
Public-Health Puzzle: Young People Having Less Sex, Contracting More STDs - kick
https://www.wsj.com/articles/public-health-puzzle-young-people-having-less-sex-contracting-more-stds-11571391000?mod=rsswn
======
simonsarris
Can't read article but solving this theoretical (and perhaps now real) puzzle
is the primary story in the relatively poor book "More Sex is Safer Sex: The
Unconventional Wisdom of Economics" which came out in 2008. Don't bother with
the book, it's essentially a lamer freakonomics, but it's interesting that the
central story has come up.

Basically if you have many to many pairing up (many one person with one or two
partners), there may be less mixing, and less transmission.

In a one to many pairing (one person with ten partners) you can more easily
transmit disease even if the total number of pairings is fewer.

~~~
diego
And there is a good reason for more one-to-many pairings: more choices. Back
in the day less desirable partners had more chances because of proximity.
Today it's easier to search for partners (for the same reason it's easier to
shop), so more desirable people have more choices.

~~~
wavefunction
"more desirable" aka disease-carriers 8D

------
pharrington
"The CDC attributes the recent surge in STDs to decreased condom use,
increased drug use, poverty and cuts to prevention programs run by state and
local health departments. In recent years, the agency reports, more than half
of local STD programs have experienced budget cuts that led to clinic
closures, as well as reduced screening and patient follow-up.

Federal spending has also been curtailed.

“In the federal government, there is one dedicated STD funding line, and that
is the line item in the appropriation bill funding the division of STD
prevention at the CDC,” said David Harvey, executive director of the National
Coalition of STD Directors. “That appropriation has been whittled away over
the last 18 years.”"

Seems we know what the solution to the puzzle is.

------
dahdum
I’m not saying it’s causation, but the timing is amusing.

Article

> “Something changed starting around 2012,” said Gail Bolan, director of the
> CDC division of STD prevention. “We’ve seen dramatic increases each year in
> both males and females.”

Wikipedia

> Tinder was launched in 2012 within startup incubator Hatch Labs,[7][8] a
> joint venture of IAC and mobile development firm Xtreme Labs.[9] By 2014,
> Tinder was registering about one billion "swipes" per day.[10]

~~~
mantap
Yeah it's not a puzzle at all. People in committed relationships have more sex
than people who are having casual sex.

------
buboard
What an interesting X-Ray of the sexual marketplace in the graph. Apparently
young men have less than half infections as women (i.e. less than half sexual
partners than women do - all things being equal) , but the situation tapers in
later age and slightly reverses in the 40s when men have slightly more sexual
partners.

Other than that, the data shows that the sexless generation is driving itself
to extinction. That's just natural selection at work.

~~~
catalogia
> _" Apparently young men have less than half infections as women (i.e. less
> than half sexual partners than women do - all things being equal)"_

All things certainly aren't equal though. There is a very large asymmetry in
the chance to contract some STDs (specifically HIV, maybe others as well but
I'm not sure.)

> _In general, receptive sex is riskier than insertive sex. This means that
> women have a higher risk for getting HIV during vaginal or anal sex than
> their sex partners._

[https://www.cdc.gov/hiv/group/gender/women/index.html](https://www.cdc.gov/hiv/group/gender/women/index.html)

(There are some CDC documents that put numbers to this generality, but I don't
have the time to go find them right now.)

~~~
buboard
The graph is about Chlamydia though.

(also the factors you mention wouldn't explain the age asymmetries)

~~~
catalogia
I don't mean to suggest that there are no asymmetries in who is having more
sex. Only that the assumption of equal transmission rate shouldn't be made. I
don't know if there is a transmission asymmetry for Chlamydia, but I don't
think it's safe to assume there isn't.

------
abjKT26nO8
I'm bisexual (male) and for a long time now I have had a lot more sexual
success among men than among women (i.e. zero success in the latter case).
I've been meaning to change this situation, so I tried Tinder with the
settings adjusted, so that Tinder thinks I am only "interested in women".
First try - no matches. Second try - one match, conversation ended with no
explanation after 2 exchanges. Third try - 3 matches per day (here I tried
different photos and a shorter bio). But it turns out that, even though men
were quite willing to partake in one night stands, women - not a single one I
matched with. Well... that's not entirely true. There were pairs who were
willing to do that. And there were women looking for threesomes. I wouldn't
want that to be my first time with a woman. Too stressful for a first time.

And I am not interested in a relationship. I've been alone for such a long
time (not of my own volition, just didn't have too much success) that after
all the time during which it was painful, this way of living got ingrained
into me and I can't see myself sharing a life with anyone anymore. I do
everything in my own peculiar way now. And if I wanted a relationship, I would
want that to develop from a friendship, or generally more naturally, not
"search for love" over the Internet...

I would like to have sex from time to time, but now it seems I can only do
that with men. What a weird world I live in.

~~~
marchenko
I think you are discovering that women, on average, have different
expectations from a sexual relationship than men. In fact, it is not weird _at
all_ to find that men are much more interested in one night stands than women.
Even women who are interested in casual sex tend to want their partner to be
at least open to the idea of entering into a relationship. If anything in your
bio hints that you are only interested in sex, you will pare your respondent
pool down to exactly the type of women you discovered to be receptive:
adventurous women interested in threesomes and those who want the safety of
having a trusted third party along with their new bit of strange.

~~~
joshspankit
It’s also worth noting that in (north america? western societies?) many women
(and certainly almost 100% of women using dating apps) are numbed by a nearly
constant and pervasive onslaught of possible sex partners. From that position
then, they would never _look_ for sex partners, they would simply choose to
say yes the next time someone asks.

------
dev_dull
This study is funny to me because there's such obvious answers to the trends:

Having less sex: more and more people are putting off marriage. I'm sure
happily married couples are leaving even their most promiscuous peers in the
dust with their nuptial regularity.

Rise in STDs: the risk of unwanted pregnancy is much lower these days then in
say, the 60s and 70s allowing for "riskier" sex. Longer time to marriage +
hookup apps + less risk of pregnancy = more partners, more chances for STDs to
spread.

~~~
grumple
> I'm sure happily married couples are leaving even their most promiscuous
> peers in the dust with their nuptial regularity.

The traditional wisdom is that this isn't true at all.

~~~
kd3
Yeah, getting married is a sure way to stop having sex.

~~~
seibelj
Definitely for some people but I still enjoy the company of my wife, every
couple is different.

------
ronnier
The world is changing rapidly. The magic year of 2012 is when Tinder was
release and then grew rapidly.

Move forward to today: a large percentage of men are totally removed from the
dating market (not by choice), they do not have sex, they have no hope of
getting into a relationship. The reverse is not true for women, who have
countless options and can at any time open their phone and have their pick of
men.

In general, women still have sex but are increasingly only doing so with the
top few percentage of men, which is why we see the skewed std rates.

Another issue, there are a lot more single men in cities, especially west
coast cities, than single women. Indian and China aborted so many women that
there are men there that will never be with a woman.

Marriage rates are down, there no pressure to get married anymore.

So, when it says young people are having less sex, it’s primarily men who are
having less sex. The world changed, women do not need your money or your
protection. The fancy jobs do not matter like they did before, nor does having
a ton of money. What matters more than anything now are your looks.

~~~
MrsPeaches
This doesn’t stand up to even the most basic analysis.

Just look at attractiveness ratings between sexes and races[1]. White men are
consistently rated as the most attractive, with black women faring least well.

Genuine question: why are the people who subscribe to this world view
predominantly white men?

[1] [https://theblog.okcupid.com/race-and-
attraction-2009-2014-10...](https://theblog.okcupid.com/race-and-
attraction-2009-2014-107dcbb4f060)

~~~
jnwatson
Just because white men are racially preferred does not necessarily contradict
the conclusion that it is more winner-take-all than it has ever been.

White males are still the plurality in the US dating market. If just the top
20% of those get dates, that leaves millions of US men lonely.

At the same time, the Tinder and the OkCupid markets are slightly different
(but overlapping) markets; the less strictly hookup-oriented women on OkCupid
might accept a wider range.

------
ceilingcorner
The sexual marketplace, like all marketplaces with few restrictions, has
returned to a “winner take all” state. Fewer men have sex with more women.
Thus STDs rise as more people have a smaller and smaller “sexual range.”

~~~
RangerScience
Do you have any sources for this?

------
WhyNotThough
Maybe top 80% of one gender are having sex with top 20% of another?

------
TheCapeGreek
I've read through the comments related to relationships here and a lot of the
same arguments were made. One that stood out was "Women are selectors and men
take what they can get" (paraphrased) and a few similar statements.

This isn't a bad thing. [1][2][3][4] If you as a straight man are putting some
effort into being a decent human being and better dating prospect, in the long
term you're far more likely to have a good outcome than a woman of "equal"
"value" (subjective concepts).

[1] [https://www.smh.com.au/lifestyle/why-women-lose-the-
dating-g...](https://www.smh.com.au/lifestyle/why-women-lose-the-dating-
game-20120421-1xdn0.html)

[2]
[https://putanumonit.com/2016/02/03/015-dating_1/](https://putanumonit.com/2016/02/03/015-dating_1/)

[3]
[https://putanumonit.com/2016/02/10/017-dating_2/](https://putanumonit.com/2016/02/10/017-dating_2/)

[4]
[https://en.wikipedia.org/wiki/Stable_marriage_problem](https://en.wikipedia.org/wiki/Stable_marriage_problem)

------
wolco
So less young men are having sex but the ones that are, are spreading more
diseases.

So everyone having sex with fewer partners is better overall than less people
having sex with more partners.

Makes me think society is getting less sexual which is turning into a major
health problem.

------
guelo
"In recent years, the agency reports, more than half of local STD programs
have experienced budget cuts that led to clinic closures, as well as reduced
screening and patient follow-up.

"Federal spending has also been curtailed."

“In the federal government, there is one dedicated STD funding line, and that
is the line item in the appropriation bill funding the division of STD
prevention at the CDC,” said David Harvey, executive director of the National
Coalition of STD Directors. “That appropriation has been whittled away over
the last 18 years.”

~~~
dev_dull
Blaming this on budget cuts is absurd. There didn't even use to be something
such as an "STD clinic", let alone easy access. In many states STD testing is
totally free and anonymous. How long has that been around?

Besides, have you seen sex education in schools these days? Let's just say
it's... comprehensive. Compare that to the 70s, 80s, 90s, ANY other time.
Children today go into sexual relationships with _way more information_ that
any previous generation.

~~~
guelo
I find it more absurd to think that closing clinics has no effect on the
health outcomes of the affected communities.

------
90stosser
I was in college in the early 2000s. I've never used a dating app. I have
dated since the advent of dating apps.

The generation that has grown up with apps (esp social media apps) for
everything has really gotten the short end of the stick in my opinion. There's
an image consciousness that underlies everything now. Everything needs to have
that Best Life sheen.

Take for example, the differing experiences of getting a tattoo. When I got
one, it was a classic impulsive decision. I didn't save up for it for months,
I didn't even think about what I wanted until I was in the studio (a word
applied loosely here...) looking at a binder of the art (a word applied
loosely here...) people got tattoos of. I didn't have a voice in my head that
said "picking from the same 50 tattoos as everybody else is BASIC", didn't
seek out a renowned artist who might pose with me for a selfie and @mention me
afterward, none of that. I was incapable of even forming the thought. There
definitely wasn't some heart-rending, inspiring story behind it that would get
hundreds of likes on Instagram. I just got a little tipsy, got a questionable
idea in my head, went down to a very working class strip mall and _bam_ , from
then on I had a tattoo.

Consider also: I didn't try to hide that tattoo from my parents and they still
didn't find out about it for nearly an entire year. The other day a friend of
mine was able to deduce that in the beginning of the past decade they had
slept with someone who was now in a relationship with their
coworker/acquaintance based on an internet search, and my parents didn't know
I had a tattoo for an entire year! Once everyone could see what everyone else
was doing, you couldn't just get a tattoo out of the tattoo binder any more.
The average tattoo I see nowadays is far more artfully executed, well thought
out and tastefully designed. The freedom to not worry about these things,
however, was vastly underrated.

You still had to worry about your image back then, but it wasn't this always-
on national pastime. When you were around someone you wanted to impress, you
tried to impress them. When you weren't, you just did other things. If you and
your friends went hiking and decided to get a photo of yourselves at the top
of the mountain? Decent chance the film was never developed at all. Best case,
it ends up on someone's corkboard as a happy memory. You could eat a
cheesesteak when you visited Philadelphia without the exhausting worry about
whether this particular place was the too-famous one that marked you as a lame
tourist because everybody knows <x> is strictly for out-of-towners only. You
just ate a sandwich and moved on with your life.

Life was better when we weren't so acutely aware that we were being observed.

Dating is harder now. I agree with some of the somewhat controversial comments
on here in that it probably is more of a winner take all game now than it was
in the past. The mistake to my way of thinking is in throwing up your hands,
going full on misanthrope and dismissing everybody who is having success on
these platforms as a bunch of Chads and Stacys. You don't have to play the
Tinder game even if you're of this generation. It can work even if your not
the sort who can just sit down on a barstool and wait for opportunity to find
you. Cultivate an IRL social network. You'll be surprised how much mileage you
get out of friend of a friend or friend of a friend of a friend dating.

------
SapporoChris
A couple of comments.

I think education is a huge factor. Anecdote: I took human sexuality at
university. We had pop quizzes daily. For quiz on birth control someone comes
in and states, 'Oh I didn't need to study for this, I've been using birth
control since I was 16' They failed the quiz.

Honest communication is a huge factor in prevention. My current girl friend
let me know early in our relationship she had chronic hepatitis B. I'm in
process of testing for my own exposure, and will get vaccine if needed.

If you're not 100% sure about your history, get tested, lots of stuff can be
asymptomatic. Some healthcare systems offer free testing for some diseases.

Isn't STD Sexually Transmitted Disease a bit of a misnomer? While sex might be
the primary method of transmission, from the article CDC attributes increased
drug use as one of the factors. Or am I just being pedantic?

additional info: I'm definitely not young anymore.

------
Engineering-MD
Uu I Up

------
kick
You can bypass the paywall by using the "web" button with HTTP
referer/referrer spoofing turned off, or you can click here for a raw pastebin
of the article:

[https://pastebin.com/raw/i7du0Jfy](https://pastebin.com/raw/i7du0Jfy)

~~~
m00dy
I think copying copyrighted material from place to another is a fraud.

~~~
nyolfen
it may be copyright infringement, but it's not fraud

------
jimbob45
Once again, PrEP is a miracle drug and future generations will be baffled as
to why we were so slow in adopting it.

~~~
heavyset_go
It's not baffling at all, it costs $1,800 for 30 days worth of Truvada.

Descovy has less side-effects than Truvada, but Gilead conveniently timed
Descovy's indication for PrEP to align with Truvada's patent expiration.
Truvada is particularly hard on the kidneys, and can cause kidney damage or
failure. Descovy doesn't put its users at risk of kidney damage.

The wholesale cost of generic Truvada in the developing world is $6 to $8.

~~~
jimbob45
My thing is that the government would want to subsidize it. Who wouldn't want
to score political points as the guy who eradicated HIV? (or made a big dent)

However, based on what you're saying, I wonder if the push is being delayed so
that the government can wait for the patent expiration and subsidize at a much
cheaper cost.

~~~
heavyset_go
There's more political value in demonizing at-risk populations than there is
addressing the public health issues that affect them.

------
kd3
Having riskier sex and sexual perversion (think anal sex and other more
extreme forms) go hand in hand with sexual suppression/repression. Sexual
suppression/repression also results in people having less sex. Its very clear
what's happening. The root cause are all the policies in society promoting
sexual suppression/repression which have only increased and are becoming more
absurd every year.

------
TimTheTinker
> Something changed starting around 2012

One hypothesis to consider: the Affordable Care Act which became effective in
2010. It may be that somehow the healthcare changes that followed had an
adverse effect, and that it took 2 years for increased infection rates to
compound and begin to be reported.

~~~
chmod775
Do you have any suggestion as to how that piece of legislation could possibly
have an impact on how much sex young people have and with what partners?

I fail to see any kind of chain of events here where one might lead to the
other.

"We wouldn't have had sex if it weren't for Obamacare." doesn't exactly seem
like something you'd be likely to hear.

~~~
aianus
Obamacare made non-barrier birth control free so it's possible that some
people switched from condoms and were therefore more likely to contract STDs.

(I just made this up as a suggestion, I have no evidence this actually
happened)

