The paper presents findings from the analysis of 'Love Matters' website in five countries and the engagement with it by users, as per Google analytics available data. It demonstrates the need and importance of taking a pleasure inclusive approach to sex education in order to meet the demand by young people who are interested in learning about a wider scope of sexual experience than provided through risk reduction only models. 

Review 1 

Thank you for this contribution to the pleasure inclusive literature that draws on a substantial and wide-reaching resource. I think there is much merit in using the Love Matters website and taking this approach to consider the popularity of the content available in these respective country contexts.

The paper is well written and concise with good background provided. My main comments relate to the method and some critical reflections on this method. I think the paper should be published but it would would benefit from these things being discussed explicitly in either the 'Limitations' or 'Discussion' section in order to strengthen the method/analysis. 

The authors created an ‘artificial separation’ between the sex education and pleasure-based content and use these as two fundamental categories. Although I understand the necessity and value of doing this in order to answer questions about the difference between the two, I think it would be helpful in the data categories section or limitations section to have more critical explanation about what is included (and not), and why in these respective categories. It says that ‘Marriage’ and ‘harassment’ themed items for example were included in the ‘Pleasure’ category. You state that items included reflect ‘the full scope of sexual experience under pleasure’ but could it be problematic to classify such content in this way? Is there an argument some content could have been omitted from this classification process altogether? Critical address of this could ensure claims made in results are more robust.  Also what, if anything, was ‘missing’ from the topics you categorised and have you any reflections on why that might be? e.g. diverse sexualities and relationship types, which are not mentioned in the examples in the Data Categories section.  

Why did you select Love Matters from the specific countries that you did out of all those available? Was it because of the duration of their operation (four of the longest running)? Why did you not include the others? I think the reason for this decision could be stated (more) clearly.

In terms of who is using Love Matters, I think it is absolutely reasonable to assume that as the resources are for young people, this is largely the audience. However, can we actually know who the users are from the analytics data available? If not, this could be noted in the limitations. The framing of the resource as ‘Love Matters’ (rather than ‘Sex Matters’ for example) could offer an interesting point of reflection regarding the nature and motivations of the audience.

The sex education topics attract more organic (specific key word searching) traffic than pleasure topics. I think this is very interesting and could warrant a reflection in the discussion for future research. What could this say about the available and legitimate vocabulary learnt about sex informs search terms? How does this vary by country context and language spoken?

Pleasure positive or pleasure integrated or pleasure focused - which is the authors preferred approach? I was unsure of their own position.

There are some popular topics mentioned such as ‘virginity and the hymen.’ I would like to see some critical commentary about such topics to avoid reinforcing any problematic norms related to sex, bodies and gender.

Finally, I think that the use of ‘organic traffic’ in the abstract could be written in plain language as at that point, what it means has not been explained for the reader. In the 5 ^th paragraph in the Introduction it may be better to stress the ‘academic’ arguments or similar as in many realms there is still resistance to including pleasure at all.

Overall, the research and analysis you present is very helpful especially in terms of pleasure in the global context. Having such a huge number of visits to the Love Matters resources documented and analysed in this range of settings is great evidence to pave the way for future pleasure inclusive work in these countries and beyond. Thank you.

Review 2

A really well written and concise paper. A large data set providing insightful material for study.

I would be interested to hear what the authors think about new technologies and pleasure as a unique combination of factors for education as these seem to be the two main threads; a) a method of delivery and how this can be enhanced and used to best effect and b) the ‘topic’ or ‘theme’ of pleasure and how this can be utilised as a vehicle for better outcomes?

The term ‘notion’ is used throughout but I’d suggest using a firmer term to strengthen the argument or point.

Finally, any insight or reflections on the diversity and inclusion literature you cite early in the paper and how this works in conversation with the analysis of the content and six themes of the Love Matters site and content. It may be a broader question framed around the reconciliation of theory and practice, which the authors allude to.

Thank you for the opportunity to review a well-researched project, which will make a useful contribution to a burgeoning field.

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

Not applicable

Are all the source data underlying the results available to ensure full reproducibility?

Partly

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Yes

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Sexual health, sexualities and pleasure. Health inequalities. Young people

We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.

The authors have made some adjustments to the article which is great. However, a number of comments such as the various restrictions young people face have also not been addressed. How about PWD, LGBTQI in countries with restrictive policies? The article still includes various sweeping statements which can be distractive.

For example: “In the last decade, the arguments are no longer about  if you should include pleasure, but  how (Allen, 2012 ¹ ; McGeeney & Kehily, 2016 ² ; Wood  et al., 2019 ³ ). Whose arguments? The arguments of the quoted researchers? The need to include pleasure as part of sex ed is still contested in many countries- can statements like these be nuanced?

The article still starts with presenting pleasure without defining it upfront, implicitly claiming a universal and ahistorical understanding of the term. There is also no discussion on pleasure and rights and boundaries. One person’s pleasure can be another person’s pain. Could the authors address these concerns?

The authors claim that some literature has given “some promising findings” but do not specify what these findings are. Intervention and evaluation reports and studies are lumped together with observational and descriptive studies. Can this be unpacked and nuanced? Quoting them in this fashion suggests a universality and a consensus which is not warranted by the quoted studies. (Hanbury & Eastham, 2016 ⁴ ; Gruskin,  et al., 2019 ⁵ ; Müller  et al., 2017 ⁶ ; Philpott  et al., 2006a ⁷ ; Philpott  et al., 2006b ⁸ ). The authors contradict themselves staring a paragraph with “In the last decade, the arguments are no longer about  if you should include pleasure, but  how” and ending it with when writing that Unfortunately, many of these projects “… tend to occupy marginal spaces and are not included in mainstream policy-making or news reporting. There are still a number of  instances in this article where interpretations are made about universality that need nuancing such as “Some research has been done in Africa, Asia and South America that indeed implies more universality of pleasure. Can this be unpacked? Pursuing pleasure in sexual relations may be universal but not what pleasure constitutes of- peoples sexual preferences in terms of what they do or would like to do or fantasize about is very diverse. 

What do the authors mean when that say that porn can inform people about sex? Do the authors perhaps mean inform but not necessarily educate people about sex or inform but in a way that is different from comprehensive sex education? Please clarify.

Methods. Good to see the list of criteria used. Were there cut off points for these criteria? Was there a minimum number of seconds that a user needs to stay on a page in order to be included as a user? Suggest clarification.

The phrasing on the limitations for google analytics reads a little odd. “A second limitation is that using Google Analytics provides reliable insights in user traffic on websites but cannot provide 100% accuracy due to its dependency on user cookie settings and limitations in recognising source traffic.” Do the authors want to suggest that they believe there are analytics that are 100% accurate? I suspect they don’t so I suggest rephrasing.

The limitation section is still a little weak. Could the authors expand this and ad a bit more detail and rigor?

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

Not applicable

Are all the source data underlying the results available to ensure full reproducibility?

Partly

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

Reviewer Expertise:

NA

We confirm that we have read this submission and believe that we have an appropriate level of expertise to state that we do not consider it to be of an acceptable scientific standard, for reasons outlined above.

Review 1.

The paper argues that despite a growing body of evidence on the importance of recognizing pleasure as a motivation for sex and relationships most sexual health education programs continue to solely focus on risk reduction and avoid larger conversations about sex and sexuality. This article looks at on-line sex-education offered in several contexts which is important for researchers and practitioners not in the least because of the impressive numbers of young people who are reached by on-line platforms such as Love Matters. 

The authors rightly point out that with the growth of the internet and mobile technology, new media has become increasingly important as a source of information for people’s sexual and reproductive health.

A central argument of the authors- that seeking pleasure is one of the reasons why people have sex and relationships is very important for sex education. There is -as the authors say- indeed a growing body of evidence on this. But sexual preferences and experiences of pleasure are very diverse- and there can be conflicts- one persons pleasure may not be pleasurable for another. It would be good to highlight the importance of consent and what this means in different circumstances. The importance of consent in relation to pleasure has also been made in classrooms and campaigns such as “tea consent” (https://www.youtube.com/watch?v=oQbei5JGiT8) Many of these tensions- reflect gendered inequalities which are important both on-line and off-line.

It would be good to clarify what the authors mean with “information” about sexual and reproductive health, and how sexuality is defined. The numbers of people (and possibly bots) visiting sex education sites is dwarfed by the number of people who visit porn sites. Porn reaches young people intentionally and unintentionally and is an important- some would argue the main- vehicle through which young people learn about sex and sexual relationships. How do the authors conceptualize and measure differences between pleasure as an entry point to consumption and pleasure as an entry point to sex education? Can and should this be measured?

On-line worlds, just like the offline worlds, are moderated. One argument for such moderation is to prevent harm and abuse and create safer digital spaces. The level and extent of this moderation and its relation to freedom of speech is highly controversial. What is clear is that the moderation industry employs thousands of people to moderate on-line content. Moderators of platforms such as Facebook and search engines such as google have particular instructions on nudity, obscenity and violence which do affect the content of on-line sex education platforms including Love Matters. On-line sex educators such as Love Matters add another layer of moderation to make sure that on-line sex education spaces are safe spaces. It would be useful to be more upfront about these different layers of moderation which shape what kind of information young people can access. In some countries providing information on sexual orientation (such as lesbian, bisexual, queer, and gay) is problematic, some people such as young people with disabilities are hardly present in on-line sex-education, and some sexual practices such as bondage have encountered resistance. In practice, for young people, this means that the information on “pleasure” and “sexuality” on sex education platforms is restricted. It would be very helpful to be more upfront about the digital environment in which digital sex education takes place recognizing the various levels and dimensions of the restrictions and the opportunities at the 1) global level with transnational companies such as facebook shaping sex education 2) national level where national legislators can also restrict on-line information and the legislate companies or NGO such as Love Matters who have offices on the ground. Donors also play a role in the content of on- and off-line sex education.

Methodologically it would strengthen the article if the authors could clarify set the boundaries of the data sets which have been analyzed and the rationales for these boundaries. What it included and what is excluded? What are the limitations of the methodology chosen? Love Matters, as a group of on-line platforms offers a variety of services and pathways into sex education, on- and off-line. These platforms are part of a group but they also have unique features to match the users’ needs in specific regions- that is why there are different platforms. Each platform offers a variety of services such as the publicly accessible sex education platforms, virtual reality pilots, the on-line discussion groups and bulletin boards. There are Facebook ads and Facebook queries, off-line peer education etc. It would be very helpful if the users describe each of these platforms, the various services and other key features together with the data sets that each of these features generate. This could be in a visual or a table. The authors should then explain why this article focuses on one feature and what the strengths and limitations of that feature are in terms of their main argument. Are there differences between the kinds of questions that young people ask in these different moderated and less or unmoderated on-line spaces? Are all the on-line and off-line spaces focused more on pleasure than on health, or would it be more accurate to say that users go to different places depending on what they need and what these spaces offer? What is the added value of these different moderated and semi-private services in these spaces to the publicly available platforms? What does that tell us about the role of pleasure in on-line sex education?

The article can and needs to be strengthened but after that it should be published as it does contribute to new thinking, new evidence and new lesson for interventions on sex-education.

Review 2.

Indeed, good sex matters and pleasure matters. And as this article says, while the debates may be shifting from if you should include pleasure to how, there have been few accounts of how to do so. Using google analytics, this article analyses how young people using the Love Matters websites in different regions search for sexual health information including on pleasure, and how much time they spend on different kinds of content on the sites. They find that, overall, pleasure focused content attracts a higher number of visitors than sex education content. However, visitors spend more time on the sex education pages than on the pages about pleasure. They conclude that while pleasure is an important content in itself, it can also be a driver to draw young people in to learn more about other aspects of sex education.

The article is clearly written and provides an important piece of evidence on how pleasure can potentially function in online sexuality education, adding vital new evidence to an ongoing debate.

This article should absolutely be published, after minor adjustments. The two areas that I would suggest need to be revised are outlined below.

The first issue which needs addressing is the definition of pleasure and the politics of pleasure. The article declares in the introduction that better definitions of pleasure are needed. Yet this article does not adequately define pleasure, or discuss at all a politics of pleasure. When examples are given of pleasure focused content on Love Matters sites, eg. ‘making love’, or ‘orgasms’, there is little information on how these are presented. For example Tepper, a UK author, has critiqued “the orgasm imperative” a norm that we should all be having orgasms, and that we are somehow inadequate or dysfunctional if we do not achieve this or desire this, or if we find pleasures in other ways (Tepper, Mitchell S., 2000, ‘‘Sexuality and Disability’ the Missing Discourse of Pleasure’, Sexuality and Disability 18: 4 ¹ ). Do the Love Matters pages on orgasms reinforce this norm or challenge it? Are they providing diverse and sensitive information on pleasure which can empower young people to find their own path to realising their own desires, or do they set up new pressures that will actually undermine pleasure? Reading a webpage on pleasure is not necessarily empowering. A political conception of pleasure which links it to a rights framework can increase the chances that engaging with information on pleasure will be empowering. Some of the debates around the politics of pleasure need to be brought into the article. (See for example Jolly, S., 2010, ‘Pleasure and Empowerment: Connections and Disconnections’, in Development, 53, 227 ² ).

The second issue is the claim to a “Universality of pleasure”. The article says that the majority of research on pleasure in sex education is from the United States, Australia and New Zealand. The authors argue that “theory” would suggest that pleasure and empowerment of young people as sexual beings are universal. Which theory would suggest that pleasure and this kind of empowerment is universal? What kind of pleasures are they talking about? What about people who label themselves asexual, not just in the West but also in some southern contexts like China? Asexual people might describe a claim to universality of sexual pleasure as an oppressive enforcement of a norm which excludes them. There have been debates around pleasure by African feminists in the Journal Feminist Africa which could provide some answers to some of these questions. These debates should be included in the discussion by this article.

One paragraph is included suggesting that the principle of hedonic consumption in marketing strengthens the argument that pleasure is a universal concept. The principle of hedonic consumption is explained as people making decisions based on what they believe will make them happy, not just on ideas of utilitarian use and practicality. I find it problematic to use a marketing principle as evidence of the universality of pleasure. Marketing principles might tell us more how people can be manipulated for profit than about what constitutes a universal human desire. Some debates about the politics of pleasure have posited deployment of pleasure as a marketing strategy as undermining sexual rights.

I would agree that pleasure is relevant internationally to people in both the global South and North, but the term universality is a problematic claim. I would suggest renaming this section something like “Pleasure is globally relevant”.

I look forward to seeing this article indexed. It addresses a gap in the current literature, and has important practical implications for how to develop online sexuality education.

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

Not applicable

Are all the source data underlying the results available to ensure full reproducibility?

Partly

Is the study design appropriate and is the work technically sound?

Partly

Are the conclusions drawn adequately supported by the results?

Partly

Are sufficient details of methods and analysis provided to allow replication by others?

Partly

Reviewer Expertise:

Sexual and reproductive health, human rights, international development

We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.

This research article addresses a critical issue in sexuality education: adolescent use of online platforms to receive content focused on sex education (including safer sex, STIs, and HIV) and pleasure (love and relationships, making love, and marriage).  Data are reported from Love Matters websites in five nations: Mexico, Kenya, Nigeria, Egypt, and India. Google analytics is used to provide information on the search behaviors of youth visiting websites in these countries.  A comparison of search behavior for content focused on sex education and pleasure is provided. 

This study is a useful and interesting comparison of youth use of online sexuality education. The Internet - in many communities - has become the destination of choice for sexuality education.  The inclusion of pleasure-focused content is particularly important as such content is seldom included in school- or community-based sexuality education. This non-judgement exploration of adolescent behavior gives an adolescent “voice” to young people’s interests and needs, unconstrained by adult fears and social norms. This study exists against the backdrop in many local communities where there is a failure to provide sex ed or the only education provided is about abstinence. The key clinical implication of this study is that young people online are searching for information about a myriad of topics related to human sexuality. 

The review of existing literature on sex education and pleasure in the Introduction is excellent and provides a comprehensive rationale for the work of Love Matters. It would be helpful in revising the article for the authors to return to this literature in the Discussion. In the study, we learn that young people are searching for information about multiple topics including pleasure. Does this study reaffirm or refute the work of Fine and others who are cited? 

There are a number of places where further explication or definitions could be provided to readers who are not digital natives. These include organic traffic (Abstract) and paid traffic (Results). 

In understanding the ratio of searching on pleasure vs. sex education pages, it would be helpful if the reader had some idea of the “denominators”, the number of pages or words devoted to these two categories on the Love Matters websites in each country.  Search behaviors could have been influenced by the amount of content available to view. 

The study provides little information about pleasure-focused content.  A bit of information is found under in the Methods section under Data Categories. More information and/or examples would be helpful. Likewise, it is unclear how abstinence is classified. Of course, it is difficult to classify certain information as either pleasure or sex education; how did the authors deal with that issue? 

A few other specific comments:  on page 7, line 3 “increase in average time” would be better as “greater amount of time.”  Also, on page 7, line 10 “5 times more popular” is difficult to understand. 

Overall, a noble and important effort!

Is the work clearly and accurately presented and does it cite the current literature?

Yes

If applicable, is the statistical analysis and its interpretation appropriate?

Yes

Are all the source data underlying the results available to ensure full reproducibility?

Yes

Is the study design appropriate and is the work technically sound?

Yes

Are the conclusions drawn adequately supported by the results?

Yes

Are sufficient details of methods and analysis provided to allow replication by others?

Yes

Reviewer Expertise:

Adolescent health and medicine, sexual and reproductive health, sexuality education

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.