Roundups Sexual Health

Sexual Health Roundup: Sexting is Normal and Summer Is the Season to Think “Sex”

Martha Kempner

In this week's sexual health roundup: researchers at the University of Michigan looked at the sexting behavior and psychological health of over 3,000 college students and determined that sexting did not, in fact, lead to heartache; another study of college students found that mixing alcohol and caffeinated energy drinks may increase risky behaviors such as drunk sex and casual sex; and a survey of Google searches since 2006 confirms what birth records have suggested for years -- Americans do actually think about sex more in the summer. 

Latest Research on Sexting Says It’s… Normal

There has been a lot of focus on young people and sexting in the last few years which is understandable because it is a brand new sexual behavior and one that seems designed to get young people who are thought to have more tech-savvy than common sense in trouble (though Anthony Weiner and others may disagree with that assumption). The media certainly latched on to the idea that sexting had reached epidemic proportions among teens and continually suggests that it is a dangerous and even deviant behavior. 

The newest academic research on the subject tells us that it’s neither. 

Researchers at the University of Michigan surveyed 3,447 young men and women ages 18 to 24 and found that over half (57 percent) were not sexters. Among those who were sexters; 28.2 percent were two-way sexters, 12.6 percent were receivers, and 2 percent were senders. The researchers found that sexually-active respondents were more likely to be two-way sexters than those who were not sexually active (suggesting that it is a behavior done as part of a relationship). Interestingly, males were more likely to be receivers than their female counterparts.  

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Participants were also asked about their sexual behavior (how many sexual partners they’d had) and their psychological well-being. The researchers found that there was no difference between sexters and non-sexters. Specifically, among participants who were sexually active in the past 30 days, the study found no differences “across sexting groups in the number of sexual partners or the number of unprotected sex partners in the past 30 days.”  It also found no relationship between sexting and psychological well-being; sexters did not, in fact, report increased anxiety, depression, or low self-esteem as has been suggested in media stories.

The authors say that most studies on sexting have focused on who is doing it and not on whether sexting impacts their health. They believe the findings “should help reverse the negative perception the news media-gobbling public has of sexting as a deviant or even criminal behavior.” That said, they acknowledge that this study looks at participants who were considerably older than the pre-teens whose sexting behavior dominate the media discussions on this topic. One of the authors explained: “For younger age groups, legality is an issue. They are also in a very different place in their sexual development.”

For older groups it seems that sending pictures of your privates to a good friend doesn’t have much impact on your sexual health—you’re political career, though, may be another story. 

Caffeine and Alcohol Together May Lead to More Casual Sex and More Drunk Sex than Alcohol Alone

I have to admit that I’ve never had a Red Bull. And though I’m on my second cup of coffee this morning, Starbuck’s wasn’t around when I was in college and I hadn’t yet developed a reliance on this morning drink, so I can’t quite relate to the habits of today’s college students who frequently mix caffeinated energy drinks with alcohol. Though the pre-packaged version, Four Loko, was taken off the market, students on campuses across the country make their own by mixing Red Bull with vodka or Jagermeister.  According to new research, when it comes to clouding your judgement this is worse than the old version of a Jagerbomb which was just made with beer.

Kathleen Miller, a researcher at the University of Buffalo, surveyed 648 college students asking them how often they mixed alcohol and caffeine, whether their last sexual encounter had been with a casual partner, whether it was unprotected, and whether it had taken place while they were drunk or high. The study, which was published in the Journal of Caffeine Research, defined casual partner as someone they weren’t in love with, weren’t exclusive with, and/or didn’t know well. 

About a third of the sample had mixed alcohol and energy drinks and though they were no more likely than their peers to have had unprotected sex recently, they were more likely to say their last partner was casual and that they had been drunk or high the last time they had had sex. Miller concluded that for both men and women mixing drinks with caffeine appeared to have effects on sex that alcohol alone did not have even when she control for alcohol use general. 

Miller explains that this mixture can increase sexual behavior because “when you’re drinking lots of alcohol, your judgment is impaired, and if you’re having caffeine, you don’t realize how impaired you are.” In short, energy drinks keep you from feeling tired and let you drink more. There’s also some evidence that energy drinks increase your desire for alcohol. 

There are some limitations to the study, however, in that it analyzed behaviors over a period of time but did not look at event-level behavior (meaning it didn’t ask about what happened the last time students mixed vodka and red bull and had sex). I also take some issue with the suggestion that a “casual” partner as it is defined in this study is indicative of risky sex–many people have had sex with partners who they are not in love with or exclusive with and it does not qualify risky–especially given that the alcohol/energy drink combination did not seem to increase unprotected sex.

Nonetheless, I think we all would prefer that when sexually-active college students have sex—whether with a casual or an exclusive partner—they are both sober and protected. 

Summer Loving: Americans think about Sex More in the Summer

My grandfather was a psychiatrist who specialized in couples counseling and I remember him once telling me that he thought people were more likely to hook up in the summer because it was hot, they were wearing less clothing, and inhibitions were down. Okay, he didn’t actually use the phrase hook up but you get the point and apparently he had a point.  A new survey of key word searches on Google suggests that June and July are not just about swimming and barbecues but porn and prostitutes as well.

Researchers analyzed the keywords used in Google searches between January 2006 and March 2011. They looked at keywords related to finding a mate (such as “eHarmony” and “Match.com”), prostitution (such as “call girl” and “escort”) and pornography (such as “porn” and “boobs”). As a control measure, they also looked at the number of searches for neutral keywords, such as “dog” and “windshield.”

They found that there are two times of year that Americans become more interested in sex—the brightest summer days of June and July and the darkest winter days of December and January. Searches for prostitution-related keywords were 2.78 percent above average in January and July and mate-seeking searches were 5.67 percent above average during these months. Similarly, searches for pornography were 4.28 percent above average during December and June. (Data on searches about prostitution in March of 2008 were thrown out because they were 35 percent above average which researchers attributed to the Eliot Spitzer scandal.)

This research confirms other data from over the years that suggested Americans were having more sex in certain months based on STDs rates and birth records.  Still, none of the research has been able to tell us why this is the case. Some have suggested that yearly variations in sperm quality and hormonal fluctuations are responsible for these spikes in interest. Research into birth records has suggested a natural tendency to give birth in the late summer or early fall. The author of this study, which was published in the Archives of Sexual Behavior, points out that “…if that was the only reason, there’d be no reason to watch porn or find a prostitute.” He speculates that the increase in sexual activity is about being around people and points out that summer tends to have more social activities as does December which includes holiday gatherings and shopping crowds.    

I kind of like Papa’s explanation better—in the summertime we walk around half-naked already. Though I suppose that doesn’t explain December when we’re wearing parkas, if only he were still around to ask about that.    

Commentary Politics

No, Republicans, Porn Is Still Not a Public Health Crisis

Martha Kempner

The news of the last few weeks has been full of public health crises—gun violence, Zika virus, and the rise of syphilis, to name a few—and yet, on Monday, Republicans focused on the perceived dangers of pornography.

The news of the last few weeks has been full of public health crises—gun violence, the Zika virus, and the rise of syphilis, to name a few—and yet, on Monday, Republicans focused on the perceived dangers of pornography. Without much debate, a subcommittee of Republican delegates agreed to add to a draft of the party’s 2016 platform an amendment declaring pornography is endangering our children and destroying lives. As Rewire argued when Utah passed a resolution with similar language, pornography is neither dangerous nor a public health crisis.

According to CNN, the amendment to the platform reads:

The internet must not become a safe haven for predators. Pornography, with its harmful effects, especially on children, has become a public health crisis that is destroying the life [sic] of millions. We encourage states to continue to fight this public menace and pledge our commitment to children’s safety and well-being. We applaud the social networking sites that bar sex offenders from participation. We urge energetic prosecution of child pornography which [is] closely linked to human trafficking.

Mary Frances Forrester, a delegate from North Carolina, told Yahoo News in an interview that she had worked with conservative Christian group Concerned Women for America (CWA) on the amendment’s language. On its website, CWA explains that its mission is “to protect and promote Biblical values among all citizens—first through prayer, then education, and finally by influencing our society—thereby reversing the decline in moral values in our nation.”

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The amendment does not elaborate on the ways in which this internet monster is supposedly harmful to children. Forrester, however, told Yahoo News that she worries that pornography is addictive: “It’s such an insidious epidemic and there are no rules for our children. It seems … [young people] do not have the discernment and so they become addicted before they have the maturity to understand the consequences.”

“Biological” porn addiction was one of the 18 “points of fact” that were included in a Utah Senate resolution that was ultimately signed by Gov. Gary Herbert (R) in April. As Rewire explained when the resolution first passed out of committee in February, none of these “facts” are supported by scientific research.

The myth of porn addiction typically suggests that young people who view pornography and enjoy it will be hard-wired to need more and more pornography, in much the same way that a drug addict needs their next fix. The myth goes on to allege that porn addicts will not just need more porn but will need more explicit or violent porn in order to get off. This will prevent them from having healthy sexual relationships in real life, and might even lead them to become sexually violent as well.

This is a scary story, for sure, but it is not supported by research. Yes, porn does activate the same pleasure centers in the brain that are activated by, for example, cocaine or heroin. But as Nicole Prause, a researcher at the University of California, Los Angeles, told Rewire back in February, so does looking at pictures of “chocolate, cheese, or puppies playing.” Prause went on to explain: “Sex film viewing does not lead to loss of control, erectile dysfunction, enhanced cue (sex image) reactivity, or withdrawal.” Without these symptoms, she said, we can assume “sex films are not addicting.”

Though the GOP’s draft platform amendment is far less explicit about why porn is harmful than Utah’s resolution, the Republicans on the subcommittee clearly want to evoke fears of child pornography, sexual predators, and trafficking. It is as though they want us to believe that pornography on the internet is the exclusive domain of those wishing to molest or exploit our children.

Child pornography is certainly an issue, as are sexual predators and human trafficking. But conflating all those problems and treating all porn as if it worsens them across the board does nothing to solve them, and diverts attention from actual potential solutions.

David Ley, a clinical psychologist, told Rewire in a recent email that the majority of porn on the internet depicts adults. Equating all internet porn with child pornography and molestation is dangerous, Ley wrote, not just because it vilifies a perfectly healthy sexual behavior but because it takes focus away from the real dangers to children: “The modern dialogue about child porn is just a version of the stranger danger stories of men in trenchcoats in alleys—it tells kids to fear the unknown, the stranger, when in fact, 90 percent of sexual abuse of children occurs at hands of people known to the victim—relatives, wrestling coaches, teachers, pastors, and priests.” He added: “By blaming porn, they put the problem external, when in fact, it is something internal which we need to address.”

The Republican platform amendment, by using words like “public health crisis,” “public menace” “predators” and “destroying the life,” seems designed to make us afraid, but it does nothing to actually make us safer.

If Republicans were truly interested in making us safer and healthier, they could focus on real public health crises like the rise of STIs; the imminent threat of antibiotic-resistant gonorrhea; the looming risk of the Zika virus; and, of course, the ever-present hazards of gun violence. But the GOP does not seem interested in solving real problems—it spearheaded the prohibition against research into gun violence that continues today, it has cut funding for the public health infrastructure to prevent and treat STIs, and it is working to cut Title X contraception funding despite the emergence of Zika, which can be sexually transmitted and causes birth defects that can only be prevented by preventing pregnancy.

This amendment is not about public health; it is about imposing conservative values on our sexual behavior, relationships, and gender expression. This is evident in other elements of the draft platform, which uphold that marriage is between a man and a women; ask the U.S. Supreme Court to overturn its ruling affirming the right to same-sex marriage; declare dangerous the Obama administration’s rule that schools allow transgender students to use the bathroom and locker room of their gender identity; and support conversion therapy, a highly criticized practice that attempts to change a person’s sexual orientation and has been deemed ineffective and harmful by the American Psychological Association.

Americans like porn. Happy, well-adjusted adults like porn. Republicans like porn. In 2015, there were 21.2 billion visits to the popular website PornHub. The site’s analytics suggest that visitors around the world spent a total of 4,392,486,580 hours watching the site’s adult entertainment. Remember, this is only one way that web users access internet porn—so it doesn’t capture all of the visits or hours spent on what may have trumped baseball as America’s favorite pastime.

As Rewire covered in February, porn is not a perfect art form for many reasons; it is not, however, an epidemic. And Concerned Women for America, Mary Frances Forrester, and the Republican subcommittee may not like how often Americans turn on their laptops and stick their hands down their pants, but that doesn’t make it a public health crisis.

Party platforms are often eclipsed by the rest of what happens at the convention, which will take place next week. Given the spectacle that a convention headlined by presumptive nominee (and seasoned reality television star) Donald Trump is bound to be, this amendment may not be discussed after next week. But that doesn’t mean that it is unimportant or will not have an effect on Republican lawmakers. Attempts to codify strict sexual mores are a dangerous part of our history—Anthony Comstock’s crusade against pornography ultimately extended to laws that made contraception illegal—that we cannot afford to repeat.

Commentary Sexual Health

Fewer Teens Are Having Sex, But Don’t Pop the Champagne Yet

Martha Kempner

The number of teens having sex may be less important than the number having protected sex. And according to recent data from the Centers for Disease Control and Prevention, condom use is dropping among young people.

Every two years, the Centers for Disease Control and Prevention’s Division of Adolescent and School Health (CDC-DASH) surveys high school students to gauge how often they engage in perceived risky behaviors. The national Youth Risk Behavior Surveillance (YRBS) is wide ranging: It asks about violence, guns, alcohol, drugs, seat belts, bicycle safety, and nutrition. It also asks questions about “sexual intercourse” (which it doesn’t define as a specific act) and sexual behaviors.

Started in 1991, this long-running study can provide both a picture of what high school students are doing right now and a historical perspective of how things have changed. But for more than a decade, the story it has told about sexual risk has been the virtually the same. Risk behaviors continually declined between 1991 and 2001, with fewer high school students having sex and more of them using condoms and contraception. But after the first 10 years, there has been little change in youth sexual risk behaviors. And, with each new release of almost unchanging data, I’ve reminded us that no news isn’t necessarily good news.

This year, there is news and it looks good—at least on the surface. The survey showed some significant changes between 2013 and 2015; fewer kids have ever had sex, are currently sexually active, or became sexually active at a young age. More teens are relying on IUDs and implants, which are virtually error-proof in preventing pregnancy.

In 2015, 41 percent of high school students reported ever having had sexual intercourse compared to 47 percent in 2013. The researchers say this is a statistically significant decrease, which adds to the decreases seen since 1991, when 54 percent of teens reported ever having had sexual intercourse.

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Another change is in the percentage of students who had sex for the first time before age 13. In 2015, 4 percent of high school students reported this compared to almost 6 percent in 2013. This is down from a full 10 percent in 1991. As for number of overall partners, that is down as well, with only 12 percent of students reporting four or more partners during their lifetime compared to 15 percent in 2013 and 19 percent in 1991. Finally, the percentage of students who are currently sexually active also decreased significantly between 2013 (34 percent) and 2015 (30 percent).

These are all positive developments. Delaying sex can often help prevent (at least temporarily) the risk of pregnancy or STIs. Having fewer partners, especially fewer concurrent partners, is frequently important for reducing STI risk. And those teens who are not currently having sex are not currently at risk for those things.

While I want to congratulate all teens who took fewer risks this year, I’m not ready to celebrate those statistics alone—because the number of teens having sex is less important to me than the percentage of teens having sex that is protected from both pregnancy and sexually transmitted infections. And that number is lower than it once was.

Among sexually active teens, there were no significant positive changes in measures of safer sex other than an increase in the number of sexually active high school students using the IUD or implant (up to 4 percent from 2 percent in 2013).

Moreover, some results indicate that today’s teens are using less protection than those who were teens a decade ago. The most telling finding might be the percentage of teens who used no method of contraception the last time they had sex. This decreased between 1991 and 2007 (from 17 percent to 12 percent), inched up to 14 percent in 2013, and stayed the same in 2015 (14 percent). There was also little to no change in the percentage of high school students who say that either they or their partner used birth control pills between 2013 (19 percent) and 2015 (18 percent) or those who say they used the contraceptive shot, patch, or ring (5 percent in 2013 and 2015).

For me, however, the most distressing finding is the backward progress we continue to see in condom use. The prevalence of high school students who used a condom at last sex went up from 45 percent in 1991 to 63 percent in 2003. But then it started to drop. In 2015, only 57 percent of sexually active high school students used condoms the last time they had sex, less than in 2013, when 59 percent said they used condoms.

It’s not surprising that teens use condoms less frequently than they did a decade ago. In the 1990s, the HIV epidemic was still front and center, and condoms were heavily promoted as a way to avoid infection. As this threat waned—thanks to treatment advances that now also serve as prevention—discussions of the importance of condoms diminished as well. The rise of abstinence-only-until-marriage programs may have also affected condom use, because these programs often include misinformation suggesting condoms are unreliable at best.

Unfortunately, some of the negative messages about condoms inadvertently came from public health experts themselves, whether they were promoting emergency contraception with ads that said “oops, the condom broke”; encouraging the development of new condoms with articles suggesting that current condoms are no fun; or focusing on teen pregnancy and the use of highly effective contraceptive methods such as long-acting reversible contraceptives (LARC). The end result is that condoms have been undersold to today’s teenagers.

We have to turn these condom trends around, because despite the decreases in sexual activity, young people continue to contract STIs at an alarming rate. In 2014, for example, there were nearly 950,000 reported cases of chlamydia among young people ages 15 to 24. In fact, young people in this age group represented 66 percent of all reported chlamydia cases. Similarly, in 2014, young women ages 15 to 19 had the second-highest rate of gonorrhea infection of any age group (400 cases per 100,000 women in the age group), exceeded only by those 20 to 24 (489 cases per 100,000 women).

While we can be pleased that fewer young people are having sex right now, we can’t fool ourselves into believing that this is enough or that our prevention messages are truly working. We should certainly praise teens for taking fewer risks and use this survey as a reminder that teens can and do make good decisions. But while we’re shaking a young person’s hand, we should be slipping a condom into it. Because someday soon (before high school ends, for more than half of them), that teenager will have sex—and when they do, they need to protect themselves from both pregnancy and STIs.