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More Sex Is Safer Sex
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By Steven
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E. Landsburg
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(1102 words; posted
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Friday, July 5; to be composted Friday, July 12)
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It's true: AIDS is
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nature's awful retribution for our tolerance of immoderate and socially
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irresponsible sexual behavior. The epidemic is the price of our permissive
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attitudes toward monogamy, chastity, and other forms of sexual
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conservatism.
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You've
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read elsewhere about the sin of promiscuity. Let me tell you about the sin of
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self-restraint.
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Suppose you walk into a bar and find four potential sex
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partners. Two are highly promiscuous; the others venture out only once a year.
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The promiscuous ones are, of course, more likely to be HIV-positive. That gives
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you a 50-50 chance of finding a relatively safe match.
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But suppose all
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once-a-year revelers could be transformed into twice-a-year revelers. Then, on
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any given night, you'd run into twice as many of them. Those two promiscuous
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bar patrons would be outnumbered by four of their more cautious rivals. Your
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odds of a relatively safe match just went up from 50-50 to four out of six.
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That's why increased
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activity by sexual conservatives can slow down the rate of infection and reduce
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the prevalence of AIDS. In fact, according to Professor Michael Kremer of MIT's
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economics department, the spread of AIDS in England could plausibly be retarded
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if everyone with fewer than about 2.25 partners per year were to take
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additional partners more frequently. That covers three-quarters of British
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heterosexuals between the ages of 18 and 45. (Much of this column is inspired
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by Professor Kremer's
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research.
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If
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multiple partnerships save lives, then monogamy can be deadly. Imagine a
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country where almost all women are monogamous, while all men demand two female
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partners per year. Under those conditions, a few prostitutes end up servicing
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all the men. Before long, the prostitutes are infected; they pass the disease
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to the men; and the men bring it home to their monogamous wives. But if each of
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those monogamous wives was willing to take on one extramarital partner, the
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market for prostitution would die out, and the virus, unable to spread fast
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enough to maintain itself, might die out along with it.
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Or consider Joan, who attended a party where she ought to
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have met the charming and healthy Martin. Unfortunately Fate, through its
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agents at the Centers for Disease Control, intervened. The morning of the
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party, Martin ran across one of those CDC-sponsored subway ads touting the
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virtues of abstinence. Chastened, he decided to stay home. In Martin's absence,
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Joan hooked up with the equally charming but considerably less prudent
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Maxwell--and Joan got AIDS. Abstinence can be even deadlier than monogamy.
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If those subway ads are
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more effective against the cautious Martins than against the reckless Maxwells,
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then they are a threat to the hapless Joans. This is especially so when they
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displace Calvin Klein ads, which might have put Martin in a more socially
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beneficent mood.
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You
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might object that even if Martin had dallied with Joan, he would only have
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freed Maxwell to prey on another equally innocent victim. To this there are two
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replies. First, we don't know that Maxwell would have found another partner:
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Without Joan, he might have struck out that night. Second, reducing the rate of
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HIV transmission is in any event not the only social goal worth pursuing: If it
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were, we'd outlaw sex entirely. What we really want is to minimize the number
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of infections resulting from any given number of sexual encounters; the flip
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side of this observation is that it is desirable to maximize the number of
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(consensual) sexual encounters leading up to any given number of infections.
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Even if Martin had failed to deny Maxwell a conquest that evening, and thus
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failed to slow the epidemic, he
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could at least have made someone happy.
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To an economist, it's clear why people with limited sexual
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pasts choose to supply too little sex in the present: Their services are
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underpriced. If sexual conservatives could effectively advertise their
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histories, HIV-conscious suitors would compete to lavish them with attention.
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But that doesn't happen, because such conservatives are hard to identify.
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Insufficiently rewarded for relaxing their standards, they relax their
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standards insufficiently.
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So a socially valuable
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service is under-rewarded and therefore under-supplied. This is a problem we've
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experienced before. We face it whenever a producer fails to safeguard the
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environment.
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Extrapolating from their
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usual response to environmental issues, I assume that liberals will want to
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attack the problem of excessive sexual restraint through coercive regulation.
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As a devotee of the price system, I'd prefer to encourage good behavior through
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an appropriate system of subsidies.
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The question is: How do we
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subsidize Martin's sexual awakening without simultaneously subsidizing
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Maxwell's ongoing predations? Just paying people to have sex won't work--not
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with Maxwell around to reap the bulk of the rewards. The key is to subsidize
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something that is used in conjunction with sex and that Martin values more than
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Maxwell.
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Quite
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plausibly, that something is condoms. Maxwell knows that he is more likely than
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Martin to be infected already, and hence probably values condoms less than
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Martin does. Subsidized condoms could be just the ticket for luring Martin out
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of his shell without stirring Maxwell to a new frenzy of activity.
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As it happens, there is another reason to subsidize
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condoms: Condom use itself is under-rewarded. When you use one, you are
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protecting both yourself and your future partners, but you are rewarded (with a
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lower chance of infection) only for protecting yourself. Your future partners
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don't know about your past condom use and therefore can't reward it with
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extravagant courtship. That means you fail to capture the benefits you're
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conferring, and as a result, condoms are underused.
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It is often argued that
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subsidized (or free) condoms have an upside and a downside: The upside is that
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they reduce the risk from a given encounter, and the downside is that they
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encourage more encounters. But it's plausible that in reality, that's not an
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upside and a downside--it's two upsides. Without the subsidies, people don't
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use enough condoms, and the sort of people who most value condoms don't have
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enough sex partners.
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All these problems--along
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with the case for subsidies--would vanish if our sexual pasts could somehow be
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made visible, so that future partners could reward past prudence and thereby
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provide appropriate incentives. Perhaps technology can ultimately make that
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solution feasible. (I envision the pornography of the future: "Her skirt slid
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to the floor and his gaze came to rest on her thigh, where the imbedded monitor
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read, 'This site has been accessed 314 times.' ") But until then, the best we
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can do is to make condoms inexpensive--and get rid of those subway ads.
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