OThe rise in risky, non-traditional sexual relations
that marked the swinging '60s actually began as much
as a decade earlier, during the conformist '50s,
suggests an analysis recently published by the
Archives of Sexual Behavior.
"It's a common assumption that the sexual revolution
began with the permissive attitudes of the 1960s and
the development of contraceptives like the birth
control pill," notes Emory University economist
Andrew Francis, who conducted the analysis. "The
evidence, however, strongly indicates that the
widespread use of penicillin, leading to a rapid
decline in syphilis during the 1950s, is what
launched the modern sexual era."
As penicillin drove down the cost of having risky
sex, the population started having more of it,
Francis says, comparing the phenomena to the
economic law of demand: When the cost of a good
falls, people buy more of the good.
"People don't generally think of sexual behavior in
economic terms," he says, "but it's important to do
so because sexual behavior, just like other
behaviors, responds to incentives."
Syphilis reached its peak in the United States in
1939, when it killed 20,000 people. "It was the AIDS
of the late 1930s and early 1940s," Francis says. "Fear
of catching syphilis and dying of it loomed large."
Penicillin was discovered in 1928, but it was not
put into clinical use until 1941. As World War II
escalated, and sexually transmitted diseases
threatened the troops overseas, penicillin was found
to be an effective treatment against syphilis.
"The military wanted to rid the troops of STDs and
all kinds of infections, so that they could keep
fighting," Francis says. "That really sped up the
development of penicillin as an antibiotic."
Right after the war, penicillin became a clinical
staple for the general population as well. In the
United States, syphilis went from a chronic,
debilitating and potentially fatal disease to one
that could be cured with a single dose of medicine.
From 1947 to 1957, the syphilis death rate fell by
75 percent and the syphilis incidence rate fell by
95 percent. "That's a huge drop in syphilis. It's
essentially a collapse," Francis says.
In order to test his theory that risky sex increased
as the cost of syphilis dropped, Francis analyzed
data from the 1930s through the 1970s from state and
federal health agencies. Some of the data was only
available on paper documents, but the Centers for
Disease Control and Prevention (CDC) digitized it at
the request of Francis.
For his study, Francis chose three measures of
sexual behavior: The illegitimate birth ratio; the
teen birth share; and the incidence of gonorrhea, a
highly contagious sexually transmitted disease that
tends to spread quickly.
"As soon as syphilis bottoms out, in the mid-to late
1950s, you start to see dramatic increases in all
three measures of risky sexual behavior," Francis
says.
While many factors likely continued to fuel the
sexual revolution during the 1960s and 1970s,
Francis says the 1950s and the role of penicillin
have been largely overlooked. "The 1950s are
associated with prudish, more traditional sexual
behaviors," he notes. "That may have been true for
many adults, but not necessarily for young adults.
It's important to recognize how reducing the fear of
syphilis affected sexual behaviors."
A few physicians sounded moralistic warnings during
the 1950s about the potential for penicillin to
affect behavior. Spanish physician Eduardo Martinez
Alonso referenced Romans 6:23, and the notion that
God uses diseases to punish people, when he wrote:
"The wages of sin are now negligible. One can almost
sin with impunity, since the sting of sinning has
been removed."
Such moralistic approaches, equating disease with
sin, are counterproductive, Francis says, stressing
that interventions need to focus on how individuals
may respond to the cost of disease.
He found that the historical data of the syphilis
epidemic parallels the contemporary AIDS epidemic.
"Some studies have indicated that the development of
highly active antiretroviral therapy for treating
HIV may have caused some men who have sex with men
to be less concerned about contracting and
transmitting HIV, and more likely to engage in risky
sexual behaviors," Francis says.
"Policy makers need to take into consideration
behavioral responses to changes in the cost of
disease, and implement strategies that are holistic
and longsighted," he concludes. "To focus
exclusively on the defeat of one disease can set the
stage for the onset of another if preemptive
measures are not taken."
For more information
The Wages of Sin: How the Discovery of Penicillin
Reshaped Modern Sexuality
http://link.springer.com/article/10.1007/s10508-012-0018-4
(MDN)
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