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Call to Action: Depicting Safer Sex in Fiction to Influence Public Health Behavior

By Phyllis Zimbler Miller
October 7, 2018 | Comments

Editor’s Note: We were struck by these thoughts from Phyllis Zimbler Miller when she told us about them and asked her to write them down for Critica. The use of automobile seat belts is an unequivocal public health success and has, as Ms. Miller explains, been embraced by the entertainment industry. We know that safer sex practices reduce the spread of sexually transmitted diseases and unwanted pregnancies. If publishers and producers included safer sex practices in books, movies, and television shows, as they have with seat belt usage, would that influence behavior and increase their adoption? That is an empirical question, exactly the kind that we at Critica want to see addressed and answered with rigorous study. But given the urgent public health need for increased safer sex practice and the apparent lack of adverse consequences in messaging about them, we join Ms. Miller in advocating that the publishing and entertaining industries accept her recommendations, even as scientists sort out how much effect such messages can have on behavior.

As I watched yet another movie (or TV show) depicting a sex scene without any reference to protection (safer sex) – this time the newly released movie Puzzle, I cringed once again at my failure 25 years ago to start a movement in the entertainment industry to portray (or mention) safer sex in the story line of movies and TV shows.

At that time, I didn’t realize that an industry which had embraced showing safety belt usage on the screen would balk at embracing a similar public health issue. (Due to a commitment many years ago by the entertainment industry in the U.S., in almost all American visual media entertainment that takes place in present day, people in the front seat of a vehicle are visibly using their safety belts. Sometimes dialogue is even included in the vein of the driver saying to the passenger, “Buckle your safety belt.”)

Fast forward to now – and my reading the May 7, 2018, Los Angeles Times article by Soumya Karlamangla entitled “STDs in L.A. County are skyrocketing– which made me see red.

Before I discuss why #safersexinfiction (I use this hashtag on Twitter at @ZimblerMiller) could be so powerful, let me give two examples so that we are all on the same page.  (In other words, I am not talking about actually portraying putting on a condom – unless it is an R-rated film.)

In Mercedes Lackey’s novel Sacred Ground (first published in 1994), this is a scene between protagonist Jennifer Talldeer and David Spotted Horse:

… Her skin tingled at the touch of his tongue; his technique had definitely improved. He pulled away just long enough to ask, “Your safe-sex, or mine?”

“Mine,” she replied, rattling the little plastic packet she pulled out of the pocket of her jeans.

In Episode 4 of Season 2 of Netflix’s Dear White People, Coco (Antoinette Robertson) has a conversation with her roommate. Coco admits she’s pregnant and explains why she hadn’t used a condom: “I got caught up.” She later tells her roommate, “You really should use condoms.”

Simple, right? Yet not so simple if these “mentions” can influence positive public health behavior on the part of so many people.

Imagine a real-life sex scene of today:

The female has brought along her own protection – no fool she – and the male refuses to use the condom. Then the female mentions some actor the male admires. “Remember that scene in [movie x] where [actor y] uses a condom? You’ll be just like him.”

Are people really influenced by fictional stories they view or read?

In a 24/7 world in which we are all constantly bombarded with information (both nonfiction and fiction), the lines of reality are easily blurred.  And in a world that often idolizes movie and TV stars, what they do “on screen” can subconsciously, if not consciously, affect our opinions.

Watching the movie Puzzle, a viewer might wonder whether this married woman and unmarried man with whom she is about to sleep for the first time have stopped to consider the consequences of pregnancy and STDs. A single sentence such as “Do you have protection?” would go a long way toward reinforcing the concept that this action is an accepted part of sex between partners.

My call to action in writing this article:

If you are in one of the following positions — writer, book editor or publisher, content creator, movie or TV producer, high school or college English teacher, or similar role — consider how to include safer sex portrayal or discussion in order to influence positive public health behavior.

Finally, in light of my failure 25 years ago, due to the incredible amount of time today that everyone spends watching films, TV, YouTube, etc., the depiction of safer sex in fiction may be even more beneficial now than it could have been 25 years ago.

Phyllis Zimbler Miller is a screenwriter and author in Beverly Hills, California. She blogs on a variety of issues at

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