Public-Health Puzzle: Young People Having Less Sex, Contracting More STDs
wsj.com
wsj.com
Basically if you have many to many pairing up (many one person with one or two partners), there may be less mixing, and less transmission.
In a one to many pairing (one person with ten partners) you can more easily transmit disease even if the total number of pairings is fewer.
Federal spending has also been curtailed.
“In the federal government, there is one dedicated STD funding line, and that is the line item in the appropriation bill funding the division of STD prevention at the CDC,” said David Harvey, executive director of the National Coalition of STD Directors. “That appropriation has been whittled away over the last 18 years.”"
Seems we know what the solution to the puzzle is.
Article
> “Something changed starting around 2012,” said Gail Bolan, director of the CDC division of STD prevention. “We’ve seen dramatic increases each year in both males and females.”
Wikipedia
> Tinder was launched in 2012 within startup incubator Hatch Labs,[7][8] a joint venture of IAC and mobile development firm Xtreme Labs.[9] By 2014, Tinder was registering about one billion "swipes" per day.[10]
Other than that, the data shows that the sexless generation is driving itself to extinction. That's just natural selection at work.
Please consider contributing to the discussion in a more meaningful way in the future. Name calling doesn’t help anyone.
All things certainly aren't equal though. There is a very large asymmetry in the chance to contract some STDs (specifically HIV, maybe others as well but I'm not sure.)
> In general, receptive sex is riskier than insertive sex. This means that women have a higher risk for getting HIV during vaginal or anal sex than their sex partners.
https://www.cdc.gov/hiv/group/gender/women/index.html
(There are some CDC documents that put numbers to this generality, but I don't have the time to go find them right now.)
(also the factors you mention wouldn't explain the age asymmetries)
And I am not interested in a relationship. I've been alone for such a long time (not of my own volition, just didn't have too much success) that after all the time during which it was painful, this way of living got ingrained into me and I can't see myself sharing a life with anyone anymore. I do everything in my own peculiar way now. And if I wanted a relationship, I would want that to develop from a friendship, or generally more naturally, not "search for love" over the Internet...
I would like to have sex from time to time, but now it seems I can only do that with men. What a weird world I live in.
Also, there was no "would you at least be open to the idea of entering into a relationship?". It was simply "casual? nope".
Another weird bit - the cherry on top - is the fact that most people are heterosexual and yet all my sexual experiences were strictly homosexual - again, the proportions are not the result of my choice.
And again the idea of "looking for love" on the Internet on Tinder sounds ridiculous to me. Think about it: you're essentially swiping photos left and right. It's what this app is focused on. And yet a lot of women seem to want to find the love of their lives there. I just can't... You want something meaningful? Grow a relationship IRL, don't swipe photos thinking "is this the one?".
You are right that I am simply discovering that men and women have different expectations. But the proportions are mind-boggling to me + the means by which so many women seem to hope to fulfill their expectations are absurd.
Having less sex: more and more people are putting off marriage. I'm sure happily married couples are leaving even their most promiscuous peers in the dust with their nuptial regularity.
Rise in STDs: the risk of unwanted pregnancy is much lower these days then in say, the 60s and 70s allowing for "riskier" sex. Longer time to marriage + hookup apps + less risk of pregnancy = more partners, more chances for STDs to spread.
The traditional wisdom is that this isn't true at all.
> Married couples have on average sex 5 times a month[1]
Under 30 it's even higher, over 8 times a month. Honestly consider your average 30 year old unmarried coworker. You think they even have the time to go out and get laid that often? That sounds exhausting!
1. https://healthresearchfunding.org/sexless-marriage-statistic...
Move forward to today: a large percentage of men are totally removed from the dating market (not by choice), they do not have sex, they have no hope of getting into a relationship. The reverse is not true for women, who have countless options and can at any time open their phone and have their pick of men.
In general, women still have sex but are increasingly only doing so with the top few percentage of men, which is why we see the skewed std rates.
Another issue, there are a lot more single men in cities, especially west coast cities, than single women. Indian and China aborted so many women that there are men there that will never be with a woman.
Marriage rates are down, there no pressure to get married anymore.
So, when it says young people are having less sex, it’s primarily men who are having less sex. The world changed, women do not need your money or your protection. The fancy jobs do not matter like they did before, nor does having a ton of money. What matters more than anything now are your looks.
The shape of the graph have changed, with much more "stars" – as in, top men who have several partners at the same time. Amount of active nodes may have even gone down, but the connectivity went up.
Well perhaps if they were in the dating market, they'd have a bit more hope of a relationship. This is like not buying a lottery ticket and then complaining about not winning. This is both true - if you don't enter a competition you simply can't win - and unpopular.
You said they're not in the market ("totally removed"). If they're not in the market, attempting to make a sale, the odds of ever making sale are zero.
If you're in the market, and nobody is buying, you need to improve your product or target other potential customers. If this was about software or other such, everyone would be all over it with great ideas and helpful comments and suggestions for improvement and so on, but because this is about men having trouble finding a girlfriend, they blame the market and stop trying.
For example, if there are 800 million men in your country and 700 million women, "try harder" will only work for 700 million men and will never work for the other 100 million (assuming they want long-term monogamous marriages etc.)
SF isn't China/India but even in SF there is enough structural imbalance that "work harder" won't be enough to help 10s of thousands of young men.
An appropriate hair cut (which might be going totally bald for some people) is a big deal. This also involves facial hair. Clothes are another easy and very effective thing to change. Eyeglasses. And all these things have to work together.
Edit: woah, that's going down fast, what's the matter here? Are you expecting that girls should come where you live and do as you please?
"try the good old speaking to a girl instead of going through an app"
I think the issue may be that women are using digital tools to find relationships. Talking to my SO, being friends with a number of women, and reading the news, I can't say I blame them, as it allows them to be the selector on the first contact in a safer environment.
So:
"Are you expecting that girls should come where you live and do as you please?"
No, they probably are trying, and then when you hear that women get a multitude more of messages than men on these platforms, and going by first impressions/looks is generally easier ...
Unless you're suggesting people go out and try to pickup people at the gym, grocery store, and bar. But (being in a relationship I wouldn't know), my assumption is that's generally not what women want at this time. Or at least wasn't when I was getting advice, as a man, a handful of years ago.
It seems as though the root of this is less socialization. I always thought you were usually supposed to get to know someone before asking out. I know HN isn't big on religion, but churches served this function among others for a long time, and I don't think the large, secular group of young people has yet found an adequate replacement. In terms of a close-knit community with similar values, religion is hard to beat.
Like I said, I'm in a relationship. I don't go to the gym, don't drink, and never attempted to pick someone up at a store. Like finding a job, I've found the best way to meet people is by way of recommendation from people you know. Doesn't always work out - had some extremely poor experiences - but that's life.
Otherwise, I would mostly agree with your second paragraph in general. I was raised Catholic, but stopped being Catholic somewhere between 4th and 6th grade (so there may be some bias, both ways), and agree that church, sports, school, and work were typically the ways people would get to know others, and eventually hook up.
I'm not a young person, so I'm not about to know what challenges they face in an always connected world, 24/7 news cycle, and world leaders (and their speakers) using Twitter/social media platforms to communicate with each other, but that seems to be the big shift since I was. Disconnecting is great (playing board games is my go-to), but with the world placing such importance on the benefits of the Internet and all these social platforms ...
Tinder and the like (yep, the year stood out for me too) creating a magnifier effect on a previously geographically constrained imbalance, funneling a significant percentage of short term hook ups through murky, disease-ridden "alpha male" bottlenecks.
More sexual activity, fewer people (particularly, fewer straight men) doing it.
This theory should be easily falsifiable if the data shows that there isn't a particular decrease in overall male numbers as a percentage compared to female.
I don't know man? Are you guys sure about this whole theory?
And, these women. They are so averse to the "date down" idea in your view, that they are willing to contract HIV to avoid dating firemen or truck drivers?
I'm probably too old to understand anymore. But I'll just say that in my day, more women were in college than men. Even so, that idea of risky sex because a guy has a degree would have been patent nonsense. Very few women in my day would have been willing to risk their lives to have sex with you. A guy's degree was just not that attractive.
I find it difficult to believe that women have changed very much in that regard. But, hey, I guess if you guys say so.
Since I entered the dating market I have observed that women prefer men being taller, at least comparable smartness and earning a bit more than them. The couples around for which this isn't true are probably < 10% of all.
I'm very skeptical of this. Attractiveness is sort of a constant across population, and sorts into several bucketed gradients, its not as if there are suddenly a ton more attractive women or unattractive men than there was before 2012 - there does however seem to be fewer situations where people can meet via traditional means however.
Now if you want to argue that non-conventionally beautiful women are not connecting with their counterparts on the male side, that might be a more interesting discussion - but one I dont think that can be proved out with data.
Women are the selectors. Men tend to take whatever they can get.
SF; where people can be convinced they'll beat incredible odds and become tech millionaires (billionaires), but give up on dating because the odds are slightly against them. These are the same people who buy lottery tickets but forego seatbelts, presumably.
http://web.archive.org/web/20170307114500/https://theblog.ok...
The post seems to be gone though.
Just look at attractiveness ratings between sexes and races[1]. White men are consistently rated as the most attractive, with black women faring least well.
Genuine question: why are the people who subscribe to this world view predominantly white men?
[1] https://theblog.okcupid.com/race-and-attraction-2009-2014-10...
I would assume asians and indians would subscribe to it even more
White males are still the plurality in the US dating market. If just the top 20% of those get dates, that leaves millions of US men lonely.
At the same time, the Tinder and the OkCupid markets are slightly different (but overlapping) markets; the less strictly hookup-oriented women on OkCupid might accept a wider range.
Going theory:
If you are constantly told "you are the most attractive category" and yet your personal experience is of not being attractive, you will wonder why that is.
If you have underlying assumptions about the attractiveness of certain qualities (wealth, success, etc), and yet having them is not felt to impact your personal dating experience, you will wonder why that is.
If you are told that your demographic category means that you _should_ be successful simply by virtue of being in that category, and yet you feel you are not, you will wonder why that is.
After that, I think, simple https://www.lesswrong.com/posts/DB6wbyrMugYMK5o6a/correspond...
Edit: note that this may only happen when you're young: older women, by force, are of course less able to be picky. So 'non alpha male' are still able to go in a relationship, but later..
Please don't make up things like this. There's tons of well-researched data available from the CDC and NIH. None of it supports this misogynist conspiracy that men have stopped having sex.
> Regarding opposite-sex sexual behavior, 95.3% of women and 93.5% of men aged 18–44 had ever had any opposite-sex sexual contact.
There are pages of tables in this study alone: https://www.cdc.gov/nchs/data/nhsr/nhsr088.pdf
Sexual activity is slowly declining across the board, and more in young women than young men:
> In 2011–2015, 42.4% of never-married female teenagers (4.0 million) and 44.2% of never-married male teenagers (4.4 million) had had sexual intercourse at least once by the time of the interview (were sexually experienced). These levels of sexual experience among teenagers are similar to those seen in 2002 and 2006–2010 data. Longer-term trends, from 1988 to 2011–2015, show declines in the percentage of teenagers who were sexually experienced.
The share of Americans not having sex has reached a record high
% of 18-30 year olds reporting no sex in the past year
2008
Women: 8% Men: 10%
2018
Women: 18% Men: 28%
The rate of change is twice higher for men. I guess reality is misogynist by your definition of misogyny
Second, and more importantly: the GSS is an survey of 1,000 people. There were 396 people in this age range (https://gssdataexplorer.norc.org/variables/53/vshow) and 45% were men (https://gssdataexplorer.norc.org/variables/81/vshow). Seems safe to assume those variables are independent, so that's 178 men in the age range. You are hanging a sweeping claim that there's been a total upheaval in heterosexual sexual activity whereby a "large percentage of men are totally excluded from removed from the dating market" on literally 31 guys answering one question differently. The CDC studies linked above had tens of thousands of subjects.
https://www.niddk.nih.gov/health-information/health-statisti...
40% of the adult US population is now obese, 70% is obese or overweight. Overweight people have a hard time dating, for those obese it is even tougher, and many give up hope. Men have a further problem: obesity is very strongly linked to diseases that have an impact on their ability to have an erection.
Someone who only had sex once leaves a very different STI footprint than someone who have different partners every week, yet they will both be classified as "have ever had sex" in the study.
Now compare that "have had actual sex with another human" study with studies from places like OK Cupid where they found that:
- women overall got the most messages on dating sites
- the second decile of women got more than 50% of the attention (ie: the hottest women got a lot of messages but the "in my league" hot women got far more)
- most women got some attention (even just 1 message during the study)
- only the most attractive men got attention, but closer to the level of the least attractive women
- the most attractive men will "date down" to improve their chances of having sex on their terms
- women in general will "date up"
Informal study with ten invented people: http://jonmillward.com/blog/attraction-dating/cupid-on-trial...
OK Cupid has plenty of studies, but here's one that looks at who sends the first message (overwhelmingly men): https://theblog.okcupid.com/a-womans-advantage-82d5074dde2d (there's another study based on interracial relations, and it turns out that all women prefer white men).
Spreading STDs isn't about how much sex you have, it's whether the one person you had sex with had an STD. Given the extremely asymmetrical nature of the dating and hookup successes, it's highly likely that the one person you had sex with this month had sex with a lot more people than you.
It doesn't help that the news agencies are reporting "cure for AIDs" and nonsense like that, so people don't take STDs seriously — we basically have an anti-awareness campaign making people more cavalier about sexual health.
There's no real puzzle here, just lots of contributing factors.
"Queer Eye" does a great job of demonstrating the impact of self-care on looks; aka; that a lot more is possible with what you're born with than you might be thinking. There's a great quote from one of the clients that I can't find, that's something along the lines of "showed me what was possible if I just cared."
If you feel like you're doing that, and still unhappy / unsuccessful, you might be https://www.ted.com/talks/joseph_gordon_levitt_how_craving_a... What I'm thinking now with this is that phrases like "trying too hard" and "just be yourself" are saying is that rather than try to do actions to cause some outcome, you need another level of indirection: do actions that express your inner self, and then adjust (aka, work on) that inner self until the outcomes of that expression are what you're after. It's like, I don't know, skipping leg day, or eating a balanced meal: you're a system, and to modify a system you have to approach it holistically.
Anecdotally, this is working for me (as much as I can actually assign causality). Recently, within a specific but repeating and thus suited for experimentation context, my "dating" life did a ridiculous 180. Most of what I did with my looks was keep the beard a lot more trimmed (theory: this way it can look taken care of) and have been doing a sort of mixed coached yoga / PT thing that's had a subtle but positive impact on my physique. The _other_ major change was my vibe, but that's a lot harder to describe; suffice to say "go to talk therapy." So either not a lot of appearance-based self-care / improvement had a massive impact, and/or a lot of emotional self-care had a huge impact.
That all said, I am not expressing agreement with your thesis; I am only expressing my own experience with impacting my dating life through long-term self-care.
You are totally ignoring the demographic of women over 40. Older women have a very hard time dating.
> So, when it says young people are having less sex, it’s primarily men who are having less sex. The world changed, women do not need your money or your protection. The fancy jobs do not matter like they did before, nor does having a ton of money. What matters more than anything now are your looks.
This was already foreseen by many feminist and population control advocates in the middle of the 20th century, such as Mary Daly. Here is Terence McKenna's take on it in a 1994 talk:
"There are not only too many people, there are too many men. I would be very interested in seeing a set of social policies, tax incentives, medical policies, insurance policies, put in place to limit male birth. It is very rare in mammal populations that you have a 50/50 ratio of male to female. In fact, it is well known that male infants are less robust than female infants, and the reason we have a 50/50 sexual ratio is because we artificially support males and withdraw resources from females. I suspect that in the high paleolithic the ratio was closer to two to one. My supposition, in thinking about this, is probably that the best ratio is three to one. This is the way to feminize the human race, if you are serious. This is the way to advance women, if you are serious… I have never heard anyone say that male birth should be limited, but it obviously should… we can steer ourselves towards a population with a predominance of females, and those females should have only one child, and 75% of those children should also be female. I don't consider myself a gung-ho feminist… As a humanist, I advocate a reduction in male births. It just seems obvious that it is the way to go. If it does not seem obvious to you, then let's have a public debate about it, and at least make it part of the rhetoric of the culture, that this is an option to think about."
Yikes. So how does this mesh with the idea that the modern left is about gender equality? That's pretty much naked eugenics and this individual does not seem to be broadly vilified as one would expect.
Mary Daly was a Catholic professor of theology and prominent second-wave feminist in the late 1960s/1970s, and according to her "If life is to survive on this planet, there must be a decontamination of the Earth. I think this will be accompanied by an evolutionary process that will result in a drastic reduction of the population of males." Valerie Solanas argued for total androcide in her 1967 SCUM Manifesto (IMO a very underrated book).
These ideas are not new, are not liberal, and should not be particularly surprising if you stop emotionally investing in consumer society, corporate indoctrination, and "traditional" (authoritarian and misogynist) cultural values, and instead look at where the life-carrying capacity of the Earth has been, where we currently have reduced it to, and where it is heading towards if present trends continue.
Even in the comment above you can see someone has been conditioned to think that men caring about their own rights is somehow "mysoginist" when the truth is MRAs are concerned with things like false accusations, equal rights, fair treatment in family courts and many other important issues. And some MRAs are female, just like some feminists are male.
Since you seem to be so well-informed on the subject, maybe you can help me with a question about the "modern left" that I have had for several years now: what does John Zerzan have in common with Hillary Clinton?
The feminist philosophy of Clinton and the primitivist ecophilosophy (?) of Zerzan share at their core the same ideas as Marx: they see the world as a struggle between innocent oppressed groups and evil oppressor groups, with everyone being categorisable into one of those two categories and in which world progress inevitably builds to an overthrow of the oppressors leading to a kind of universal peace.
Zerzan uses the same terminology as Marx even, that of alienation. Feminists don't use that rather archaic word, but they do talk a lot about discrimination, oppression, patriarchy (instead of bourgeoisie) and so on. The phrase "the future is female" expresses the same sentiment as Marx when he predicted the inevitable victory of the working classes over their oppressors.
Stop right there. You know nothing about the "modern left" if you have never heard of John Zerzan. And if you think that he is some kind of Marxist because you skimmed a Wikipedia page, you are clearly a know-it-all idiot Dunning-Krugering himself.
You don't seem to have any real response to my points Mr Throwaway. If he isn't then respond to my comparisons?
That theory, last I glanced at it, was that 70% of females expect to reproduce in any given generation compared to 30% of males, and was then used as explanations for higher risk behavior in males.
What that was based on (species used, or timelines in human society, etc) I do not know.
It was also attached to some dubious headlines like "the myth of male power" which undermined IMO the theory, but the core theory seems to explain a large amount of strange things in society, even though technology has upended the conditions from which it arose.
This is a good thing, we men will need to evolve to what women desire if we want to be competitive in the dating market. Speaking as someone who has lost tremendous amount of competitiveness by moving to US.
> The fancy jobs do not matter like they did before, nor does having a ton of money.
Fancy jobs and tons of money still matter, just the bar is higher now. Cool jobs are also becoming desirable, giving men more options to pursue non-traditional careers.
> What matters more than anything now are your looks.
Look has always been important for women, the playing field is just becoming more even between the genders.
Yes, the dating landscape is changing at a faster pace than before, like many other parts of society. The answer is the same, evolve or become obsolete.
People seem to weigh the pros and cons and choose to not play the game rather than entering a rat race. Its not clear for what thing they "become obsolete", esp. considering these data are not about marriage / reproduction
So yeah, women can pick adventures with alpha males (especially considering looks) instead of a long term relationship with the average guy. This leaves almost nothing (ok-ish) for the average guy.
What's an average guy supposed to do? I'm genuinely interested in answers.
When you are experiencing something you'd call "hardship"; first, go slower with yourself; then consider: Are you trying to become numb to something unpleasant or painful, or are you in an opportunity to become more than who you once were?
Worked for me. Yes young men struggle to date young women, but wasn't it always like that? Women respond to age and age signals in the reverse way to men.
This isn't a bad thing. [1][2][3][4] If you as a straight man are putting some effort into being a decent human being and better dating prospect, in the long term you're far more likely to have a good outcome than a woman of "equal" "value" (subjective concepts).
[1] https://www.smh.com.au/lifestyle/why-women-lose-the-dating-g...
[2] https://putanumonit.com/2016/02/03/015-dating_1/
So everyone having sex with fewer partners is better overall than less people having sex with more partners.
Makes me think society is getting less sexual which is turning into a major health problem.
"Federal spending has also been curtailed."
“In the federal government, there is one dedicated STD funding line, and that is the line item in the appropriation bill funding the division of STD prevention at the CDC,” said David Harvey, executive director of the National Coalition of STD Directors. “That appropriation has been whittled away over the last 18 years.”
Besides, have you seen sex education in schools these days? Let's just say it's... comprehensive. Compare that to the 70s, 80s, 90s, ANY other time. Children today go into sexual relationships with way more information that any previous generation.
This also correlates with what has happened here in England. Because public health/sexual health is funded by councils at the local level and not the NHS it has borne the brunt of cuts to council budgets. As a result we've seen decreased rates of testing and increased rates of infection [0].
While there's a case to be made that Tinder et al. have something to do with it it seems like the funding view is one with actual data behind it rather than 'all the girls are sleeping with Chads and I'm forever alone' finger pointing.
[0]: https://www.bashh.org/news/news/sexual-health-experts-highli...
The generation that has grown up with apps (esp social media apps) for everything has really gotten the short end of the stick in my opinion. There's an image consciousness that underlies everything now. Everything needs to have that Best Life sheen.
Take for example, the differing experiences of getting a tattoo. When I got one, it was a classic impulsive decision. I didn't save up for it for months, I didn't even think about what I wanted until I was in the studio (a word applied loosely here...) looking at a binder of the art (a word applied loosely here...) people got tattoos of. I didn't have a voice in my head that said "picking from the same 50 tattoos as everybody else is BASIC", didn't seek out a renowned artist who might pose with me for a selfie and @mention me afterward, none of that. I was incapable of even forming the thought. There definitely wasn't some heart-rending, inspiring story behind it that would get hundreds of likes on Instagram. I just got a little tipsy, got a questionable idea in my head, went down to a very working class strip mall and bam, from then on I had a tattoo.
Consider also: I didn't try to hide that tattoo from my parents and they still didn't find out about it for nearly an entire year. The other day a friend of mine was able to deduce that in the beginning of the past decade they had slept with someone who was now in a relationship with their coworker/acquaintance based on an internet search, and my parents didn't know I had a tattoo for an entire year! Once everyone could see what everyone else was doing, you couldn't just get a tattoo out of the tattoo binder any more. The average tattoo I see nowadays is far more artfully executed, well thought out and tastefully designed. The freedom to not worry about these things, however, was vastly underrated.
You still had to worry about your image back then, but it wasn't this always-on national pastime. When you were around someone you wanted to impress, you tried to impress them. When you weren't, you just did other things. If you and your friends went hiking and decided to get a photo of yourselves at the top of the mountain? Decent chance the film was never developed at all. Best case, it ends up on someone's corkboard as a happy memory. You could eat a cheesesteak when you visited Philadelphia without the exhausting worry about whether this particular place was the too-famous one that marked you as a lame tourist because everybody knows <x> is strictly for out-of-towners only. You just ate a sandwich and moved on with your life.
Life was better when we weren't so acutely aware that we were being observed.
Dating is harder now. I agree with some of the somewhat controversial comments on here in that it probably is more of a winner take all game now than it was in the past. The mistake to my way of thinking is in throwing up your hands, going full on misanthrope and dismissing everybody who is having success on these platforms as a bunch of Chads and Stacys. You don't have to play the Tinder game even if you're of this generation. It can work even if your not the sort who can just sit down on a barstool and wait for opportunity to find you. Cultivate an IRL social network. You'll be surprised how much mileage you get out of friend of a friend or friend of a friend of a friend dating.
I think education is a huge factor. Anecdote: I took human sexuality at university. We had pop quizzes daily. For quiz on birth control someone comes in and states, 'Oh I didn't need to study for this, I've been using birth control since I was 16' They failed the quiz.
Honest communication is a huge factor in prevention. My current girl friend let me know early in our relationship she had chronic hepatitis B. I'm in process of testing for my own exposure, and will get vaccine if needed.
If you're not 100% sure about your history, get tested, lots of stuff can be asymptomatic. Some healthcare systems offer free testing for some diseases.
Isn't STD Sexually Transmitted Disease a bit of a misnomer? While sex might be the primary method of transmission, from the article CDC attributes increased drug use as one of the factors. Or am I just being pedantic?
additional info: I'm definitely not young anymore.
This approach is like putting promiscuous people on constant antibiotic treatment to avoid bacterial venereal diseases. It doesn't make sense long-term.
It seems as though in the backlash against complete puritanism towards sexual activity, many people have moved too far and started implying that it is completely safe. It's not, even if you practice it "safely", and it's still important to emphasize that.
Descovy has less side-effects than Truvada, but Gilead conveniently timed Descovy's indication for PrEP to align with Truvada's patent expiration. Truvada is particularly hard on the kidneys, and can cause kidney damage or failure. Descovy doesn't put its users at risk of kidney damage.
The wholesale cost of generic Truvada in the developing world is $6 to $8.
However, based on what you're saying, I wonder if the push is being delayed so that the government can wait for the patent expiration and subsidize at a much cheaper cost.
One hypothesis to consider: the Affordable Care Act which became effective in 2010. It may be that somehow the healthcare changes that followed had an adverse effect, and that it took 2 years for increased infection rates to compound and begin to be reported.
I fail to see any kind of chain of events here where one might lead to the other.
"We wouldn't have had sex if it weren't for Obamacare." doesn't exactly seem like something you'd be likely to hear.
(I just made this up as a suggestion, I have no evidence this actually happened)