Suppose you’ve been following social media lately. In that case, you may have seen a viral commercial for EXTRA gum showing images of post-pandemic life: individuals hesitantly peering out from behind locked doors, closing their laptops until emerging maskless out of their toilet paper–filled caves into the street. The performers, all messy and unclean, dash to the local park, where they each jump on the first stranger they see and begin a passionate make-out session set to Celine Dion’s power ballad “It’s All Coming Back to Me Now.”
It’s been almost a century since the “Spanish” flu epidemic suffocated our sexual life to the level that COVID-19 has. I can speak to witnessing empty waiting rooms for months as a sexual health physician and researcher. At the same time, individuals kept their social and sexual distance, their desire squelched by fear of infection. Indeed, some people’s pandemic-induced abstinence was only temporary, and I was pleased to see public health agencies in New York and Canada cheerfully offering advice on the subject, such as encouraging masked sex or even using glory holes in barriers like bathroom doors to facilitate anonymous oral sex.
Our sexual appetites, on the other hand, waned along with our psyches as we drained our energies simply attempting to stay alive. It wasn’t only Americans: research from the United Kingdom, China, Israel, and Australia indicated that during the epidemic, 40–60 percent of persons reduced their number of sexual partners or the frequency with which they had sex. After hitting record highs in 2019, rates of sexually transmitted infections (STIs) in the United States dropped in the second quarter of 2020 due to our collective abstention (plus a countrywide scarcity of testing kits).
There’s little stopping us from having sex again now that immunizations have arrived in large numbers in the United States. Our muscle memory surrounding sex will be like that of riding a bicycle, according to Celine Dion’s song: even if we haven’t done it in a while, we haven’t forgotten how. It’s unclear whether we’ll still be able to drive. Even among the most sexually active age bracket, American sexuality had declined for about two decades previous to the epidemic. A third of young males aged 18–24 reported no sexual activity in 2018, according to a research of over 9,000 persons based on surveys from 2000 to 2018. The action also fell for both men and women aged 25–34 across the research period.
It’s natural to assume that a year of living with COVID, donning masks, being tested, and negotiating safe socializing would transfer to talking safer sex for those of us who do restart having sex. According to Lisa Wade of Tulane University, who spoke with over 120 college students about sexual behavior during the epidemic, this is not the case. Even though her research participants are diverse in terms of color, sexual orientation, and past sexual experience, when asked if living with COVID has affected the way they think about sex and STIs, their replies are “strikingly consistent”: a wrinkled nose, a confused expression, and a loud “no.”
Wade’s kids test for COVID two to three times per week and have no qualms about asking each other about their findings. However, it is not as typical to inquire about STI testing. STIs still have a stigma surrounding these talks in judgment, with people saying things like, “Why would you need to test?” “What have you been up to?” and “What have you been up to?” Even people who are comfortable asking others to wear a mask may find it unpleasant to ask a partner to use condoms or may encounter opposition if they do so.
Condom and barrier resistance cuts across gender, age, and sexual orientation. HIV experts have long acknowledged the idea of “condom fatigue” among males who have sex with males, tiredness felt after years of being advised to use condoms by HIV prevention efforts. Condoms, according to Benjamin Klassen of Simon Fraser University, have taken on the character of public transit among homosexual men: something you’d like everyone else to use without having to use it yourself.
Condoms are also losing favor among Generation Z, even though adolescents are the demographic most likely to use them. Condom use by high school students during their most recent sexual encounter decreased from 62 percent in 2007 to 54 percent in 2019, according to the CDC’s Youth Risk Behavior Survey. Dental dams, which are rubber squares put over the vulva during oral sex, have an even worse future. According to Juliet Richters of the University of New South Wales, less than 10% of Australian women who had intercourse with other women had ever used a dental dam. Only 2% had used one regularly.
In this day of technological advancement, it appears that we should have something more advanced than barriers—perhaps a smartphone app or an STI-blasting laser. Condoms, on the other hand, remain the only multipurpose preventative item that provides both contraception and STI/HIV protection. But that, perhaps, is about to change.
Efforts by organizations such as the Global Initiative for Multipurpose Prevention Technologies (IMPT) are advancing the development of at least 20 products, including pills, rings, diaphragms, gels, injectables, and implants, each of which protects against at least two conditions: unintended pregnancy, STIs, or HIV.
Why don’t you make a better condom? In 2013, the Gates Foundation offered $100,000 seed funding to entrepreneurs to develop a next-generation condom that “preserves or increases pleasure” to “increase uptake and frequent usage.” By 2019, three of the 11 initial recipients had earned an extra $1 million to progress to the clinical trial stage. It remains to be seen if these items will survive the epidemic and reach the market. Traditional condom sales are increasing, at least for the time being, but they are unlikely to last long as we return to our old habits.
Then there’s the possibility of an STI vaccination. New clinical studies for vaccinations against herpes and gonorrhea are underway, albeit no results are expected soon. And, as Operation Warp Speed has demonstrated, pharmaceutical corporations can swiftly develop viable vaccinations with enough political will and financial assistance.
It makes little difference if the future of prevention is a better condom, a new technology, or an STI vaccine. What’s important is to have preventative items that people will utilize. If prophecies of a Roaring Twenties revival or a post-COVID Summer of Love come true, STIs and HIV will undoubtedly grow. To address the contemporary demands of a sexually varied population, we shall need more than our traditional barrier systems. We must invest today to create new preventative solutions, or we will be caught off guard later.