Roundups Sexual Health

This Week in Sex: More Porn Stars Test HIV-Positive and Researchers Take On Testes and Testosterone

Martha Kempner

This week, filming stops yet again as two more porn stars test positive for HIV, researchers find that men with smaller testicles are more-involved dads, and it turns out that estrogen may play a bigger role in male libido than testosterone.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

And Then There Were Four: More Porn Stars Test Positive for HIV

Porn sets are dark again as industry insiders collect information about what may be an outbreak of HIV among performers, and public health advocates say that enough is enough. As Rewire has been reporting, filming stopped in late August when a female star, who uses the stage name Cameron Bay, announced she had tested positive for the virus. The industry’s self-imposed moratorium was lifted when all of Bay’s on-screen partners tested negative. As the industry was recovering from this pause in filming, an actor whose screen name is Rod Daily announced on Twitter that he, too, had tested positive. Daily stars mainly in gay porn but has been romantically linked to Bay. His announcement did not cause a second moratorium on filming, however, because he was tested at a facility not linked to the industry. The Free Speech Coalition, the industry trade group that takes responsibility for testing actors, told the New York Times that it asked Daily to present his test results to them but he was not under any obligation to do so (presumably because he was not reporting to work).

In the week since Daily’s announcement, there have been two other confirmed cases of HIV in porn actors, both of whom opted not to be named. The Free Speech Coalition has halted production again. A spokeswoman for the organization said in a statement, “While we don’t have evidence to suggest an on-set transmission as opposed to a transmission from non-industry (off-camera) related activity, we are taking every measure to determine the source and to protect the performer pool.”

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Michael Weinstein, president of the AIDS Healthcare Foundation, an advocacy group that has been pushing for mandatory condom use on all adult films, sees the outbreak as proof that the current system is not working regardless of whether any of these stars were infected on set. He told the Los Angeles Times, “Whether or not [Bay] was infected on set, she performed with HIV between her tests. If you think that Russian roulette is a great way to protect workers, then the present system is perfect.”

Weinstein hopes that this new outbreak will at least be a catalyst for change in the industry. “People thought it was a weird, quirky thing,” he told NPR, “and now I think they see it as a real health issue.”

Do Men With Smaller Balls Make Better Dads?

To add to our list of things that we can’t believe anyone thought to research, we now know that men who take a more active role in child care have smaller testicles. Yep, researchers at Emory University asked 70 heterosexual cohabiting couples with very young children to complete a questionnaire about how they divided up parenting jobs (like baths, doctor’s visits, and nighttime comforting) and gave the man a score based on how involved he was. They then measured each man’s testicles using MRIs and found a clear trend—as parenting scores rose, testes size fell. This correlation remained even after the researchers controlled for men’s height and testosterone levels.

Though these findings only show a correlation and do not explain the cause (are men with smaller testicles drawn to parenting activities or do parenting activities cause testicles to shrink?), the researchers believe that the results add to our understanding of evolutionary biology and something called life history theory. Essentially there are two ways that male animals can maximize their chances of having offspring who can continue their lineage—have a few children and invest heavily in their upbringing or spread your seed far and wide but do little to raise your kids. Chimpanzees do the former, sea turtles do the latter. The authors believe that their findings about males “are the strongest evidence yet that variations in male anatomy reflect competing evolutionary strategies.”

The study’s lead author, Jennifer Mascaro, told the Guardian, “We are not saying you can determine a man’s parenting aptitude based on their individual biology. But it does suggest that some men may be wired to participate in childcare more than others. They may take to it more readily.”

Estrogen, It’s Not Just for Women

We all know that estrogen is one of the main female sex hormones and that men make testosterone, but the truth is that both genders produce and need both hormones. And a new study published in the New England Journal of Medicine has found that male libido is actually dependent on estrogen.

Researchers enrolled 400 men between the ages of 20 and 50 and gave them treatments to suppress their bodies’ production of all reproductive hormones. Some men then received a placebo, another group got testosterone-boosting gel, and another group got testosterone-boosting gel and a drug that suppressed estrogen. They found that those men who were getting the estrogen-suppressing drug had a greater reduction of sexual desire than the other men in the study.

Joel Finkelstein, the study’s author, told Bloomberg News that many might find the results unexpected. “What will surprise many people is that loss of sexual desire in men with low testosterone is due to lack of estrogen,” said Finkelstein. “People think estrogen in men makes them very effeminate; they think of it as a female hormone, they think it is testosterone that gives men their sexual desire.” He went on to explain that these results should not change the treatment for men with low libidos who are often given replacement testosterone. The body is able to convert these treatments into estrogen so taking testosterone should also increase estrogen levels. That said, Finkelstein believes the results should “discourage drug makers from trying to develop new forms of testosterone replacements that aren’t able to be converted to estrogen.”

Roundups Sexual Health

This Week in Sex: News From the HIV Epidemic

Martha Kempner

This week in sex: Scientists report the first case of HIV transmission to a patient adhering to PrEP protocols, two studies show a new vaginal ring can help women prevent HIV, and young people still aren't getting tested for the virus.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

With the death of Nancy Reagan, the 1980s AIDS crisis is back in the national spotlight. But, of course, HIV and AIDS are still ongoing problems that affect millions of people. This week in sex, we review scientists reporting the first case of HIV transmission to a patient adhering to PrEP protocols, two studies showing a new vaginal ring can help women prevent HIV, and evidence that young people still aren’t getting tested for the virus.

First Case of HIV Transmission While on Truvada

Last week, Canadian scientists reported on what they believe to be the first HIV infection in a patient who was following a PreP (Pre-Exposure Prophylaxis) regimen.

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PrEP is a method of HIV prevention. By taking a daily pill that contains two HIV medicines, sold under the name Truvada, individuals who are HIV-negative but considered to be at high risk of contracting the virus can prevent infection. Studies have found that PrEP is very effective—the Centers for Disease Control and Prevention estimates that people who take the medication every day can reduce their risk of infection by more than 90 percent from sex and by more than 70 percent from injection drug use. One study of men taking PrEP found no infections over a two-and-a-half-year period.

PrEP is less effective when not taken regularly, but the new case of reported PrEP failure involves a 43-year-old man who said that he took his medication daily. His pharmacy records back up that assertion. The man’s partner has HIV, but is on a drug regimen and has an undetectable viral load. The man did report other sexual encounters without condoms with casual partners in the weeks leading up to his diagnosis.

Dr. David Knox, the lead author of this case study, notes that it is difficult to know if a patient really did adhere to the drug regimen, but the evidence in this case suggests that he did. He concluded, “Failure of PrEP in this case was likely due to the transmission of a PrEP-resistant, multi-class resistant strain of HIV 1.”

Experts say, however, that they never expected PrEP to be infallible. As Richard Harrigan of the British Columbia Center for Excellence in HIV/AIDS told Pink News, “I certainly don’t think that this is a situation which calls for panic …. It is an example that demonstrates that PrEP can sometimes be ineffective in the face of drug resistant virus, in the same way that treatment itself can sometimes be ineffective in the face of drug resistant virus.”

Still, some fear that the new study will add to the ongoing debate and apathy that seem to surround PrEP. While some experts see it as a must-have prevention tool, others worry that it will encourage men who have sex with men to forgo using condoms and perhaps increase their risk for other sexually transmitted infections. Still, only 30,000 people in the United States are taking the drug—an estimated one-twentieth of those who could benefit from it.

A New Vaginal Ring Could Help Women Prevent HIV Infection

Researchers have announced promising results from two studies looking at new technology that could help women prevent HIV. The dapivirine ring, named after the drug it contains, was developed by the International Partnership for Microbicides. It looks like the contraceptive ring, Nuvaring, and is similarly inserted high up into the vagina for a month at a time. Instead of releasing hormones to prevent ovulation, however, this ring releases an antiretroviral drug to prevent HIV from reproducing in healthy cells. (A ring that could prevent both pregnancy and HIV is being developed.)

The two studies of the ring are being conducted in Africa. One study recruited about 2,600 women in Malawi, South Africa, Uganda, and Zimbabwe. It found that the ring reduced HIV infection by 27 percent overall and 61 percent for women over age 25. The other study, which is still underway, involves just under 2,000 women in seven sites in South Africa and Uganda. Early results suggest that the ring reduced infection by 31 percent overall when compared to the placebo.

Both studies found that the ring provided little protection to women ages 18-to-21. Researchers are now working to determine how adherence and other biological factors may have impacted such an outcome.

Young People Not Getting Tested for HIV

A study in the February issue of Pediatrics found that HIV testing rates among young people have not increased in the last decade. The researchers looked at data from the Youth Risk Behavior Survey (YRBS), which asks current high school students about sexual behaviors in addition to questions about drugs and alcohol, violence, nutrition, and personal safety (such as using bike helmets and seat belts). Specifically, the YRBS asks students if they’ve ever been tested for HIV.

Using YRBS data collected between 2005 and 2013, the researchers estimated that 22 percent of teens who had ever had sex had been tested for HIV. The percent who had received HIV tests was higher (34 percent) among those who reported four or more lifetime partners. Overall, male teens (17 percent) were less likely than their female peers (27 percent) to have been tested.

Researchers also looked at data from the Behavioral Risk Factor Surveillance System, which asks similar questions to young adults ages 18 to 24. Among people in this age group, between the years of 2011 to 2013, an average of 33 percent had ever been tested. This review of data also found that the percentage of young women who get tested for HIV has been decreasing in recent years—from 42.4 percent in 2011 to 39.5 percent in 2013.

The authors simply conclude, “HIV testing programs do not appear to be successfully reaching high school students and young adults.” They go on to suggest, “Multipronged testing strategies, including provider education, system-level interventions in clinical settings, adolescent-friendly testing services, and sexual health education will likely be needed to increase testing and reduce the percentage of adolescents and young adults living with HIV infection.”

Roundups Sexual Health

This Week in Sex: Can an Orange a Day Really Keep Viagra Away?

Martha Kempner

This week in sex: Tinder adds an STI test locator, research shows a connection between HPV and oral cancer, a diet rich in fruits and vegetables may help with erectile issues, and the Brits weigh in on the ideal number of past sexual partners.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Tinder Adds a Sexual Health Landing Page, But It’s Not So Easy to Find

Amid criticism that online dating is increasing the spread of sexually transmitted infections (STIs), Tinder agreed to add a sexual health page to its website and app—but some outlets argue that it’s not at all user-friendly.

Tinder and other apps like Grindr have been targeted by the AIDS Healthcare Foundation (AHF) as a culprit in rising STI rates. The California-based advocacy organization, famous for its long battle to make condoms mandatory in adult films, paid for billboards in New York City and Los Angeles implying that users of the apps are potentially exposing themselves to chlamydia and gonorrhea. The billboards pointed people to freestdcheck.org, an AHF-run site that provides information on STIs and helps people locate testing facilities.

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Tinder responded to the billboard with a cease and desist order from the company’s attorneys that read, in part, “These unprovoked and wholly unsubstantiated accusations are made to irreparably damage Tinder’s reputation in an attempt to encourage others to take an HIV test offered by your organization … While Tinder strongly supports such testing, the [b]illboard’s statements are not founded upon any scientific evidence, and are incapable of withstanding critical analysis.”

AHF did not immediately back down. On Jan 21st, the two organizations agreed to a settlement: Tinder agreed to add an STI test locator to its website and AHF agreed to take the down the billboards.

The end result, however, may leave users no more informed than they were before. Newsweek points out that the locator is nothing more than a link to an outside website operated by Healthvana and that the link is hard to find. Newsweek notes, “On the mobile app, where Tinder really happens, you [need] to click on the settings button on the top left, then click ‘help & support,’ transfer over to a Web browser, click on ‘health safety’ and then scroll down to the STD locator link.”

In short—locating the link may be just as difficult as it was to locate a clinic without it.

New Study Confirms HPV-16 Increases Risk for Head and Neck Cancers

A study published this month in JAMA Oncology finds that the presence of a strain of human papillomavirus (HPV) in the mouth leads to an increase risk of oropharyngeal cancer. In two studies, 97,000 participants provided mouthwash samples proving they were cancer-free at the beginning of the research. Scientists followed the participants for four years and identified 132 cases of head and neck cancers that emerged. They then compared the original samples of each of these people with those of participants who did not develop cancer during the four years, and concluded that the presence of one strain, HPV-16, in the mouth put people at as much of a 22-fold increased risk of developing head and neck cancer.

Though HPV is known to be transmitted through oral sex, the study does not specifically mention transmission methods.

This was the first time studies have found that the HPV-16 virus precedes these cancers. Researchers warn, however, that this study is not sufficient to prove that HPV-16 specifically caused the cancers that were found.

Another Reason to Eat Your Fruits and Veggies: Better Erections

A new study published in the Journal of Clinical Nutrition found that eating a diet rich in flavonoids may be as good for erectile health as walking briskly for two to five hours a week. Flavonoids give fruits and vegetables their bright colors. The study examined three types of flavonoids: anthocyanins, which are found in blueberries, blackberries, cherries, radishes, and red wine, and flavanones and flavones, which are both found in citrus fruits.

The results showed that men who ate foods high in these nutrients were 10 percent less likely to have erectile problems. And they didn’t have to ingest huge quantities; just a few portions a week.

This correlation, however, is not enough to prove that an orange a day will keep the Viagra away. It is possible that the men who had these fruits in their diet were leading an overall healthier lifestyle than those that didn’t. Still, if a handful of blueberries and a glass of red wine might help get (or keep) you hard—what’s the harm?

Survey Says Ten Sexual Partners in a Lifetime Is Just Right

A new survey of adults in Britain attempted to determine how many lifetime partners adults thought was ideal for a new partner to have had. One thousand adults weighed in: Overall, a person who had more than ten partners was considered promiscuous, but fewer than that and they were perceived as sexually inexperienced.

Interestingly, the survey was conducted by IllicitEncounters.com, a British website that helps people have extramarital affairs. It’s unclear whether the respondents cared how many of those ten partners were in long-term relationships at the time of their new partner’s experience with them.