Sexual Health Joy Schaubhut, MPH Public Health Educator NBHCBCHEALTHPROMOTION@MED.NAVY.MIL 504-678-7912/3483

Overview Myths STI (sexually transmitted infection) Contraction Reduction Condom Use Increased Risk Statistics Contraceptives Protect Yourself Choices Navy/Marine Guidelines

Myths About Sex If I’ve had an STI once and have been treated, I don’t have to worry about getting it again Withdrawal or pulling out is a good protection for STIs and pregnancy If I don’t show symptoms after a few weeks of sexual contact, I must not have an STI If I used a condom, I am not at risk for STIs or unplanned pregnancy If my partner has never shown any symptoms of an STI, it is ok to engage in unprotected sexual behaviors

STIs - Contraction Reduction Abstinence  100% effective Assess your partner’s risk status Obtain prior medical examinations Use condoms (correctly) Monogamy Common sense Assess your partner’s risk status –> for example, is your partner having sex with multiple partners

Proper Condom Use – there is more than one step to putting on a condom Condom Demonstration video

Sex and Alcohol – Think Before You Drink Statistics: From Georgia Health Sciences University - http://www.georgiahealth.edu/shs/sexualhealth/sexalcohol.html Almost 50% of unplanned sexual encounters are under the influence of alcohol 80% of first sexual experiences occur under the influence of alcohol Alcohol impairment often leads to not knowing your partner, not having a condom available, not using a condom or not using it correctly

Be Honest With Yourself

Unplanned Pregnancy Discuss birth control with partner/PCM Spermicides There are numerous contraceptive choices available at the NBHCBC: Oral contraceptives Depo Provera NuvaRing Spermicides Condoms Diaphragm IUD Norplant Tubal ligation and Vasectomy

Protect Yourself Abstinence Monogamy Open communication (a must for responsible sex) You and your partner should be tested Finding the best methods for you Finding the best method for you: What are the potential health risks/side effects associated birth control methods? How well does it prevent pregnancy?

If You Choose To Have Sex Use CONDOMS and other barriers (proper protection) Reduce the number of sexual partners Do not have sex with “high-risk” people Stay sober If you choose to have sex, there are things you can do to reduce the risk of acquiring a sexually transmitted disease, including HIV: Monogamy Monogamy is sex between two people, who only have sex with each other, as part of a long-term relationship. If neither partner is infected, there is no risk of disease transmission. A series of short-term relationships is not as safe because of the increased risk that one of those partners will be infected. Use Condoms and other barriers Although not as safe as abstinence or monogamy, the correct and consistent use of latex condoms during sexual intercourse - vaginal, anal, or oral - can greatly reduce a person’s risk of acquiring or transmitting many STIs, including HIV infection. In fact, recent studies provide compelling evidence that latex condoms are highly effective in protecting against HIV infection when used for every act of intercourse. A variety of male condoms are available. Female condoms and oral barriers are also available. Condoms can reduce both the risk of pregnancy and the risk of disease transmission. Put the condom on before any vaginal, anal, or oral contact. Condoms can be expected to provide different levels of risk reduction for different STIs. There is no one definitive study about condom effectiveness for all STIs. Several studies have demonstrated that condoms can reduce the risk of acquiring chlamydia, gonorrhea, trichomoniasis, syphilis, chancroid, herpes, Humanpapilloma Virus (HPV) and cervical cancer. Plastic Condoms. Studies show that the new polyurethane condoms have the same barrier qualities as latex. Lab testing has shown that particles as small as sperm and HIV cannot pass through this polyurethane material. Polyurethane condoms offer an alternative for condom users who are allergic to latex. Also, polyurethane condoms can be made thinner than latex, have no odor, and are safe for use with oil-based lubricants.

Navy/Marine Guidelines HPV – female and male beneficiaries age 11-26 Cervical Cancer Screening same with or w/out vaccine Plan B – emergency contraception Rx at MTF (must see provider) Limited to 2 pack in 6 months Chlamydia screening for sexually active women aged 25 and younger HPV – 1st Dose (NOW) 2nd Dose (1-2 months after 1st DOSE) 3rd Dose (6 months after 1st DOSE) HPV vaccine is recommended for girls and boys 11 or 12 years of age and may be given starting at age 9. Catch –up dose Females 13-26 Males 13-241 (this vaccine may be given to men 22-26 years of age who have not completed the 3-dopse series)

Navy/Marine Guidelines Continued Cervical Cancer Screening 1st screening at age 21 Women younger than 30 every 2 years Women age 30 or older who have had three consecutive normal screenings may be screened every 3 years Women infected with HIV should be screened 2 times in the 1st year of diagnosis and then annually Well Woman exam - annually

Navy/Marine Guidelines Continued Mammogram Woman age 40-45

Health Promotion Counseling may include: Diet & exercise Sleep management Stress management Disease prevention Risk reeducation (tobacco, alcohol/drugs, sexual health, etc.)

Summary Myths STI (sexually transmitted infection) Contraction Reduction Condom Use Increased Risk Statistics Contraceptives Protect Yourself Choices Navy/Marine Guidelines

Resources: http://www.cdc.gov/std/default.htm http://www.uhs.uga.edu/sexualhealth/contraception/putoncondom.html http://www-nehc.med.navy.mil/Healthy_Living/Sexual_Health/sharp_statistics.aspx http://www.georgiahealth.edu/shs/sexualhealth/sexalcohol.html Manual of the Medical Department U.S. Navy (NAVMED P-117) Department of the Navy Bureau of Medicine and Surgery (NAVMED POLICY 09-006 and 07-005)