TikTok Tackles Taboos & Toobin's Terminated
While we all continued to wait for Trump to admit defeat and watched as his administration tried to topple ACA on the way out the door, I celebrated a birthday along with many, many people I know who also have birthdays this week. (The 17th would have been my grandmother’s 100 birthday.) I hate to say it, but we’re a bit of a sex-only-on-holidays cliché as we were all born nine months from Valentine’s Day. I had some socially distanced cocktails around the fire table, got a new travel scrabble set (in her very first game, my 10-year-old played “queen” on a double word for 30 points), and was promised that my best present will be delivered on January 20th. In the meantime, I have a birthday request for those reading—please share Sex on Wednesday widely with your friends, family, colleagues, listservs, barbers, Uber drivers, book groups, and anyone else you think might enjoy a weekly dose of sex information.
PrEP in Shot Form Works Better Than Pills for Women
Researchers ended a clinical trial of an HIV-prevention shot for women early because it worked so well. The study was looking at pre-exposure prophylaxis (PrEP) medications, drugs used by HIV-negative individuals to prevent infection. Currently the only form of PrEP available to women is Truvada, a once-daily pill that combines two antivirals. (There is another pill, called Descovy, but in the U.S. it is only approved for use by men and transwomen.) This study compared Truvada to a new medication, called cabotegravir, which is given as a shot every two months.
Over 3,000 women in 20 sites in sub-Saharan Africa were enrolled in the study; half were given Truvada and the other half got the shot. Three years into the study, there were 34 cases of HIV in the Truvada group and just four in the cabotegravir group. The results show that the shot was nine times more effective than the pill. Truvada itself is an amazing breakthrough as it can be 99% effective if taken every day, but as any birth control user knows, sticking to a once-a-day pill regimen can be tricky. A shot that only needs to be given every two months can take forgotten pills out of the equation.
Everyone’s favorite public health expert, Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, announced in a briefing that the study was being stopped early because of its overwhelming success. He said: “I don’t think we can overemphasize the importance of this study….One of the stumbling blocks in our prevention [efforts against HIV] has been the inconsistency or lack of efficacy of pre-exposure prophylaxis in those who need it the most…namely young women, particularly those in southern Africa.”
There may still be barriers for women to overcome, including price. Until generics became available, Truvada was cost-prohibitive for many. Moreover, the women in the study had transportation arranged for them to ensure they didn’t miss a shot which won’t happen under real-world conditions. Still, HIV experts see a lot of potential for cabotegravir which does not need to be refrigerated, likely lasts longer than two months in the body, and could ultimately be bundled with injectable birth control.
Indeed, this looks like a major breakthrough. A trial of the shot in over 4,500 men and transwomen who have sex with men was also stopped early because the results were so good.
Your Mask Protects You, Too; Will Self-Interest Finally Get People to Wear Masks?
A few months ago, I talked about the similarities between getting people to wear a mask and getting them to wear condoms. I noted that like sex educators at the beginning of the HIV/AIDS pandemic, those promoting masks today were up against a populous who doesn’t like being told what to do, doesn’t want to acknowledge personal risk, and perceives the protective device in question as inconvenient and unpleasant. One big difference made mask promotion even harder. While condoms were always seen as protecting both the wearer and their partner, masks were being sold as a civic duty to protect random people in the supermarket. A particularly hard sell in such a self-absorbed society.
Well, this week, the CDC updated its guidance on mask wearing and pointed to new research that suggests masks’ protective benefits go both ways. We already knew that masks protect other people from the droplets that we exhale. Emerging research now shows that the same mask also helps the wearer by filtering the air we breathe in. Research estimates that mutual mask wearing reduces the risk of transmitting or contracting the current coronavirus by more than 70% in some instances. This seems very logical and many people who have adopted mask wearing already think of it as personal protection. The big question for public health experts is whether proof of self-interest will get masks on previously resistant faces.
I hate to say it, but probably not.
Some of the resistance to masks seems to rest on notions of masculinity that have gotten in the way of condom prevention for decades. The American Psychological Association recognizes an ideology of masculinity that values toughness, status, adventure, risk, and violence as one barrier to condom use. This has been exacerbated—or at least highly encouraged—by our soon-to-be-former President. During one of the debates, he accused now President-elect Biden of wearing “the biggest mask” as if to say the bigger the mask, the smaller the man.
Emily Willingham wrote this about Trump’s followers in Scientific American, “These men have made a deep commitment and probably engaged in some willful self-deception to remain loyal to Trump. Donning a mask would mean wasting their investment and the perceived fruits of all that self-compromise.”
This brings us to the other reason that new facts about masks are unlikely to help: the deep commitment to one’s beliefs actually gets deeper when contradictory evidence is revealed. We want to be right and spend most of our time looking for proof that we are. When we are instead confronted with facts that don’t support our existing world view, we may undervalue them or dismiss them entirely.
This isn’t new, a team of social psychologists had this to say in 1957: “Tell him you disagree and he turns away. Show him facts or figures and he questions your sources. Appeal to logic and he fails to see your point … Suppose that he is presented with evidence, unequivocal and undeniable evidence, that his belief is wrong: what will happen? The individual will frequently emerge, not only unshaken, but even more convinced of the truth of his beliefs than ever before.” Our increasingly partisan identities coupled with the easy spread of misinformation on the interwebs have just further entrenched us in our existing world views.
So, those people storming state houses demanding their right to indoor dining are unlikely to start wearing face masks despite their self-interest. For the rest of us—those who have been willing to do our part to protect our communities from spread—the new guidance can provide some reassurance that we are actually helping ourselves stay safe as well.
Random Fact: I know a lot about condoms and have even had the privilege of watching them get made, but in researching this piece, I learned something new. Apparently, the first documented condom was made out of a goat’s bladder in 3000 BC and used to protect women (his wife and others) against the sperm of King Minos whose semen was thought to contain serpents and scorpions and was blamed for the death of one of his mistresses.
TikTok Promotes Vaginal Health
Unlike some parents, I love TikTok. Yes, there was a moment a few months ago when I thought my head would explode if I heard the same four lines of Renegade one more time. But, my 10-year-old makes creative videos with costume changes, complicated make-up looks, and cinematic smash cuts (that she shares with all eight of her followers) and my 14-year-old joined forces with fellow members of Gen Z to troll Trump by reserving rally tickets she never planned to use.
Apparently, the newest viral sensation on the app is called GripTok and it encourages watchers to kegel to the beat of various songs. For those not familiar with this particular form of exercise, a kegel is done by squeezing the muscles in one’s vagina and holding (those with vaginas can find the right muscles by trying to stop the flow of urine mid-pee). Kegeling can help with child birth, incontinence, and pelvic pain, and some credit it for making sex feel better. GripTok videos and corresponding hashtags have gotten over 60 million views in recent weeks.
Some experts caution that the songs promote short kegels in rapid succession which is not the best way to do this exercise. It’s better to go slow—squeeze, hold, let go, and then pause to allow the muscles to relax before trying again. But, as Alya Mooro points out in Vox, the real benefit of this is likely not about any teen’s pelvic floor. These videos are promoting an increased comfort level around vaginas and vaginal health, formerly taboo topics. And, we all benefit when sex and bodies are discussed without shame.
My takeaway from TikTok: the kids will be alright.
Wednesdays Revisited: Jeffrey Toobin Fired from The New Yorker
In an update to a story from a couple of weeks ago, Jeffrey Toobin has officially been fired from The New Yorker where he was a staff writer for 27 years. The Chief People Officer (yes that’s a title) for Condé Nast said the parent company had completed an investigation and decided to terminate Toobin’s employment. With no further details given, it’s unclear whether the investigation uncovered any new information about the zoom masturbation incident (or accident as Toobin would call it) that would change my previous assessment. In fact, it’s also unclear if the investigation was limited to that fateful video call or included other behavior. And, while we’re at it, it’s unclear if Toobin still has a job with CNN. Perhaps we’ll have to re-revisit this one.