's up to us how we want to use it for our own benefit and pleasure.

But also, how can we share it with a group of people that are still trying to understand us and also maybe a little bit scared at the same time.

And so that is definitely our power, and what people may try to do with it, that's their business.

And it's also our business to ensure that we maintain that and we push back when we need to, if we need to.

And hopefully many Afro Latinos, many Caribbenas, won't feel the need to constantly do that in the future and that the movement for Black Lives is a global movement and that black lives includes those that are in Central South America and other Spanish speaking communities as well.

- Now, I want to shift a little bit to talk about teenage pregnancy.

There was a lot of talk back in 2010, 2012, you might know this, about Latinas and high rates of teenage pregnancy.

I haven't seen much of that.

But would you say that the trend is going down or what's going on with that?

- Yeah, you know, it's interesting you bring that up because that was such an important conversation that was happening for almost 20 years in our field, where that was sometimes the only type of research we could find about Latina sexuality was really talking about fertility rates of young Latinas.

And I think what we're realizing now is that there has been a little bit of a shift because the focus on education, of maintaining Latinas in education, the attempts to bring Latinas into math and sciences through STEM, I mean, these are really specific ways that we've shifted the understanding of what Latinas are capable of in this country of the United States.

And that wasn't always the case.

And so in many ways, you know, when you look at the early literature about teen pregnancy and Latinas, it is very stereotypical.

It says things like, oh, you know, Latinos want to be parents and they want to be moms.

And I think for a lot of us today, we may want to be not, but we also don't want to be that so quickly.

We want to have fuller lives and different experiences, and we want to plan our families in a way that feels good for ourselves.

And so forming our families is really now, for many of us, beyond a biological connection.

Many of us build our families and our kinship practices with people in ways that make us feel full and happy.

And that doesn't always have to include birthing a child.

And so what I think we're seeing now is what happens when people invest in us at a young age and what happens when we also invest in ourselves in a different way.

It doesn't necessarily mean it's a negative outcome.

I think many people are able to dream bigger, and I think that's one of the joys and the pleasures.

And I think another piece is, you know, the young people who are young parents, they've made really important choices for themselves and for their own happiness in life.

And so we're now beginning to see a lot more resources and a lot more listening to young parents about what they need versus telling young parents what not to do.

And so I think it's really important that we've seen that shift, because that's one of the main ways that we can create programs and create supportive networks to care for young Latinos so they get to share that body autonomy that we believe is deeply connected for all people.

And so when we talk about body autonomy and making those decisions for ourselves, usually people think those are adults' rights.

But children and youth, they also have the right to body autonomy as well.

- That's a good example of how sex education can sort of shift trends.

So I'm glad to hear that.

We're wrapping up this segment.

We have a little bit, around three minutes left.

But I want to ask you a question.

Men are not going to get away on this segment easy.

How does machismo fit into this conversation?

- Machismo's one of those terms that was not organic to us or our community members.

And then it became so common that we really embraced it.

And I think one of the ways that we need to remember machismo has always been here it is not unique to Latinos, you know, misogyny, which is a translation of machismo, exists in every community.

And so I think some of the things that we need to do is really encourage Latino men and masculine people to think about what does it mean to be a man for you?

Does it really mean all of these negative things that other people may say or are there positive elements to being a Latino man?

And what we know from 90s and early 2000s research with Latino men is that they believe machismo is about positive aspects.

So tending to their family, bringing respect to the family, showing up in a particular way, you know, providing for the family in a variety of ways.

I think those are the really important pieces that I want us to encourage to think about when it comes to masculinity.

And another piece of machismo is also if we're going to take care of our families, that means we have to take care of ourselves.

And sometimes taking care of ourselves means using a condom because using a condom decreases sexually transmitted diseases or infections.

It also means that we're also communicating with our partners about what we do and don't want.

And I think it's also important to remember that there are ways that machismo can also harm Latino men as well, thinking about the fact that many men and boys can also experience sexual violence.

And what does it mean when those individuals don't feel comfortable sharing that harmful, violent experience?

It means that we're not really meeting their needs and they feel ashamed and scared of what might come to them if they share this information.

And so I really hope for all of us that we're creating and imagining a world where all of us feel safe and full and comfortable to be ourselves and also to get the resources that we're seeking to make the best decisions.

So, yes, Latino men are not going to get off on this conversation when it comes to responsibility.

But, yeah, it's a collective responsibility to an extent.

And it's also a reminder that we have a lot of power in our lives.

Even if we don't like our options, we still have some power to make the best decisions for ourselves.

- A really, really great conversation.

There's so much to unpack.

I'm glad that we were able to hear your insight on this.

Thank you again, Dr.

Laureano, for speaking with us today.

- Absolutely.

Thank you, Genesis.

- Let's speak with our next guest.

Joining us virtually as Susan Gilbert.

She is the co-director for the National Coalition for Sexual Health at Altarum.

Thanks, Susan.

Thanks for joining us today.

Welcome.

- Thanks so much for having me.

- So can Covid-19 spread through sexual activity?

- That's a great question.

I think where we need to start with that is first to understand that Covid-19 can spread through close contact.

Right?

So if you're close enough to touch someone who's infected, you're close enough to actually get Covid-19.

So this means when you're hugging someone, when you're sitting together, when you're lying in bed together, you can actually be transmitting the virus.

And that's because the virus is airborne, right?

It can be spread when people are talking, breathing, even singing.

And so that's why that can happen if you're within six feet of another person.

Now, in terms of sexual activity, what we do know is that it can easily be spread through kissing because they found the virus in both saliva and mucus.

It's also possible that it could be spread if you have contact with someone else's feces or more plainly poop through oral anal sex.

It might also be spread that way.

We don't know yet.

And there really haven't been a lot of studies done to understand whether it's spread through semen or vaginal fluid.

And I think most scientists agree that we need more work in this area before we really know the answer to that, so I think in the meantime, what we're advising people is that just to be safe, it's best to use barrier methods when you're having sex so you can use condoms, you can use dental dams to protect you during vaginal, anal or oral sex.

- Now, when we're talking about kissing, I mean, how do you wear a mask when you're trying to kiss someone?

- Well, that's a hard one.

And you really can't do that.

And there are people right now that are suggesting that wearing masks during sex, if both partners are wearing masks, could reduce your risk.

To date, I don't know studies that have actually documented this, but I think because we know masks can be effective in other situations, people are suggesting you can mask up.

We've heard this from people at the Mayo Clinic.

We've heard it from the Canadian Health Minister and others who are now making this kind of recommendation.

- Now, I've heard this question a lot.

I'm sure you've probably heard this, too.

But for people who are dating someone new, what's the protocol?

When do you know to take the next step in the relationship?

- I mean, I think that's a really good question, and when you say the next step, I'm assuming that we're moving beyond just virtual contact, right, that we're talking about potentially seeing somebody in person.

So I think there are a number of things we can recommend.

And, you know, no matter what we do, there's always some risk around Covid.

So I think that's important to recognize, whether it's with an existing partner or a new partner.

First of all, I mean, you can consider during your first meet up to have a physically distant meet up, right?

You could wear a mask.

You could sit six feet apart.

So you can apply that same rule to someone that you're meeting on a first date.

Then I think if you want to go beyond that and you want to have close contact with a partner, it's really important to talk openly about Covid risk.

And this kind of reminds me of how we encourage people to talk openly about STIs.

And it might seem a bit awkward at first, but I think it's important to have a conversation about this.

And one way you might do that is by starting and saying something like, look, either of us could have Covid-19 and not know it.

In fact, up to 50% of people who have Covid don't have any symptoms at all.

So I think it's important that we talk about this so that we can keep each other safe.

And then if your partner's willing to have this conversation, that's great.

But if they're not willing to talk about it or they shut you down, then I think you really need to take a step back and think, is this worth it?

Because, frankly, you deserve better and your health deserves better than that.

So if they're willing to have a conversation with you, I would start asking questions like, have you always been wearing a mask?

Are you physically distancing?

Are you hand washing?

Could you have been exposed to Covid through work, at social gatherings, on transit?

Have you had Covid?

Do you have any symptoms of Covid?

And then lastly, and probably most importantly, would you be willing to limit your exposure to other people and get tested before we meet up and share, of course, share those results with me?

So I think these are some of the questions that you can ask each other before you're close, before you have intimate contact that could help you reduce the risk.

- STI testing, birth control.

How can someone continue to take care of themselves during the pandemic?

- Well, you know that since I serve as co-director of the National Coalition for Sexual Health, we think that sexual health is always important even during a pandemic like Covid-19.

And this could include STI testing and treatment, birth control, HIV care and treatment and routine immunization.

So it's important to know that for routine care, many health care providers are providing care through what we call telehealth, either phone or video appointments.

They're also providing care in person.

And this no touch care can actually reduce your contact with other people who might have Covid.

You can check locally to see what's available.

I mean, different communities are in different places with Covid right now.

So you might be able to easily go in for an in-person visit or it might be better to do that remotely.

But in-person care is always available if you have symptoms, if you're undergoing treatment and if you have emergencies.

So I'd like to talk a little bit about STIs.

One of the things that's really important right now is that if you have any symptoms, you should contact your health care provider and seek care right away.

This is not something that you want to delay because most STIs can be easily cured.

They can be treated.

And if you don't treat them and you don't pay attention, they could lead to some serious consequences like infertility or ongoing pain.

Also, if you've been diagnosed with an STI, it's important to keep up your treatment, keep up your visits and complete everything that's been recommended for you.

In terms of birth control, we know this is really important for people who want to plan or prevent pregnancies.

And even during Covid-19, there are many options to do so.

Just like STI screening, many providers are offering birth control via phone and video appointments, and some are seeing patients in person.

If you have a birth control prescription, you can often ask for multiple refills at one time.

That way you don't have to keep going back to the pharmacy over and over and you can limit your exposure.

Also, you can possibly order it online and do this through telehealth and we'll give you some resources at the end that can help you do that.

Kind of last but not least, if for some reason you're not able to get a prescription, not able to refill that, remember, you can always go to the pharmacy and get over-the-counter methods like condoms and emergency contraception.

- Now, something that I found great was that your organization has a bilingual guide, so you don't have to memorize all of this information we're talking about today, but it's called Take Control of Your Sexual Health.

And in Spanish.

Can you tell us more about that?

- Yeah, so we developed this guide because we realize that many people were not getting recommended sexual health services, and these services include things like STI screenings, vaccines, birth control and counseling.

And so we developed a guide, and it's for men and women, for teens and adults to really help them identify what are the services that they need.

And so we produce things like very easy to use charts, which you could print out and bring to a visit.

So you can go through this with your provider and say, hey, you know, I think I'm supposed to get this immunization, I think I'm supposed to get screened for STIs.

And you can take charge of your health and make sure you're getting the services that you need.

And as you mentioned, it's available in English and in Spanish.

It's on a website.

It's free and it's something that everyone in the public can take advantage of.

- Now, let's talk about abusive relationships, because you guys also specialize in providing resources and giving information to people who might find themselves in an abusive relationship.

And now during the pandemic, it might be a little bit more dangerous with stay at home orders.

So what do you do if you're stuck at home and your significant other is abusive?

- Yeah, I think this is very challenging and it's for people who are abused both sexually, physically, emotionally.

This can also apply to people who might be mistreated because of their sexual orientation or gender identity.

So I think, you know, the first step is really to think about making a plan for yourself.

You know, how can you try to protect yourself?

For example, can you identify places that might be safe for you in your house?

Can you try to plan to put space between you and someone who might be abusive?

In other words, taking walks, going to the store, trying to basically create some of your own space, and then, of course, prepare a safety plan.

And part of that plan might be having a buddy system, identifying one or two close friends or family members who you can contact.

You have a code word to say, hey, I'm in trouble and I need help.

And then the other thing is to really think about how you're communicating during this time.

Unfortunately, you might not have all the privacy that you want.

So think about can you make phone calls safely?

Can you text safely?

If you're using your phone, do you maybe want to erase that history over time?

But I think also most importantly, remember, you can always call nine one one.

You can reach out to the National Domestic Violence Hotline.

You can call them, you can live chat with them.

And there are resources available to you during this time.

- I want to kind of pivot on a positive note because it's not all just negative.

We learn so much about staying safe and doing things the right way.

But what can you tell us about having a sex positive mindset?

- You know, the first thing I'd like to say about that is that there's so many ways to experience pleasure and intimacy and I mean this in both a sexual and non sexual way.

And we know that this is important to most people and to their physical, emotional and mental health.

So I think part of it is being creative.

We need to think outside of the box.

We need to think about intimacy broadly.

How can we experience it on our own, with our partners?

How can we experience it virtually?

How can we experience it in person?

But at the same time, even though I know we want to end on a positive note, I think we also need to acknowledge that this is a challenging time and it can be stressful for a lot of people and it can be stressful for a lot of couples.

And so to take off the pressure, I think it's best to acknowledge that.

And also for us to try to talk openly with our partners, particularly if your sex drives are a mismatch, which is happening for a lot of people right now.

- You know, this is a topic that you can't really cover in just a few minutes.

So if there is somebody who's looking for more information, you know, where can they go?

- So I would definitely refer them to the NationalCoalition forSexualHealth.org.

On our website, we actually have a series of fact sheets that covers a wide range of topics around Covid-19 and sexual health.

It also talks about sexual health more broadly.

We also have the five action steps to good sexual health, which talk about relationships, advocating for yourself, self esteem.

So there are a lot of resources available there.

As I mentioned earlier, if you are trying to find support, if you're living in an abusive situation, you could also reach out to the National Domestic Violence Hotline, and their number is 1-800 799 7233, for help with accessing birth control during this time.

I'd also recommend going to bedsider.org or PlannedParenthood.org.

They can also provide you with resources to help during Covid-19.

- Thank you so much, Susan.

We appreciate your insight on this topic.

- Thank you very much, great to be here.

- I want to thank our guests, Dr.

Bianca Laureano and Susan Gilbert, for sharing their insight with us today.

And thank you for tuning in.

We look forward to seeing you again soon.

Don't miss next week's episode.

We'll discuss fertility, pregnancy and how that's impacted by the current pandemic.

If you have a suggestion for a medical topic you'd like for us to cover, send your message on social media.

You can find me on Facebook and on Instagram.

Plus, you can tune in to hear more of my reporting on 91.3 FM WLVR news, your local NPR news source.

From all of us here at Lehigh Valley Public Media, stay safe, be healthy, and cheers to your health.