Thirty years ago next month, the first reports of the illness that came to be known as AIDS were published. Five cases, all among young gay guys in Los Angeles. Since then, we’ve racked up over 60 million HIV prevention failures worldwide. But new draft guidelines on safe sex advice proposed for the UK suggest we’ve learned almost nothing from three decades of failure.

The guidelines, proposed by the British Association for Sexual Health and HIV are depressing, at very best. They seem to assume that it is the duty of health professionals to protect people from their own bad behaviour, in part by informing them of every possible risk, however marginal. They seem also to assume that the sort of people who take significant risks on a regular basis care about their long term health prospects. We don’t. And that comes from someone who today happens to be wearing a T-shirt embazoned with a slogan picked by algorithm on the basis of answers to 10 behavioural questions. Mine reads: “Runs with scissors”, but it might equally have read “Cycles without a helmet”, “Shags without a condom” or “Rolls her own cigarettes”.

The guidelines available here in pdf form, are open for public comment for another week or so. I would strongly urge people (especially people who’ve ever used a sexual health clinic) to look through them and put in their tuppence worth. The full text of my own comments is available in a doc file here.

In summary, I’m upset that we are still telling people to use condoms every time they have anal, vaginal or oral sex, even though we know perfectly well that that’s no more feasible than never having sex at all, for the same reason: for most of us, consistent condom use in every act of sex involving every orifice with every partner type at every age and level of sobriety is not feasible because it is not desirable.

I’m upset that we don’t give more practical and nuanced advice that people are more likely to act on. Example from my response:

“If you don’t have a condom handy, or don’t want to use one, then oral is your safest bet”. More useful still to a random gay man would be: “Do you have HIV? Yes? Then try always to use a condom if you’re top in anal sex. It would be great if you could use one if you’re bottoming too, but it’s less important, especially if you’re good about taking your meds. Don’t worry too much about oral, though it’s best if you don’t come in some other guy’s mouth. Definitely don’t come in his mouth if he’s just been to the dentist, or looks like he needs to go!”

I’m upset that we’re using evidence selectively. The guidelines imply there’s evidence that condoms work, and no evidence that abstinence works. In fact, condoms work and abstinence works even better, when they are used consistently and correctly. The more important evidence is around whether the promotion of condoms or abstinence lead to their consistent and correct use. Frankly, there’s very little recent evidence from the UK that condom promotion works very well; what worked in an age when HIV meant AIDS and an ugly death does not necessarily work in this post-AIDS age.

And I’m upset that, not content with giving clients information they won’t act on, we’re suggesting things that service providers won’t act on either. Sizing your clients up for condoms using a pasta measurer? Really?

I hate to wish HIV a happy 30th birthday, but I think at this rate it can expect to stay alive and well for several decades to come.

For reasons largely nerdy, I was wandering the London Book Fair today. It put me in mind of books I’ve read recently, and those I can’t help but revisit. Caught in the spider’s web of my memory is Joshua Foer’s Moonwalking with Einstein, a book in small part about memory and in large part about memorisation techniques. But under my skin, in much more persistent and uncomfortable ways, is Ariel Sands’ out-today Never the Face.

Foer’s book is delightful, if not ultimately all that memorable (for more, see my grown-up review in Prospect last month). But it does make the point that turning events, names, even playing cards into graphic sexual images tends to make them a lot more memorable, at least to the 20-something year-old blokes who tend to dominate the world memory championship circuit. I’m obviously not a 20-something year-old bloke, and I admit to not yet having read the final published version of Never the Face, a first novel by the publicity-shy Ariel Sands. But I can say that the sexual imagery (and its psychologically complex provenance) of an early draft is deeply etched in my memory in ways I sometimes wish it weren’t.

Daphne Merkin, who regaled New Yorker readers with the joys of spanking, describes it thus:

“Never the Face is a story in the tradition of 9 1/2 WEEKS – about the twisted corkscrews of desire, the hearkening after the call of brute submission and dominance that is the dark side of romantic attachment. Rarely has this skewed version of love been portrayed with the clarity and daring that Ariel Sands brings to it; her rendition makes for compulsive and disturbing reading.”

I can’t say more than that. Read it and (possibly) weep. Certainly, you’re unlikely to be unmoved.

The answer from the American South (in which New Orleans sits by an accident of geography rather than a convergence of spirit) seems astoundingly last-century. As you can see from the map, it’s also not all that successful.

According to an HIV prevention meeting in Albany, Georgia, the problem is pop music, which makes us drink, which makes us shag. But only if we’re teenagers. Adults are too out of touch to understand deep and meaningful lyrics such as these, from Jamie Foxx’s “Blame It on the Alcohol”.

‘I’ll keep filling up your cup while I feeling on your butt and you don’t even care that I was unaware of how fine you were before my buzz set in.’

Despite the double negatives, that seems pretty straightforward to me. It’s helpfully translated for us by hip and happening youth culture consultant Marc Fomby as ‘I’m the one that has to get drunk to go home with you, in other words you don’t care that I thought you were ugly before you got drunk’.

The solution, obviously, is to tell kids that what their hormones, their instincts, their natural curiousity and very probably the example of their friends, siblings and even parents are suggesting they do is BAD.

“When they come to school they are expecting us, both the students and the parents, to redirect those bad behaviors but we cannot do that unless we can educate them on the dangers of some of the bad things they are doing,” says Barbara Turner, Coordinator for Student Support Services.”

Seventy million people infected with HIV around the world, over half of them already dead. And still, the richest and most scientifically self-congratulory country in the world is pushing the “sex is bad” approach to prevention, and pushing it hardest in the parts of the country where people appear to be at highest risk.

Think I’m kidding? Check out this reworking of abstinence only lessons at work in the US school system (from OMG blog via NL).

I notice that in teens, as in the 20-24 year-olds shown in the earlier map, New York is an outlier in the northeast. (Note that because of CDC’s disgracefully slow surveillance procedures, these data are at least three years old.) More on New York’s new campaign for women and girls shortly.

London’s Natural History Museum celebrates with an exhibition of a Sexual Nature. For those who can’t make it to Kensington, Isabella Rossellini has made little sex-pods available on line. Here’s her take on young bucks:

Rossellini also offers charming, two-minute insights into the sex lives of spiders, sea-horses, dolphins and others, courtesy of the Sundance Channel. If your interest in the sex lives of other species is piqued by these vignettes, I would urge you to go to the (unacknowledged) source: Olivia Judson’s Dr Tatiana’s Sex Guide to All Creation. Judson is an evolutionary biologist and sometime New York Times columnist who takes joy in the pleasures of creation, and who infects others with her enthusiasm for life. Give her more than two minutes: you’ll be richly rewarded.

Predictably, most of the comments on the YouTube site are of the “This stigmatises gay men, especially those with HIV” ilk. More nuanced views over at Towleroad, one of the most consistently rational and informative gay blogs.

I found it slightly depressing that I’m out of the denominator (they only look at data from 18-32 year olds). But I was particularly delighted by this graph:

It looks at the effectiveness of showing clevage in your profile picture. The bad news is that all women’s pulling power falls over time. But Apparently, showing clevage bounces up your chances of getting a date more the older you get. Men, depressingly, don’t lose out on dates as they age. Unless they’re trying to show off their six-pack. Abs shots are less successful the older you get.

Now tell me data analysis is not sexy…

Thanks to Nico, who is definitely in the denominator, but has tragically stopped sharing his wisdom with us.

And from my best side:

Thanks to dkj for driving me to them.

Unsustainable? Well, there’s latex to dispose of, or worse still, population growth. But on the upside sex warms you up without needing to burn fossil fuels. It’s a renewable resource. And if it’s on offer for free this week in Copenhagen, it might just provide the positive energy to break some of the log-jams in the negotiations.

I’ve followed the build-up to the conference (beautifully dissected by Sam Kinght, writing in Prospect), with some amusement. Way back when I was writing The Wisdom of Whores, a friend from the World Bank was rolling his eyes at every UN agency’s willingness to hook itself to the HIV wagon. I quoted him thus:

““The UN institutions are professional beggars, and beggars go where the money is,” he said. “So you get “culture and AIDS”, “kids and AIDS”, “fish and AIDS”. I’m just waiting for “climate change and AIDS”.”

It wasn’t until months later that I saw the first headlines linking HIV to climate change. Just recently, there’s been a UNFPA report about it, which means it’s now official. As Rasna Warahp pointed out in Kenya’s The Nation, the real link between HIV and global warming will probably be that as more funding goes to the latter less will go to the former.

An aside, since I’m mentioning both development fashion and the World Bank: I am reliably informed that that venerable institution last week headed off a bid to have every loan reviewed for the effect that it has on trafficking of persons (which in the current climate is more or less equated with trafficking of women into the sex indutry). Just sometimes, common sense does prevail.

Thanks to Ron of greencollar for sharing the determination of the Danish with me.

The paper, in the (wonderful, open access Public Library of Science), even includes a little cartoon video. Bat porn. In essence, scientists in China have found that a female fruit bat will go down on her partner while he’s taking her from behind. Apparently, the extra stimulation helps him keep it up longer (not a universal observation among females of our species, I venture to guess). The researchers come up with a number of reasons why a lady bat might go to this trouble, among them that it might give his sperm more oomph, might make him less likely to roam, might clean up nasty infections before he passes them to her. But I particularly like their closing shot:

“The behaviour presumably favours the donor, although it may also benefit both partners especially if fertilization success is increased. It is conceivable that the female manipulates the male by increasing sexual stimulation, so that she ultimately benefits.”

I think that’s known as the Pleasure Principle.

Thanks to Klaus for stimulating me to post on this.

So we’ll have more pregnant teenagers, more ill-equppied child-mothers, more kids being poorly raised by resentful single parents whose own opportunities in life were cut short for lack of a pill or a condom. None of which leads to great health outcomes for either mother or child. Is it any wonder that the world’s wealthiest country trails the likes of Cypress, Morrocco and the Dominican Republic in health care?

If this depresses you, this gem from Paul Hipp might cheer you up.

Thanks to Txema and Kim Thomas.