Power In Sexual Relationships | Page 2

development. Par-ticipants pointed to the need for greater
efforts in multiple areas—continuing the-
oretical work, descriptive psychological
and sociological analysis, and operations
research to name a few. Evidence present-
ed indicated that such changes in behavior
and attitudes are possible. We heard about
progress made in eight field-based in-
terventions, all providing valuable infor-
mation and one overwhelming message—
many men and women in less-developed
countries are ready to discuss the issue of
inequality in sexual relationships and
believe changes are in order. We heard
from members of donor and implement-
ing agencies that they have taken note and
that sexuality and power in sexual rela-
tionships has become a central theme in
some of their programs. And, significant-
ly, we heard from those leading the fight
against HIV/AIDS. For this community,
changing the dynamics between men and
women and within sexual relationships
and “empowering” the weaker partner
(usually, but not always, a woman) have
become vital points of intervention.
We thus hope this report will inspire
commitment within the reproductive
health community to respond to this call
for action.
Purnima Mane, Population Council
Judith F. Helzner, IPPF/WHR
and
USAID Men and Reproductive
Health SubcommitteeJudith Bruce, Population Council
Sam Clark, PATH
and
USAID Men and Reproductive
Health Subcommittee

The meeting on power in sexual rela-
tionships, convened in Washington, DC,
l–2 March 200l, was a joint effort of
the Population Council’s New York and
DC offices and the USAID
Interagency Gender Working Group’s
Men and Reproductive Health Sub-
committee. We are grateful to the
Subcommittee for providing substan-
tive and financial support to the meet-
ing and for assistance in publishing this
report. We are also grateful to the
Swedish International Development
Cooperation Agency (SIDA) for pro-
viding leadership on this agenda and
financial support to the meeting.
We thank Ann Leonard for persist-
ing with this topic and keeping it high
on the Population Council’s agenda.
She and Judith Helzner, of the Sub-
committee, spearheaded this meeting as
representatives of their respective
organizations. Other colleagues from
the Council who put tireless effort into
conceptualizing and planning this meet-
ingincluded Sandra Bjegovic, Judith
Bruce, Erica Chong, Rachel Goldberg,
Michelle Gray, Purnima Mane, Carey
Meyers, Julie Pulerwitz, Naomi Ruten-
berg, and Ellen Weiss. Thanks also to
Sarah Douglass, Emily Knox, Eva Roca,
and Melissa VanderKooi from theCouncil’s Washington, DC office for
providing logistical support on the
meeting days. PATH kindly helped us
to secure the meeting space.
We also thank Ann Blanc for taking
up the challenge of preparing the state-
of-the-art review of the literature on
power in sexual relationships. This re-
view served as a starting point for our
discussions throughout the meeting. We
had an illustrious and dedicated group
of speakers—too long to be listed here,
but named in the report—who led us
through two highly stimulating days.
Rachel Goldberg conceptualized the
report, wrote each summary, and over-
saw its production. However, this final
product represents the collaborative
work of many: Michal Avni, Susan
Bloodworth, Sam Clark, Margaret
Greene, Rebeca Quiroga, and Karin
Ringheim acted as notetakers. Debbie
Rogow offered invaluable editing,
reviewer comments, and text contribu-
tions. Jennifer Blum, Judith Bruce,
Erica Chong, Judith Helzner, Ann
Leonard, Purnima Mane, Carey
Meyers, Suellen Miller, and Monica
Rocha provided insightful reviewer
comments and guidance. And Sandra
Bjegovic provided technical assistance
throughout the writing process.
vii
ACKNOWLEDGMENTS

Opening remarks
(Margaret Neuse)
The opening session was chaired by
Margaret Neuse, Director of USAID’s
Office of Population. Neuse reflected on
the historical reliance on certain contra-
ceptive methods over others within the
population and family planning field.
Those methods that have been favored
not only provide the most effective pro-
tection from pregnancy, but also require
little or no involvement of partners in use
or decisionmaking. As a result, few pro-
grams have experience discussing meth-
od use in the context of sexual relations.
Neuse noted the growing recognition
in the family planning field that deci-
sionmaking on sexual matters, including
the use of contraception, is complex
and often involves many actors other
than the woman herself (or the man in
the case of vasectomy). There have been
some successful efforts at male involve-
ment, but these are relatively small-scale
and often not well evaluated. She argued
for dedicating sufficient resources to
learning, measuring, and assessing issues
of power in sexual relationships, and
how it relates to use of contraception
and associated decisions.
The spread of HIV/AIDS, she
noted, demands a great acceleration of
the learning and application process.Condom use, the one effective means to
prevent transmission, requires commu-
nication and working out some of the
sexual dynamics and power relation-
ships. Those in the field now have a
dual responsibility—to keep a central
focus on family planning and reproduc-
tive health, and to define and assume
our role in fighting the epidemic. Neuse
concluded by stating that an under-
standing of power in sexual relations is
crucial for both tasks.
The effect of power in sexual
relationships on reproductive and
sexual health: An examination of
the evidence (Ann Blanc)
The first session centered on an
overview paper reviewing research in the
area of power and sexual relationships,
which the Population Council had
commissioned Ann Blanc
lto prepare
for this meeting. Blanc addressed three
tasks:
l.Review what has been learned to
date about the role of gender-based
power in sexual relationships in
determining reproductive and sexual
health outcomes;
2. Draw lessons from clinic and com-
munity-based interventions that
address power; and
1
POWERINSEXUAL RELATIONSHIPS:
WHAT IS THE EVIDENCE?
lAnn Blanc was formerly with the Demographic and Health Surveys (DHS) program and is current-
ly president of her own demographic consulting firm.

3. Highlight gaps in knowledge and
priority areas for future interventions
and research.
Blanc told the group that she was
struck by the magnitude of what is
already known. She reviewed principally
the