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Sex Stories: Does Watching Porn Really Lead to Divorce?

News bloggers have run amok lately with a study claiming to show evidence of a link between porn watching and divorce. The study, published last month in Psychology of Popular Media Culture, spawned headlines like:

Study Says Your Spouse’s Porn Habit Might not be So Harmless After All
Watching Porn May Lead to Divorce: Study
Revealed—Porn Addiction can Lead to Divorce

At first blush, the study appears fairly well done from a technical standpoint. It has a good sample size (551), a decent mix of participants including divorcees, and the researchers controlled for nine potential confounders including marital unhappiness, gender, and religiosity. They designed the study directly in response to limitations of other studies in this area and clearly state that their data is correlative in nature.

That being said, there are a number of issues which call into question the validity of the study’s results:

  • Participants were only asked if they watched porn in the last year, not how often.
  • Participants who admitted to watching porn were not asked any questions about the types of porn watched, their motivation for watching, etc.
  • The extrapolation that positive attitudes towards extramarital affairs lead to marital issues and then divorce.

Perhaps the biggest issue with this study though is how it was reported. Yes, journalism tends to go for the gut with catchy, dramatic headlines. But by making the jump directly from attitude to action, the reporters, and researchers, failed to do due diligence to the topic. Simply put, the study did not actually look at porn consumption and rates of divorce. It looked at porn consumption and attitudes towards affairs. While attitudes can be strong predictors of behavior, and affairs are a common cause of divorce in the U.S., there are other mediating factors. Additionally, the study only establishes a relationship between the two variables rather than a specific causation.

Furthermore, the authors are operating on several broad assumptions that do not necessarily hold up in real life. These include:

1) Extramarital sex always leads to the breakdown of marriage. Given the many types of relationships that exist, it is certainly possible that people who have more positive attitudes towards extramarital sex also have different attitudes towards and expectations of monogamy in marriage.

2) Porn is a uniform product that always portrays extramarital sex positively. There are as many types of porn out there as there are sexual interests in the world. Porn is not one-size-fits all. Without delving further into the types of porn people are viewing, it is incorrect to say watching any porn, regardless of what is portrayed, automatically leads to a change in attitude and, further, behavior.

The researchers do deserve some props for not outright stating that porn leads to divorce and for creating a more complex study to look at an issue which continues to be of interest to many people. It is particularly interesting to note that most of the articles reporting on the study’s outcome were written in countries with stricter gender rules and conservative sexual views. Despite all this, the study’s lack of nuance around pornography as a product and its consumption makes the results difficult to respect, and no doubt played a role in the overblown reporting.

Other Sexual Health News this Week

Mayor de Blasio Touts Reduced Rent for People with AIDS or HIV (Daily News)

Judge Overturns PA’s Same-sex Marriage Ban (WNEP) and the governor has no plans of challenging this decision. (CNN)

Kansas County Rejects State Funds for Contraception After Commissioner Conflates IUDs With Abortifacients (RH Reality Check)

While N.Y. State Suggests HIV Tests for 13-Year-Olds, Sex Ed in Elementary School (CBS Local), the Louisiana House voted down a bill that would allow additional sexual health questions from the Youth Risk Behavior Surveillance (YRBS) System to be asked. (

Inmates Allege Sexual Abuse by Prison Doctor (USA Today)

Federal Judge Strikes Down Oregon’s Same-Sex Marriage Ban (CNN)

La. Plans New Abortion Restrictions Modeled after Controversial Texas Rule. (Fox News)

Important Dates

The following conferences are taking place in May and June. Click on each title for more information and to register.

The 46th Annual AASECT Conference, Monterey, CA, June 4-8.

The Sero Project’s HIV is Not a Crime conference, Grinnell, IA, June 2-5.

13th Annual Philadelphia Trans Health Conference, Philadelphia, PA, June 12-14.

Sex Stories: A Daily Dose of HIV Prevention

Two weeks ago, the FDA made waves in reproductive health by approving a new HPV screening test.This week, the CDC had a turn at shaking things up by recommending a pill to prevent HIV.

Similar to the HPV test, the new CDC guideline makes official a new use for something that has been around for a while. In this case, it’s Truvada, an antiretroviral drug with few side effects that most insurance companies already cover. These facts make it an appealing option, and may explain why no other antiretrovirals were recommended for prophylactic use. It will be interesting to see if any of the similar drugs are eventually recommended as well.

The official guideline states that pre-exposure prophylaxis (PrEP) regimen should be used only in conjunction with condoms. The CDC also recommends that this regimen, which requires taking Truvada daily, should be considered for people at high risk of infection, including:

  • men who have sex with men (MSM) without condoms
  • people who have sex with high-risk partners, such as drug injectors or MSM who have sex without condoms
  • people who regularly have sex with anyone they know to be HIV-positive
  • anyone who shares needles or injects drugs.

The guidelines make two additional recommendations:

  • 1) Patients should get an HIV test before taking the drug.
  • 2) Patients should be tested for STIs every three months.

These two recommendations make it clear that the CDC recognizes some individuals will use PrEP in lieu of condoms rather than in addition to them. The goal is obviously to catch and treat other STIs as quickly as possible as well as to monitor HIV status. Though Truvada is often used as part of HIV treatment, the therapeutic dosage is much higher compared to that used for PrEP.

The CDC’s decision comes at a critical time. While HIV infection rates have remained relatively stable over the past 30 years, condom use is on the decline. That being said, not all health care providers are on board with the new recommendations. Many feel this move will only lead to further decreases in condom use among the highest-risk populations as well as corresponding increases in rates of other STIs. Other barriers to widespread acceptance of Truvada for PrEP include the lack of advertising by its manufacturer, stigma associated with its use, and a dearth of knowledge among general practitioners about this use.

This new drug regimen begs comparison to birth control pills. Though more effective than condoms alone, we know that the oral contraceptives are quite as effective as they could be, thanks to human forgetfulness, error, and the day-to-day struggles that can make taking a pill daily difficult. There are many things about how PrEP is implemented that will be important to watch, namely whether it will gain widespread acceptance among intended users, and how they actually use it.

Other Sexual Health News this Week

Losing the Script: Montgomery Clears the Way to Change How Sexual Orientation Is Taught (Washington Post)

Judge Denies Otter’s Request: Same-Sex Marriages in Idaho Can Start Friday (Idaho Statesman)

Texas Bill Requiring Sex Education Dies in Committee (Houston Chronicle)

Transgender Controversy Reopens Louisvile Schools Discrimination Debate (Courier-Journal)

South Dakota’s Sexually Transmitted Disease Rates Up (The State)

Harvard President Accepts Recommendations from Sexual Assault Prevention Task Force (Boston Globe)

Labs Are Told to Start Including a Neglected Variable: Females (New York Times)

Important Dates

The following conferences are taking place in May and June. Click on each title for more information and to register.

The 46th Annual AASECT Conference, Monterey, CA, June 4-8.

The Sero Project’s HIV is Not a Crime conference, Grinnell, IA, June 2-5.

13th Annual Philadelphia Trans Health Conference, Philadelphia, PA, June 12-14.

Sex Stories: Questioning C-section Overuse

PageLines- SEXSTORIES.pngThe C-section has long been heralded for its ability to save the lives of mothers and babies who may go into distress or encounter other medical complications during the birth experience. The surgery is one of many measures that has contributed to an overall decrease in maternal deaths. And of course busy moms-to-be appreciate that they can schedule their delivery.

Yet for nearly as long, the natural birth movement has argued that many C-sections are unnecessary and that they can cause a variety of future health problems for both mom and baby.

Who is right? Well a new report from Consumer Reports may have the answer.

In short, the report shows that many C-sections are being done for all the wrong reasons.

The non-profit looked at over 1,500 hospitals in 22 states. The researchers focused on C-sections done for women considered low-risk. They report shows that rates vary drastically from hospital to hospital, even among those in similar geographic areas with similar patient populations; and many C-sections were performed unnecessarily, whether out of habit, a desire to be efficient, or a fear of being sued. Perhaps even more unsettling, a hospital’s C-section rate is difficult to find, meaning that many parents-to-be are making important decisions about their birth experience with incomplete information. Two-thirds of the hospitals reviewed earned Consumer Reports‘ lowest or second lowest rating.

Some of the variation seen is not all that unexpected. For example, hospitals in southern states have higher rates than those on the West Coast. This could correspond with the South’s higher rates of chronic diseases like diabetes and hypertension, both of which can lead to complications during pregnancy and delivery that may endanger the life of mom or baby. Nevertheless, most of the variation is random, even when controlling for factors such as:

  • the percentage of patients on Medicaid
  • the number of births
  • the number of neonatal intensive care units beds.

This randomness speaks to vast differences in hospitals’ views on C-sections and their attitudes towards birth, pregnancy, and even their obstetrics providers.

Of course, the ultimate question is, why does this matter? Regardless of what popular media may say, C-sections are still major surgeries. Women have longer hospital stays and recoveries as well as a higher risk of both short- and long-term complications like infection and chronic discomfort at the incision site, respectively. All of these factors mean that C-sections tend to cost more than vaginal births. Additionally, women who’ve had one C-section often are encouraged to deliver future children in the same way despite the fact that the risk of complications increases with each additional surgery. It should be noted, however, that vaginal birth after Caesarean (VBAC) has gained much support from the medical community in recent years and is becoming an increasingly popular option. Vaginal birth may also benefit babies. They have a lower risk of breathing problems, are more likely to breastfeed, and may be less prone to chronic ailments like asthma an allergies.

The report also adds important data and publicity to new guidelines from the American Congress of Obstetricians and Gynecologists and Society for Maternal-Fetal Medicine. The recommendations, released in March of this year, debunk the outdated myth that labor should be induced or a C-section performed if labor is going on “too long.” In fact, this myth may contribute to the high rates of C-sections because inducing labor before a women’s body is ready to deliver may led to complications. Additionally, the recommendations also put to bed the idea that C-sections should be the go-to delivery method for large babies, identifying 11 pounds as the marker for when surgical interventions may be necessary.

Ultimately, there needs to be more transparency around C-sections and larger shifts within the medical field to address healthcare providers’ fears about meeting quotas or getting sued. Because at the end of the day, C-section overuse doesn’t benefit providers or patients.

Other Sexual Health News this Week

Coalition Issues Call-to-Action to Increase Shockingly Low Uptake of Sexual Health Services
The National Coalition for Sexual Health (NCSH), which consists of nearly 40 leading health and medical organizations, issued a call-to-action to increase the shockingly low uptake of essential sexual health care services in America, and launched a new guide and website to help Americans get the services they need.

See related: Taking Charge Of Your Sexual Health—How Preventive Services Can Protect Your Health (HuffPost Live)
With featured guests Dr. Edward W. Hook III, M.D., of University of Alabama at Birmingham, and Dr. E.W. Emanuel, M.D., MBA, an Og/Gyn at Kaiser Mid-Atlantic.

Some Parents Angry About Graphic Sex Education Book (USA Today)

White House Will Announce Measures to Combat Sexual Assault on Campus (Los Angeles Times)

Vatican Details Efforts to Combat Sexual Abuse (The Times-Picayune)

How a Single Low-Level Election Could Change Same Sex Marriage in the South (Think Progress)

Military Sexual Assault Victims May Get Amnesty for Minor Crimes (US News)

Three new organizations hope to make gender identity a protected classification in their anti-discrimination policies. These include Virginia Tech University, the University of Georgia, and the city of Spokane.

No LGBT Representation in NC as Gay Candidates Take a Beating in Primary (LGBTQ Nation)

Louisiana Senate Committee Passes Omnibus Anti-Abortion Bill (RH Reality Check)

Syphilis Cases Increase Among U.S. Gay and Bisexual Men: CDC (Reuters)

Important Dates

Cataylst Con West’s Call for Speakers applications are due on May 15. Click here to apply.

The following conferences are taking place in May and June. Click on each title for more information and to register.

The 46th Annual AASECT Conference, Monterey, CA, June 4-8.

The Sero Project’s HIV is Not a Crime conference, Grinnell, IA, June 2-5.

13th Annual Philadelphia Trans Health Conference, Philadelphia, PA, June 12-14.

Sex Stories: An End to the Primacy of the Pap?

Last week, the FDA rocked the sexual and reproductive health world when it approved a new tool to be used in cervical cancer screening. The test, made by Roche Diagnostics, is a primary HPV test that detects the presence of the virus’ DNA in a cervical sample. This differs from a Pap smear which looks for abnormal, potentially cancerous cells.

Primary HPV testing is not actually a new tool. It has been used for years both as a follow-up test to resolve ambiguous Pap results and together with Pap smears as a primary screening tool in women over the age of 30. The FDA ruling allows it to now be used alone in women 25 years and older for primary screening. If it were to detect either HPV types 16 or 18, the two strains causing the majority of cervical cancers, patients would then be sent for a cervical biopsy. If, however, it detected any of the other strains, they would go for a Pap smear as a follow-up.

Proponents of the test, including the Society of Gynecologic Oncology (SGO), argue that this ruling simply offers health care providers another tool. They point to the fact that it is not completely replacing the tried-and-true Pap smear, but rather adding nuance to cervical cancer screening.

Some consumer groups and professional organizations, however, are worried about the impact of this ruling. There are concerns that this may turn into another PSA-screening debacle where large numbers of patients receive medical care—either additional screening procedures or cancer treatment—that do more harm than good. Simply having HPV does not automatically mean that a woman will develop cervical cancer. HPV infections are incredibly common—almost every sexually active individual will have the infection at some point—and usually cleared by the immune system. If the Roche test detects HPV, a patient will be referred for additional procedures that may be invasive, expensive, and ultimately unnecessary.

Those in favor of using the test for screening emphasize its potential to increase detection of precancerous and cancerous cells. It’s estimated that HPV causes 90% of cervical cancers. But only screening for the virus instead of looking for cancerous cells could delay diagnosis and treatment for the minority of patients in whom cancer of the cervix is not associated with HPV. Finally, the validity of the study used by Roche to test the product is being questioned. As the Patient, Consumer, and Public Health Coalition writes:

“The basis for approval of this indication is a flawed clinical trial. Flaws include the design of the comparator arm, participant age and HPV vaccination status, trial duration, and testing interval.”

For now, the Pap will remain the go-to test while medical societies and organizations like the SGO and the American College of Obstetricians and Gynecologists (ACOG) develop best practice standards for the use of the Roche test.

Other Sexual Health News This Week

Tennessee: Governor Signs Bill Targeting Drug Use During Pregnancy (New York Times)

White House Issues Report on Steps to Prevent Sexual Assault on College Campuses including a new PSA. (Washington Post)

Minn. HIV/AIDS Cases Drop Slightly in 2013 (Kare 11)

Maryland Lawmakers Launch Drive to Overturn Transgender ‘Bathroom Bill’ (Fox News)

Transgender Students Protected Under Title IX, DOE Says (MSNBC)

55 US Schools Face Federal Sex Assault Probes (AP)