Wednesday, February 25, 2009

You may already have an STD

The Medical Institute for Sexual Health (a conservative abstinence advocating health group) has created an STD Wizard to help people realize which STDs they are at risk for. I applaud the idea. People way underestimate their risk for chlamydia and HPV, and the latter is extremely extremely common. The only reason why many people who have had sex test negative is because they had the virus and then cleared it.

So I was looking forward to hearing them say that. I went through their quiz, filling in age, region of country, gender, race, drug use and STD history, and some yes/no sexual activity and drug questions. Not as fun as the purity test "Have you done it in a box? Have you done it with a fox?" They don't ask lifetime number of sex partners, only whether you have recently been raped or gotten a new sex partner.

And my results were. . .

I should take an HIV test, based on the fact that I haven't had a test in the past 12 months.

A healthy woman having unprotected vaginal sex with an HIV+ person has less than a 0.1% chance of contracting HIV. On the other hand, she is more than 2 orders of magnitude more likely to contract chlamydia or HPV if she's having sex with a person with those.

They follow this by, "Note: Even though many sexually active people have herpes, testing is rarely recommended."

And then, "Fact sheets for STDs you may have:" with links to HIV/AIDS fact sheets.

Way to go with the inaccurate fear-mongering. There is plenty of risk you could talk about.

Thursday, February 19, 2009

Pastor calls to end virginity pledges

A Christian clergy member calls for churches to stop using abstinence pledges. Amusingly, one of his criticisms is that they are "pharisaical".

(In fact the Pharisees would not allow them: pledges have always been forbidden by rabbinic law!)

Speaking of religious kids' decisions to have sex

The Bristol Palin interview reminded me of the strange wrong number 6 months ago from the 25 year old yeshiva kid from Brooklyn thinking about having sex with his girlfriend for the first time. I wonder what happened. Did they have sex? Are they still together? Did they get engaged? They could have even gotten married by now.

Is abstinence realistic?

The liberal reactions to Bristol Palin's statement that abstinence is not realistic were expected. The religious ones haven't gotten much attention.

One evangelical site says abstinence is an obligation so not up for discussion; instead society must be made so that abstinence becomes realistic. There are certainly groups of teenagers with lower (but non-zero!) rates of sexual activity than evangelical teenagers. I'm just not sure that those models work in the evangelical context. The whole principle of evangelical Christianity going back to Paul is to have a relatively low admission price in terms of obligations, so not everyone will be as committed and so may not be as likely to change their dating habits as in religious groups where adherents also have to change their diet or dress style. One admission price is attending an evangelical school as this person notes, so norms can be more successfully perpetuated in this environment in which everyone has already made a substantial commitment to even be there. It will be interesting to see whether more evangelical groups change their culture to become more conservative and separate the sexes more.

Bristol Palin's statement comes with very good timing. Hints at the future of abstinence-only education for FY 2010 will come at the end of the month when Obama submits his budget. Separately, according to the Economist Louise Slaughter's bill for medically-accurate sex education is likely to pass.

Monday, February 2, 2009

Girls and casual sex: syphilis epidemic, but no rainbow parties

I've read a few accounts lately about girls and young women in casual sexual relationships, and the same pattern emerges. These women started a behavior for adventure and experimentation, but when they decide they've had enough of the behavior they feel unable to step away from the behavior pattern due to social pressure.

Hooking Up by Katherine Bogle is about casual relationships in college. She studied two colleges: one small and religious, and one secular and larger. Freshman young women hook-up initially out of a mixture of curiosity, interest, exercising independence from earlier restrictions, and perhaps because it's what others are doing. By hooking up these college students mean anything from kissing to oral or vaginal sex, with or without alcohol, but according to their reports one time hookups are more likely to be at the less intimate end of the spectrum and alcohol is a good social excuse ("beer goggles"). Hooking up is almost always with an acquaintance or an acquaintance of an acquaintance: the closed atmosphere of a college makes women feel safe being alone with someone they just met. Within a year or two, most of the women report that they stopped being so interested in hooking up: they want a real relationship. The dynamic on campus, though, is still aimed at hooking up. The guys who are unassertive are not part of the hook-up culture at all, and they don't date much either. The guys who are assertive are part of the hook-up culture, and seem to have numbers in their favor: they can almost always find a woman willing to hook up with them, so a woman who wants to have any sexual contact and sees her dating pool as comprising such guys has the choice between hooking up or not hooking up: they do not feel that they have the option of a relationship. Some women hook up and hope for a relationship, and are inevitably disappointed. They don't talk about why they don't go for relationships with the nice guys, though probably for the clicheed reasons.

After college, the women are able to assert themselves: they are meeting people outside their comfort zone, hooking up would be with relative strangers and does not feel safe to anyone, and perhaps the men mature as well. Women can insist on real dates and relationships in this new social environment.

Bogle describes a limited time period in which women get involved in casual sex for a time, get tired of it and want real relationships, but don't feel that they have other options. These women seem to feel coerced into hook-ups: not at a level of sexual contact beyond their comfort level, but in a non-relationship context that is beyond their comfort level. After college, women find more power in the romantic arena and are able to have relationships as they want.

This reminds me of the story of the group sex in Atlanta suburbs hosted by 13-16 year old girls that led to a syphilis outbreak. This interview talks about how the girls say that they started having group sex parties partially out of boredom, and partially for similar motivations as the freshman college women reported for hook-ups: curiosity, interest, independence. After awhile, though, the girls felt that they couldn't control the situation any longer: both within an actual event and over many events. At a single event as activity escalated, girls felt unable to slow or stop the activity, especially when with multiple males simultaneously. After going to a few activities, girls felt unable to turn down future activities. The girls engaged in sexual activity with each other as a means of controlling the activity together. Reading that description, I keep thinking of some generally misogynist contexts --- women trafficked into commercial sex work, perhaps --- and have to remind myself that these are upper middle class girls in the US who are told they can become doctors and lawyers and astronauts.

The girls here clearly seem to have less control than the hook-up case because they feel out-numbered and pressured by other attendees, and are obviously less mature and less confident and below the age of consent. Nonetheless, it's interesting that there is a similar dynamic here as well: becoming involved completely willingly initially, and ending up feeling coerced or forced into sexual contact that they did not want both within a single episode and within their social context.

College graduation and syphilis, respectively, intervened, but what if they hadn't? It seems so easy for an outsider to say that a woman should just walk away from a situation she is so uncomfortable with, and yet clearly they didn't feel able to. What inner resources do women need in order to extricate themselves from an uncomfortable situation filled with social pressures? It looks so easy on Degrassi Junior High: one girl finally gets uncomfortable enough to say "Enough! This is not cool." and then everyone suddenly realizes she is right. If nothing else surely these girls have seen Degrassi Junior High or similar! Clearly it's not that easy, and eventually it sounds like the girls did stand up and stop this, maybe before the syphilis, but not after they'd been well past the point of feeling forced and out of control and like they might be traumatized for their future sexual experiences.

No answers, just questions.