If you’ve been paying attention to social media recently, you may have come across a viral ad for EXTRA chewing gum depicting scenes of post-pandemic life: people slowly peeking out from behind closed doors and closing their laptops before opening maskless from theirs filled with toilet paper Caves burst into the street. The actors, all unwashed and unkempt, happily run to the next park, where everyone pounces on the first stranger they meet, and initiate a passionate make-out session that leads to Celine Dion’s power ballad “It’s all about now me back ”plays.
It has been over 100 years since the “Spanish” flu pandemic suppressed our sex life to the same extent as we experienced during COVID-19. As a doctor and sexual health researcher, I can attest to seeing empty waiting rooms for months while people kept their social and sexual distance and their cravings suppressed by fear of contagion. Surely there have been some for whom pandemic abstinence was short-lived, and I was delighted to see the New York and Canada public health officials gleefully giving guidance on the matter: encouraging masked sex, or even the use of Holes of glory in barriers like the bathroom doors to facilitate anonymous oral sex.
For the most part, however, our sexual appetites dwindled alongside our psyche as we exhausted our energies just to survive. And it wasn’t just Americans: Studies from the UK, China, Israel and Australia found that 40 to 60 percent of people reduced their number of sexual partners or the frequency of sex during the pandemic. As a result of our collective abstinence (plus a national shortage of testing kits), sexually transmitted infections (STIs) rates in the US fell in the second quarter of 2020, after previously hitting record highs in 2019.
Now that the vaccines have hit the US en masse, There’s little stopping us from having sex again. Celine Dion’s ballad would mean that during sex, our muscle memory will be like riding a bike: even if we haven’t done it in a while, we still haven’t forgotten how. What is not clear is whether we still have the drive. Before the pandemic, American sexuality was in decline for nearly two decades, even among the most sexually active age groups. In a study of over 9,000 adults based on surveys from 2000 to 2018, a third of young men between the ages of 18 and 24 reported no sexual activity in 2018; The activity also declined during the study period for both men and women between the ages of 25 and 34 years.
For those of us having sex again, it is logical to think that a year of living with COVID, putting on masks, testing, and negotiating safe socialization would lead to a discussion about safe sex. Not so, says Lisa Wade of Tulane University, who surveyed over 120 college students about sexual behavior during the pandemic. Despite the racial diversity, sexual orientation, and previous sexual experience among their study participants, their responses are “strikingly consistent” when asked if COVID has changed the way they live about sex and sexually transmitted diseases think: a wrinkled nose, an expression of confusion and a resounding “no”.
Wade’s students test for COVID two to three times a week and have no qualms about asking each other about their test results. However, questions about testing for STIs are not so natural. STIs still carry a stigma that envelops these “why should you need to test?” Discussions. and what have you done?” Even those who have felt comfortable asking others to wear a mask may find it difficult to ask a partner to use condoms or encounter resistance when such requests are made.
Our resistance to condoms and barriers extends across gender, age, and sexual orientation. HIV researchers have long understood the concept of “condom fatigue” in men who have sex with men. This fatigue occurs after years of instructing the use of condoms through HIV prevention campaigns. As Benjamin Klassen of Simon Fraser University noted in 2019, condoms have a status similar to public transportation among gay men today: something you would like everyone else to use without having to use it yourself.
Condoms are also declining in popularity with the Generation Z set, although teenagers are the age group in which condoms are most commonly used. According to the CDC Youth Risk Behavior Survey, student condom use during their last sexual encounter fell from 62 percent in 2007 to 54 percent in 2019. The prospects for dams having latex squares over the vulva for oral sex are even worse. Juliet Richters of the University of New South Wales found that less than 10 percent of Australian women who had sex with women had ever used a rubber dam, and only 2 percent used it consistently.
In our current era of technological innovation, we seem to have something better than barriers – maybe a smartphone app or an STI beam laser. However, condoms remain the only multipurpose prevention device that provides both contraception and protection against sexually transmitted diseases / HIV. But hopefully that will change. Groups like the Global Initiative for Multipurpose Preventive Technologies (IMPT) are working to advance the development of at least 20 products: pills, rings, membranes, gels, injectables and implants, with each product offering protection against at least two diseases: unplanned pregnancy, STIs or HIV.
What about building a better condom? The Gates Foundation tried to give it a try, and in 2013 offered companies $ 100,000 in seed grants to develop a next-generation condom that “preserves or enhances pleasure” to “improve uptake and regular use.” By 2019, three of the top eleven award winners had received an additional $ 1 million to advance into the clinical trial phase. It remains to be seen whether these products will have survived the pandemic and will hit the market. For now, at least, traditional condom sales are rising, but if we revert to our old usage patterns, they’re unlikely to last.
Then there is always hope for an STI vaccine. While there aren’t any imminent ones, new clinical trials are ongoing for vaccines for herpes and gonorrhea. And, as Operation Warp Speed has shown, with sufficient political will and financial support, drug companies can produce effective vaccines quickly.
However, whether the future of prevention is a better condom, a new device, or an STI vaccine doesn’t matter. The key is to have prevention products that people actually use. If predictions of a Redux of the Roaring Twenties or a Summer of Love after COVID are correct, an increase in sexually transmitted diseases and HIV is certain to follow. It will take more than our old barrier methods to meet the current needs of our sexually diverse population. We have to invest in the development of new prevention products now, otherwise we risk getting caught with our pants down later.
This is an opinion and analysis article.