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Section III – Lifestyle Issues - Sexual Health
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HealthyLife® Students' Self-Care Guide

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 Section IIILifestyle Issues

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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.


©2005,
6th edition. American Institute for Preventive Medicine
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December 08, 2005