People Drop the Ball When It Comes to Safe Sex on New Year’s Eve

A new study in the annual BMJ Christmas issue suggests high levels of unprotected sex during New Year’s Eve celebrations in the U.S., with an increase in sales of levonorgestrel (Plan B) in the week after that surpasses other holidays.

In this video interview, study author Brandon Wagner, PhD, of Texas Tech University in Lubbock, discusses the research.

The following is a transcript of his remarks:

The paper that we’re talking about explores how emergency contraception sales in the United States increase following certain holidays — in particular, New Year’s Eve.

We find, essentially, a big jump. Every year there’s a substantial increase in that week that follows New Year’s Eve. This is kind of consistent with the timeline when it’s effective to take levonorgestrel — 96, possibly 120 hours after unprotected sexual intercourse, though sooner is obviously better. So looking at this weekly data, we find that the weeks that follow New Year’s Eve have this kind of substantial increase.

Just as an idea of trying to understand what it was about New Year’s, we looked at some other holidays as well. Like we looked at a similarly romantic themed holiday, Valentine’s Day, and you see an increase — about half as much.

We looked at holidays where lots of people are drinking and you might expect that any sex is less likely to be protected — those are St. Patrick’s Day and the Fourth of July. And you see an increase, but again, nowhere near as much — which kind of leads us to think that there’s just something about the combination of all the factors for New Year’s that leads to high levels of unprotected sex.

Reports from people around the United States suggest that people have intentions or at least end up having sex following New Year’s. Not just that though, because of high substance consumption — like a lot of drinking, cheering in the New Year — lots of drinking is normally associated with less likelihood to use contraception, or if you use it, less likely to use it correctly. So you might not remember to get a condom, but if you get one, you might not remember to put it on correctly.

The third issue is New Year’s Eve celebration is a late-night celebration, right? So when you’ve closed down the bars, if you will, there’s not a lot of places open if you do need to stop and get contraception if you don’t have it on hand.

Then finally, the last issue is that there are relatively high rates of sexual assault reported on New Year’s, and in cases like that, contraception is often less common to be used. So those are the four factors that led us to investigate whether there was this particular surge in sales following New Year’s in the U.S.

It’s hard to talk about implications of reproductive rights access in the U.S. without acknowledging the dramatic sea change that we’ve seen in the last year or so. Increasing abortion restrictions following the Dobbs v. Jackson decision in 2022 mean that, as we have argued in our paper, emergency contraception is increasingly important for preventing unwanted pregnancies. Our results and what we’re finding here are really consistent with documenting substantial increases in unprotected sex during these particular holiday periods.

These are the kinds of things that should draw attention to — how can we meet the need for contraception in these periods? How could we increase provider availability? How could we make sure that people have contraceptives on hand and the wherewithal to use them correctly, or depending on the method, not having to do something in the moment to use them correctly? Those are the kinds of implications that we’ve tried to draw attention to in our work.

I think that what we’ve tried to do in the paper, and what I try to do more generally in my work, is think about these problems, think about these situations as a rising in influence by a variety of factors. So we’ve talked a little bit here about how providers can play in, but this is a story that has lots of different components, right?

It has a story about how do people get access to these and whether they can use insurance or how much does it cost? It has a story about [how] levonorgestrel is not effective for every individual, every person at risk of pregnancy. Other forms are harder to get access to; they require prescriptions or they require clinician visits.

So in some ways this is a story that has lots of different components. Trying to tackle this requires us to think systematically from lots of different perspectives.

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