This Week in Sex is a summary of news and research related to sexual behavior, sexuality education, contraception, sexually transmitted infections (STIs), and more.

Syphilis/HIV Outbreak in Milwaukee Includes High School Students and Infants

Earlier this month, the Milwaukee Journal Sentinel reported a combined syphilis and HIV outbreak has affected at least 125 people in the city. The newspaper interviewed public health professionals at organizations across the city and noted that there appeared to be a “cluster” of infections, meaning that diagnosed people could be connected to each other and have had recent contact. Most of those affected in the group were men, and 45 percent were HIV positive. Additionally, at least some were high school students, and three babies were born with syphilis. Many of the affected had both HIV and syphilis.

A cluster of 100 people might not seem alarming in a city of 600,000. But think about this: In 2015, the Centers for Disease Control and Prevention (CDC) identified rapidly growing clusters of HIV infection using genetic markers found in the virus. It considered anything more than five related infections to be a cluster and found 903 infections across 60 clusters over the course of a year.

Despite the size of the cluster and the fact that, according to the newspaper, health officials in Milwaukee have known about this outbreak since at least December, the city was slow to comment. In fact, the health department didn’t announce the cluster or comment publicly about it until a press conference on Tuesday.

The health department’s months-long silence on this issue is puzzling because public health depends on communication: sharing information about outbreaks, risks, and prevention and treatment. Melissa Ugland, a public health consultant who works with local nonprofit organizations, told the Journal Sentinel: “This is an epidemic people are not talking about enough, and it leads to people taking unnecessary risks.” Gary Hollander, former CEO of Milwaukee’s Diverse & Resilient, a grassroots organization that focuses on LGBT issues, added that with clusters like this it’s especially important for public health officials to move quickly to help prevent further spread of disease.

The HIV virus is transmitted through contact with bodily fluids such as blood, semen, and vaginal secretions. Syphilis is caused by a bacteria that is transmitted when an uninfected partner comes into contact with a sore, known as a chancre. Chancres can occur on or around the external genitals, in the vagina, around the anus, in the rectum, or in or around the mouth. Both of these STIs can be transmitted during oral, anal, or vaginal sex, and transmission of both can be reduced if couples use condoms consistently and correctly. In addition, pre-exposure prophylaxis (PrEP)—daily antiviral medication—is now available to individuals who are at high-risk for exposure to HIV. If taken daily, PrEP reduces risk of getting HIV through sex by 90 percent.

Moreover, pregnant people should be tested for syphilis during their first trimester. People who test positive can be treated with penicillin, which is up to 98 percent effective in preventing mother-to-child transmission of the diseases. In contrast, according to the CDC, “untreated syphilis infection in pregnant women results in infant death in up to 40 percent of cases” and can lead to serious disabilities in surviving children.

Early testing and treatment is also key to staying healthy after infection. Syphilis can be cured without causing any major health problems if caught in the early stages. While HIV never leaves the body, early adoption of a medication can suppress the virus and keep a person healthy longer.

In response to the cluster, the AIDS Resource Center of Wisconsin (ARCW), the largest provider of HIV treatment in Milwaukee, participated in that Tuesday press conference and reminded the community of its free, confidential testing services. ARCW President Mike Gifford said: “We can’t let this cluster fool us. HIV and [STIs] are high throughout the community and throughout the region.”

The Milwaukee Public School District has also gotten involved in the response to the outbreak as some of its students are among those infected (the number of students is being described only as less than 10 percent of the 125 individuals involved). The state of Wisconsin mandates that public schools take an abstinence-only approach, which typically avoids discussion of STI prevention in favor of telling students just not to have sex. But in light of the outbreak, the superintendent has invited health care professionals to speak with students.

The number of cases associated with this cluster will probably increase as more people get diagnosed and more links are made between those who have been diagnosed with HIV and/or syphilis in the city.

Making Oral Sex Safer and Sexier

There is little sexy about a dental dam. The name is certainly not erotic and the object itself—a relatively thick latex rectangle—evokes images of the dental surgery it was originally intended for, not of intimate moments between lovers. Yet, sex educators have suggested that couples awkwardly hold this object between them when one partner is licking the other’s vulva.

Soon there will be a new option on the market that looks more like lingerie and—we hope—will feel more like skin. Lorals are like a pair of skimpy underwear made of latex similar to that used in condoms. They are meant to be worn during sexual activity and discarded afterward. Though the product is not available yet, its makers say that it will be thin enough to allow for oral and finger penetration.

Melanie Cristol, the inventor of this product, is applying to the Food and Drug Administration to have it declared a medical device so that it can be used as a tool for safer sex. But she says her bigger hope is that it makes women feel more comfortable with oral sex.

Cristol, a former peer sex educator at Columbia University, was concerned by stories and statistics that suggested women were not getting oral sex nearly as much as they were giving it. As part of her startup, she surveyed women and was found that it wasn’t all a matter of men being unwilling. Women turned down oral sex for many reasons. She told Fast Company: “They might be concerned that they haven’t showered yet, have just come back from the gym, or are on the tail end of their period. They might be worried about how their sexual partner feels about tastes and scents.” She’s hoping that the thin, latex lingerie can help calm these fears.

Of course, such a product doesn’t dispel the lies we’ve all been told about how vaginas are dirty and vulvas should smell like fields of wildflowers. But if it works to get more couples into oral sex and ends up giving more pleasure all around, while also preventing STIs, we are all for it. By the way, you can preorder a four pack of Lorals now, but it won’t arrive until August.

ABC: Animals on Birth Control

The Paignton Zoo in Devon, England, is usually all about pregnancy and birth. It’s a breeding program that sends animals to zoos around the world to mate with others of their kind.

But a tuberculosis outbreak last year has forced a temporary hold to these raucous road trips, and the zoo is facing overcrowded conditions. To ensure that it does not have its very own population explosion and a whole new generation of sick animals, the zoo is putting more than 60 species on contraception.

Think baboons taking birth control pills, monkeys with Mirena, and rhinos getting Depo. But don’t think about it too hard because we don’t know which contraceptive method will be given to which species. Ghislaine Sayers, the zoo’s head veterinarian, explained: “Animals are individuals, so—like humans — some contraceptives suit some better than others.” The zoo is consulting with experts to figure out the best solution for each of its mammals, but pills, injectables, and IUDs are options.

All of the methods being used must be reversible, however, since the zoo plans to start up its breeding program again as soon as it is TB-free. We’re relieved to hear that no tigers will be having their tubes tied.