I’m not a reality TV person. The Real Housewives of all cities stress me out too much, Survivor is like living in a shipwreck nightmare, and Dance Moms (which I saw a lot of while my children binged it) makes me question whether humanity deserves to survive. I can do cooking competitions and have watched all seasons of Project Runway, but that’s it for me an unscripted television. (I wish real life had better writers not the other way around.) That’s all to say, I haven’t watched Love Island and had to consult Wikipedia to understand the rules of this particular dating show when it made headlines recently. It’s worse than I thought:
It's sounds like spending weeks worrying that you’ll have nowhere to sit at the lunch table and no date for prom, only in front of the whole f**king world. Plus, the mix of dating and constant video surveillance was the topic of a Law and Order SVU episode that seems entirely plausible. (That one I do watch.) I’m not bringing this up to rant about the idea the of finding love under the most manipulative of circumstances. You do you. I’m bringing it up because a conversation about sexually transmitted infections (STIs) between contestants made news recently. Apparently, Cierra—who is a content creator and a Virgo rising—told other Islanders that we could blame our current STI epidemic on men who had sex with animals. She said:
In addition to slandering koalas, she blamed cows for giving us gonorrhea and suggested that Christopher Columbus added to our STI burden by having sex with manatees. That’s not how it f**king works, Cierra. But there are a few kernels of truth in there. Let’s start with Koalas. Way back in 2021, I wrote about how these adorable—but apparently not all that friendly—creatures are dealing with a chlamydia outbreak. The bacterial infection is spreading from koala to koala and causing blindness, infertility, and death. It is one of the reasons that the koala population is down as much as 80% in some areas of Australia. A few years ago, wildlife experts in New South Wales began vaccinating koalas against chlamydia in the hopes of stopping the epidemic.
But we can’t blame men for giving koalas chlamydia or koalas for giving it to us. The chlamydia they get (chlamydia pecorum) is not the same one we are dealing with (chlamydia trachomatis). Thankfully, chlamydia in humans is not deadly. It is an easily treatable bacterial infection that is passed through secretions (vaginal fluids, cervical fluids, and semen) during oral, anal, or vaginal sex. The problem with chlamydia is that it usually has no symptoms so it can go undiagnosed and untreated. When this happens, it can lead to Pelvic Inflammatory Disease (PID) which can lead to scar tissue in the reproductive tract which can cause infertility. While the connection between koalas and chlamydia is clear, Cierra’s suggestion that cows caused gonorrhea is harder to track. Gonorrhea has actually been around for thousands of years, so pinpointing the origin is almost impossible, but friendly farm animals that go moo seem an unlikely source. Gonorrhea is also a bacterial infection that is spread through the exchange of bodily fluids during oral, anal, or vaginal sex. It often has no symptoms, and it too can lead to PID and infertility. The biggest issue with gonorrhea today is that it has become resistant to many of the medications we have for it. Currently, there is only one class of antibiotics that works, but there are some new ones in development. As for Christopher Columbus, he has been accused of bringing syphilis back from the “new world” because the timing seemed to fit. He returned to Spain in the 1493. The first recorded syphilis outbreak in Europe began in Italy in 1494 when an army of mercenaries from all over the continent invaded Rome and “for one month, led a life of limitless depravity.” The end result was a disease that, “manifested as a generalized eruption consisting of pustules, more terrifying than leprosy and elephantiasis and that could be lethal and was transmitted through sexual intercourse.” But the origins of that terrifying disease we now know as syphilis go back much further than that poorly behaved army. Scientists have found evidence that the bacteria (or perhaps the bacteria’s great-great-great-great grandparents) existed as many as 9,000 years ago. It’s presence in Europe likely predates the return of the Nina, the Pinta, and the Santa Maria. Moreover, nothing in the lore suggested that Chris got the syphilis from sea mammals. Bestiality is not behind our past or current STI outbreaks, but animals are part of the story. There have been cases of bacteria and viruses—some of them sexually transmitted—making their way from animals to humans, and it’s becoming more common. According to the CDC, scientists estimate that more than 6 out of every 10 known infectious diseases in people can be spread from animals, and 3 out of every 4 new or emerging infectious diseases in people come from animals. We all heard about the likelihood that Covid-19 came from bats. There’s a similar theory that smallpox came from horses. Despite originally being called monkeypox, mpox likely came from small African mammals such as squirrels, mice, and giant-pouched rats. (The hyphen suggests that they are not Rodents of Unusual Size, just rodents with unusually large pouches.) And researchers now believe that HIV evolved from a similar virus that originally infected monkeys. The jump from animals to humans is thought to have happened in Africa in the 1930s. With all of these infections, however, the jump from animals to people did not involve inter-species sexual behavior. Instead, people likely became infected from the blood of the animals after killing and butchering them. Sounds like something they might have to do on Survivor season 50 (yes, we’re almost up to the big five-o). Honestly, I blame reality TV for much of our current reality. Mark Burnett successwashed Donald Trump, and now he’s playing dress up in the situation room with a cast of equally unqualified contestants. Remarkably Effective HIV Shot Gets FDA Approval, But Will Anyone Get It?Last summer, I told you about lenacapavir, a twice-yearly injection that prevented HIV in almost all clinical trial participants. This week, the FDA approved the drug for sale in the United States. It’s a major step-forward for HIV prevention, but we’ve taken so many steps backwards since Trump II began that it might not get to those who needed it, here or around the world. There are currently three medications approved for use as PrEP—pre-exposure prophylaxis—in the United States. Truvada and Descovy are pills that need to be taken daily. (The two brands are made by different manufacturers but contain similar active ingredients.) There is also a shot given every two months called Apretude which uses a different active ingredient. Truvada and Apretude are approved for men and for people who have receptive vaginal sex (cisgender women or transgender men). Descovy, however, has not been approved in the U.S. for those having vaginal sex. (Remember, PrEP is for people who are currently HIV-negative.) Lenacapavir did very well in clinical trials called the PURPOSE Studies. These were double blind studies in which users got the shot or one of the two existing PrEP pills. To keep the study ethical, everyone got some form of PrEP. To keep the study blind, all participants took two daily pills and got a shot every six months. Depending on the group they were in, participants were either getting placebo pills or placebo shots. PURPOSE 1 tracked over 5,300 cisgender women in South Africa and Uganda starting in 2021. None of the participants who received lenacapavir contracted HIV over the course of the trial. In contrast, there were 16 infections among people taking Truvada and 39 among those taking Descovy. The study was so successful it was stopped early so that everyone could be offered the new drug. PURPOSE 2 tracked more than 3,200 participants, including cisgender men, transgender men and women, and those who identified as non-binary. In this study just two of the participants getting lenacapavir became infected with HIV. It's not a vaccine, but at between 96-to-100% effective, it’s a remarkable prevention tool. We shouldn’t expect RFK, Jr. to like or promote it—he thinks HIV was caused by poppers—but the rest of us can clearly see the potential. Unfortunately, that potential may not be met because of politics and profit. Gilead, the manufacturer of lenacapavir, is planning to sell it under the brand name Yetzugo for a mere $28,500 a year without going through insurance. That’s about the cost of current PrEP treatment but puts it out of reach for many people without insurance. Prevention programs that help pay for this have been slashed or put on hold by the Trump Administration. (This is extra infuriating because in his first term Trump took on HIV prevention and made ending the epidemic a priority. This time around he only cares about making enemies suffer). In addition, the potential cuts to Medicaid that made Republican Senator Joni Ernst say “Well, we are all going to die” would hurt many people who could benefit from Yetzugo. (Brief Aside: Brand names for drugs are so interesting. They have to be pronounceable but not sound like a word. I feel like in the past decade they’ve all had at least one Z or X. I wonder what focus group finding made that a thing. In my opinion this one sounds like a Yiddish sneeze. YETZUGO!) The situation is worse in areas hard hit by HIV like sub-Saharan Africa. Trump hasn’t canceled PEPFAR—a George W. Bush Program focused on HIV in Africa that is credited with having saved 26 million lives and enabling 7.8 million babies to be born without HIV infection—but he has essentially destroyed it. Early on, the administration froze funds and issued a stop-work order. A few weeks later it offered a limited waiver that would allow some programs to keep offering services including medications for people living with HIV and PrEP for others. But by that point many funded agencies had had to let go of staff and cancel services. Moreover, PEPFAR funds were primarily managed by USAID which we all know got DOGE’d early on. Gilead has entered partnerships with several generic drug manufacturers that allow them to create a cheaper alternative long before the U.S. patent runs out on the new drug. But these partnerships are only available in some areas (not here and not in moderate income countries with high HIV rates like Brazil), and the generic versions won’t be ready for a while. What we have for now is an amazing scientific advance that people couldn’t dream of at the beginning of the AIDS epidemic and an environment that makes getting it into people who need it potentially impossible. Politics and profit will do that. Sex on Wednesday is free today. But if you enjoyed this post, you can tell Sex on Wednesday that their writing is valuable by pledging a future subscription. You won't be charged unless they enable payments.
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Koalas, Columbus, Chlamydia?
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