Will PrEP unleash our nation’s second wave of imaginary Slut Soldiers? Ummm…no.
In 1960, approval of a pill for pregnancy prevention changed the world and fueled an international debate about the impact on sexual behavior and the potential increase in sexually transmitted infections (STIs)—many of the same concerns being voiced today about PrEP.
When PrEP was approved as a biomedical approach to prevent HIV in 2012, there was immediate chatter from skeptics that the medication would bust Pandora’s Box wide open to unleash a thirsty army of Truvada Whores, Bareback Brothels, and Slut Soldiers riddled with a laundry list of STI’s. And while the chatter has started to lessen, the parallels between the reaction to PrEP and the Pill are undeniable.
We dug through the archives of the Arizona Republic, where it wasn’t difficult to find sentiments about what Phoenicians were saying about the Pill back in the day, and how similar some of those statements are to what we hear around PrEP today. Enjoy this special edition of Throwback Thursday, where we’ll walk down Phoenix’s STI Memory Lane!
Anxiety Over The Pill
In this 1967 article, the author felt that while side effects of the Pill should be seriously considered, it was “all the more disturbing to find that an extremely vocal minority is causing alarm in those women who have made the decision to use it.” The author theorized that doctor’s attitudes stemmed from something much more than pharmacological anxieties; but that sex outside of marriage was wrong. “Many eminent doctors have issued dire warnings of increase in venereal disease, loose living and parental irresponsibility during the past 11 years, and will doubtless continue to do so.”
The author continued, “The medical and popular press is full of the sensational results of ‘surveys,’ case histories and sporadic instances where a link has supposedly been found between some pathological condition and the pill.” And that’s fake-news-shade, 1967 style!
Do you suffer from bladder ills?
In this 1970 article about all your bladder woes, the president-elect of the urological association blames birth control for “an alarming increase in gonorrhea and syphilis.”
He stated, “While the pill gives some assurance against pregnancy, it offers absolutely no protection against venereal disease. It is therefore the duty of the male to protect himself against infection.” Ummm…WOW. So, he’s right – like PrEP, the Pill doesn’t protect against other STI’s. But DAMN, chauvinist much?
Paying for your promiscuity
And we saved the best for last! In this 1973 editorial, the author writes in reaction to support for a birth control health center at ASU, which would act as “counselor and backstop to sexually immature students,” further stating that, “some students bucking for birth pills and venereal disease treatment don’t know the difference between chastity and promiscuity, and the costs thereof.”
The author later states that “The public education system does not need to add, in Arizona or anywhere, a function designed to bail out students whose frolicsome sexual freedom is pursued with abandon, often with sad results. Now is the time for them to learn on their own the costs of promiscuity, and to either use common sense or pay.” Welcome to the University of Hard Knocks!
After The Pill was approved for use, many of the articles we found related to venereal diseases (VDs) heaped the blame on The Pill and the “loose moral codes” of that era’s youth. However, Arizona was no stranger to VD – ranking 8th highest in the nation in this 1940 report – 20 years prior to the Pill.
The parallels that happened toward the end of the first decade of the Pill was pieced together from circumstantial evidence only and never definitively established. STI’s were happening long before PrEP, and long before the Pill. People who had an abundance of sexual expression were spreading their legs and dipping their sticks long ago – and the presence of birth control or PrEP doesn’t automatically create an army of immoral slut soldiers – which is actually pretty insulting when you think about it. (Some of us make their trick at least buy us a burger at FEZ before we’re marinating the loin back at his place.) It has, however, created an investment in personal sexual health and awareness that some may actually applaud.
While careful surveillance of ongoing sexual behavior of persons using PrEP is appropriate, longer-term societal trends were established long before PrEP entered the market; similar to the Pill, and changes in behavior should not automatically be blamed on the new HIV prevention pill. The presence of antibiotic-resistant gonorrhea shouldn’t be minimized, nor should our limited treatment options for treatable gonorrhea, but neither should the more than 100 people in the United States who acquire HIV every day, which is incurable, while a pill exists that can prevent it. PrEP or not, unprotected sex is still happening out there, and it’s exciting there’s a tool in the toolbox that can help prevent new HIV infections in a different way.
Finally, this expensive medication can only reach those communities most in-need and who face the worst health disparities, if public funding is secured, as it was for the Pill. In 1968, Maricopa County Health Department gave 80,000 birth control pills to over 300 low-income individuals, but as of today, no public funding has been made available in Maricopa County to provide individuals at the greatest risk for contracting HIV a tool that can effectively eliminate their risk. Cities like San Francisco, however, that do cover the cost of PrEP for residents have declining HIV rates.