Tag Archives: STDs

How to Shop for Condoms

Today we’re reposting an oldie, but goodie. Happy condom shopping!

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:

condom

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.

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Why Don’t More People Use Condoms?

Most of us know that condoms are great at preventing pregnancy and sexually transmitted infections, so why aren’t more people using them? The most common reasons why people state they don’t use condoms are:

  • It takes away from the moment
  • It smells or tastes bad
  • Some men lose their erection
  • Reduces pleasure for both men and women
  • They don’t have one when they decide to have sex
  • Their partner will think they don’t trust them if they ask to use a condom
  • Their partner will think they sleep around if they ask them to use a condom
  • Fear of being identified as “high risk”

Man unwrapping condom, woman lying on bed in background, close-up of hands, close-up

All of these are valid reasons, but there is more to it. Most people know at least a little bit about the risks of unprotected sex and the consequences, but someone’s “Perceived risk” is a bigger factor in whether they choose to protect themselves. Education by itself is not enough to change behavior. Our personal beliefs on how likely we are to become infected with STI’s or pregnant play a much bigger role in whether someone uses a condom use. The components of these beliefs are part of the Health Belief Model listed below which can help an individual or medical provider address sexual risk and behavior.

Perceived Susceptibility People will not change their health behaviors unless they believe that they are at risk. Ex: 
If someone doesn’t think they are risk for STI’s they won’t use a condom.

Perceived Severity 
The likelihood that someone will change their behavior depends on the severity of the potential consequences. Ex: I had a pregnancy scare and now I always use a condom.

Perceived Benefits 
People won’t change their behavior if there isn’t something in it for them.
 Ex: I really like the way it feels without a condom and partner doesn’t make me use one.

Perceived Barriers People won’t change their behavior if they think it will be hard. Ex: My partner and I have already had unprotected sex and I can’t start using condoms now.

Self-Efficacy The extent or strength of one’s belief in one’s own ability to complete tasks and/or reach goals. For many individuals something has to change or connect with them to make them step back and decide that their current choices are not working for them or place them in danger. Ex: If a person truly believes they can avoid chlamydia by negotiating condom use, they are apt to be more successful in reaching their goal.

Things to consider:

  • Get tested if you don’t know your status or your partners status.
  • Think about your risk factors and what safer sex strategies you could implement.
  • Go to a reliable website to learn more about safer sex or make an appointment and learn how to protect yourself and make safer sex fun.

Sources: here and here

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HIV and Trans Women

Now that transgender issues are coming into mainstream conversation, here’s a repost of a topic that needs attention…

Nearly a fifth of the world’s transgender women are infected with HIV. A 2013 analysis compiling the results of 39 studies involving 11,000 transgender women from 15 countries came to this startling conclusion. This number is 49 times higher than the general population, 36 times higher than males and 78 times higher than other females. For the study, transgender women were defined as individuals born as biological males who currently identified as female. Transgender women who engaged in sex work were also significantly more likely to be infected with HIV than male and other female sex workers.

So why are transgender women so much more likely to contract HIV? The authors of the report offered several reasons. They believe that many of the infections occurred through unprotected anal sex. Next to direct blood to blood contact through needle sharing, anal sex is the easiest route for transmission. Anal tissue is more easily torn during anal sex than through either vaginal or oral sex. If they have had a recent vaginoplasty/vaginal construction, they are also at greater risk of infection. Transgender women are more likely to be involved with sexual partners who are infected with HIV and engage in sex work.

transgender_HIVPrevalence

The stigma, discrimination, and fear of judgement associated with being transgender are significant factors that lead to many women avoiding routine health screenings. And to make matters worse, few health care workers, HIV counselors, and physicians are trained in transgender women’s health care issues.

Hopefully, this study will help open doors to future strategies to help address this overlooked population. To read the entire article, click here.

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My Pap Came Back Abnormal…Now What?

Pap tests come back abnormal all the time so this re-post from E.G. Hanna still applies…
Pap test

So you got your annual screening and a few weeks later you get a phone call stating your pap test came back “abnormal.” Don’t freak out! This can mean a couple different things. To be clear, infections like chlamydia or yeast do not count as an abnormal pap! An abnormal pap means atypical cells on your cervix, that is, that the cells have begun to change in such a way that may be or become cancerous. This is called dysplasia.

After a pap smear comes back abnormal, what happens next depends upon a couple of factors, including your age and the severity of the dysplasia.

You may only need to repeat your pap smear in a few months, as often a health immune system can fight off the changes itself. Or you and your provider may opt for a colposcopy, which is a better way of looking at the cervix. A speculum is inserted into the vagina, solution is applied to the cervix with a cotton swab to highlight abnormal areas of tissue, and then a special microscope is used to look at the cervix. This allows the provider to see the dysplasia and, if deemed necessary, take one or more small tissue samples. This biopsy may feel like a small pinch and, while slightly uncomfortable for most women, it is usually tolerated very well. This biopsy allows the pathologist (the person who examines the tissue sample at the lab) to get a more detailed and accurate reading of the cervical cellular changes.

Depending on the colposcopy results, you may need to go back to pap smears every 3-6 months or, if the dysplasia is severe, you may need further treatment to fully remove the abnormal tissue. This treatment may consist of cryotherapy or a LEEP (Loop Electricosurgical Excision Procedure). Cryotherapy uses a freezing chemical to remove abnormal cells, allowing healthy cells to grow back in their place. A LEEP cuts away abnormal cells with a thin wire carrying an electrical current. Though both procedures may sound intimidating, in truth they are not very painful (many patients tell me their LEEP was more comfortable than their colposcopy, because of the numbing solution applied).

Cervical dysplasia is most often caused by HPV, a very common virus transmitted through sexual contact. Here are a few tips on how to avoid HPV and cervical changes:

Don’t smoke! Smoking is not good for your immune system, and you need a healthy immune system to fight the virus.

Consider the Gardasil vaccine, which protects you from 4 strands of HPV, 2 of which cause 75% of cervical cancers.

Use condoms. Though they may not fully protect you from HPV, as HPV is passed through skin to skin contact, because condoms cover parts of sexual anatomy they reduce the chance of transmission. Try female condoms too, which cover more skin.

Practicing abstinence or limiting sexual partners is also helpful, but isn’t foolproof. The CDC sums it up really well: “People can also lower their chances of getting HPV by being in a faithful relationship with one partner; limiting their number of sex partners; and choosing a partner who has had no or few prior sex partners. But even people with only one lifetime sex partner can get HPV. And it may not be possible to determine if a partner who has been sexually active in the past is currently infected. That’s why the only sure way to prevent HPV is to avoid all sexual activity.”

Most of all, if you have a pap come back abnormal, keep these two things in mind: 1) Don’t panic. 2) Don’t ignore it. Cervical dysplasia is treatable and it does not necessarily mean you have or will get cancer. The keyword there is “treatable,” meaning you must see your provider for treatment to avoid detrimental effects to your health!

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Never Too Old: Sex and Aging

elderly-couple-300x219What age should someone stop having sex? How old is too old? For many people, the answer is that they would like to have some sexual activity, whether it is with a partner or with themselves, for as long as they possibly can. Sex or not, intimacy is important throughout our lives. Some, unfortunately, are judgmental of people having sex later in life.

Most of us have sexual desires, and this is not necessarily going to go away as we age. Additionally, medicine is getting more adept at making sex possible for people later in life, despite health conditions that might have previously impacted their sexual behavior. This is done in various ways, like the use of hormone therapy for people who have been through menopause, or drugs that help people get or maintain an erection despite circulation issues. All of this culminates in allowing people to remain sexually active later in life than might have been possible without medical intervention.

However, because our society is so focused on youth, we often forget that older people can be sexual beings. Additionally, some generations of elderly people today may not be as comfortable talking about sex and sexuality with those around them. Generational hang-ups about the stigma of sexuality may mean that continuing desire is not discussed in “polite company.” This could affect how individuals talk to those around them about sex. As a society, this also means that we may be confusing discomfort talking about sex from discomfort participating in sexual acts, giving us false notions about elderly people not having sex.

As sexual health advocates, it is important to make sure that our work does not leave out older generations. Sexual health, including regular STD testing, the use of barrier methods, and the ability to have an open and honest dialogue about sex with one’s care provider, is important for sexual wellbeing throughout all stages of one’s life!

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The Challenges with a Cure for HIV

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.

Since the discovery of Human immunodeficiency virus (HIV) as the cause of Acquired Immune Deficiency Syndrome (AIDS) in 1983, it continues to pose a huge threat worldwide to the health of millions of people. Data from the World Health Organization (in 2013) revealed that worldwide 35 million people were living with HIV, there were 2.1 million new cases and 1.5 million deaths.

hivThe development of multi-drug combination therapy known as Highly Active Antiretroviral Therapy (HAART) for treatment of HIV/AIDS in 1996 was one of the major successes of modern medicine leading to a dramatic drop in the death rate by 50 to 80% between 1996 and 2006. This period is known as “the decade of HAART.” This changed the view of HIV/AIDS from a fatal and catastrophic disease to what is now a manageable chronic illness.

After this initial success, the next step was to find a cure and/or an effective preventive method. Currently the best way to avoid HIV/AIDS is to take conscious steps to avoid contracting the virus in the first place. This has been the aim of a lot of efforts all around the world teaching safe sexual health practices and healthy lifestyle behaviors. However, changing human behavior is quite difficult.

Due to the rapid and constant mutation of HIV, the human immune system finds it very difficult to defend against it and scientists have found developing an effective vaccine very problematic. Also, HIV is able to create reservoirs in its hosts leading to latency of the disease, which is the main reason HAART can’t eliminate the virus but only reduce its load in the human body to very low levels. For this reason HIV positive patients are unable to stop HAART therapy to avoid dramatic increase in their viral load.

Despite all these issues, promising advances in therapy are being made. Drugs like Prostratin, which are able to reactivate latent HIV and therefore increase the effectiveness of HAART therapy, are being developed. There are also a small group of people who are known to be immune to HIV due to the absence of the cell receptor necessary for HIV to infect cells known CCR5. This knowledge was used in the case of Timothy Ray Brown, the first case of a cured HIV positive patient. Although the therapy used on Timothy is very risky and expensive and therefore can’t be applied on a large scale, it has given researchers ideas on how to modify a patient’s immune system to resist HIV.

Continuing research in this field, including various promising results from numerous clinical trials show that there is hope for an effective cure for HIV. Tests in the lab have shown promise at a cellular level and the aim is to replicate these results at the macro level. This process may take years but with each passing year we get a better understanding of the virus and the disease mechanisms which would bring us closer to developing a cure and possibly a vaccine. Until then, maintaining a healthy lifestyle approach and engaging in healthy sexual behaviors (using condoms) will be the mainstay of HIV prevention.

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Check Your Judgments at the Door

define yourselfWe are still doing a lot of work eliminating stigma here in the reproductive health field, and I’ve been thinking a lot about how to get our supporters to examine their own judgments. As I’ve discussed before, shame and judgment are large parts of why people don’t access the reproductive health care they need. As supporters of safe sexuality and reproductive health, some of the biggest steps we can take are working to make sure that we create and promote safe spaces surrounding these issues. While we may be strong advocates of reproductive health, it is also important to remember that we come from a society where we are inundated with negative messages about sex and sexuality every day. Because of this, it is important that we work to examine our own judgments, and how stigma has personally affected us. When you live in a society that expects you to have negative views surrounding sexual health, it is not your fault that you have picked up tendencies to judge people regarding sex, abortions, STDS, and other areas of reproductive health. But it is a problem if you let your judgments hinder or harm people attempting to seek the health care they deserve. Here are some questions you can ask yourself if you find you are judging someone else about sexual or reproductive health care.

1. Why am I feeling judgmental?

The first step you can take in evaluating your own negative feelings towards others is to ask yourself WHY you are feeling judgment. Is this a situation you have been through before that made you feel stigmatized? Something you were raised to have very strong beliefs about? Something you may have seen media representations of that influenced your views? If you can examine where the sources of your judgment is coming from, you can examine whether or not it is actually useful. For example, if you realize that your judgment is coming from somewhere like media representations, you can think critically about whether or not those judgments are accurate and warrant your emotional energy.

2. How is this judgment useful to the person I am interacting with?

If you have examined the root of your judgment, and found that it is comes from a more serious place (i.e. personal experience or belief you grew up with), a great next step would be to examine how useful the judgment you hold is to the person you are interacting with or thinking about. For example, if you are feeling very angry towards someone because they are having a pregnancy scare because they did not use any form of birth control, think about how your anger might affect them. Do you think for their own health it is better to project your anger towards them, or to position yourself as an advocate of reproductive health, and supportively present them with all their options?

3. How does this judgment play in to stigma-free reproductive health?

A final question you can ask yourself is: how does your judgmental attitude impact goals to stigma-free reproductive health as a whole? Does your view contribute to any negative societal outcomes that affect reproductive health access? Have judgments like yours been used to prevent people from getting health care, or to demonize the people who do receive health care? If you realize that your judgment could contribute to stigma, you might find it is best to try and step away from your current thought process, and strive for something more positive!

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So You’re LBGT, Why is STD Testing Important?

Today’s guest writer, “Deeds,” is a Masters of Public Health student (with a concentration in health education) and has BA in exercise science. Some of her areas of interest are body image, sexual health, and LGBT issues.

Hello there friends of the rainbow!

cake Continue reading

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The Condom That Kills STDs

condomsBIG NEWS from the condom world! An Australian condom manufacturer is about to start producing a LifeStyles brand condom with Viva-Gel. Viva-Gel is a microbicide that is shown to disable viral STDs such as Herpes, HIV, and  HPV. Although laboratory results prove that the condom inactivates 99.9% of the viral STDs it comes in contact with, at least one doctor is skeptical.

gelDr. Anna-Barbara Moscicki gives us reason to exercise caution. Her research using the antiviral compound as an intravaginal cream for women showed that it caused mild irritation and inflammation after two weeks of daily use.

So what’s a little inflammation? What’s the big deal? Well, inflammation attracts our healing cells, our white blood cells. And if you recall from 5th grade health class, HIV uses white blood cells to disguise itself and replicate. Inflammation also breaks down the already-thin vaginal walls, leaving them susceptible to HPV infection. Essentially, inflammation of the sexual parts is like an open invitation for HIV infection.

But there’s good news! Starpharma, the pharmaceutical company who conducted the clinical trials on the groundbreaking condom reported to Huffpost that they used a fraction of the gel on their condoms that Moscicki did in her clinical trial (1% versus 3%) and subsequently found that irritation and inflammation weren’t problems among their 1,000 clinical participants. And though they tested the safety at a 1% concentration, the amount on the condom is actually .5%. If the results prove positive, you can bet that the Viva-Gel condoms will soon be available all over the world.

Remember, next to abstinence, correct and consistent condom use is the best protection against contracting STDs. However, condoms do not provide great protection against STDs that are transmitted by skin to skin contact (like Herpes and HPV), because they do not cover the entire genital area that may be infected. Know your status, talk to your partners, and use protection for the best combined protection.

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The ABC’s of STD Prevention

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?

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