Tuesday, August 11, 2009

Withdrawal increasing as STI/pregnancy prevention?

A recent blog post on XX, a women's -oriented web magazine (here) describes data showing that younger women are increasingly using withdrawal rather than condoms for contraception and STI prevention. Apparently there are some data suggesting that withdrawal is almost as effective as condoms in preventing pregnancy, and is strongly preferred, sensation-wise. Of course many STIs are not well prevented by withdrawal.

Is this a variation on the "safer sex burnout" that has been obvious among MSM - particularly younger MSM - for a number of years? Or does it represent a lessening of completely casual sex and an increasing trust in male partners (who, after all, have to do the pulling...). It would be interesting to see data on the social and sexual contexts within which women make a decision to insist on a condom or trust her partner to pull out at the critical time.

If accurate, this trend flies in the face of research and public health efforts to develop more women-controlled contraception and STI prevention devices. Of course by "women-controlled" is meant not just the technology - such as recent major efforts toward microbicides - but the context within which the women is empowered to make key sexual decisions.

Are younger women as tired of condoms as gay men have become and backsliding to an earlier health perspective, or are they now in enough sexual control that they can tell their male partner to pull out on time and fully expect him to actually do so?

Thoughts on this?

(I know the paper posting mechanism is still bad, but the "comments" link works fine).



  1. It's hard to know what to say to this. I think I was most disturbed to read the comment in this article that "affluent" women don't have to worry about HIV and some STIs as much as lower income women -- disturbed first, because it assumed that most women who would read this article, and most women of importance, are affluent; and second, because operating under between person statistics does not always work out for the within person case.

    As for whether it's "safer sex burnout," I think it's hard to know. It could be "sex in the era of Gardasil and less negative feelings toward abortion". Also, the women they were talking about in the article were mid to late 20s -- is it really that bad to get pregnant at that point in time? Especially as the love--marriage--children--happily ever after paradigm seems less and less plausible, having children out of a serious relationship may be perceived as, well, less serious, and may be more desirable. As for STIs: who knows why some women may be less concerned. Maybe it is "STI optimism" or some women still may not be as educated about STI risk. With "absistence only" education in the schools, who knows what this generation of young women are learning about when it comes to sexual risk!

  2. To respond to David's inquiry about the withdrawal method being an example of females being sexually passive or sexually empowered: My experience while HIV/STI testing at the BYC has been that females usually just allow their male partners to dictate how and when he comes. Neither partner is saying anything in the moment, so typically the male orgasm just happens. If the male pulls out, he does; if he doesn't, he doesn't. When I ask the females why they don't be more proactive about either using condoms or asking/telling their partners to pull out, they usually state that they are concerned about pregnancy/HIV and STI, but that they don't want to interrupt the sexual moment. Incidentally, both genders often report regret about not having withdrawn in time.