Condoms Are Not Enough

Earlier this week Simon Copland launched a salvo at anyone that dares to engage in risk-taking sexual activities. While the underlying message of safer sex is necessary after the sharp rise of HIV transmissions this year, particularly in the 20s demographic, the overly simplistic message is not going to address the underlying problems. Nic Holas later published a counterpunch in response, which he outlines such an approach is stigmatising. I take the issue further, and it is something I have commented on before.

Condom use is still the best means of preventing the transmission of most sexually transmissible diseases, to the point that most of the sexual health sector would encourage its use even amongst long-term committed relationships. What Copland’s message does not do is engage with the broad number of psychological and social issues that inflame people’s desires around risk-taking behaviour. It is not like condom use is not a message that isn’t already out there.

Even though condom use plays an important role in safer sex, an over-reliance on it shifts the issue away from the issues of desire and aversion, and does nothing to speak to the underlying causes of risk-taking sex. The implicit message is one that equates risk-taking sex and aversion to condom use to stupidity, rather than trying to grapple with the harder question of why people pursue it even with the knowledge that there are potential dangers.

There are multiple studies that have sought to find out the answer to this question. Some of the best scholars on this subject include Michael Shernoff (author of the book Without Condoms) as well as other authors like David Moskowitz and Michael Roloff. What this research shows, among other thing, is that desire is a powerful drive that isn’t incredibly rational, and that this is why simplistic messages of condom use doesn’t enter people’s thinking when influenced by incredible sexual appetites; especially when that is compounded by drug or alcohol use.

There are a great number of underlying motivations that complicate people’s thinking, some of those include a sense of distance from the impact of HIV, a sense of invincibility in youth, a desire to embrace a sexually liberated lifestyle, or even a sense of stifling dread that they will eventually contract HIV and thus leading them to giving up on trying. While none of these should be seen as justifications, they do speak to the fact that human sexual psychology is incredibly complex, and therefore no single one-stop solution will work completely.

So any approach that fails to grapple with these complex issues relegates the legitimacy of those desires into the taboo. When something becomes taboo it becomes shameful and stigmatised. More, the denial of these desires creates a sense of forbidden fruit, and that tends to excite and inflame those desires. When taboo behaviours have no opportunity to discuss those desires publicly without shame, those discussions go underground.  It is little wonder that MSM who are hungry for this type of risk taking behaviour are finding ways to meet in a discreet manner outside of the gaze of a disapproving public.

By making it harder for people to speak candidly about their experiences, their acts, and their risks, it actively discourages people to approach and access public health services when they do. It means that people who don’t normally partake in risky sex acts, or perhaps indulge in one after normal judgment is impaired by alcohol have a huge disincentive for approaching sexual clinics for services like PEP, or even PrEP.

So what is the solution? There is no single solution, but to start it’s best to think in terms of safer sex, (rather than safe sex). No sex is completely safe, and so any approach to condom use must be accompanied by a humanisation of desire and transmission. STIs are fundamentally a human problem, and if we only approach it with only a clinical solution we begin to dehumanise the people involved.

Silence leads to erasure, victim-blaming, and a breakdown of community.