"Safer sex" means making sexual activity safer: safer from
sexually transmitted diseases (STD), safer from pregnancy, and
safer from violence. "Safer sex" means being smart and staying
healthy. It means taking control, having self-respect and
respect for our partners. It means talking about sex, knowing
how to protect ourselves and taking precautions every time we
engage in sexual activity.
Being at risk of catching an STD has little to do with who you
are and everything to do with what risky behaviours you engage
- Sex is a normal and healthy part of our lives. Staying
healthy and developing healthy attitudes requires being armed
What Are Sexually Transmitted Diseases (STD) ?
- STD are diseases which are passed from one person to another
through intimate physical contact, including sexual
- STD are very common and are serious health problems. The
highest rate of infection in females occurs between the ages of
15 and 19. In males, the highest rate of infection occurs
between ages 20 and 24.
- We all need to be acutely aware of the threat of AIDS in our
lives. But at the same time, we must not forget the dangers of
other STD. Some (such as Hepatitis B) can lead to chronic
disease and even death. Others can cause infertility or genital
or anal cancer.
- Women are particularly susceptible to STD and the resulting
complications, and they bear more than their share of the
- many STD are more easily transmitted to women by men than
vice versa (e.g. AIDS)
- some STD cause blockages of the Fallopian tubes, leading to
years of pain in the pelvic area and the risk of "ectopic"
pregnancies (pregnancies outside of the womb), or even
- some women develop cancer of the cervix from STD
- infections can be passed on to a baby during pregnancy or
childbirth, sometimes resulting in birth defects or infant
How Can I Protect Myself?
- The only sure way to avoid STD is to abstain completely from
- Making sexual intimacy as enjoyable and safe as possible
means knowing what kinds of intimate contact can transmit various
- Protecting yourself means choosing only safer sex practices
and using latex barriers correctly every time to protect against
STD. This goes for both women and men.
- You do not have to have sex with a lot of different people to
get STD. Your chances of being infected increase with the number
of chances you take, no matter how many partners you have.
Always take precautions whenever you have sex.
Safer Sex Guidelines
Pubic lice (crabs)
- Pubic lice are insects that live on the skin. Often, but not
always, they are sexually transmitted.
- You can get them if you use the bed linen, clothes or towels
of someone who is infected.
- They infect hairy parts of the body, especially around the
groin and under the arms.
- Eggs can be seen on the hair, close to the skin, where they
hatch in six to eight days.
- Pubic lice are treated using creams, lotions or shampoos,
which are available in drug
- stores (e.g. Kwellada, or Nix).
- The symptoms are
- itching around the genitals
- light brown insects on the skin (sometime moving around)
- oval-shaped eggs attached firmly to hairs
- you might not have symptoms, yet still be infected
- Scratching can cause an infection which requires medical
attention. The itching can also continue for some time after
- These are similar to pubic lice. An itchy rash is caused
when a female mite burrows into the skin to lay her eggs.
Treatment is the same as for pubic lice.
- Symptoms include:
For both scabies and pubic lice, physical contact with others
should be avoided while affected. Clothes and bed linens should
be washed in very hot water, and freezing them for a period of
two weeks or so will destroy any insects and eggs. Those who
have come into contact with someone who has pubic lice or scabies
should also get treated, even if they do not have any
- itching, especially at night
- rashes that usually appear in skin folds, between fingers or
on the wrists, elbows, abdomen and around the genitals
- This is an infection of the liver which is caused by a virus.
Often, there are no symptoms. Treatment includes rest, eating a
healthy diet, and avoiding alcohol. It is the only STD that can
be prevented by a vaccine.
- Any symptoms will usually appear within 2 to 6 months after
coming into contact with the virus. They include:
Some people carry the virus but display no symptoms, so they can
pass the virus to their sex partners unknowingly.
- poor appetite, nausea, vomiting
- a general unwell feeling
- jaundice (yellowing of the eyes and skin)
- dark, tea-coloured urine
- light-coloured stools (feces)
- Most people will recover from the disease, but it can lead to
serious health problems in the future, such as permanent liver
disease (e.g. cancer of the liver).
- Hepatitis B is spread through infected blood or saliva. It
can also be passed from mother to baby during childbirth.
- You should never
- share needles or syringes
- share instruments for piercing (e.g. ears), tattooing, or
- share toothbrushes or razors
- If infected, you should avoid sexual contact until it is
okayed by your doctor.
- If your regular partner has been infected, ask your physician
if you must be vaccinated.
Condylomata (genital warts)
- These are (obviously!) warts that grow on and around the
genitals. They resemble ordinary warts, since both are caused by
- The warts often appear between 2 weeks and 8 months after
sexual contact with an infected partner.
- They are fleshy, resembling a cauliflower, and they grow on
moist areas such as the penis, anus, or vagina. Genital warts do
not cause any pain.
- After oral sex, these warts might appear in or around the
- Some people do not display any visible signs of infection, so
they can pass the virus to a partner unknowingly.
- Treatments include the application of medication to affected
external areas and surgery to remove internal warts.
- If left untreated, the effects of genital warts can be very
dangerous, especially for women. There is a link between genital
warts in the vagina and cancer of the cervix. People with anal
warts also have increased chances of developing anal cancer.
Children born of mothers with genital warts can develop throat
- Vaginitis is an inflammation of the vagina, sometimes caused
by germs which are transmitted during sex.
- The symptoms depend on the cause of infection. They
- an abnormal, foul-smelling, vaginal discharge
- itching or pain inside or around the vagina
- redness and swelling on the outside of the vagina
- pain during sex or while urinating
- Causes include:
- yeast or fungus infections resulting from pregnancy, birth
control pills, diabetes or antibiotics; or
- T vaginitis, a germ not normally found in the vagina, which
can be transmitted during sex. Most men do not display symptoms
of it and can pass it to their partner without knowing. Other
men have a slight discharge from the penis and/or a burning
sensation while urinating.
- Vaginitis is usually treated with creams or pills. If the
vaginitis is sexually transmitted, your partner should also be treated, even if he has no
symptoms. If your partner is not treated, he could re-infect
- Until the vaginitis is cured, tight pants, nylons, and
underwear made from synthetic materials should be avoided.
- This is an STD which causes painful sores on and around the
- Cold sores and fever blisters on the mouth are
caused by members of the same virus family.
- There is no cure for genital herpes, and the sores can come
back from time to time. Sexual contact should be avoided when
they are present. It is, however, also possible to spread the
disease to a sexual partner without displaying any symptoms.
- Itching or tingling in the genital area might appear from a
few days to one week after the sexual contact which transmits the
virus. This will be followed by the arrival of a cluster of tiny
blisters which burst and leave painful sores, lasting from 2 to 4
weeks. Headaches and fever might accompany the first attack.
- In women, sores usually appear inside or around the vagina,
near the anus, or on the thighs and buttocks. They might also
appear in the mouth after oral sex.
- Man can have sores on the penis, around the testicles, near
the anus, or on the buttocks and thighs. Men, too, can get sores
in the mouth after oral sex.
- This is not a serious illness for most people, but it can be
quite dangerous for a baby, who can become very sick.
- If you touch a herpes sore, wash your hands with soap and hot
water. This will help to avoid the spreading of the disease to
other body parts, such as the eye.
- If you think that you might have herpes,
- contact your doctor
- keep the infected area clean and dry
- bathe quickly and use a hair dryer, instead of a towel, to
dry around the sores
- avoid wearing tight pants, nylons, or underwear made from
- If you experience pain when urinating, do it during your
shower; pouring warm water over the affected area might have a
- Chlamydia is very common, and is one of the more serious STD.
If left untreated, it can spread in the body, causing sterility
in both men and women. Babies who contract this disease during
birth can get eye or lung infections.
- Symptoms usually appear from one to three weeks after having
sex with an infected person. Some people do not display any
symptoms, even though they are infected.
- Women might notice
- a new or different discharge from the vagina
- a burning sensation when urinating
- pain in the abdomen, often accompanied by fever and chills,
- pain during sex.
- Signs of chlamydia in men include
- a watery or milky drip from the penis
- an itchy feeling inside the penis
- a burning feeling while urinating
- pain or swelling of the testicles
- Chlamydia can be spread to the anus, often resulting in pain,
discharge and bleeding.
- Most women do not display any symptoms, and if the disease
goes untreated it can cause
- development of chronic lower abdominal pain
- spreading of the germ to the uterus and Fallopian tubes,
possibly requiring hospitalization and later causing
- pregnancy in the Fallopian tubes ("Ectopic pregnancy"), which
can rupture and cause serious internal bleeding
- Men will usually show symptoms, which, if left untreated, can
cause sterility if the germs spread to the testicles.
- This disease can cause serious problems, especially in women.
It can also be passed to a baby's eyes during birth.
- Symptoms might or might not be visible, usually occurring
three to five days after having sex with an infected person.
They include such things as:
- a new or different discharge from the vagina
- a burning feeling when urinating
- pain in the abdomen, sometimes accompanied by fever and
- pain during sex
- a discharge from the penis which is thick, creamy and yellow-green
- pain or swelling of the testicles
- Gonorrhea can be spread by oral, vaginal, or anal sex.
- If treated (usually with antibiotics), it can be cured. But
if left unattended, serious problems can develop, including:
- chronic lower abdominal pain
- spread of the germs to the Fallopian tubes and uterus, or to
the testicles, possibly resulting in sterility
- tubal pregnancy (see "Chlamydia"); and
- painful joints.
- Syphilis is a serious disease which can have repercussions
throughout the entire body. You might have it and unknowingly
pass it on to your partners. It can cause birth defects or even
death if passed on to an unborn child. It is usually treated
- Syphilis has three stages:
- Stage one: painless sores can appear on the area where the
germ first entered the body, usually between 9 and 90 days after
having sex with an infected person; sores inside the anus or
vagina might go unnoticed and disappear, even if untreated, but
the germ remains
- Stage two: from 6 weeks to 6 months after infection, you
might experience flu-like symptoms; rashes can appear in
different areas all over the body and they, too, might disappear
although untreated, but the germ remains
- Stage three: years later, if syphilis remains untreated,
serious health problems can arise, such as heart disease,
blindness, paralysis, brain damage, and death.
AIDS (Acquired Immunodeficiency Syndrome)
- AIDS is caused by the HIV virus, which attacks the body's
immune system, destroying your defences against infection.
Without the protection of a healthy immune system, people with
AIDS suffer from fatal infections and cancers.
- HIV is spread when there is an exchange of infected blood,
vaginal fluids, or semen. This can occur during sexual
activities, through sharing of needles, or
between mother and baby at, or close to, the time of birth.
- HIV is NOT spread through everyday social contact, such as
touching, sharing food, or shaking hands. Pets and biting
insects do not spread HIV.
- You can not become infected with HIV if you donate blood,
since a new needle is used for every donor and therefore there is
no contact with anyone else's blood.
- Today, the risk of becoming infected by receiving donated
blood is very, very low because the blood is always screened for
the HIV virus.
- HIV infection can be detected by a simple blood test which
screens blood for antibodies to the virus.
- HIV antibodies can take twelve weeks or longer to appear in
quantities large enough to be detected. You can, therefore,
still test negative even though you were infected during this
- AIDS is the last stage of HIV infection, and it can take many
years before a person who is HIV-positive develops full-blown
- You can protect yourself from HIV by practising safer
- Kissing an infected person on the cheek or with dry lips is
not a known risk. No case of AIDS or HIV infection due to deep
(French) kissing has ever been reported, and this activity is
- There is no cure for either HIV infection or AIDS; the virus
will remain in the body for life. Several drugs which can
sometimes slow the progress of the HIV virus's attack on the
immune system are now available (e.g. AZT, DDI, DDC, etc.) or are
in the testing stages. These are, however, not cures. Other
drugs are used to treat the infections and cancers
("opportunistic infections") which result from HIV's lowering of
the body's natural immunity.
- If you have been exposed to HIV, you should inform your
sexual partners and anybody with whom you might have shared
needles or syringes. If you are unable to tell them yourself,
your doctor or nurse can help; talk to them about it.
How Can I Reduce the Risk?
- Practice safer sex every time:
- properly use a latex barrier (condom/dental dam); and
- avoid risky behaviours.
- Communicate with your partners.
- discuss concerns, fears, safer sex choices
- honesty communicates respect; it also promotes honesty from
- decide together what you are both comfortable doing
- Remember! It is up to you to protect yourself in every sexual
relationship. Just talking about safer sex is not enough - you
must also practise it! Talking will not protect you.
- Choose lower-risk sexual activities and know what STD-related
risks are involved in various sexual practices.
- Remember! Activities involving direct exposure to a
partner's semen, vaginal secretions, or blood have high risk
- Do not mix alcohol and drugs with sex. Drunk sex is rarely
safe sex. These substances impair judgement and reduce your
ability to make wise decisions.
- Remember! Birth control pills do not prevent STD, nor do
IUD's or diaphragms. To prevent both STD and pregnancy, use
effective contraception along with a latex condom.
- Limit your number of sexual partners. STD are transmitted by
risky activities. While some people are able to negotiate safer
sex practices quite easily, others are unable to do so
consistently. The less you know your sexual partner, the more
difficult it can be to negotiate safer sex.
- Remember! Unprotected penetrative sex (oral, anal, or
vaginal) with only one HIV/STD-infected person is all it takes
for transmission to occur.
What Are the Signs and Symptoms of STD?
These can appear alone or with other symptoms, and some people
might not display any of them, yet be infected. If you have no
signs or symptoms but have taken risks, see your doctor and ask
for an STD check-up.
- abnormal vaginal or penile discharge
- burning sensation when urinating
- unusual sores and itching around the sex organs
- rash or swollen glands in the groin
How Can I Avoid STD?
- Before engaging in sexual activity with a person, get to know
him or her. Open up the lines of communication by discussing
previous sexual experiences, injection drug use, avoidance of STD
and "safer sex" guidelines.
- Use a latex condom every time you have sex: germs cannot pass
in either direction through a condom.
- Never use the same condom more than once.
- Insist on "safer sex" even if your partner says that he or
she is safe. Say NO to anyone who refuses to practice "safer
sex". They don't respect themselves very much, and they
obviously don't respect you.
How Do I Use a Condom?
- condoms should be stored in a cool, dry place
- use condoms anytime there is potential for contact with body
fluids (semen, blood, vaginal secretions)
- open the package carefully to avoid any tearing or damage to
- never check condoms by stretching or inflating them
- before rolling a condom on, pinch the tip of it to remove any
air trapped inside; condoms with no reservoir at the tip require
about half an inch free to catch the semen
- unroll the condom to the base of the penis; if uncircumcised,
pull the foreskin back (gently!)
- you can use two condoms to better diminish the risks, but
make sure that there is plenty of lubricant between the condoms,
since any friction could lead to tearing.
- use only water-soluble lubricants (K-Y jelly, Surgilube,
Muko) because Vaseline, or any other oil-based lubricant, will
cause the latex to break down
- you should remove the condom while the penis is still hard;
hold the base of the condom while pulling out, to avoid spilling
the fluids or losing the condom; throw it away!
- Condom failure has been known to occur with respect to
preventing both pregnancy and STD. Condoms fail if they are not
used properly every time they are needed.
- tears can occur, especially if insufficient lubrication is
- condoms used properly make penetrative sex safer - not
- Remember! Spermicidal preparations containing Nonoxynol-9 can
irritate the vagina, the penis, and/or the rectal walls of some
people. In such cases, repeated use can actually facilitate HIV
transmission. Therefore Nonoxynol-9 is recommended in cases of
condom breakage only.
What Should I Do If I Think I Have An STD?
- Do not be shy or afraid to ask for medical help. Your doctor
will test you and treat you if necessary.
- Follow all of the guidelines set by your doctor and take all
of the medication that is prescribed. Return to your doctor for
a follow-up visit to be sure that you are cured.
- If you have an STD, you must inform all of your sexual
partners, so that they can get checked and treated if necessary.
- protect them from illness
- prevent them from passing STD to others
- avoid your re-infection by them
- If you and your partner are being treated for STD, do not
have sex. Wait for your doctor to tell you that it is okay.
How Often Should I Get Tested for STD/HIV ?
- Getting tested is not a substitute for having safer sex.
- Getting tested when starting a new relationship can, like
using a condom, be offered as a token of respect. However, first
results are not conclusive, due to the 12-week detection delay.
Safer sex practices should still be followed if the test results
- Testing prior to having sex with a new partner might not
always be realistic (though desirable), for some, but if testing
is put into the context of an annual health exam or PAP test, it
can detect unsuspecting carriers.
- Women benefit the most from getting tested between sexual
partners. Early detection will reduce the chances of serious
complications due to infection.
- The greater the number of sexual partners, the greater the
need for testing.
Pros and Cons of HIV testing
- Pros of testing for HIV and having a positive test result
- useful information for medical treatment, including anti-HIV
therapies, treatment against opportunistic infections, following
new treatment programs, and other aspects of health
- incentive to modify behaviours that contribute to worsening
health and progression of the disease, such as exposure to STD,
poor nutrition, and drug, alcohol and tobacco use
- incentive to modify behaviour to avoid transmission of the
disease to other people
- ability to take HIV infection into account when making
- peace of mind and diminished anxiety from uncertainty about
- Cons include;
- lack of emotional or psychological preparation for a positive
- lack of support system from friends, family, and
- additional life stresses, especially for those who already
lead very stressful lives
- past sexual or drug-using behaviour might be revealed
- conflict with cultural and spiritual values attached to HIV
and AIDS, illness and death
- Pros of getting tested and having a negative test result
- peace of mind and reassurance
- promotion and maintenance of behaviours that continue to
minimize the risk of HIV infection
- confirmation that behaviour changes to prevent infection have
- qualify for insurance and visa to travel to some foreign
- "clean slate" - opportunity to make any necessary changes in
behaviour to avoid future infection
- Cons include:
- false sense of security - a negative test result might be
obtained simply because antibodies have not yet formed in
sufficient numbers to be detected
- might feel immune to infection in the future, feel a reduced
need to take precautions.
Not knowing doesn't
make you negative !!
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