Assignment 20 - Safer Sex

Safer Sex Questions and Answers

Why do we use the term "safer sex" instead of just saying "safe sex"?

  • Abstinence, or abstaining from any intimate sexual contact. This includes the exchange of bodily fluids, genital-to-genital, or genital-to-skin contact. Abstinence is the only 100% safe sexual behaviour.
  • Any measures that you take, like using condoms or birth control pills, can reduce the risk of pregnancy or infection with a Sexually Transmitted Infection (STI), but they do not completely eliminate the risk. Sexual activity is never completely without risk. We can only make it "safer" by taking steps to protect ourselves and our partners.

So, if you have sex you may get pregnant. I already know that.

  • Sexual intercourse obviously has a risk of pregnancy. You can reduce the risk by using one or more methods of birth control. There are many different methods out there and each has their pros and cons.
  • Did you know that pregnancy can occur even without having actual intercourse? If sperm is ejaculated near the entrance of the vagina it is possible for them to travel through fluids inside and fertilize an egg.

What about STIs?

  • Sexually Transmitted Infections (STIs) used to be called STDs, but we have now expanded the term to cover minor infections that are easily cured and life-long and deadly diseases that are passed on through sexual contact.
  • Many STIs have signs and symptoms that are hard to detect. Some have hardly any symptoms at all. That is why it is important to be tested regularly for STIs when you are sexually active. At least once a year at your yearly doctor checkup is good advice.
  • Even serious diseases like HIV may not be noticed by the person until months or years later if they aren't tested because symptoms may be mild at the beginning and can easily be mistaken for other minor illnesses.
  • Only barrier methods, like male and female condoms, protect sexual partners from STIs. The birth control pill is effective against pregnancy, but condoms must also always be used to prevent infections.

What methods are available?

  • Men and women have different options available to them for birth control. Remember that multiple methods can be used at once, so this can reduce your risks even more. It is the responsibility of each partner to let the other know what methods they are comfortable using. It should be an agreement between the two partners. The responsibility of birth control should not always be the woman's job or the man's job.
  • Men have 4 birth control options:
    • Abstinence: No sexual contact at all. Obviously the most effective against pregnancy and STIs.
    • Condoms: A male condom covers the penis and prevents the exchange of semen and other fluids. This protects against pregnancy and many STIs, but not all. If used properly every time they are only 82% effective at preventing pregnancy.
    • Withdrawl: If a man uses this method he will have intercourse up until the point of ejaculation. Just before that, he withdraws his penis and ejaculates somewhere else. It doesn't protect against other STIs because there is no barrier in place. This method is very unpredictable because it relies on the man knowing exactly when he will ejaculate and pulling out in time. Because of that this method can be anywhere from 70 to 90% effective at preventing pregnancy.
    • Vasectomy: This is a surgical method where the tube that carries sperm into the penis is cut and tied off. This prevents any semen from entering the penis. A man can still ejaculate, but no sperm will be there and pregnancy can not happen. If a man has intercourse without other protection there is still a risk of STI infection though. This method is permanent and cannot easily be reversed. Because of this, doctors usually won't even perform this surgery on someone under the age of 25 or so, even if you think you are sure that you never want to have children.
  • Women have many more methods of birth control and they fall into several categories:
    • Hormones: A woman's usual cycle of egg production can be interrupted with hormones. If a woman absorbs these hormones, their eggs will be affected and will not mature and descend from the ovaries into the uterus. Hormonal birth control methods are only really effective against pregnancy prevention and do not protect against infection from STIs.
      • The Pill: Hormones are taken in pill form every day. They're the most effective if you take them at the same time every day. About >90% effective against pregnancy.
      • The Patch: A small plastic patch is put onto the skin and hormones are absorbed through the skin. The patch is sticky and stays on even if you bathe or shower. You change the patch once a week. About >90% effective.
      • Contraceptive Ring: A small flexible plastic ring is inserted into the vagina. It is infused with hormones and gradually releases them. You change it once a month. About >90% effective.
      • Injections: A shot, like an immunization, in your arm that contains hormones to prevent pregnancy. One shot protects you for three months. This is more effective than the others at >94%.
      • Implant: A small, flexible plastic rod infused with hormones is implanted under the skin of your arm. It gradually releases hormones over time. A doctor needs to insert and remove the implant in their office. It lasts up to 3 years. It is very effective at 99%.
    • Intrauterine Device (IUD): An IUD is a small flexible plastic piece that is inserted into the cervix using special instruments. It may be uncomfortable to have inserted at first, but it does not hurt. A doctor needs to insert and remove the IUD at their office. Depending on the brand, an IUD can last from 3 to 12 years. It is very effective at 99%.
    • Female Condom: This looks very similar to the male condom, but it is larger. It has a flexible ring on the closed end. A woman squeezes this ring and inserts the condom into her vagina. The plastic tube hangs outside the vagina and can protect the woman against contact STIs like genital warts and herpes. To have protected intercourse, the man needs to carefully insert his penis into the condom and then into the woman. They are only 79% effective, so they should be used with another method of birth control to prevent pregnancy.
    • Tubal Ligation: This is a surgical method where the tubes that carry the egg into the uterus are cut and tied off. This prevents pregnancy because there is no egg that can be fertilized. If a woman has intercourse without other protection there is still a risk of STI infection though. This method is permanent and cannot easily be reversed. Because of this, doctors usually won't perform this surgery on someone under the age of 25 or so, even if you think you are sure that you never want to have children.
    • Other methods: There are other, less commonly used, methods of birth control available. These include: spermicides, sponges, cervical cap, etc. Each one has a limited use and less effectiveness than the ones listed above. If you are interested in using one of these methods, make sure you research whether it is right for you.

Click on the link below to read some information fact sheets about many different methods of birth control.

http://teachers.teachingsexualhealth.ca/resources/print-resources/birth-control-fact-sheets/

Really?! tl;dr Just tell me what I should do?

  • Use a barrier method (male condom, female condom) to prevent against pregnancy and most STIs
  • Use a hormonal method (the pill, injections, IUD) to prevent against pregnancy
  • Use both at the same time to make the safest choice possible, but remember that no method of birth control or combination of methods is 100% effective. Abstinence is the only 100% safe choice.

What about oral sex? You can't get pregnant from that.

  • That is true, however you can still get a STI from unprotected oral sex.
  • Some STIs like herpes, chlamidia, gonorrhea, and syphilis can be passed through mouth to genital contact for men and for women. These infections are carried in the body's fluids and can move from one person to another if there is no barrier in the way.
  • Infections that are passed thorough blood contact like hepatitis and HIV can be caught from oral sex because we have a lot of blood vessels close to the skin in our mouth. It would be easy for viruses to enter into your blood stream and infect you here, but it's not as high risk as through intercourse.
  • A man can be protected during oral sex by wearing a male condom over the penis. Since the condom only covers the penis and not the surrounding area, there is still a risk of passing on genital warts or herpes if there is an outbreak outside an area that is covered by the condom.
  • A woman can be protected during oral sex by wearing a female condom or using a dental dam. This covers the vaginal area and prevents direct contact. If none are available one can be made by cutting one side of a male condom so it lays as a flat piece of plastic.

Click on the link below to watch informative videos on how to safely use latex barriers during sex.

http://teachers.teachingsexualhealth.ca/resources/demonstration-videos/

But I know that my partner doesn't have any infections. Why do I need protection?

  • That is an important point. Knowing your partner well is the first step towards safer sex. If you are honest with your partner and you have known them for a long time, you will know what their sexual history is and you will know whether or not you are at risk of STI infection.
  • Even though you know a person very well and they have been completely honest about their sexual history, it is still possible that they may have been infected with an STI without their knowledge. If a previous partner was not honest with them, then it's possible that they may also infect you unknowingly. 
  • If you know that you want to become sexually active with someone, it is a good idea for both of you to get tested for STIs before you have sexual contact for the first time. It is a quick test that can be done at most clinics and you get the results back relatively quickly. It gives both partners complete confidence because you have a medical guarantee.
  • Until you have been checked by a doctor to give you a guarantee that you are free from all STIs, it is best to use barrier methods every single time you have sexual contact.

What else can I do?

  • Communicate with your partner: Be aware of their past sexual history and let them know yours. The more information you have about each other, the safer you both can be.
  • Be assertive about your choices: If you want to use a certain safer sex method and your partner is resistant, be persistent. You have a right to make informed choices that are good for you and your partner should respect that.
  • Maintain abstinence or postpone sexual activity: Since abstinence is 100%, the longer you stay abstinent the longer you are 100% safe.
  • Limit partners: The less sexual partners you have, the less opportunities to have to be infected with STIs or become pregnant unintentionally.
  • Use protection: Always use protection anytime you have sexual contact. Be sure that you use protection correctly every time. It only takes one mistake to make a permanent impact on your life.

Assignment 3 - Safer Sex Script

For this assignment you will be writing a script for a conversation between you and your friend. Your script should include a complete discussion of the topic between you and the other person with responses from both sides. You need a minimum of 10 lines of dialogue for each person.

The Scenario

You and your best friend have been there for each other since elementary school. You go to the same school, you're in the same classes, and you hang out almost every weekend. Most importantly, you tell each other everything - no matter how happy, sad, scary, or weird.

Your best friend has been together with their partner (boyfriend or girlfriend, you decide) for a long time. Your friend told you a while ago that they've gotten intimate together before, but they haven't had sex yet. Today your friend told you that they are thinking about having sex together for the first time. You know that using protection is important during sex and you want to make sure that your friend is protected.

The script is started below. Remember you need 10 lines of dialogue per person.



Me: I want to talk to you about condoms. You're planning to use them, aren't you?

Friend: Who are you, the health police? I don't know ... condoms sort of interrupt the moment.

Me: No, I'm not the health police. I'm just someone who cares about what happens to you.

Friend: Well, what are you trying to say?

(continue)