The Maths of Sex (GUEST CHAT) (PART TWO)

The Maths of Sex (Part 2)

with Associate Professor Simon Graham

Part 2 of Catharine’s conversation with Associate Professor Simon Graham about sexual health, STI testing, condoms, contraception, harm reduction, public health, relationships, and why shame is often terrible health policy.

If you haven’t listened to Part 1 yet, go back and start there first.

In this episode, Simon and Catharine discuss:
 • STI testing and taking control of your sexual health
 • Condoms, contraception, and bodily autonomy
 • Needle and syringe programs in Australia
 • Hepatitis C treatment and public health savings
 • Violence, vulnerability, and sexual health risk
 • Why free sexual health clinics matter

This is an honest, funny, occasionally chaotic conversation about sex, health, and human behaviour in the real world.

Important note

Associate Professor Simon Graham and Catharine Redden are not medical doctors. This podcast is intended for conversation, education, and entertainment purposes only and should not be considered medical advice. Please speak with a qualified healthcare professional if you have concerns about your sexual health.

Free Sexual Health Clinics (Australia)

Public sexual health clinics in Australia are generally free, confidential, and do not require a Medicare card.

• SA: SHINE SA
• VIC: Melbourne Sexual Health Centre
• NSW: NSW Sexual Health Clinics
• QLD: Queensland Sexual Health Services
• WA: HealthyWA Sexual Health Services
• TAS: Tasmanian Sexual Health Service
• NT: NT Sexual Health & BBV Programs
• ACT: Canberra Sexual Health Centre

Needle & Syringe Programs (NSPs)

Needle and syringe programs help reduce transmission of blood-borne viruses including HIV and hepatitis C.

• Australia-wide NSP directory: AIVL NSP Directory
• SA NSP sites: SA NSP Site List
• NSW NSP info: NSW NSP Program

Content Note
This podcast gets into bodies, panic attacks, trauma, sexism, mental health, and the occasional emotional sinkhole. Please look after yourself only listen when you feel safe to engage with potentially triggering material. 
Also, I swear.

Support
These aren’t here as a formality. I’ve used some of these myself.

Lifeline 13 11 14 (24/7)
Kids Helpline 1800 55 1800 (ages 5–25)
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Emergency 000

Outside Australia, local crisis services are available.

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Credits
Recorded on the lands of the Ramindjeri and Ngarrindjeri peoples.
Sovereignty never ceded.

Recorded & edited at Ridley Farm Studio by Luke Ridley
https://ridleyfarmstudio.com.au...

Transcript

SPEAKER_01 0:00

Hello, hello, hello. This is part two of my conversation with Associate Professor Simon Graham about sexual health. If you haven't listened to part one yet, pause this episode, go back and listen to that first. Or this episode may feel a bit like walking into a movie halfway through carrying hot chips and confusion.

SPEAKER_02 0:20

Okay. Here's part two. Bye. I'm gonna try and do something here, and I hope I don't hang up on you and that's not working. Good. Okay, it's still there. Yes. I suppose I can give a plug for one thing. Oh, do a plug. Love a plug. We've said we've had so many sexual puns in this, and I've it's been really hard for me to keep a straight face. Thanks very much.

SPEAKER_00 0:43

Like a lot of people, and I suppose it's a really marginalized group of people, and a lot of people, a lot of Australians do wonder why we do it. But there is a massive benefit for the universal healthcare system in Australia because of it. And you know, before you were it's like return in investment reducing future medical costs for the Australian government. And in one example of this, and we're going to get a little a tiny bit outside of sexual health here, but it's the needle and syringe programs that are in Australia.

SPEAKER_02 1:14

Yes.

SPEAKER_00 1:15

And they provide clean needles and syringes to people who inject jars. Actually, they provide clean needles and syringes to any Australian citizen that walks through the door.

SPEAKER_02 1:23

Yeah, for whatever reason.

SPEAKER_00 1:25

And I don't think many Australians know there's over 4,500 of these NSP pro uh sites, and some of them are pharmacies. They're not just needle and syringe specific programs.

SPEAKER_02 1:38

They're all that's actually a really good point. So for anyone listening, if you need a clean needle or syringe, you may be able to get it at your pharmacy.

SPEAKER_00 1:47

I know from some of the studies of uh people who have entered them uh or received gone into pharmacies to to get them, um, there's been a bit of judgment uh behind the counter. But they're called thick packs. What are they called? Think packs. Fit packs. Right. And it's a box, it has about five needles and syringes in it. You don't have to pay anything, they're free.

SPEAKER_02 2:15

I think just for me to get on my high horse a little bit, the less judgment we have for anyone, the better. Like honestly, like it really a clean needle is better for the person than you know, like I love universal healthcare. I feel so lucky to live in Australia. Why dentistry isn't on it is a whole other matter. But I love universal healthcare. I think we're so lucky in Australia. But I think what a lot of taxpayers don't understand is it saves the government money.

SPEAKER_00 2:44

Yeah, and this the NSP programs is a great example of this. So just to give people an idea, in terms of disease, and obviously hepatitis C is the most common sort of disease or infection that is transmitted through sharing needles and syringes. So over a 10-year period, NSPs have prevented around What's an NSP? I don't even know what's a needle and syringe program or accessing needles and syringes has prevented around 200,000 new EPC infections coming. So, and if you think about it, if if we didn't have NSPs or needle and syringe programs, the costs associated with treating and managing people with Epsy would be incredible. We've got these great economic evaluations now with the needle and syringe programs. So for every $1 that we pay for a needle and syringe, a clean needle and syringe, we receive up to $4 back in savings from that person not getting liver cancer or needing a liver transplant or going through expensive treatments for hep C.

SPEAKER_02 4:01

We and the work to get treated.

SPEAKER_00 4:07

And the better number is that this is maybe a little bit of an older number, but between 2000 and 2010, the needle syringe programs in Australia saved the Australian taxpayer up to 200 million dollars in Medicare costs.

SPEAKER_02 4:24

Yeah, and so for anyone clutching their pearls about this program, I could say, fuck you. I can say that because I'm not associated.

SPEAKER_00 4:34

And they've estimated that in the future that the NSP programs will save up to 300 million to 900 million dollars to Medicare.

SPEAKER_02 4:43

We could round that up to a billion.

SPEAKER_00 4:46

So it's really, and you know, Dean, we have the new Hep C treatments, which have completely changed treatment for Hep C were able to clear the virus out of the body within a three-month period with very low symptoms because previous treatments for Hep C were horrendous in terms of side effects from the treatment. So nobody was taking them. But now we have these new treatments which from 2016, and those people who are not in Australia probably won't know this, but we have the pharmaceutical benefits scheme here in Australia, which significantly reduces the costs of certain drugs that are on that list.

SPEAKER_02 5:25

And actually, Donald Trump hates this scheme. Hates it. Hi Donald, hope you're listening. Um how are you?

SPEAKER_00 5:32

Yeah, so we've reduced new Pepsi infections by up to 53% because of the new treatments. So it's really saved us millions and millions of dollars to have the needle syringe program plus the new DAA treatments for her.

SPEAKER_02 5:50

And I think through all of this, because we have touched on a lot of topics, through all of this, I'm just thinking getting tested once a year, four times a year, depending on how many sexual partners, different sexual partners you have, is a real key, would you say?

SPEAKER_00 6:07

Like I suppose it all goes back to taking control of your body and taking control of your sex life and not feeling embarrassed that you go and get an STI check, uh, you know, once a year or every three months, or whenever you want to go and get tested.

SPEAKER_02 6:22

If you do feel embarrassed about it, just think of Auntie Catherine and Uncle Simon. We are on your fucking team.

SPEAKER_00 6:29

Yeah, it's free for you to go in and get tested. And I know strange interactions with nurses and doctors, I get it. Yeah, and you know, especially for uh more uh for certain populations like trans men and women, I think that some of those uh clinical consultations can get a little funny and a little awkward. Of course, I would hope. What overrides all of that is that you're taking control of your sexual health in your body.

SPEAKER_02 7:02

Yeah, and I think that's hard for I mean, it's been hard for me in my life, but when you start doing it, you do get a sense of freedom, you know, when you take control of going to the doctor and following their advice.

SPEAKER_01 7:14

Yeah.

SPEAKER_02 7:15

And I think sexual health clinics being free and not needing a Medicare card is it's not only is it great, but it's telling you how important it is for you.

SPEAKER_00 7:27

Yeah. And I think, you know, there if we go down the taking control of your body, we can, you know, that includes contraception for young women. And the key point here, when I used to do a lot of the school high school visits for sexual health education, I think one of the really important things was that if you go to a GP and so let's just say there's a few options for contraception. There's long acting and short acting. And so let's just say you go to the GP and you start contraception and you do you decide that the best decision for you and your body is to take the pill, the tablet on today, right? Let's just say you start there. If your body starts reacting to that pill or you don't feel great, or it's not working, it's really important for young women to take control of their bodies and go back to the GP and say, This isn't working. I need another option. And a lot of young women end up using implanon, which is the thin rod that goes in under their arm and lasts for three years. So they don't have to remember to take a pill every day. And they have the thin rod inserted under their arm and it slowly releases the contraceptive into their arm. But again, if you do if a young woman does do that and it doesn't work and they feel sick or it's not working, the key is to take control and go back to the GP and have it removed and get your your next option.

SPEAKER_02 9:00

Yeah, and this is a really important point. It's not just sexual health when you're chatting to your GP, but it is about saying that's not working for me. Because I do think, yes, the doctor knows a lot about health, of course. But you know your body, right? And there actually are many, many things doctors don't know or have to look up, which is fine, but you know your body. And if you're not feeling well after the implant or when you're taking the pill or whatever's happening, you will actually need to push it with your doctor. And I'm only going to briefly touch on this now, but in America, there's a doctor who was a resident at a hospital, and she got her first patient. And she noticed on the file in handwriting in Borough, it said WW. And she said to her boss, what does the WW mean? And he said, Look, we will never admit this publicly, but that means winning woman. So it's an acronym. The woman in the file, she had a very complicated history of and nothing ever really got resolved with her reproductive health. And that's recent. And what I think that what says to us, if you are a woman or a girl and you're going to the doctor and the doctor's pushing back on you, you have every right to say, no, no, wait a minute. This is a real symptom.

SPEAKER_00 10:19

Yeah, it's and I suppose I shouldn't leave the boys out.

SPEAKER_02 10:23

Look, I'm not I I suppose this podcast is mainly for women, and I'm not saying that men don't have that problem as well. And I'm I'm not saying that at all, but I'm saying if you are a woman and you're having problems getting treated by your GP or whoever, it's not you. It's really not you, it's them.

SPEAKER_00 10:43

Yeah, and I think there's the thing, you know, that was really important for the young women in those high school and also the university education stuff as well, was that you know, this trend of men not wanting to use a condom with a young woman, I suppose my issue with that is one, in terms of the young boys, I don't think many of you are ready to be a father, firstly, and the costs associated with being a father.

SPEAKER_02 11:11

Um and how much it's going to impede your social life.

SPEAKER_00 11:14

But also for the young girls, if a 19-year-old guy is telling you, oh, I don't use condons because I don't like them and they hurt or they affect my erection, I mean, like a 19-year-old man, if a 19-year-old man is having erection problems, is that really the young man you want to be having sex with? Is the bigger question there.

SPEAKER_02 11:34

So I was just gonna say that again for the people at the back. If you are a young girl or a woman or who anyone, if you're anyone, and then the young man that wants to have sex with you is saying, Look, I'm gonna get an erection problem if I use a condom, what you need to be saying to him is, okay, next. Because 19-year-old boys on the whole, men, do not have problems getting an erection.

SPEAKER_00 12:07

Say a 19-year-old male, only a very, very, very small proportion of 19-year-old men are having erection blood.

SPEAKER_02 12:15

Okay, that's a lovely way of saying we feel a lot of empathy for that small minority of 19-year-old men who are having problems getting an erection, feel for you, and we're here for you. The other percentage of you wankers who are saying, Oh, I can't possibly use a condom, you know, and it's tricky. I mean, the other layer for that for girls and women too is when you say no to a man who wants to have sex with you, it can get violent, you know?

SPEAKER_01 12:43

Yeah.

SPEAKER_02 12:44

And that is a whole other podcast. But I'm gonna wind this up now, Simon, and I'm gonna say, is there anything we haven't touched on that you wish more people understood about sexual health?

SPEAKER_00 12:54

I would say that maybe it's a bit of a dark story, but I think it is very clear that there's a clear link between violence and increases in sexually traveling infections and who are in violent relationships or violent situations have a increased risk of STI uh infection. And I think we we don't talk about that very much. And it is an important factor. We also, the other thing probably would be is the amount of violence that, say, trans women have to face in terms of sexual violence as well. But I know that we're we're going a little bit outside uh historically.

SPEAKER_02 13:33

No, no, no, no, it's a really important point. We we've covered a lot of topics, and I want to thank you, Associate Professor Simon Graham. And I don't say that in jest because I am really proud of everything you've achieved, and I I don't even know half of what you've achieved. And you've been so generous today, sharing what you know, and I've learned so much. And I'm sure that the pod listeners will have really learned a lot too. I'm just really grateful for you know sharing this time with us. So thank you very much. Thank you. I think we're gonna sign off now. Bye. Talk to you soon.