Roundups Sexuality

This Year in Sex: We’re Living in the Future

Martha Kempner

Between the high-tech sex toys, transplanted uteri, lab-grown penises, and perils of hookup apps, 2014 sometimes sounded like a science fiction novel. But we can't forget the news about IUDs and STIs that came out this year, either.

This Year in Sex takes a look back at the news and research related to sexual behavior, sexuality education, contraception, sexually transmitted infections, and other topics that captured our attention in 2014.

The HPV Vaccine Works, It Doesn’t Cause Promiscuity, and There’s an Even Better One Coming

HPV and its vaccine made headlines many times this year. The upsetting news is that two new studies came out suggesting that we had been underestimating the number of both HPV cases and cervical cancer, but as far as the vaccine itself was concerned, things were looking pretty good.

First, and most importantly, it appears to be working. A 2013 study found that despite the fact that only half of teen girls had gotten one dose of the vaccine—and fewer than a third had gotten the recommended three doses—the proportion of teen girls infected with the HPV strains that the vaccine addresses has dropped by 56 percent. This year, another study confirmed this success when it found that states with high rates of HPV vaccines have lower rates of cervical cancer, and vice versa.

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Additional research this year should (though probably won’t) also put to rest the idea that giving young people the HPV vaccine encourages them to engage in sexual behavior. One study found that young women do not change their attitudes or behaviors toward safer sex if they get the shot, and the other showed that girls with the vaccine are no more likely to get pregnant or be tested positive for a sexually transmitted infection than their unvaccinated peers.

More good news: Last week, the Food and Drug Administration (FDA) approved a new version of Gardasil, one of the two HPV vaccines on the market, which will protect against more strains of the virus. The original vaccine protected against strains 11 and 6, which cause most genital warts, and strains 16 and 18, which cause 70 percent of cervical cancer. The new vaccine, called Gardasil 9, will protect against these four strains in addition to five more cancer-causing strains—31, 33, 45, 52, and 58. Public health experts are hopeful that this added defense can prevent 90 percent of cervical, vulvar, vaginal, and anal cancers.

Wins and Losses for Those Who Want Condoms in Porn

Last year ended with a shutdown of filming—the third of its kind in 2013—in the porn industry after another actor was found to be HIV-positive. So it should be no surprise that this year included numerous rounds in the battle between producers who say no one wants to see condoms on film and public health experts who insist safer sex should start on set.

An effort to get California to pass a statewide law mandating condom use ultimately failed after facing a lot of opposition from porn company representatives, who threatened to take their business to a friendlier state, and porn stars who said it would force their industry underground and make their work more dangerous.

Defenders of the ban, however, did get an end-of-year victory this week when Measure B—a Los Angeles County ordinance requiring condoms on adult industry sets—was upheld by the Ninth Circuit Court of Appeals. A lower court had formerly upheld the measure, though it has yet to be systematically enforced.

The IUD Gains Supporters and Users

The intrauterine device (IUD) was once one of the more popular methods of birth control available. Then one model, the Dalkon Shield, came on the market with numerous design flaws that caused many users to become infertile, even resulting in several deaths. Though the dangers were unique to Dalkon Shield, women and physicians became suspicious of all IUDs; for many years, very few women—and only those who had already had children—would use them for contraception. In the last few years, however, IUDs have started getting more attention as providers and public health experts note the safety of newer models and the unparalleled efficacy rates.

This year, the IUD gained even more supporters, such as the American Academy of Pediatrics, which came out with a recommendation in October suggesting that IUDs be considered a first-line contraception for sexually active young people. Three months prior, research out of Colorado suggested that increasing the number of young women at Title X clinics using long-acting reversible contraceptives (which include both IUDs and implants) had led to lower than expected fertility rates among low-income women ages 15-to-24 in the state.

Other states, even conservative ones, decided this year that fixing the way Medicaid pays for IUDs—to make it possible to obtain one in a single visit, or even while still in the hospital after delivering a baby—could help prevent unintended pregnancies.

All of this support seems to be translating into increased use of the method. The National Survey of Family Growth found that 6.4 percent of contraceptive users were using an IUD in 2011-2013, compared to just 3.5 percent in the 2006-2010 survey.

Lab-Grown Penises and Transplanted Uteri

The future of reproductive health may include penises grown in a lab and babies born from transplanted uteri.

This year, the first baby to grow in a transplanted uterus was born to a 36-year-old Swedish woman whose name is being withheld. The woman, like the nine others who began the trial, had functioning fallopian tubes but was born without a uterus. After she received a donor organ from a friend of the family, doctors put her on anti-rejection drugs immediately. She became pregnant using IVF and had a relatively uncomplicated pregnancy, though the baby was delivered at 32 weeks when she showed signs of preeclampsia.

The medical team who undertook the trial hailed this as great news for assisted reproductive technologies, but others have expressed worry that the procedure is too invasive for both the donor and the recipient. Two of the nine women in the original study had to have their donor uteruses removed.

Meanwhile, no one has yet to be given a lab-grown penis, but new research on rabbits publicized in October suggests that it’s just a few years off. The process starts with a donor organ that is first stripped of its cells, then seeded with two different types from the genitals of the intended recipient. By making the penis out of the recipient’s own cells, scientist say they are reducing the chance of organ rejection. The procedure was tested on 12 rabbits; all successfully tried to mate using their engineered penis, eight were able to ejaculate, and four impregnated their bunny partner.

Truvada Dominates HIV-Prevention Discussion

Truvada is a combination of two antiretroviral drug used to treat individuals who have HIV. When used daily in HIV-negative individuals, these drugs have been shown to prevent transmission of the virus. The FDA approved the use of Truvada as a form of pre-exposure prophylaxis (PREP) in 2011 and it has been gaining popularity ever since.

This year, both the Centers for Disease Control and Prevention and the World Health Organization released guidelines suggesting that those at high risk of HIV infection—including injection users and men who have sex with men who are not in a monogamous relationship—consider using Truvada.

The method is highly effective. Studies have found that men who take it every day can reduce their risk of HIV infection by as much as 92 percent.

Still, some HIV advocates are concerned that those who choose Truvada—which can cost as much as $10,000 a year and needs to be taken every day—will stop using condoms, putting themselves and their partners at increased risk of other STIs, such as gonorrhea or syphilis.

The Dangers of Mixing Sex and Technology

The intersection between technology and sex got a little tricky this year as officials pointed to a dating app, Grindr, as being at least partially responsible for a syphilis outbreak; meanwhile, a jury in California found that an STI dating site called PositiveSingles had been sharing private information.

Grindr uses global positioning technology to help users meet other users nearby who are interested in getting together, presumably for sex. Grindr is marketed to men who have sex with men, but similar apps exist for heterosexual couples and women who have sex with women. This March, the popular app was at the center of an outbreak of syphilis in Onondaga County, New York.

A few months later, research in Los Angeles found that men who have sex with men who met partners on apps like Grindr had a 25 percent greater incidence of chlamydia and a 37 percent greater incidence of gonorrhea than those who met men in person at a bar, club, gym, private sex party, or even an online dating site. There was no difference in HIV rates or syphilis rates based on where men met.

The online dating sites, however, might pose another problem, at least according to a California jury that awarded 16.5 million dollars last month to a man who says the dating website PositiveSingles—which advertises itself as a place where people can meet other people living with STIs—violated consumer law and committed fraud by sharing information among many other niche websites owned by the same company. As the plaintiff’s attorney put it: “[my client] is not Black, gay, Christian or HIV positive and was unaware that [the] defendant was creating websites that focused on such traits that would include his profile, thus indicating that he was all of these things and more.”

Always a New Sex Toy

Finally, lest anyone worry that we will get bored heading into the new year, we take a look at the sex toys that emerged in the public eye in 2014. There’s the Svakom Gaga, a new vibrator introduced by a Chinese company that comes equipped with a camera and a USB port—plug it into your computer and star in your very own vulva video.

Of course, if you’re not ready for your close-up or you live far from your partner, you could instead turned to the OhMiBod, a vibrator that can be controlled from an iPhone via Bluetooth.

And, for the fitness buffs who aren’t satisfied knowing that they took their 10,000 steps a day, there is the kGoal, a U-shaped device that counts kegels. Women put one side of the device inside their vagina and the hook the other to their phones and are able to know exactly how many times they squeezed their pelvic floor muscles. Known as kegels, these exercises have been shown to help during childbirth, prevent or control urinary incontinence, and improve orgasms.

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