Sex & Relationships

The World Health Organization defines sexual health as a state of physical, emotional, mental and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.” (CDC, 2014)

Sexual pleasure is linked to healthy psychological and social development and can reduce stress, improve sleep, and increase happiness

Communication and trust are also important in sexual relationships. In addition to feeling safe from infections and disease, trusting sexual partners and being able to freely discuss sexual desires and aversions are building blocks for relaxed, comfortable, and healthy sex.

SEXUALLY TRANSMITTED INFECTIONS  

What Are They?

Sexually transmitted infections (STIs), also called STDs, are spread mainly through sexual contact, including vaginal, anal, oral, or manual sex. STIs can also spread via pregnancy, childbirth, and needle sharing. Some of the most commonly known STIs are chlamydia, gonorrhea, herpes simplex virus (HSV1 and HSV2), human immunodeficiency virus (HIV), human papilloma virus (HPV), syphilis, trichomoniasis, Hepatitis B, pubic lice (crabs), and scabies.

Types of Infection and Causes

STIs are caused by bacteria, viruses, or parasites that are spread sexually through blood, semen (including pre-ejaculate), vaginal fluid, and breastmilk, and sometimes through skin-to-skin contact, (herpes, HPV, scabies, syphillis). The most common STIs are classified as follows:

BACTERIAL

VIRAL

PARASITIC

Chlamydia

Herpes Simplex Virus

Trichomoniasis

Gonorrhea

Hepatitis B

Pubic Lice

Syphilis

HIV, HPV

 Scabies

Signs and Symptoms

Many people with STIs do not experience signs/symptoms and are not aware of infection until complications occur (i.e. pelvic inflammatory disease, infertility, pregnancy complications, cervical
or rectal cancer, etc.). If symptoms do occur, they can look like the following:

  • Sores/bumps in genital, oral or rectal area
  • Unusual/odd-smelling discharge or bleeding
  • Sore, swollen lymph nodes in the groin
  • Pain or burning during urination or sex
  • Rash over the trunk, hands or feet
  • Abdominal pain

Prevention

Anyone who is sexually active has some risk of getting STIs. The most effective way to prevent STIs is to not engage in sexual or other intimate contact. Strategies to reduce the risk of STIs include:

  • Get vaccinated for HPV and Hepatitis B
  •  Use barrier methods such as condoms, finger cots, or dental dams during sexual contact
  • Wait until all partners are tested for STIs before engaging in sexual contact
  • Know your sexual partners and communicate openly with them
  • Limit your number of sexual partners
  • Engage in mutual and consensual monogamy
  • Avoid excessive alcohol or drugs, which may lead to riskier sexual behaviors
  • Get tested regularly to know your status in order to protect yourself and others.

Treatment

Most bacterial STIs can be cured with antibiotics. However, there are antibiotic-resistant strains emerging, such as with gonorrhea. Viral STIs cannot be cured, but they can be managed. Parasitic STIs can be cured with the appropriate medicine prescribed by a doctor.

For more in-depth information, please visit these sources: The American Congress of Obstetricians and Gynecologists at  www.acog.org, Centers for Disease Control and Prevention at www.cdc.gov, Mayo Clinic www.mayoclinic.org. and Kinsey Institute at www.kinseyconfidential.org

What is safer sex?

Origins of “safer sex”

The phrase “safer sex”itself did not emerge until the beginning of the AIDS epidemic in the 1980s. In “How to Have Sex in an Epidemic”, AIDS activists Richard Berkowitz and Michael Callen introduced the concept of “safer sex” as methods gay men could use to reduce the possibility of infecting one another with the pathogen causing AIDS (later identified as HIV). Today “safer sex”, based on the understanding that having sex brings some level of risk and that people can be proactive about minimizing this risk, is widely recommended as a practice for sexually active people.

STI risks and risk reduction

Many people think of oral sex or anal sex as safer sex because pregnancy cannot occur. Yet engaging in any intimate contact in which you or others are exposed to body fluids (vaginal fluids, semen, blood, and pre-ejaculate) carries risks for all partners. Barrier methods (e.g. condoms, dental dams, gloves) prevent STI (sexually transmitted infection) transmission by blocking the exchange of body fluids.

Some STIs, such as HPV (human papilloma virus) and herpes, can be transmitted via skin-to-skin contact through warts/sores that may not be visible or covered by barriers. Therefore, STI transmission can occur even when barrier methods are used. Employing practices such as using barriers reduces harm, but does not make sex completely safe.

Some great ways to have safer sex

  • Use barrier methods (with lubricant) correctly and consistently on body parts or toys involved in any type of sex
  • Get immunized against some viral STIs (e.g. Hepatitis B and HPV)
  •  Get a full screening for STIs (and get treatment if you test postive):
    • at least once a year
    • before starting a new sexual relationship
    • after having unprotected sex
    • if you think your partner has an STI
  • Choose intimate acts that don’t involve exposure to others’ body fluids (e.g. masturbation, phone sex, cuddling, etc.)
  • Make lifestyle choices such as:
    • avoiding sex when drinking alcohol or using drugs
    • having mutually exclusive sexual relationships
    • limiting number of partners

Safer sex is better sex

Safer sex practices can seem challenging, unfun and unsexy — focused on the negative. Instead of thinking of safer sex as a list of things that you have to do or should not do, think of it as a way to practice self-care and care for others. Make it a part of your lifestyle, just like brushing your teeth!

Sex is about intimacy, eroticism, fantasy, and desire, and we engage in it for pleasure and connection. Make it a habit to communicate openly with your partners and incorporate safe practices into sex play.

Sexual Communication

Communication is an important aspect of sexual health and pleasure. An open, honest dialogue with a sexual partner supports gratifying and safe sexual experiences. It may seem challenging or awkward at first, but the more you practice, the easier and more comfortable it will be.

Talking with your partner

The goal is to create and foster an environment where you and your partner can talk freely about sex. In this environment, someone can say “no” without judgment, fear, or pressure to change their mind, and someone can say “yes” with the understanding that “yes” now does not mean “yes” every time.

If you want to have an honest and open dialogue with your partner(s), try:

  • asking about preferences

    • What are you into? What turns you off?
  • sharing favorite and least favorite words for body parts and sexual acts
  • sharing what you think is silly and what you think is sexy
  • using phrases such as
    • I prefer when you..., I love when you..., or I want you to ... instead of: I hate when you..., or I don’t like when you...

Checking in

People have different desires, limits, and curiosities that can change over time. Whether you have just met your partner or you know each other well, it is important to check in and talk with one another. Talk before sex in order to avoid “trial and error’ situations, talk during sex to provide guidance and receive feedback, and talk after sex to reinforce what worked for each partner.

Try these pro tips for communication:

  • confirm consent via verbal affirmation
  • listen just as much as you are asking and telling
  • respond accordingly and with respect
  • make specific requests
  • speak up if you are unsure or change your mind
  • continue to check in with your partner

Like sex itself, sexual communication gets better, and sexier, with practice. Start with what is most comfortable for you. Have fun!

Resources

Contraceptives/Birth Control

Pap Exam/Smear

Pregnancy

Rape/Date Rape/Sexual Assault

Sexual Health