Category Archives: Sexually Transmitted Infections

Sexual Behaviors: No Risk…Some Risk…Risky


Posted on February 13, 2013 by

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An important part of my job as a sexual educator is informing people about the risks of various sexual activities and giving them the knowledge to make informed decisions. One of the ways to look at sexual behaviors is to place them on a spectrum ranging from no risk to high risk.

safe to unsafe postcardNO RISK
Activities that involve NO exchange of body fluids released from the genitals or skin to skin genital contact fit in this category. While saliva can spread the flu, a cold and mono, as long a neither party has oral herpes, you can kiss to your heart’s content. Mutual masturbation is about as safe as things can get and still involve genital contact. Good old humping, bumping, grinding, dirty dancing, anything with clothes is no risk. Showering together, erotic massage are acceptable as long as things don’t slip on over to other higher risk activities.

LOW RISK
Here’s where protected sexual activity comes into play. We’re talking oral, anal and vaginal intercourse. Think barriers. It could be a male or female condom. Plastic wrap or latex dental dam type protection for oral sex on vulva or anus. Slightly riskier is oral sex without a barrier.

HIGH RISK
Any vaginal or anal sex without a barrier puts you at high risk for STIs. Using drugs or alcohol can easily cloud your ability to make good decisions. Any activity that involves the possible exchange of blood is also right up there, including menstrual blood.

Any sexual activity can have some risks, but you can greatly reduce your chances of spreading or contracting an infection by knowing how to wrap it up, cover it up or just think of something else to do! (We’ve got plenty of suggestions for you!)

SANE: Sexual Assault Nurse Examiner, and How They Can Help You


Posted on February 12, 2013 by

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SANE programAfter experiencing a sexual assault a hospital is often the first place the victim goes for help and medical services. Unfortunately, a hospital is not always well-equipped to provide services for a rape victim. Often they experience long wait times in a busy and crowded place, their trauma is seen as less important than other patient’s trauma, the staff is not sufficiently trained in the type of examination needed for forensic evidence, and worse, the staff may be unsupportive and even judgmental of the victim (from a report by the US Department of Justice.)

The SANE program was created to combat this issue and provide a safe and competent way for the sexual assault victim to receive the care they need. “Sexual Assault Nurse Examiners (SANE) are registered nurses who have completed specialized education and clinical preparation in the medical forensic care of the patient who has experienced sexual assault or abuse.” Planned Parenthood of Southwest & Central Florida operates a SANE program in our private health center in Manatee County, allowing rape victims to receive their care in a quiet, private environment. Typically, the person is referred to the SANE program by police or paramedics, and brought to the center. There, the nurse examiner provides the exam, which in general consists of “the medical forensic history, a detailed physical and emotional assessment, written and photographic documentation of injuries, collection and management of forensic samples, and providing emotional and social support and resources.” After the exam, the nurse also ensures the integrity of the samples is maintained so that they are admissible in court, and may testify in legal proceedings related to the examination.

Overall, the SANE program provides many services: professional forensic evidence collection, documentation, and preservation of evidence, screen for and prophylactically treat for sexually transmitted infection, evaluate for pregnancy risk and offer prevention, document and care for injuries, refer for followup medical care and counseling, and aid law enforcement in prosecution. All of this is done in a private, supportive and nonjudgmental environment by a professional who is trained to provide specialized care.

It should be noted that the program is geared towards prosecution of the rapist, and if the victim is not interested in filing an official report she will be encouraged to discuss her reasons with the nurse examiner. SANE often encourages the victim to go through the criminal justice process. For a lot of victims, going through the process of reporting the rape and dealing with the legal process is stressful and potentially harmful (personally or professionally), and so many rapes are not reported. Still, the SANE program is a more private and emotionally supportive way to receive medical care, pregnancy prophylaxis, STI testing, and other resources after a sexual assault.

Links We Love in Sex & Health: Thursday Edition


Posted on February 7, 2013 by

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Brendon Ayanbadejo, Feronia's new hero. Photo copyright Keith Allison.

Brendon Ayanbadejo, Feronia’s new hero. Photo copyright Keith Allison.

Happy Thursday, Feronians! We’re sharing some of the best links in love and sex that we’ve found around the web:

What have you seen lately that’s interesting in love and sex? We’d love to hear about it! And do you love Brendon Ayanbadejo or what?

Redefining SEX


Posted on January 23, 2013 by

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So you switched birth control methods, forgot a condom, met a stranger you just could’t resist, were under the influence of drugs or alcohol, or any of the other excuses people use when they don’t have protection, but still want to have sex. I suggest you redefine your definition of sex.

Many people have a very narrow definition of sex. They think if there is no penis in a vagina, it’s not the real thing. People in same gender relationships learn early on that sex involves much more than just those body parts.

Let’s do a basic review of what we don’t want in our body from someone else’s body so we can reduce the chances of pregnancy or STIs. A male’s seminal fluid contains millions of sperm who have one objective: find the egg. They are mobile and motivated! As soon as a male becomes aroused, the Cowper’s gland at the base of the penis releases a drop of fluid commonly known as pre-cum, pre-nut or pre-ejaculatory fluid. This tiny drop may contain sperm, depending on when the male last ejaculated, but it will definitely contain any STI he happens to have. So the thing to remember is that while you can’t become pregnant unless this fluid gets into or near the vagina (remember they can SWIM,  so fooling around just a little is no guarantee a pregnancy can’t happen) this fluid can spread a STI through oral or anal sex.

glandsOn the female side of things, for her to become pregnant she must have released an egg. Although this generally happens once a month around the mid-point between periods, females have gotten pregnant anytime during the month that an egg has been released. Most females don’t know when this is about to happen and the sperm can live in her body for about 5 days just waiting for an egg to be released. STIs live in and near her vagina, so oral sex on a female won’t cause a pregnancy, but it may pass a STI to the mouth.

For most people, a major component of sex is orgasm. While some people may be satisfied with cuddling, kissing and all other assorted foreplay, most people want to COME! So here is where a creative mind is a wonderful thing. Slow down and enjoy some experimentation. Here are a few suggested avenues to explore.

Use Your Hands

The delightful chef Julia Childs said that when cooking, use your hands as tools. I think this is excellent advice for sexual pleasuring as well. Learn to explore your partner in ways you may never have done before. Find sensitive spots you or they may never even knew existed. Try the, “does this feel good?” technique. There is a whole body that is sensitive to touch. Mutual masturbation can also be very exciting with the same result as vaginal sex.

Use Your Mouth

While you do need to be careful about seminal and vaginal fluids of partners whose STI status is unknown or known to have a STI, if you are just trying to prevent pregnancy, oral sex can be a fulfilling alternative. Not sure what to do? Check out this fantastic book The Guide to Getting it On. Their section on oral sex is particularly helpful to beginners.

Use Alternative Body Parts

In various cultures around the world, partners would rub the penis between thighs, breasts wherever else feels good, to preserve a female’s virginity and prevent pregnancy. Similarly, for many females, rubbing whatever feels good against the clitoris can stimulate to orgasm even better than a penis.

Use a “FiFi”

Remember the movie American Pie where the teen uses a warm apple pie to imitate a vagina? I learned about “fifis” when teaching in detention centers. Teens became very creative making fake vaginas and penises out of materials available to them. Especially popular were washcloths and hand lotion!

Use a Sex Toy

There is massive variety of apparatus available that can enhance sexual pleasure (see this previous post for some suggestions). Just be careful not to share anything that can spread fluids between partners. See section one and try the, “does this feel good?” technique here too. Go online or to an adult store and pick something out together. This in itself can be very arousing.

Add Lubrication to Hands And Anywhere Else It Feels Good

Lubricants can greatly enhance sensitivity, especially when using your hands to pleasure someone (check out a previous post about lube).

I’m sure many of you have other ideas to share! Between two (or more) consenting adults, there is no limit to the variety of ways to give and receive pleasure safely. Enjoy!

 

 

 

 

 

 

HIV-Positive? Tips to Help You Talk to Your Partner About Your Status


Posted on December 6, 2012 by

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AIDS Red RibbonA study has found that a “significant number” of teens who were born with HIV are not disclosing their status to their partners. For some, it was because they did not know their status, but others knew and did not tell their partners. This study focused only on teens who were infected before birth, so it does not contain information on teens who became infected through sexual activity. Thankfully, many of the teens who did know their status practiced safer sex by using a condom, but not all of them did.

Not telling your partner not only puts them at risk, but you as well; most states have criminal statutes making it a criminal offense to not disclose HIV status to partners. In Florida, “It is unlawful for any person, knowing him/herself to be HIV positive and knowing the risk of transmission through sexual intercourse, to have intercourse without informing his/her partner of his/her HIV status and receiving consent.”(You can find the full list of state laws here.) This makes it even more important to have the HIV talk with your partner.

If you have HIV and your partner does not, you should know that while there is always a risk of passing on the infection but you can take action to reduce the risk. Aids.gov nails it:

“If you are the HIV-positive partner in a mixed-status relationship, you can lower the risk of transmitting HIV to your partner if you are on anti-retroviral therapy. Taking all your medications, on time, will help to lower the viral load in your body fluids and decrease the chance that you will transmit HIV to your partner. But remember, even if you have a low viral load, you can still transmit HIV to your sex partner. So it is important to always use a condom and practice safer sex. And, if you inject drugs, never share syringes, water, or drug preparation equipment with others since HIV-infected blood can be transmitted through them.
If you are the HIV-negative partner in a mixed-status relationship, talk with your partner about condoms and safer sex practices. If you are in an ongoing relationship with your partner, support him/her in taking all of his/her HIV medications at the right times. This “medication adherence” will lower his/her viral load and reduce the risk that HIV can be transmitted. You may also want to stay up-to-date on developments about pre-exposure prophylaxis (PrEP). Though researchers are not recommending PrEP be immediately used to prevent HIV infection, recent research findings suggest this may someday be another prevention method to be used with – not instead of – condoms, safer sex practices and other HIV prevention methods.”

The article I linked to above notes that most HIV-related sex education focuses on avoiding infection rather than living with the infection, which is an excellent point. Luckily there are organizations out there with good advice on how to talk to partners and family. When you’re ready to have the talk, try HIV.va.gov’s tips for telling your partners and Womenshealth.gov’s advice on telling people you are HIV positive. Make sure you talk to a case manager or counselor first if you are telling a partner and there is a history of violence or abuse in your relationship.

If you’ve contracted HIV, it’s important to talk to your sexual partner(s) about it. It’s not an easy conversation to have but it’s one that will help keep your partner(s) safe and alert to their status.

What to Expect at Your STI Exam


Posted on November 8, 2012 by

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So you’ve made your appointment to get tested for STI’s, and you’re nervous. No worries! It’s actually very easy to get tested. The most common things to get screened for are HIV, syphilis, chlamydia and gonorrhea, and if you have no symptoms you may not even need an exam. If you have symptoms like genital bumps or sores, you may get a physical examination by the practitioner for diagnosis.

Chlamydia and gonorrhea are often tested for together. They can now be tested for with a simple urine test, no exam needed. It’s important to not urinate for at least an hour before your appointment and follow the instructions for the urine sample precisely, because an incorrect sample can make the test inaccurate. If you have a vagina, you can also do a self-obtained vaginal swab or have the practitioner swab your cervix during a pelvic exam, but the urine test is the least invasive way. It is no longer common for a swab of the penile urethra to be performed (whew!).

For HIV testing, you have some options. Depending on which test you and your provider discuss, you may have your mouth swabbed, your finger stuck, or your blood drawn from your arm. Many places require you to return to the clinic for the results, so if you have the option of doing the 20 minute rapid test, go for it. You get your results the same day. Don’t forget it can take up to 3 months, and rarely, 6 months, for HIV to show up on a test, so take that into account and plan to retest if you’ve been potentially exposed recently.

Syphilis is a blood test, no way around that one unfortunately. To prepare for your blood test, eat and drink something before your exam and tell your provider if you have a history of fainting or getting sick with needle sticks.

Other infections people frequently request screening for are genital warts and Herpes.  These tests are ideally performed when physically symptoms are present. It is important to get into your health center as soon as possible if any new bumps or lesions are noticed, because if they begin to heal or go away by your visit time it can make diagnosis more difficult. A blood test for the Herpes Simplex Virus does exist, but it is usually extremely expensive and will only tell you if you have anti-bodies to the virus (meaning you’ve been exposed), which many of us have. It can’t tell you if you will have an outbreak or if you are capable of passing it to a partner. The best test for genital Herpes is a culture of an open sore or lesion.

Important tips for your visit:

  • Ask every question you think of! There are no stupid questions, and we clinic workers like to educate our patients so we’re happy to talk about whatever your concerns are.
  • Tell your provider what’s going on. If you have symptoms or discomfort, let them know. You may need another test, an exam, or some medication. Don’t be embarrassed to talk about possible exposure, symptoms or anything else.
  • Make sure you call or return to the clinic for your results. Your provider should contact you with any positive results, but it’s always best if you check on the results yourself.

STIs: The Facts About Trichomoniasis


Posted on October 30, 2012 by

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If you are having genital discharge that is uncomfortable, itchy, or odorous, or if you are just getting tested for STIs, you probably are already thinking about the possibility of chlamydia and gonorrhea. But there is another infection called trichomoniasis that is lesser known and can also cause discomfort and other problems.

What is trichomoniasis? Trichomoniasis is the term for infection, usually vaginal or urethral, with the protozoa Trichomonas vaginalis. According to the CDC, “In the United States, an estimated 3.7 million people have the infection, but only about 30% develop any symptoms of trichomoniasis. Infection is more common in women than in men, and older women are more likely than younger women to have been infected.”

Where did I get it? It’s a type of sexually transmitted infection, although very rarely it’s been reported to be caused by swimming in a lake, jacuzzi, or sharing wet towels. It is most often spread by genital sexual contact.

What symptoms might I have?

It is possible to have no symptoms, especially if it is in the urethra. A vaginal infection is more likely to produce symptoms. If you do have symptoms, you may experience copious green or yellow frothy vaginal discharge, vaginal odor or irritation, and severe itching, burning after urination or ejaculation, itching of the urethra, urethral discharge. It is possible to transmit the infection to a partner even if you do not have symptoms.

Why should I be concerned?

Aside from it potentially being massively uncomfortable, trichomoniasis can increase a person’s risk of acquiring HIV and delivering premature or low birth weight babies.

How do I find out if I have it?

The best way is an exam by a practitioner. A sample of vaginal discharge is taken and put under a microscope so the provider can visualize the organism. Testing for urethral infection is a little bit more difficult; if there is penile discharge the provider can sample that under a microscope. Trichomonas is not routinely screened for in STI screening panels, so if you are concerned you may have it be sure to ask your provider for an examination.

How do I treat it?

Treatment is simple, with either the antibiotic Metronidazole or a newer drug, Tinidazole. You may take the medication only one day, or for 3-5 days depending on the medication and your providers orders. It is important to avoid alcohol while on this medication and finish the full course.

Trichomoniasis is curable and can be prevented by using condoms.

How to Shop for Condoms


Posted on October 25, 2012 by

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When you’re standing in the condom aisle, seconds seem like hours. Your eyes dart nervously across the colorful packaging, waiting for some clear sign that you should grab one particular box and make a mad dash for the checkout line. Oh yeah, then there’s that pack of gum to grab.

Condom shopping doesn’t have to be difficult or awkward. If you use my three-point condom shopping system, you’ll be outta’ there and gettin’ busy before you know it.

Step #1 – Material

Condoms are made from three different materials – latex, polyurethane and lambskin.

  • Latex: helps prevent pregnancy and sexually transmitted infections; stretchy, yet durable; ring at base; reservoir tip for ejaculate; inexpensive (or free if you get them at the health department or Planned Parenthood)
  • Polyurethane (fancy word for plastic): helps prevent pregnancy and sexually transmitted infections, safe for those with a latex allergy; less stretchy than latex, but still durable, ring at base; reservoir tip for ejaculate; transfers heat better than latex; female condoms come in this material
  • Lambskin: helps prevent pregnancy ONLY (because it is made from animal intestinal lining, it has small pores that bacteria and viruses can fit through, but sperm are bigger, therefore contained by the condom); a bit more eco-friendly than latex or polyurethane; safe for those whose culture or religion dictates the use of a “natural” method of birth control or for those not worried about sexually transmitted infections; no ring at base (more like a drawstring); no reservoir tip for ejaculate; distinct odor; fairly expensive

So, decide which material is right for you and, when you’re shopping, let your eyes wander to the bottom right side of the boxes – that’s where the material type is usually printed. I recommend latex or polyurethane.

Step #2 – Expiration Date

Condoms are manufactured about 5 years before they expire so if your condoms expire next month, they’re already 5 years old. Age degrades the material, making condoms more likely to break. The expiration date is usually printed on the back or side flap of the box and on each individual condom, as seen below:

Step #3 – “The Extras”

By “extras” I mean lubricant, spermicide, size, texture, flavoring, etc. Here’s the skinny on the “extras”:

  • Lubricant: unless you have a bottle of safe lubricant (water-based, because oil-based breaks condoms) handy, opt for lubricated condoms for vaginal and/or anal sex. For oral sex, either get a dental dam or cut an unlubricated condom up the side.
  • Spermicide: this is often called nonoxynol-9 and is a chemical that helps to kill sperm. The use of spermicides is debatable on several fronts. Do your research before you decide on this one.
  • Size: condoms are basically one-size-fits-all. There are, however, “slim fit” and “extra large” versions. Just remember, condoms are SUPPOSED TO BE SNUG.
  • Texture: ribbed or studded – truth is, it doesn’t matter much, particulary for penis-in-vagina sex. Why? Because the vaginal walls have very few nerve endings, making it hard to feel tiny ribs or studs. Think about it – women can wear tampons for hours and not feel a thing! Really, ribs and studs and such are just marketing tools.
  • Flavoring: If it tastes like strawberries, that means it has some sugar and flavoring to make it taste like strawberries. These condoms are meant for oral sex only. Sugar can cause a yeast infection because it throws off the pH balance in the vagina.

But what about the brand name!!!??? I get this question a lot. Just pick a trusted brand. You might need to try various types of condoms before you find one that you really like.

If going to the store to purchase condoms or going to the health department or Planned Parenthood to get free ones is just too intimidating for you, do your shopping online.

Ten of the Craziest, Yet Common Sex Education Questions


Posted on October 23, 2012 by

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I was looking at a stack of questions I’ve received from students in various classes and thought it would be fun to share a few of them with our friends on Feronia. Here are a few of the questions with brief answers. The amount of detail we give depends on the class, age of students, and any follow-up questions.

1. How do you get blue waffle? Blue waffle is actually a made-up STD that does not exist. If you Google it you will find a picture of what looks like very bruised and disfigured female genitals.

2. Is it true that the penis feeds the baby when a girl is pregnant? The vagina and uterus (where the baby is) are separated by the cervix, which blocks semen from getting to the baby. Babies get their nutrition through the umbilical cord and placenta.

3. Is it true that you can test for STDs by putting ear wax on your finger and then inserting the finger into a girl’s vagina? I heard that if she squirms or it burns then she has an STD. The only way to test for STDs is by visiting your medical provider or going to the pharmacy and getting an at-home STD kit.

4. Is it true that if you drink Mountain Dew or Red Bull it will kill your sperm so you don’t get a girl pregnant? This is a myth that has been circulating since I was in high school. These beverages will not prevent pregnancy.

5. Is it true that if the male does all the work or is on top that you’ll have a boy? Is it the same if the female does all the work? The male’s sperm determines the sex of the baby, not the position of the male or female during sex.

6. Is it true that if a male “produces” in a female while she is pregnant then the baby will look more like the father? The way the baby will look is determined by DNA when the sperm joins with the egg.

7. If you are already pregnant and you’re still having sex, can another baby form? You cannot release another egg when you are already pregnant, but now and again there will be two fetuses and an early ultrasound will only detect one.

8. What is the largest penis on record? I would normally answer this by saying that the average erect penis is 5-7 inches long and I’d talk about the importance of not focusing on penis size as a way to define masculinity. For Feronia: According to the Huffington Post, the largest penis on record is held by John Falcon, who has a 9-inch penis when he is flaccid and a 13.5 inch penis when he is erect. His penis size was publicized due to being frisked at an airport in California.

9. If you put your mouth on a penis can the sperm come out? If it does can it travel down and get you pregnant? Yes, sperm can come out but it is impossible for it to travel from the mouth to the uterus. You can, however, become infected with an STD from unprotected oral sex.

10. Could a male animal get a female human pregnant? This is impossible, but it is understandable that students would ask this question because they hear a lot about how closely matched our DNA is to primates. There’s also some crazy stuff on YouTube.

Class dismissed!

What Would Cupid Think?


Posted on October 9, 2012 by

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Love in the era of HIV. Cupid would be appalled. It’s not just a matter of aim and shoot … and more.

Some of us remember the good old days when all you had to worry about was gonorrhea or syphilis, both easily cured with a quick shot of penicillin. Now things are so much more complicated. I’ve had conversations with many people trying to explain the intricacies of HPV, and herpes detection and prevention. Many people don’t even know they are infected with these and the potential to pass them on is so murky. These two are not reportable or even frequently tested for unless there are visible symptoms.

On a more positive note, there is a website I just discovered called Qpid.me. According to its website, it is “a free, patient-authorized service that independently verifies our users’ HIV, syphilis, gonorrhea, and Chlamydia results. We do this so our users can share their results with their partner or on a dating site.”

To find more out about this creative way to notify someone of your test results or to advertise your status, check it out!