A few weeks ago, I cared for a young woman who came in to get an IUD check and be screened for sexually transmitted infections. She sat on the exam table, squeezing the vinyl covering between her fingers and palms, crossing her legs at the ankles. Her lashes were long and fake, curled up like a Kewpie doll’s. Blue streaks in her hair mingled with her natural, dark brown. On the back of her left hand, an evil eye tattoo in delicate black ink.
“I’ve been having some spotting after sex,” she told me.
“Have you had any new partners since your last STI test?” I asked.
“There was this one sneaky link,” she said. “But that was last month…”
“A sneaky lynx?” A miniature bobcat flashed in my mind.
She laughed. “A sneaky link. Like a side thing. When my partner and I were on a break.”
“Oh,” I nodded, understanding I was now old, not fluent in Gen Z vernacular.
That night I googled “sneaky link.” Apparently, a song with the same name was released by Hxllywood, Soulja Boy, and Kayla Nicole in October 2021—where had I been these last two years? Urban Dictionary: “When you and another person are f—ing but don’t want anyone to know about it.” Example: “My sneaky link rearranged these guts last night.”
This crude image of internal organ rearrangement evoked Notorious B.I.G.’s 1994 hit One More Chance—where he raps about his lyrical gift, “Hit you with the dick, make your kidneys shift.”
I grew up in the ‘90s and spent many post-school hours glued to channel 21, which in the suburbs of Indianapolis at that time, was MTV. Shows like The Grind, Yo! MTV Raps, and Lip Service filled my afternoons. I masturbated to En Vogue’s Give Him Something He Can Feel, got teary-eyes at Janet Jackson’s Again, and felt confused by what was stacked in the fridge in Dr. Dre’s Ain’t Nothin but a G Thang (it was 40’s—in my defense, I was only nine).
In the ‘90s, rappers weren’t just talking about how to reposition your vital organs with penetrative sex. In Gin and Juice, Snoop Dogg says, “So what you wanna do? Shit, I got a pocket full of rubbers and my homeboys do too.” Later in the music video, Dr. Dre flashes a row of condoms to the camera, passes them off to Snoop as he enters a bedroom full of ladies, and they fist bump. Although the video objectifies women and extols drinking and driving, it made using condoms look cool.
In 1992, the all-girl rap trio TLC came on the scene with their first single, “Ain’t 2 Proud 2 Beg.” In the video, the three women laugh and dance in oversized T-shirts and baggy, neon pants, championing female sexual desire. Lisa “Left-eye” Lopes brandished a condom over the left lens of her glasses, a literal in-your-face nod to using protection, preventing unplanned pregnancy and STIs.
While Snoop and TLC had references to safe sex in their videos, Coolio preached an entire song about the risk of unprotected promiscuity in 1995:
Javier slept wit’ Loopy and Loopy slept wit’ Rob,
Rob slept wit Lisa who slept wit’ Steve and Steve was positive H.I.V.
What started off as a plan ended up in the plot
You betta cool your—off cause it’s too damn hot
These videos came out before 1996 and the innovation of multiple antiretroviral medications, a time when HIV was still considered a death sentence. Fear of AIDS seeped into these hip-hop videos, educating young people and emboldening them to wrap up their hard-ons and find pleasure in safe sex.
They say nothing hits quite like nostalgia. Maybe it’s growing up in this era and the messaging around safe sex that makes me wistful for a time gone by.
In the late ‘90s, despite the efforts of Snoop Dogg and Coolio, I lost my virginity under somewhat lamentable, if rather ordinary circumstances: 16, drunk, at a party. I wasn’t on birth control at the time and though I insisted the guy wear a condom, he claimed he didn’t have one and promised to pull out. Unsurprisingly, he didn’t.
The next morning, I sat at my friend’s kitchen counter discussing my next move. We knew I had to get a Plan B from the teen clinic in town, and to get tested. Our fancy private school started sex education classes in 7th grade and while it obviously hadn’t deterred my behavior, at least I knew how to proceed afterward. Coolio’s ’95 musical lyrics bubbled in my unconscious, along with the plot of Larry Clark’s Kids which I’d secretly snuck into a different VHS box at the video store so I could view the NC-17 content at home (spoiler alert: they all get HIV). Primed with my STI edification from school plus Clark’s terrifying, documentary-style film, I mentally prepared myself for the fate I deserved: to get knocked up and die of AIDS before my 18th birthday.
That’s not what happened though. I took the morning after pill and didn’t get pregnant. I miraculously didn’t acquire any STIs.
The local clinic sent me away with pamphlets, free condoms, and the feeling that I wasn’t the stupidest person in the world. I stored the condoms in a tin lunchbox from Urban Outfitters, so if I ever had sex again, I would be prepared. I’d gotten a peek into the complicated and contradictory aspects of human sexual behavior: intellectually, I didn’t want to have unprotected sex with a near stranger—and yet, I had.
It was undoubtedly this pivotal experience that led me to do the work I do now: prescribing contraception, treating STIs, providing abortions.
Driving down Grand Avenue in Oakland last week, a new billboard caught my eye: “DRUG-RESISTANT GONORRHEA ALERT!” it warned in all caps. In the background, a painting of the Titanic striking its ill-fated iceberg—plumes of smoke drifting into the blue sky, the ominous ice descending deep below the water’s surface to the tag: freeSTDcheck.org. A month earlier, the same advertising space had touted a spaghetti-covered infant, smeared with marinara sauce with the question spelled out in pasta noodles “Not ready for parenthood?”: useacondom.com.
Both ad campaigns are brought to you by the AIDS Healthcare Foundation. The cautionary tale of antibiotic-resistant gonococcal infections and unplanned child-rearing from lack of condom use may be a response to the Center for Disease Control’s April 2023 media release, “Calling for more groups from local, healthcare, industry, and public health sectors to contribute to STI prevention and innovation efforts.” The CDC reported an increase in STI rates between 2020 and 2021—overall, cases topped more than 2.5 million—particularly affecting young folks, men who have sex with men, and people of color.
Screening for STIs and managing unintended pregnancy are basic medical care, yet they hover within a sphere that is often socially stigmatized, coated in shame and societal judgment. Patients with cancer or autoimmune diseases usually receive compassion; folks with a positive syphilis test or unplanned pregnancy often receive a shake of the head and a, “You should’ve known better.”
It doesn’t help that we live in a society that’s embarrassed to talk about sexual safety, where sex education is essentially nonexistent in most schools, where people have a hard time saying the word vagina out loud. When I think back on the ‘90s, Snoop and TLC flaunting condoms like badges of cool, I’m nostalgic for sex positivity, framed through a lens of empowerment and prevention.
And yet, even if Hxllywood and Souljaboy were dropping contemporary bangers about wearing condoms instead of promoting sneaky links, I’d still see teens in clinic using the pull-out method and praying to God as their main form of contraception. Even if I send every patient home with a free bag of condoms, I’m not going to single-handedly vanquish gonorrhea.
The best I can do is meet people where they’re at and give them some empathy; I can engage them about their decisions and offer them a few tools to help them have happier, healthier, less-anxiety-inducing sex lives.
I think back to my 16-year-old self in the waiting room of the teen clinic. I imagine how humiliating it would have been for her to have been met with coldness and judgment after an already disappointing first sexual encounter. By creating a sympathetic environment in my clinic, I can transform the space into one where a patient feels relief and care; a place where, even if they didn’t make a choice they’re proud of, they can receive treatment with dignity and compassion. While I can’t speak Gen Z patois, I can still bring the real talk of ‘90s hip-hop anthems like Salt-N-Pepa’s Let’s talk about sex—fostering openness with conversations about pleasure, protection, and consent. Ultimately, even if they never use a condom again, at least they’ll feel safe enough to come get tested and receive the care they need.
*Names, physical characteristics, and other identifying information have been changed to protect patient privacy.
Center for Disease Control and Prevention. “U.S. STI Epidemic Showed No Signs of Slowing in 2021.” 11 April 2023. https://www.cdc.gov/nchhstp/newsroom/2023/2021-STD-surveillance-report.html#:~:text=CDC%20Scientists%20noted%20particularly%20jarring,STI%20prevention%20and%20innovation%20efforts.
Cover Image: by the author