Safer Sex (We Hope)

19 01 2012

Warning: This article contains explicit sexual information. It has been adapted from a piece written for PKIDs’ Pediatric Hepatitis Report. We encourage young people to talk with their parents and healthcare providers about safer sex and abstinence before becoming sexually active. The methods of disease prevention described in this post are not guaranteed to work. You may practice safer sex and still acquire an STD.

Anyone can become infected with a sexually transmitted disease (STD). CDC estimates that 19 million new infections occur each year, almost half of them among young people ages 15 to 24.

Many people are unaware they have an infection. Some diseases that can be transmitted sexually may also be transmitted during the birthing process, or through a blood transfusion. You may be living with hepatitis B or herpes or human papilloma virus (HPV) and not know it.

For maximum prevention, teens and adults should either abstain from sex or always practice “safer sex,” although abstinence is the more sure method of STD prevention.

What Is Safer Sex?

Safer sex means taking action to make sure no one gets their partner’s blood, semen or vaginal fluids in their body. Similarly, safer sex means you make sure your own body fluids don’t enter your partner.

With safer sex, no body fluids enter a vagina, anus or mouth (during vaginal, anal or oral intercourse) or come into contact with mucous membranes, such as around the eyes, gums, or nostrils.

The best way to prevent body fluids from reaching someone during intercourse is to use a condom. A condom is a sheath that fits over the penis. It can be made of latex (the safest condom available), plastic or animal tissue. It is also called a rubber, safe or jimmy.

Today, nearly as many women as men buy and carry condoms. It catches a man’s semen before, during and after he ejaculates. Some condoms have a nipple-shaped tip to hold the semen so it does not spill out.

Experts consistently recommend latex because some animal tissue, such as lambskin, has pores small enough for sexually transmitted viruses or bacteria to pass through. Polyurethane condoms break more often than latex.

A study cited by Planned Parenthood observed heterosexual couples where one partner was HIV-infected and the other was not for an average of 20 months. It found:

  • None of the uninfected partners among the 124 couples who used condoms consistently and correctly for vaginal or anal intercourse became infected with HIV.
  • About 10 percent of the uninfected partners (12 of 121) became infected when condoms were used inconsistently for vaginal or anal intercourse.
  • Of the 121 couples that used condoms inconsistently, 61 used condoms for at least half of their sexual contacts and 60 rarely or never used condoms. The rate of infection was 10.3 percent for the couples using condoms inconsistently and 15 percent for couples not using condoms.

In short, nothing guards against STDs like a latex condom and other safer sex practices. Spermicidal foams and jellies, diaphragms, implants and other devices do not block body fluids and may not kill all of the harmful bacteria and viruses in your partner’s secretions.

The female condom fits inside the vagina like the diaphragm and also covers the vulva. It is a pouch with flexible rings that is inserted into the vagina. It has the advantage of not requiring a man to maintain an erection during use. Although it is not as effective as the male condom, the female condom is an option for women who want some protection against viral hepatitis, STDs and unintended pregnancies.

The birth control pill, IUDs, vasectomies, tubal sterilizations and other methods of birth control offer great protection against pregnancy, but no protection against STDs. Many people use latex condoms along with these birth control methods for the best protection against both pregnancy and sexually transmitted infections.

Even Oral Sex Requires a Condom

Oral sex may not get one pregnant, but it can still transmit disease.

It is safer to put a condom on the penis before beginning oral sex to guard against secretions that may carry infection. It is important not to get secretions or semen in the mouth. A sore throat or small cuts on the gums may serve as entryways for viruses.

Vaginal secretions can also carry viruses, especially if a woman is having her period. Latex condoms can be cut with a scissors up the middle for oral sex on the vulva or anus. Latex dams or squares, which are thicker than plastic wrap and more likely to resist tearing, may be used. Latex gloves also provide STD protection.

Proper Use of Condoms

A condom just might save a life, and should be treated like the valuable tool it is. Store condoms in a cool, dry place. Long exposure to air, heat or light makes them more breakable. Do not store them continually in a back pocket, wallet, purse or glove compartment.

Check the expiration date to make sure the condom is fresh and safe. Throw away condoms that have expired, been exposed to heat, carried around in a wallet, or washed in the washer or dried in the dryer. If they appear dry, stiff or sticky, toss them. If there are any doubts about a condom, buy a new one.

Condoms usually come rolled into a ring shape. They are individually sealed in aluminum foil or plastic. When opening the condom package, do it carefully to avoid tearing the condom.

To minimize mistakes, both partners should know how to put on and use a condom. Planned Parenthood Federation recommends learning in a safe place free of pressure or frustration. Practice on one’s own penis or on a penis-shaped object like a ketchup bottle, banana or cucumber.

To ensure maximum protection, never use a condom twice and always put a new condom on an erect penis before there’s any genital, anal or oral contact.

If intercourse has already begun, pulling out and putting on a condom right before ejaculation may be too late for protection against STDs and pregnancy.

The male should put on a condom as early as possible at the very beginning of sex play rather than waiting until his partner is ready for penetration. It’s also a good idea to have extra, new condoms around in case a condom is put on too soon or if he loses his erection.

A condom is like a sock, with a right and wrong side. First, unroll it about half an inch to see in which direction it is unrolling. Then put it on. If a male has not been circumcised, pull the foreskin back first. It should unroll easily down the penis. If it starts off on the wrong side, try again with a new condom. Don’t be afraid to practice ahead of time.

Hold the tip of the condom gently between the fingers as it rolls down. This keeps out air bubbles or pockets that can increase the chance of a condom breaking. It also leaves space at the end for the semen. Roll the condom down as far as it will go.

Anal intercourse increases the chance of STDs tremendously, because there can be small tears or bruises in the anus during sex, which makes one tremendously vulnerable to bloodborne infections like viral hepatitis and HIV.

For anal intercourse, lots of lubrication is helpful. Using a water-based lubricant is also helpful for vaginal intercourse. The lubricant goes on after the condom is put on, not before, or else it could allow the condom to slip off easily. Add more lubrication often. Dry condoms break more easily than properly-lubricated ones.

Using lubricant will make things go smoother and give added protection. Lubrication is especially helpful for women when they have intercourse for the first time, or if there is a tendency for soreness.

Always use a water-based lubricant (such as KY Jelly, Astroglide, Aqua Lube, Wet, Foreplay, or Probe) because oil breaks latex. Don’t use vaseline, hand creams or lotions as a lubricant. Also, treatments for yeast infections may contain oil and may break latex.

After ejaculation, hold the condom at the bottom of the penis so it doesn’t slip off. Try to pull out while still erect or hard. The condom comes off only after the penis is completely out of the partner.

Use a condom only once.

Never use the same condom for vaginal and anal intercourse.

Talk Contraception Before the Heat of the Moment

It may be embarrassing to talk to a partner about contraception and condoms, but it’s essential, and should be done before a sexual situation begins. Don’t wait until the heat of passion takes over. It can overwhelm good intentions.

Be honest about feelings and needs. Silence is not a virtue in this situation. Talking about condoms will make it easier for both partners. It can help create a relaxed mood and make sex even more enjoyable and safe.

Embarrassment should not become a health risk and increase chances of infection. It’s important for partners to be open and share health concerns and sexual health history.

By PKIDs staff





Safer Sex

23 05 2011

Warning: This article contains explicit sexual information.  It is intended for the sexually active and those intending to become sexually active. The only way to make sure you won’t get an STD is to not be sexually active.

More than 65 million people—about one in five Americans—are believed to be infected with an incurable sexually transmitted disease.

Safer sex practices allow partners to reduce (but not eliminate) their chance of an infection from sexual activity.  The basic rule for safer sex is to prevent contact with genital sores and prevent the exchange of body fluids, such as semen, blood and vaginal secretions.

The best way to prevent body fluids from reaching someone during intercourse is to use a condom.  A condom is a sheath that fits over the penis.  It can be made of latex (the safest condom available), plastic or animal tissue.

Experts consistently recommend latex because some animal tissue, such as lambskin, has pores small enough for the hepatitis B virus, HIV and other sexually transmitted viruses or bacteria to pass through.  Polyurethane condoms break more often than latex.

The birth control pill, IUDs, Norplant, Depo-Provera, vasectomies and tubal sterilizations offer great protection against pregnancy, but no protection against hepatitis viruses and STDs.  Many people use latex condoms along with these birth control methods for the best protection against both pregnancy and sexually transmitted infections.

Oral sex may not get one pregnant, but it can still transmit disease.

A condom just might save a life, and should be treated like the valuable tool it is.  Store condoms in a cool, dry place.  Long exposure to air, heat or light makes them more breakable.  Do not store them continually in a back pocket, wallet, purse or glove compartment.

Check the expiration date to make sure the condom is fresh and safe.  If there are any doubts about a condom, buy a new one.

To ensure maximum protection, never use a condom twice and always put a new condom on an erect penis before there’s any genital, anal or oral contact.

A condom is like a sock, with a right and wrong side.  First, unroll it about half an inch to see in which direction it is unrolling.  Then put it on.  If a male has not been circumcised, pull the foreskin back first.  It should unroll easily down the penis.  If it starts off on the wrong side, try again with a new condom.

Hold the tip of the condom gently between the fingers as it rolls down.  This keeps out air bubbles or pockets that can increase the chance of a condom breaking.  It also leaves space at the end for semen.

If using a lubricant, make sure it’s water-based because oil breaks latex.  Don’t use vaseline, hand creams or lotions as a lubricant.

After ejaculation, hold the condom at the bottom of the penis so it doesn’t slip off.  Try to pull out while still erect or hard.  The condom comes off only after the penis is completely out of the partner.

Use a condom only once.  Never use the same condom for vaginal and anal intercourse.

It may be embarrassing to talk to a partner about contraception and condoms, but it’s essential, and should be done before a sexual situation begins.  Don’t wait until the heat of passion takes over.  It can overwhelm good intentions.

Be honest about feelings and needs.  Silence is not a virtue in this situation.  Talking about condoms will make it easier for both partners.

Embarrassment should not become a health risk and increase chances of infection.  It’s important for partners to be open and share health concerns and sexual health history.

This is one in a series of excerpts from PKIDs’ Infectious Disease Workshop. We hope you find the materials useful – the instructor’s text and activities are all free downloads.

Photo credit: music2work2





Life On a Blog

24 03 2011

image by inju

Blogging is therapeutic. For those living with or affected by infectious diseases, it can be a way to connect with those whose lives mirror their own.

Brooke Davidoff, diagnosed HIV positive in January 2010, blogs about her life as a newlywed and a first-time mom. Brooke’s life turned upside down during her pregnancy, when she had a routine blood test for HIV and discovered she was positive. “If there was no baby, I’d still have no idea,” she blogged. 

Brooke started blogging “. . . to express myself, I don’t know how not to. When I was diagnosed, I searched for stuff written by other HIV positive females to relate to, and I had a very hard time finding what I was looking for. So I began to write it for other women like me who needed to know they are not alone.”

Sabina is a 15-year-old girl who loves volleyball and dancing. She’s slogging through a year of treatment for hepatitis C and blogs about it “. . .  to share my experience of HCV treatment for children or adults who are starting or already started their treatment. I know that treatment can be difficult and painful, I would just like to give another perspective. I just want to help out and be there for other kids or adults.”

Elizabeth Boskey, PhD, MPH, calls on her education and research experience each time she blogs about STDs. Ever the teacher, Elizabeth says, “There is a lot of secrecy and stigma surrounding STDs. I blog about STDs not only to address the misconceptions about them, but to make them a topic of discussion.

“Some people think that having an STD means that they’re dirty or ruined, that infection marks them as a slut or somehow undesirable—all of which is ridiculous. Still, these feelings are common in people who have had bad experiences disclosing an STD to a partner, or who have simply internalized the stigma that is widely present in American society.

“People make jokes, and not kind ones, about STD infection, but the truth is that STDs are just diseases like any other. Yes, they are often preventable, and people should do their best to prevent them, but acquiring an STD doesn’t make you a bad person.”

Are you ready to blog?
It’s easy to get started. There’s no cost, other than your time, and, if you’re speaking from personal experience, what it costs you to speak from your heart.

Brooke blogs to share with women like herself, and to let her friends and family know that she’s OK. “I think I’m helping other people feel more normal…the stigma hopefully will diminish in time.”

Blogging can be a positive experience, but there are emotional risks.

“I think that if more people blogged about STDs it might help reduce some of the stigma associated with them,” says Elizabeth. “However, I think it’s important to acknowledge that doing so is not without risks. Publicly acknowledging an STD infection may change the way that people around you treat you. It may even affect your employment—although it shouldn’t.”

Boundaries
It’s OK to not share every single thing in your life. Write honestly, but don’t fret about keeping some details private. It is your life, so you define the boundaries beyond which you’re not comfortable sharing.

Readers
If you write about it, they will come, but be prepared for the readers’ thoughts that may cascade upon you. Some comments you’ll treasure and some, well, let’s just say they’ll raise the eyebrows.

“I check daily for new comments and emails,” says Brooke. “The ones that touch me the most are people who found out the same way I did, or the ones who decided to have a baby after reading my story.”

There’s a yin yang to blogging, as there is elsewhere in life. Be prepared for the nasties you’ll find in the comments section of your blog.

“Although blogging can be a wonderful way to gather personal support, it may also have less positive results,” explains Elizabeth. “Comments can be negative, or even cruel and vindictive. It may be worth blogging anonymously if you are concerned about your privacy and the ramifications for exposure in your daily life; however, it is very difficult to ‘guarantee’ that your identity will not become known. This is particularly true if you are discussing sensitive issues such as those involving your sexuality.”

Last words
Bloggers always get the last word, and that’s no less true for our guests today.

Brooke on HIV: I live a normal life other than taking pills every day. I’m waiting to see what the disease does to me. I think all of us sit and wonder when it’s going to kick in, and what it’s going to do.
If you’re having unprotected sex, get tested. You never know. There are really no symptoms that would lead you to get the test, it’s better to know and get on meds now than find out when it’s too late and you’re really sick.

Sabina on HCV: [I want people to know] that we’re not harmful to others as long as we don’t share blood transferring items, such as razors, and toothbrushes. And that having HCV [hepatitis C virus] doesn’t set you apart from others even though it’s a serious virus.

Elizabeth on STDs: I don’t think you have to blog about STDs to help destigmatize them. Make a point of having open and honest discussions of sexuality with your partners and your family. Don’t allow people to get away with making cruel comments about infectious diseases or even “cute” jokes. And, finally, remember that a lot of the stigma surrounding STDs has to do with ignorance. Educate yourself—about how common STDs are, about testing, and about prevention—so that you can educate the people around you.





Herpes – Even If You Can’t See It

8 02 2010

Genital herpes is a sexually transmitted disease (STD) most often caused by the herpes simplex virus type 2 (HSV-2).

About 45 million people in the U.S. over the age of 11have been infected. When a person becomes infected with the virus, it causes lesions in the genital area. Once a person is infected with HSV-2, there’s no way to get rid of it. The body carries the virus forever, although there may not always be symptoms.

Scientists used to believe that the life cycle of the virus in the body moved through stages of activity and inactivity. When the virus was active, it caused genital lesions. When the lesions went away, the virus was considered inactive.

Newer evidence suggests the virus may not ever be completely inactive. Now scientists believe that the virus continuously sheds small amounts of itself to the genital area along the nerves from the spinal column, even when lesions are not present.

This information suggests that people may be more contagious during “inactive” times than previously thought. Use of condoms can help prevent transmission, but it’s still possible to become infected when using a condom. Even though there are treatments available that help reduce transmission, there’s nothing that provides 100% protection against infection.

Herpes can be painful, and it can be life-threatening to newborns. Practice safe sex to give yourself the best chance to avoid this and other STDs.

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