Sexually transmitted infections aren’t some special class of hell-viruses, contends Rachel Feltman, the executive editor of Popular Science, and the author of Been There, Done That: A Rousing History of Sex. Her book covers everything from why bats have oral sex to Cleopatra’s (rumored!) masturbation habits.
On a recent episode of The Waves, Slate’s podcast on gender and feminism, Feltman joined me to talk about the surprising world of animal and human sexual behavior. In a segment for Slate Plus, she told about what everyone gets wrong about infections that are passed around via intercourse or oral sex. Our conversation has been condensed and lightly edited for clarity. To access all of The Waves’ members-only segments and all of Slate’s culture stories, sign up for Slate Plus.
Shannon Palus: Rachel, what could possibly be good about a sexually transmitted infection?
Rachel Feltman: We have a weird line in the sand between things that are sexually transmitted, and then stuff you don’t have to feel bad about catching. We really think of STIs as being ickier than other infections. But sex is just one very efficient means of disease transmission. Just to talk about a recent news peg, there was that whole discussion about whether we should talk about monkeypox as being sexually transmitted. It’s like, well, it’s transmitted by skin-to-skin contact [specifically, via sores on the infected person] and sometimes body fluids. So, yes, having sex is a great way to get it. Having sex is also a great way to get COVID. Anything that you can get from someone’s spit or by rubbing your skin and, or mucus membranes all over each other’s mucus membranes, you do those things during sex.
As with COVID, no one should feel shame from catching anything.
No one should ever feel ashamed about anything they catch. But we have all of this weight around STIs. It’s not totally mysterious where that comes from. The AIDS epidemic is in our very recent cultural history, and America handled that horribly and used a lot of stigma and shame to try to ignore the problem into going away. And I think we’re really still feeling the echoes of those effects. I mean, my mom is an OB-GYN, and she told me once that the pictures that a lot of people associate with what a herpes outbreak looks like, are from textbooks showing what herpes outbreaks looked like in people who had full blown AIDS. Like any infection when you’re immunocompromised, of course you could have the worst possible symptoms.
That’s just one very concrete example of how, the way we talk about STIs, specifically in the US and over the last few decades, is really based on the nightmare scenario in terms of symptoms. I don’t know who decided this but they decided that you just wanted to convince high school students that they didn’t want to be the kind of person who got HIV or herpes or chlamydia. They were focused on making that seem like a really terrible club you didn’t want to join as opposed to, here are how condoms can keep you from probably getting chlamydia, and here’s why if you have herpes, it’s okay and you should talk to your doctor.
So getting an STI is like ending up in a fender-bender, it’s just a thing that can happen sometimes despite reasonable safety efforts.
But I learned from you that there are actually a few STIs, a couple in the greater animal kingdom and one in humans, that can have positive outcomes for their hosts. Explain.
We have a thriving microbiome. We are full of bacteria and fungi and other microbes. And some of them are really good for us, really important. And we also are full of viruses. We have tons of viruses inside us all the time. That’s something we’re just starting to understand. And a lot of them are benign, and some of them are important the same way some bacteria are important.
There are some non-human species where some of the microbes that they pass around sexually, actually do impart benefits. And we know of at least one in humans. It’s a relative of hepatitis, GBV-C. It’s really common, especially in certain parts of the world. And in most people, it seems to just float like many other aspects of our microbiome. But research has shown that people who carry this virus, if they’re exposed to HIV, may have better outcomes. It seems to have some kind of protective effect.
This isn’t a reason to go have a bunch of unprotected sex and try to collect a bunch of STIs like they’re Pokemon. But I think it does really serve as a reminder that STIs are just microbes. The reason we switched from calling them “sexually transmitted diseases” to “sexually transmitted infections” is that there are lots of things you pass around sexually that don’t cause symptoms, don’t cause disease. We know a lot of people have herpes and it’s usually asymptomatic, for example. But there’s also stuff you pass around sexually that we probably don’t even know about because it does nothing. And maybe it even helps you.
STIs, just like any other germs. Mostly OK, sometimes evil.
STIs of course can be dangerous, can be deadly. Like any other virus or bacterial infection, something new could show up at any time. That’s why safe sex is so important, because it’s not just about the STIs we know about, but the ones we don’t know about yet. On the other hand, I think if we should stop thinking about them as some other category of infection that different from everything else humans pass around.