PRINTSafe sex is dying
Lax attitudes about sexual histories can lead to rising STD rates
Jenn Hueting
"We have an obsession with sex." "But let's not talk about the bad parts."
December 14, 2006 | 12:00 a.m. CST
“Do you ever worry about getting HIV?” I asked.
I was on a long-distance phone call with a close friend. Three days earlier, she had had sex on a first date with a man she met online. I had become used to hearing about her flavors of the week, but until now — after starting this story on the death of safe sex — I hadn’t wondered about the risks involved in her bedroom behavior.
Apparently, neither had she. She tells me she’ll ask a guy if he’s “clean” before getting into bed, but she doesn’t make him use a condom and doesn’t give much thought to HIV. You don’t see people die from AIDS these days, she says. It’s just not a big deal anymore.
If AIDS doesn’t seem like a big deal anymore, what about safe sex? ACNielsen reports male condom sales have remained steady in the United States in the past five years, but rates of sexually transmitted infections (another term for sexually transmitted diseases) such as syphilis and chlamydia are creeping up again. And the Centers for Disease Control and Prevention estimates the reported number of 412 HIV/AIDS cases in Missouri’s North Central Region, which includes Boone County, will double in the next two years because of people who will unknowingly infect others. Safe sex is in a confused state, and it might be due to the social norms underlying our bedroom etiquette.
Let's talk about sex...
A recent story in Details magazine by Ian Daily, “The Death of Safe Sex,” shows my friend isn’t the only one unconcerned about safe sex. In the story Alan, a 43-year-old physician, recalls a wild night in a Miami swimming pool where he meets and sleeps with an attractive woman who gives him chlamydia. Three weeks later, he sees her at a party looking even hotter and decides getting chlamydia is a small price to pay to sleep with her again.
Although this doctor surely knew what he was risking the second time, some Columbians are too uncomfortable to even bring up safe sex with their partners because it’s a touchy — and often offensive — subject.
In a 2005 study conducted by MSNBC.com and Zogby International, only 39 percent of participants said they always ask whether a new partner is infected with HIV or other STIs. MU psychology professor Lynne Cooper says a big reason people don’t talk about safe sex with their significant others is because they’re afraid to convey a lack of trust in their partners.
To gauge Columbia’s attitudes, locals shared their ideas on safe sex during a panel discussion conducted by Vox in November. Columbians also shared their personal experiences during one-on-one interviews. To protect their privacy, people who participated in one-on-one interviews were granted anonymity.
One female MU student says she’d be angry if a partner asked about her sexual history or whether she has an STI.
“I’d be like, you think I’m dirty?” she says.
Another MU student says he’s never asked his partners about STIs.
“I’ve never asked because it’s insulting,” he says.
I ask how he’d react to the question if somebody asked him.
“It depends on how well I knew them, the way in which they did it and whether they were just being serious and really wanted to know,” he says. “But if they were being condescending, I’d be offended.”
So how can he bring up safe sex without being offensive? The student says being prepared and having a condom is best. The other person shouldn’t object, and if she does object, you shouldn’t have sex.
One young woman tells me it’s best to have sex only in a committed relationship. It’s easier to communicate with your partner about safe sex beforehand, so you both know what’s going to happen. You don’t have to ruin the moment because you both know what’s coming, she says.
“If you’re being irresponsible with when and whom you have sex with, it’s easy to be irresponsible when it comes to safe sex,” she says. “For a while I was having sex with a lot of people I didn’t really know. It’s hard to talk to somebody you don’t really know or trust yet.”
The problem is talking about sex beforehand is not always a reality, says a 41-year-old Columbia woman.
“It’s getting caught up in the heat of the moment, and you don’t realize you’re going to have sex with this person until, bam, you’re in bed,” she says. “And what are you going to do? Stop and talk about it? Well yeah, you should, but most people don’t.”
The truth about trust
Discussing safe sex is the first step toward practicing it, but the comfort zone that familiarity creates can be dangerous down the road. As partners learn to trust each other, they start to feel safe, and protected sex soon seems irrelevant. Even without being tested for STIs, people perceive their partners as safe, Cooper says.
One Columbia woman who hasn’t always practiced safe sex says, “I felt I knew the person enough to know they weren’t carrying any types of diseases, most importantly HIV.”
When it comes to unprotected sex, trust is an unreliable factor because some people withhold information about their sexual past. Other people don’t know they have HIV and other STIs. Trojan’s 2005 “Make a Difference” advertising campaign emphasizes the fact that one in four people with HIV doesn’t know he or she has it. It’s not a matter of being malicious; people don’t mean to be untruthful (although some are). They simply don’t know they’re carrying a contagious virus. Some people don’t get tested for HIV and other STIs because they don’t think their lifestyle habits warrant it.
“People who don’t have many high-risk behaviors don’t even think about being tested, when really, if you’ve had sex, you’re at risk for HIV,” says Mindy Mulkey, executive director of mid-Missouri’s Regional AIDS Interfaith Network.
It could never happen to me...
If all these people are living with it, how scary can it be?
This is the attitude some people have toward AIDS, says MU student and Greek advocate Tara Smutz, during the Vox panel. Twenty years ago, a diagnosis of HIV most likely led to AIDS and death. People saw friends and colleagues suddenly become sick, consumed by a rapidly acting and horrifying disease that killed otherwise healthy people in the prime of their lives. Now, because of improved treatments, more than a million people with HIV are living in the United States.
As fewer people die, so do worries about contracting the virus and efforts to practice safe sex.
Kevin Hallgren, a member of the MU Lesbian, Gay, Bisexual, Transgender Resource Center who attended the Vox panel, says there’s a perception that it’s not so bad to get HIV because medications lead to a false sense of security.
“You see advertisements for HIV where you take these medicines, and you’re fine; you can climb mountains and all this stuff,” Hallgren says. “And it’s not like that for a lot of people.”
And as advertising now shows the possibility of living with the AIDS virus, mass media no longer promote safe sex, MU student Mark Stanley says during the panel. Stanley remembers listening to rappers talk about safe sex and seeing TLC’s Left Eye wearing a condom over her eye. But the safe sex dialogue spurred by the media and entertainment industry has tapered off over the years.
“I think in our society we have an obsession with sex,” Stanley says. “It’s stylized and idealized. It’s glamorous. Lots of people are having sex, but let’s not talk about the bad parts. When AIDS came, it was like, talk about it or die. But now it’s not as urgent.”
It’s easier to embrace the flashy, fantasy-like sex scenes on TV and in the movies than to talk about genital warts or dying of AIDS. But not talking about safe sex makes it harder for people to make protection — rather than pleasure — a priority.
A dying dialogue about the harsh realities of STIs might be why fewer people are practicing safe sex, says Dr. Danny Schust, division head of reproductive endocrinology and infertility at Columbia Regional Hospital. The treatments that work today might not work tomorrow, he says, recalling a New York City HIV patient who was resistant to 19 out of the 20 drugs available to combat the AIDS virus. One more mutation could create a deadly and drug-resistant strain of HIV that is impossible to treat.
Schust says he and his colleagues joke about how all 12-year-olds should see a video of a baby being delivered. They wouldn’t have sex for a long time because it’s graphic and scary. If people saw a video showing how graphic and scary AIDS is, they’d probably think twice before having unprotected sex, too, he says.
Schust might be on to something. Stanley says the best sex education he received came from a teacher at his private high school. The teacher showed her classes photos of various STIs, and although the photos were sickening, Stanley says they transformed abstract images of STIs into a disturbing and concrete reality.
Pregnancy can be seen as a greater and more threatening reality than STIs. Although some problems created by STIs can be prevented with tests and treatments, pregnancy is an unavoidable risk for any sexually active woman. Easy access to birth control, along with the Food and Drug Administration’s approval of selling emergency contraceptives, or Plan B, over the counter might ease worries about pregnancy, but it could also create a false sense of security when it comes to unprotected sex.
Better drugs, less media coverage and more birth control options are just pieces to the puzzling question of why safe sex is dying. There’s no perfect answer, but one thing is clear: People don’t want to worry about safe sex. In today’s world, too many other threats hover over our daily lives and push concerns about safe sex out of the picture.
“I get the feeling it’s kind of like background noise, just another thing we have to deal with in the modern world,” says Seileach Corleigh, president of Columbia’s chapter of the National Organization for Women. “Here’s one more thing I have to watch out for, like locking the door from burglars and hiding your PIN number — something they’re aware of but not concerned enough about to make sure they do everything safe all
the time.”
Sex education 101
Some people don’t care about practicing safe sex, and others just don’t know how. In some states, sex education goes no further than promoting abstinence and leaves some young people in the dark about condoms and other contraceptives. Supporters of abstinence-only education say teaching teens about STI prevention and birth control sends a mixed message: You shouldn’t have sex, but here’s how you can get away with it and be OK.
According to a 2001 study by the National Campaign to End Teen Pregnancy, the results of abstinence-only education programs are unclear. The study also revealed that comprehensive sex education programs don’t speed up the start of sexual activity, nor do they increase the frequency of sex or the number of sexual partners. Comprehensive sex education might even delay the onset of sexual activity.
Even at MU, moral and health issues have collided with the distribution of condoms in residence hall bathrooms. The plan, proposed by the Phi Beta Sigma fraternity and supported by MU Residential Life, was halted by Chancellor Brady Deaton, who called for further discussion on the initiative.
The sex education debate is just one example of how sex can be transformed from a health issue into a moral and religious one. Dan Gentry, director of the Center for HIV/STD Policy Studies at Saint Louis University, says the United States has always been a more puritanical nation than other Western democracies, and the infusion of morality and religion in politics has increased over the years.
“I think that the intersection of American history and politics does pose a barrier to a more rational public debate and sensible policy for the prevention of sexually transmitted infections,” Gentry says.
The socially and self-imposed silence on sexual practices could literally be killing us. Breaking this sound barrier is a matter of life and death.
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