The ABC’s of STD Prevention

Posted on July 30, 2014 by

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

When it comes to STD prevention purposes, what defines safeOne of the most concise mnemonics for STD prevention is the ABC Rule (one of the most basic ways couples can have safe sexual experiences and healthy sex life).

  • Abstain from sex
  • Be faithful if you don’t abstain
  • Use a condom if you aren’t faithful
A roadside sign in Botswana promoting the ABC approach.

A roadside sign in Botswana promoting the ABC approach.

As simple as this may seem, it is not well understoody by some. Let’s break it down…

Abstain from sex: This means ‘not engaging in any form of sexual practice with a partner’. The notion of abstinence is misinterpreted by a lot of people to mean not performing any sexual practice that could lead to pregnancy (vaginal intercourse), while some include abstaining from any penetrative sexual practice (both vaginal and anal intercourse). This, therefore, gives room for oral sex for abstinent individuals. However, STDs like Syphilis, Gonorrhea, Human Papilloma Virus (HPV), Herpes and Hepatitis can be contracted through oral sex. I do get a surprised look from teens and young adults when I say that like vaginal sex, oral sex should be performed with protection because of risks of contracting an STD.

Be faithful: It takes two to tango, so the saying goes. Two partners who are in a monogamous relationship and want to start a physical relationship should consider the following:

  • A consentual decision to start a sexual relationship
  • Undergoing testing for STDs including HIV
  • Using a reliable contraceptive method that works best for them (if they are not planning to get pregnant)
  • Working on maintaining a faithful monogamous relationship with your partner

Here comes the twist, the definition of being faithful also varies depending on whose point of view you are looking at it from. By definition, being faithful, with regards to safe sex, refers to not being sexually involved with anyone except your partner. Since we know that STDs can be contracted through oral sex, and use of barrier methods (condoms) isn’t 100% effective, it is imperative that partners who practice ‘Being Faithful’ as their method of STD prevention do so in the strictest way possible.

Please remember we are all humans and we all can make mistakes, it is advisable to have routine STD including HIV testing, health screenings and see your physician if you have any symptoms or concerns.

Use a condom: If you choose not to be abstinent and are unable to be faithful to your partner, it is advisable to use a condom with all your sexual partners. Latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV, the virus that causes AIDS. In addition, consistent and correct use of latex condoms reduces the risk of other sexually transmitted diseases (STDs), including diseases transmitted by genital secretions, and to a lesser degree, genital ulcer diseases. Incorrect and inconsistent use of condoms increases risk of contracting STDs including HIV.

Condoms should be used during vaginal, anal, and oral sex and also when sharing sex toys (condoms should be changed before use by each partner). Condoms should be properly stored, expiration date checked before use, and the right steps followed when putting on, using, and disposing of used condoms.

It’s important to note that condoms offer protection over areas where it covers and offers lesser protection against genital ulcers and bodily secretions outside this area.

What do you think of using the ABCs for STD prevention?

Ruby Rose > Star Trek

Posted on July 28, 2014 by

A few weeks ago, while fleeing Florida’s sticky summer, I went up north to visit with family. I’m lucky: they’ve all been very supportive ever since I came out to them ages ago. But generally speaking, they aren’t all that interested in issues of gender and sexuality – topics that are pretty much always going to come up when we’re talking about my life, given that they’re a big part of my work. So it’s always interesting to dive into those conversations and rediscover what’s common knowledge, and what isn’t.

One example was a conversation that my aunt and I had about trans* issues one day. She was genuinely confused at the thought that someone could transition and then be gay – if you were attracted to the “right” gender before transitioning, then wouldn’t it be easier to stay as the gender you were assigned at birth, so that you’d have an easier time of things?

To her credit, she’s got an open mind, and we had a long talk about how gender identity, gender presentation, and sexual orientation are all separate aspects of a person, and how nonbinary identities enter into things. While I really did appreciate her willingness to explore ideas that were new to her, I was also pretty surprised at how firmly she’d linked gender with sexuality.

But then a Star Trek episode, of all things, brought it into clearer focus.

In nostalgically re-watching Next Generation episodes, I came across “The Outcast,” which focuses on a society without biological sex where everyone is (supposed to be) gender neutral. However, some folks find that they identify as a particular gender and are attracted to particular genders, but anyone who’s open about is is forced to undergo “reparative therapy,” which will make them conform.

At first, I remembered how powerful it was to see this back in the early 90’s, since the references to LGBT issues were clear even to my little closeted self. But then I was also rather appalled at how sloppily it was written. The episode completely conflated gender identity and sexual orientation: a fundamental aspect of all people who identified as female was that they were attracted to males, and the reverse for those who identified as male. (Genderqueer or pansexual identities were totally absent.)

Now, even though my family are a pretty geeky bunch, I don’t want to oversell the importance of this one hour of TV from 20+ years ago. But if you don’t think about gender often, then an old TV show can end up being one of a small number of reference points that you have.

rubyroseSo where does Ruby Rose fit into all of this? Her recent video “Break Free” explores trans* issues, it’s visually captivating, and it’s getting shared a lot on Facebook. It’s different from “The Outcast” in a ton of ways, but I’m particularly struck by the fact that it shows just how many more opportunities there are for folks to engage with these issues now, even if it’s not something they’re specifically seeking out.

I know I’ll always be in a bit of a bubble around these things compared to much of my family, but it’s heartening to see that the walls of that bubble are becoming thinner and thinner, with a lot more permeability.

The Vaccine That Prevents Cancer

Posted on July 23, 2014 by

cancerIt is time to discuss the Human Papilloma Virus (HPV) and the vaccine that helps prevent it (again). I recently took my son to the pediatrician and noticed several Gardasil pamphlets on the rack. When the doctor entered the room I asked how many parents have had their children vaccinated. He stated that it is a mix and many parents still have misinformation on vaccinations of any kind. Some parents are also concerned about giving their child something that protects against an STD. They have a hard time wrapping their head around the idea of giving a (sexuality-related) vaccine to their 11-14 year old (it is recommended at 11-12 for both boys and girls) and feel like they have to go into detail on why they are receiving the shots. The vaccine is intended for children in order to prevent infection and possible cancer later in life.

Parents can give as little or as much information as they want on the details of HPV. Human papillomavirus (or HPV) is a sexually transmitted infection that can lead to cancer of the cervix, throat, vulva, vagina, penis, and/or anus. The HPV vaccine was introduced in the US in 2006 and has helped to decrease the HPV rate among teenage girls by 56 percent. However, we can’t celebrate yet. Nationally, 33 percent of girls ages 13 to 17 and only 7 percent of boys in the same age range have received all 3 of the recommended doses. HPV is now the most common STD in the U.S. and the major cause of cervical cancer.

Facts about HPV:

  • Nearly all sexually active people will contract a form of HPV at some point in their lives.
  • There are over 100 types of HPV, but the 4 strains that the vaccine protect against (are responsible for 70 percent of the cervical cancer cases and 90 percent of the genital warts cases
  • Approximately 360,000 people in the United States get genital warts each year.
  • More than 10,000 women in the United States get cervical cancer each year.

How to help prevent HPV:

  • Get vaccinated if your under 26.
  • Use condoms.
  • Limit your number of sexual partners.
  • Get a regular pap test (starting at age 21).

Need to schedule an appointment for the vaccine or for a pap test? You can get both at Planned Parenthood!

Worried About Results?: 5 Steps for Taking Care of Yourself While Waiting for Medical Results

Posted on July 21, 2014 by

anxietyWe all know – tests can be anxiety inducing. This is especially true for tests that involve our health and our body, such as STD tests and pregnancy tests. Perhaps it’s too early for you to take one of these tests. Maybe it hasn’t been long enough since the sexual encounter occurred for you to get accurate results on a pregnancy or STD test. Perhaps you’ve already taken the test, and you’re just waiting for the results to come in. Here are some important steps for keeping yourself calm, and getting through until you get your test results.

1. Recognize that you are taking the appropriate steps for your health.

It’s important to remember, though it can be scary to wait for a test result, you are doing the right thing for yourself. You have already made the decision that knowing what is going on with your body comes ahead of living in ignorance, and that’s important. You’ve taken a huge step and that is something you should commend yourself on. You have shown that you have what it takes to face your fears, and that is a huge accomplishment.

2. Do something you enjoy to take your mind off of the situation.

Do you enjoy exercising? Taking long walks? Hanging out with friends? Reading a great book? Watching a new show on Netflix? Now is a good time to do what you like to keep yourself calm. Make a nice meal, do something fun, try a new activity! Distracting yourself from your fears by doing anything positive that will take your mind off the situation is a great way to cope right now. If it is too early for you to get tested or to know the result, there isn’t much you can do in the meantime. Waiting is a very scary part of the process, and whatever you can do to distract yourself from thinking about something you can’t currently control is great!

3. Constructively engage your emotions regarding your potential results.

Perhaps you’ve tried to disengage from the stress of waiting by distracting yourself, but you just can’t seem to do it! It might be a good time to sit in your emotions, and examine how and why you are feeling the way you are. Instead of just falling into negative emotions, however, try to constructively work through what you are feeling. Creative outlets are a great way to do this: you can try painting, drawing, or writing creatively. If you’re not feeling the creative outlets, you can also try journaling. Journaling is a private and simple way to map out your feelings and fears.

4. Talk to a trusted confidant about your feelings.

While working towards eliminating the negative side effects of stress on your own is a great start, you might be someone who needs the support of another to feel better. There is absolutely no shame in having someone close to you to rely on when you are having a difficult time. If you have someone in your life you feel safe sharing your fears with, confiding in them might be a great way to make yourself feel better. They can give you support and a shoulder to cry on. Many people also have their own story related to a sexual health scare, and they may be able to relate to you!

5. Remember that your have options, no matter the outcome.

Getting diagnosed with an STD can be a scary experience. And while finding out you are pregnant might be wonderful for some, there are other people who aren’t ready to be pregnant yet. For them, an unplanned pregnancy can be a terrifying experience. Before you know your results, you may be thinking about the absolute worst case scenario. However, it is important to remember that there are appropriate ways to deal with every possible outcome. Many STDs are entirely treatable, while ones that aren’t are becoming more and more manageable as medical technology advances. If you find out that you are carrying an unplanned pregnancy, there are non-judgmental professionals who can help you figure out your best option – whether it be parenting, adoption, or abortion. There are many caring professionals in the world who are ready and willing to help you with whatever outcome your tests reveal. Just reminding yourself that there are people out there to support you, even in the worst case scenario, can be a major relief.

Unlocking the Secrets of the Placenta

Posted on July 16, 2014 by

This week, The New York Times published The Push to Understand the Placenta. You must read it – it’s as fascinating as the placenta itself!

Ifetus2f you’re unfamiliar with the placenta, let us educate you. The placenta is the organ that forms and attaches to the inside of the mother’s uterus during a pregnancy. One side attaches firmly (we hope) to the uterine wall and the umbilical cord, which is connected to the baby’s belly button, extends out of the other side. Size-wise, the placenta is about the same diameter and thickness as a small to medium pizza crust. Or if you extend your hands out in front of you, fingers extended, with some overlap, you’ll get the general size of the placenta. The basic function of the placenta is to deliver oxygen (via blood) and nutrients to the developing fetus, and also to carry out waste. The placenta provides life support to the fetus placentaand if it malfunctions, results are often fatal. In this image you can see the web of blood vessels that form to sustain life.

The placenta is commonly referred to as afterbirth, well, because, it comes out after birth. After the baby is delivered and the uterus slowly starts to shrink down, the placenta starts to detach from the uterine wall. Uterine contractions and external abdominal massage from the doctor/midwife/nurse help the placenta continue to detach. The placenta will come out on it’s own time, often 5-20 minutes after birth. Sometimes the doctor will grab the umbilical cord and give it gentle tugs, but it CAN NOT be yanked out prematurely (hemmoraging is sure to occur). The placenta is utterly fascinating to see in person so if you’re giving birth soon, be sure to ask to see it! Unless you ask to keep your placenta, it will become medical waste. Why would you keep it? Well, some cultures bury it for spiritual reasons and some people it eat it.

So what secrets are left to be unlocked? Only recently, for instance, did scientists start to suspect that the placenta may not be sterile, as once thought, but may have a microbiome of its own — a population of micro-organisms — that may help shape the immune system of the fetus and affect its health much later in life.

Perhaps the Human Placenta Project will shed more light on “the least understood human organ[s] and arguably one of the more important, not only for the health of a woman and her fetus during pregnancy but also for the lifelong health of both.”

There’s a lot to learn and we can’t wait to hear what scientists discover!

Birth Control Sabotage

Posted on July 14, 2014 by

Many people find themselves in relationships that are not what they anticipated. No one starts out being a bully or abusive, but it’s all too common for coercion, manipulation, control to slowly creep into what appeared to be a healthy, romantic, loving partnership. You would hope if people realized someone was trying to control them or signs of abuse started showing up they would end the relationship before it progressed to physical or emotional abuse or before children came into the picture, but often excuses are made, emotional ties are too strong, or fear of retaliation comes into play. It’s complicated.

imagesOne of the ways most people don’t realize abuse can manifest itself involves birth control. While this usually happens with males trying to control a woman’s birth control, females sometimes try and sabotage his as well by poking holes in condoms or saying she is using contraception when she isn’t. In cultures where the expectation is that the male makes all the decisions, some women acquiesce to his desire to have a child or more children. I’ve heard so many times, “He doesn’t want to use a condom or for me to be on birth control.” He may throw out her birth control, poke holes in a condom, pretend to wear a condom, refuse to pay for birth control or take her to an appointment.

In cases where the female does want to use birth control without a partner’s knowledge, there are a few options.

Depo Provera – A shot every three months. However, she still needs to be able to get to an appointment and her period will most likely stop.

The Implant – Once inserted into the upper arm, bruising may appear for a few weeks. After that has disappeared, unless someone goes looking for it, it should be invisible. It provides protection for 3 years.

IUD – There are 3 types of IUDs that are effective from 3 to 12 years. Occasionally a partner may feel the strings at the top of the vagina.

Emergency Contraception – Available at health departments, Planned Parenthoods or over-the-counter, this may be a temporary fix but not a long term solution.

For more information on birth control methods, visit Planned Parenthood. To read another great article on birth control sabotage, visit this website. If you’re in an abusive relationship, please reach out to The National Domestic Violence Hotline.

Herpes Myths – Busted!

Posted on July 9, 2014 by


Herpes is very common.

TRUE! More than 50 percent of the adult population in the United States has oral herpes (a.k.a cold sores or fever blisters). Most people become infected with oral herpes as a child when grandma or Aunt Sue kisses them on the mouth when they were unaware they were contagious. According to the Centers for Disease Control and Prevention (CDC), about 16% (one in six) persons ages 14-49 in the United States has genital HSV-2 infection; however, as many as 90% are unaware that they have the virus.

If you wear a condom you can’t get herpes.

FALSE! Condoms give great protection against the STD’s spread by fluid (vaginal fluid and semen) and help reduce the spread of Herpes, but unfortunately condoms do not cover all of the genital skin. Herpes is transmitted through direct genital skin-to-skin contact.

Anyone who is sexuality active can become infected with Herpes.

TRUE! While it is more easily spread from males-to-females versus female-to-male, anyone can become infected. That’s why more females (21%) have HSV-2 than males (11.5%).

Herpes can only be spread when someone has an outbreak.

FALSE! Someone can be asymptomatic (have no symptoms) but have viral shedding on the mouth or genital skin. This means that the virus can be spread at any time. 

You can get herpes from a toilet seat.

FALSE! There are no documented cases of anyone getting genital herpes from objects such as a toilet seats, bathtubs, or towels. Herpes is a very fragile virus and dies quickly outside of the body.

Herpes tests can determine where you will have an outbreak.

FALSE! There are several different tests (viral culture, DNA, and blood tests) that can be performed by a medical provider, but they cannot tell you when you will have an outbreak or where it will occur. For more information on Herpes visit this website.