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Sexual Health

Closeness, touching, and intimacy are good for health. One way to experience these is through sexual contact. Some people decide to delay sex until they are in a long-term, committed relationship. Others decide to become sexually active without one. If you choose to be sexually active, consider your health and peace of mind by using “safer sex.”

Safer Sex

Safer sex means being intimate, but using measures that minimize the risk of sexually transmitted diseases (STDs). Not having sex, including intercourse, oral sex, anal sex, and genital-to-genital contact is the only sure way to eliminate the risk for STDs. Caressing, hugging, dry kissing, and masturbation are no risk or extremely low-risk practices. So is limiting your sexual contact to one person your entire life if your partner is also monogamous and does not have an STD.

Measures to reduce the risk for contracting an STD

	Latex and polyurethane condoms may offer partial protection in preventing transmission of HIV infection and may reduce the risk for other STDs. To do this, they must be used properly and carefully and for every sex act. Sex with condoms isn’t totally “safe sex,” but is “less risky” sex. Use condoms with “prevent disease” on the package label. Barriers made of natural membranes, such as lamb skin, do not offer effective protection against STDs. Unless they are in a monogamous relationship in which neither partner has an STD, both females and males should carry latex or polyurethane condoms and insist that they be used every time they have genital-to-genital contact and/or oral sex. Use polyurethane condoms if either partner is allergic to latex.
	For oral-vaginal sex and oral-anal sex, use latex dams (“doilies”). These are latex squares.
	Using latex condoms with spermicides, such as nonoxynol-9 (N-9) are no more effective than other lubricated condoms in protecting against HIV and other STDs. Using spermicides with N-9 are not effective in preventing chlamydia, cervical gonorrhea, or HIV infection. Thus, spermicides alone are not recommended for STD/HIV prevention. Also, frequent use of spermicides with N-9 has been associated with genital lesions which may be associated with an increased risk of HIV transmission. In addition, N-9 may increase the risk for HIV transmission during anal intercourse. For adequate lubrication during intercourse, you may need to use lubricants. Use water-based ones, such as K-Y Brand Jelly. Don’t use oil-based or “petroleum” ones, such as Vaseline. They can damage latex barriers.
	Don’t have sex while under the influence of drugs or alcohol.
	Limit sexual partners. Sexual contact with many persons increases the risk for STDs, especially if no protection is used.
	Discuss a new partner’s sexual history with him or her before beginning a sexual relationship. (Be aware, though, that persons are not always honest about their sexual history.)
	Avoid sexual contact with persons whose health status and health practices are not known.

If you have multiple sex partners, ask your health care provider to check for STDs every 6 months or as often as he or she advises even if you don’t have any symptoms.

Seek treatment for a sexually transmitted disease if you suspect or know your sex partner is infected. Your sexual partner(s) should also be contacted and treated.

For Information, Contact:

Your schools’ Student Health Center, your health care provider, or your local health department

CDC National STD Hotline
800.342.8922  –  English
800.344.7432  –  Spanish

American Social Health Association (ASHA)
www.ashastd.org

Sexual Assault

Sexual assault is an unlawful act that may involve the touching of intimate body parts, sexual intimidation, or forced sexual penetration. This includes sexual intercourse, oral sex, and digital penetration. Rape is forced sexual intercourse. Force may be by verbal threats, physical restraint, or violence. Stalking is defined as repeated, obsessive, fear-inducing behavior that makes the victim afraid or concerned for his or her safety.

A recent study funded by the Department of Justice found that sexual assault and stalking of college females are widespread and grossly underestimated. U.S. statistics report:

	About 3% of coeds are raped during each academic year. Over the course of 5 calendar years, including summers and vacations, 20-25% may be raped.
	Nationally, an additional 15.5% of college females are sexually victimized (e.g., sexual contact is completed with force or threat of non-physical force, threat of rape, or threat of contact).
	Nationally, 13.1% of coeds are stalked during the academic year lasting an average of 60 days.
	Nationally, less than 5% of completed and attempted rapes of college females are reported to the police or campus officials.  About 67% of the victims tell a friend.
	Nine out of 10 victims knew their assailant. {Note: Almost all sexual assaults on college campuses are acquaintance rapes and, in most cases, at least one of the persons involved is under the influence of alcohol or another drug.}
	Between 3 and 6% of male university students reported being raped and up to 25% reported being sexually assaulted. Only about 1% of male rape victims reported it to the police.

Safety Tips to Reduce the Chances for Sexual Assault

Be aware of the risks of date rape with drinking alcohol. About 75% of male students who take part in acquaintance rape had been drinking; about 55% of female students had.

	The best defense is to not drink. If you drink, limit alcohol intake.
	Don’t drink anything you have not brought or opened yourself. Don’t drink from another person’s container, from a punch bowl, beer bong, etc. When at a bar or club, accept drinks only from a bartender or waiter.
	Keep your drink in your hand and under your watch at all times. If needed, have a friend watch your drink. Do the same for your friend(s).
	Don’t drink alcohol in a high-risk setting for sexual assault (e.g., frat house or team parties or with persons you don’t know and/or trust).

Be aware of these “date-rape” drugs, which have no odor or color when mixed with drinks:

	Rophypnol. See the Drug Chart under “Drugs & Drug Safety”  for the effects of this drug which can last 6 to 8 hours. This drug is added to drinks and punches at parties, raves, etc., usually to lower sexual inhibitions in females. When mixed with alcohol or other drugs, Rophypnol can cause death.
	GHB and GLB. See the Drug Chart under “Drugs & Drug Safety” the effects of this drug which last about 8 hours. If you have had this drug, you may wake up partially clothed with no recollection of a sexual assault. GHB is often made in homes with recipes and ingredients found and purchased on the Internet. GHB can cause death.

Consider using a coaster or test strip made to detect date rape drugs in drinks before you take a sip. An example is Drink Safe Coaster™ by Drink Safe Technology. For information, contact www.drinksafetech.com.

If you suspect you have been drugged, keep a sample of your drink. Get help immediately. Have a friend help you get medical care. Call EMS, if necessary. Get tested for the drug within 12 hours of the suspected incident at a hospital emergency department.

Do not have sex with a person who is under the influence of alcohol and/or drugs which compromise consent. Also, look out for the safety of your friends and yourself and don’t put yourself in vulnerable situations.

	Alert your female friends (and the authorities) to rumors of guys using date-rape drugs.
	Don’t assume that anyone under the influence is “too nice a guy” to commit sexual assault. Intervene on a friend’s behalf (e.g., walk her out of a party, take her to a safe place, etc.).
	Know your sexual limitations and communicate them both verbally and nonverbally. If you sense you are being pressured to have sex and don’t want to, state your position clearly. Say “NO” emphatically when you mean “NO!” Be aware, too, that a female/partner does not need to say the word “NO” to mean “NO.” Listen for words like, “I’m just not ready,” “We’re going too fast,” etc. The female/partner may be afraid to say “NO.”
	Attend your school’s classes, etc. on preventing acquaintance rape, sexual assault, etc. Take a class in self-defense.
	Carry a cell phone with you to call for help, if needed.
	Avoid being alone, especially in unsafe situations and with strangers and persons you don’t know well or feel safe with.
	Keep the doors to your home and car locked. Don’t open doors to strangers. Don’t tell strangers that you are alone.

If Rape Occurs Do not shower, clean or wash up in any way, or change clothing before you go to the hospital emergency department. Doing so could destroy evidence (e.g., blood type, hair samples, etc.) which may not be legally acceptable if collected later than 72 hours after the rape. If you have removed clothes worn at the time of the rape, put them in a paper bag and take them with you to the E.R. Get medical or police help right away. (Date-rape drugs may not be detectable after 12 hours.) Go to the E.R. Recall and write down as much detail as you can. Report the rapist’s age, height, weight, race, hair color, clothing worn, noticeable body marks, tattoos, etc. If a vehicle was involved, report its type, color, license plate, etc. Take a friend with you for comfort and support. At the E.R., you will get information about health care providers in your area who can help you after the E.R. visit. You will likely use it at some point. Talk to the emergency care provider about emergency contraception and tests for STDs. Contact your campus Sexual Assault Crisis Center or call the Rape Crisis Hotline at 800.656.HOPE (4673).

If a rape occurs, go to a hospital ER

Birth Control Options

Discuss methods that meet your needs with your health care provider. More than one method may be needed to prevent pregnancy and HIV/STDs. If no method is used, the chance of pregnancy is 85 to 90%. (% failure rate is the number of pregnancies expected per 100 females per year.)

	Abstinence – no sex play. 0% failure rate for pregnancy and HIV/STDs.
	Birth Control Patch – hormones from a prescribed patch worn on the skin weekly for 3 weeks; not worn the 4th week. 1% failure rate. Does not prevent HIV/STDs.
	Birth Control Pill – prescribed hormones in pill form. 3% failure rate. Does not prevent HIV/STDs. Some medicines can make the pill less effective.
	Condom (Female) – OTC polyurethane barrier placed inside the vagina. 21% failure rate. May give some protection against HIV/STDs. Should not be used at same time with a male condom.
	Condom (Male) – OTC latex or polyurethane sheath worn over an erect penis. 11% failure rate. Latex condoms help protect against gonorrhea, syphilis, and HIV and are more durable than ones made of animal membranes, which do not prevent HIV/STDs.
	Depo-Provera – prescribed contraceptive injected every 3 months. Less than 1% failure rate. Does not prevent HIV/STDs.
	Diaphragm – reusable, thin, soft, rubber cap that covers the cervix. Used with spermicide. 17% failure rate. Does not protect against HIV. May help protect against chlamydia, gonorrhea, and trichomoniasis.
	Emergency Hormonal Contraception Pills or IUD Insertion – prescribed pills need to be started within 5 days; IUD within 7 days after unprotected sex. About 3-20% failure rate for pills (the sooner taken, the more effective); less than 1% for IUD. Neither prevent HIV/STDs.
	FemCap® – Prescribed silicone rubber device that fits snugly over the cervix.14% failure rate for females who have not given birth; 29% for females who have. Does not prevent HIV/STDs.
	Intrauterine Device (IUD) – small copper device inserted into uterus (and needs to be removed) by a health care provider. Can remain in place up to 12 years. Less than 1% failure rate. Does not prevent HIV/STDs.
	Intrauterine System (IUS) – Mirena®, device placed in uterus by health care provider. Can remain in place for 5 years. Less than 1% failure rate. Does not prevent HIV/STDs.
	Lea’s Shield® – Prescribed silicone rubber device that fits snugly over the cervix. Used with spermicide. 15% failure rate. Does not prevent HIV/STDs.
	Lunelle® – hormone shot given monthly, usually in a doctor’s office. 1% failure rate. Does not prevent HIV/STDs.
	Natural Family Planning (Fertility Awareness, Periodic Abstinence) – method that involves precise measurements and observations. About 20% failure rate. Does not prevent HIV/STDs.
	NuvaRing® – prescribed contraceptive ring that a female inserts into the vagina. The ring stays in place for 3 weeks; is removed the week of menstrual period. 1% failure rate. Does not prevent HIV/STDs.
	Spermicides (Foams, Jellies, Creams, Suppositories) – spermicides inserted into the vagina that kill sperm before entering the uterus. 21% failure rate. Available over-the-counter. More reliable when used with barrier methods (condoms, diaphragms). Inserted between 5 and 90 minutes before intercourse. Need to reapply for repeated acts of intercourse.
	Sterilization (Female): Tubal Ligation (having tubes tied) – surgical, permanent form of birth control to burn, cut, or tie off the fallopian tubes. Less than 1% failure rate. Does not prevent HIV/STDs.
	Sterilization (Male): Vasectomy – permanent form of birth control. The tubes through which sperm travels from the testes (vas deferens) are cut. Less than 1% failure rate. Does not prevent HIV/STDs.
	Withdrawal – removal of the penis before ejaculation. 19% failure rate. Does not prevent HIV/STDs. Control of ejaculation is necessary and sperm may leak before this occurs.

{Note: Contact your doctor or health care provider for advice on these and additional options.}

Signs of Pregnancy

Missed menstrual periods. {Note: Stress or illness can cause a period to be late, too. And, some females do not have regular periods. It may be hard for them to know if their period is 2 weeks late. Other females can have a light menstrual period or spotting and still be pregnant. So watch for other signs also listed here.} Abnormal vaginal bleeding Breast tenderness, swelling, and/or tingling The dark areas around the nipples are darker than before and the tiny glands around the nipples stick up. Feeling tired Nausea or vomiting Frequent urination Unusual food cravings or your taste for certain foods changes; a metallic taste in the mouth Mood swings Slight elevation in body temperature Acne due to extra-active oil glands

If there's even a small chance you could be pregnant, call your health care provider.

©2004, 5th edition. American Institute for Preventive Medicine All rights reserved.

October 11, 2004