Category Archives: STDs/STIs

Contraception, Pregnancy, STDs/STIs

Summer Fling Seeker: Maintaining sexual health during the summer

Dear Sexpert,

I’ve been using McCosh’s services to remain diligent about my sexual health and have gotten used to the easy, accessible resources on campus. I’m going home for the summer in a few weeks, and I am worried about accessing resources at home, especially without my parents knowing about it. My home state is also extremely strict about abortions, and while I don’t plan to get pregnant, unwanted pregnancies could still happen and I’m not in a place to have a child right now. I could use some guidance regarding this matter.

Sincerely,
Summer Fling Seeker

Dear Summer Fling Seeker, 

Planning ahead and being cautious are certainly important goals! If you intend to be sexually active this summer — especially if you are engaging with new or multiple sexual partners, it is a good idea to have a plan in place to continue practicing safer sex. It’s also great that you’ve been able to take advantage of the services at McCosh while on campus. If you already have a provider at McCosh who you are comfortable with, you can message your provider through your MyUHS portal with non-urgent questions throughout the summer. They may also assist in getting you connected to resources near you. However, this should not be used for urgent or immediate care concerns or services.

If you are not connected with a care provider at home, Planned Parenthood has clinical locations across most of the United States. These clinics offer sexually-transmitted infection (STI) testing, contraception, physical examinations, consultations, pregnancy testing and prenatal services, abortion care, and sex education. Your local pharmacy may also offer consultations, evaluations, STI and pregnancy testing, and vaccinations or treatments, as needed. 

You note being concerned about unwanted pregnancies. If you do not have a consistent or reliable contraception method, consider making an appointment at McCosh with Sexual Health and Wellness (SHAW) to explore your options before your departure from campus. There are a ton of different methods — hormonal, non-hormonal, daily use, or ones that last years once inserted. Remember that external and internal condoms also prevent STIs, in addition to pregnancy.

Even with these options, no method  is 100 percent foolproof, other than abstinence. Should you suspect a pregnancy, it can be more cost efficient to get a test at a Planned Parenthood location (since they accept insurance or offer a sliding scale fee, if paying out-of-pocket) than to pick up an at-home testing at a pharmacy. But at-home testing does ensure more privacy. Just keep in mind that if you are on your family’s insurance plan and use it, an explanation of benefits (EOB) may be mailed to the policy holder. Learn about some strategies to navigate this.

If you find yourself pregnant and want to explore your options, you may want to learn more about state laws and restrictions (e.g., ultrasound and waiting period requirement, parental consent or notification) to know more about your options, including what you could expect at a provider’s office. You can also look to any of these resources for supportive talk or text lines regarding options to navigate pregnancy. Additionally, Hey Jane is a startup that connects menstruating people to healthcare providers who can educate and prescribe contraceptives and abortion medication. This company caters to those who are less than 10 weeks pregnant and over 18 years old, and in the states Calif., Colo., Conn., Ill., Md., N.J., N.M., N.Y. and Wash. (which may not be applicable to your situation). This service is private and will work with you to financially support your decision. Plan C is another resource that has up-to-date information about accessing at-home abortion pills. More than 54% of abortions in the United States are medication abortions, and they are often chosen over surgical abortions because of the desire for privacy.

Taking preventive measures to maintain your sexual health is incredibly important for your overall well-being, as well as to avoid STIs and unwanted pregnancies. Using condoms and other forms of contraception are the easiest ways to stay diligent about this, but the only way to definitively prevent STIs and unwanted pregnancies is practicing abstinence. If you choose to be sexually active, make sure you are on top of your self-protective behaviors, know your options, and can get connected to care. 

Stay safe,

The Sexpert

Information for this article is provided by the Guttmacher Institute, Plan C, Hey Jane, Bedsider and Reproductive Rights.

Communication, Relationships, STDs/STIs

Fearful First-Timer: Managing expectations of doing well in bed

Dear Sexpert,

I’m a virgin, and my new partner is very much not a virgin. I want to have sex with them, but I’m really worried about being a disappointment in bed, and I’m constantly apologizing when we’re together. How can I feel more comfortable and less worried when being physical with them?

— Fearful First-Timer

Dear Fearful First-Timer,

First, it’s important to acknowledge that virginity is a social (and often heteronormative) construct that is narrowly defined. Most colloquially, virginity refers to not having engaged in penetrative sex. But in practice, losing your virginity can mean anything, from engaging in activities involving the genitals for the first time to engaging in sexual activities with a new partner. 

Whatever virginity means to you, it is totally normal to go through feelings of nervousness or anxiety around engaging in something new. Sex is often portrayed idealistically in media, where each partner intuitively knows what to do and how to make their partner or partners feel good (without any communication), and everyone reaches a climax. Especially when one partner has more experience than the other, it is understandable this could create more nerves or pressure that there is some sort of expectation you need to live up to. The truth is, though, that sex is a learning experience, and with each person being different, it may take some experimentation to figure out what sorts of things your sexual partner or partners (and you) like. That is completely normal, and there is no need to apologize for it! 

Sometimes these sorts of anxious feelings or pressures to be perfect in bed can be rooted in the idea that everyone else in college is having sex or knows what they are doing. On Princeton’s campus, there are lots of folks who have not had sex. The ACHA-NCHA III survey conducted at Princeton in 2020 reported that 44 percent of undergraduates had never engaged in oral sex, 53 percent had never engaged in vaginal sex, and 88 percent had never engaged in anal sex. Similarly, according to the The Daily Princetonian’s annual frosh survey, only around 30 percent of incoming students the last three years reported having sex prior to coming to Princeton. You are not the only one going through these first-time experiences, and learning is completely okay!

Other times, worries can arise from uncertainty surrounding the physical experience of sex. Sex doesn’t always happen seamlessly: consider that penetrative vaginal sex may cause discomfort to people with vaginas due to disruption of the hymen. For people with penises, erections aren’t always maintained. And penetrative sex, both anal and vaginal, can also cause discomfort if the body is tense or if there is insufficient lubrication. These (and many other) physical experiences are common and manageable — e.g., plenty of foreplay and lube (if in combination with a condom, use a water based lube!) can help with vaginal or anal lubrication, and keeping tabs on nerves by working on communication can help with erection duration and a more relaxed physical body. Know that tons of people have had sexual experiences that didn’t go perfectly according to plan and have continued on to enjoy pleasurable and fulfilling sex lives. 

The most important thing to do to feel more at ease is to create a space where there is an open line of communication. This means a place where you feel comfortable voicing your feelings, talking through boundaries, etc. This line of communication is important for any sort of sexual activity, whether it’s your first time or your 100th. While having this conversation may sound intimidating, a respectful and supportive partner will be open to these sorts of talks and will want to make sure you feel open to expressing your desires and feelings as well. Have you talked through what your partner’s expectations, hopes, and desires are — and what yours are? Sometimes, when boundaries and feelings around sexual activities are not discussed, ambiguity can generate more nerves. Clearing up any ambiguity can help you feel more comfortable and can make sex more pleasurable. These conversations are best done during a time when you are hanging out and comfortable, rather than in the heat of the moment.

Before engaging in sexual activity, make sure you are looking out for your sexual and reproductive health. The risk of contracting a sexually transmitted infection (STI) can be significantly lowered through the use of a barrier method (e.g., external condom, internal condom, dental dam). If getting pregnant is a possibility, be sure to use a contraceptive method as well (note: condoms are the only contraceptive method that reduce risk for STI and pregnancy). For more information on how to properly use any of these barrier methods, here are some tips from the CDC. If you have any other questions regarding sexual or reproductive health, you can make an appointment with a sexual health provider through MyUHS. 

I hope this helped ease some of the nervous feelings surrounding having sex for the first time. Remember that all sex is a learning experience, especially since each person has desires that differ from others’ and that can evolve over time — the learning never stops! The most important thing is to have honest conversations with sexual partners so you can create a space with an open line of communication.

Sincerely,

The Sexpert

Information for this article was obtained from the Centers for Disease Control and Prevention, The Daily Princetonian’s Annual Frosh Survey, and Princeton’s implementation of the American College Health Association’s National College Health Assessment III.

Protective Barriers, Sex Positivity, STDs/STIs

What is PrEP?: The Preventative HIV Drug

Dear Sexpert,

I’ve heard that more people are starting to use PrEP. What is it and should I start taking it?

-UnPrEPared

Hi UnPrEPared!

Thank you for your question! With acronyms flying here and there, it’s often hard to detangle what each one is and whether it is something to pay attention to. In 2012, the Food and Drug Administration (FDA) approved a first in class pre-exposure prophylaxis (PrEP) to prevent the transmission of human immunodeficiency virus (HIV), a sexually transmitted infection, in high-risk populations. (See, so many acronyms!) This simply means that the FDA approved a drug that can be taken on a daily basis to reduce the risk of contracting HIV. Only those that are higher risk for contracting HIV are encouraged to consult their doctor on whether PrEP is a good option for them.

PrEP (brand name Truvada ®), developed by Gilead Sciences, Inc., is a combination of two drugs, tenofovir and emtricitabine. These two drugs combine to provide the body the necessary fighting capabilities to attack the HIV virus once it enters the body and prevents the virus from multiplying and causing damage. Effectiveness of the medication is based on consistent and proper, daily use. For those who take PrEP every day, it is 92% effective at preventing sexually transmitted HIV infection and 70% effective at preventing HIV infection among people who inject drugs.

PrEP is only recommended for use among people at higher risk for HIV infection. This includes populations that engage in anal sex, engage with multiple sexual partners, engage with sex without a condom, or people that inject drugs and share needles. It is also recommended for people who are HIV-negative but in an on-going sexual relationship with an HIV-positive partner. Since PrEP is a preventative drug for people with on-going risk of HIV infection, it is not recommended for those who have had a single incidence of potential, high-risk exposure; a medication, called PEP, or post-exposure prophylaxis, is appropriate on that occasion.

Because it requires taking daily medication and regularly visiting a healthcare provider, PrEP is not right for everyone. Taking PrEP requires you to obtain regular lab tests and clinical visits every three months. Appointments for lab tests and clinical assessments for those required three month follow ups can be obtained at McCosh Health Center. Many private insurance companies and the University’s Student Health Plan (SHP) cover the cost of PrEP as long as the patient is considered “high risk” of contracting HIV. To figure out how much PrEP would cost, contact your personal health insurance provider, as different plans will vary in how much they require you to pay out of pocket. Gilead also may also provide helps with the cost of Truvada® through their medical assistance program.

Keep in mind that PrEP only protects against the transmission of HIV. To prevent the spread of other STI’s such as gonorrhea, syphilis, human papilloma virus (HPV), etc., PrEP should be used in tandem with condoms. If you believe that you are at a higher risk for getting HIV and can commit to taking PrEP daily, consult with a clinician at McCosh or your primary care provider to consider if you are a good candidate for PrEP. For more information, visit https://www.cdc.gov/hiv/basics/prep.html.

Best,

The Sexpert

Information regarding PrEP provided by the Centers for Disease https://www.cdc.gov/hiv/basics/prep.html Control and Prevention (CDC) and McCosh Health Center.

Masturbation, Sex Toys, STDs/STIs

Handy: Is it bad if I masturbate every day?

Dear Sexpert,

calendar view

I masturbate every single day. I used to think this was completely normal, but after talking to my friends, it seems that I do it a lot more than others. I feel really embarrassed now. Is it dangerous to 

masturbate this frequently? Is there something terribly wrong with me? Please help!

-Handy

 

Dear Handy,

Rest assured, masturbation – the sexual stimulation of one’s own genitals— is a completely healthy and normal sexual activity. Unfortunately, society tends to treat the topic as a social taboo, making it unacceptable to discuss. Because of this, people often experience feelings of shame or embarrassment when their masturbation is brought to a public light.

Just as people have different food or movie preferences, people also have different preferences for how often they masturbate. Just because your friends report masturbating less frequently than you do does not mean that there is anything inherently wrong with your activities. Both men and women can find masturbation pleasurable, and it is a great way to explore and learn about your own body. Understanding your body’s likes and dislikes will improve all your sexual experiences – by yourself and with others.

Since masturbation is a solo act, there are no risks of becoming pregnant or contracting STIs. However, if you are using toys or objects while masturbating, be sure to clean them properly (wash with a gentle anti-bacterial soap and warm water) before and after use. And never transfer your sex toys from anus to vagina or penis without thoroughly cleaning them first. If you have an active infection (HPV (genital warts) or herpes lesions on the genitals) you may want to avoid touching lesions until they’ve healed.  If you do come into contact with any sores, wash your hands thoroughly. However, if you have a wart on your hand, you don’t need to worry about passing it to your genitals; genital warts are generally caused by different strains of HPV than warts on other parts of your body.

There do exist some prevalent notions that masturbating too frequently can affect things such as fertility, sexual ability and general health. Fortunately, these are all myths. However, just like any activity, it is possible to masturbate to excess. If you find yourself masturbating to the point where it’s interfering with the rest of your life – skipping classes to masturbate, for example – then you may be masturbating too much. In the event that this is the case, there are confidential counselors available in the McCosh Health Center with whom you can discuss your concerns.

I hope this overview of masturbation was helpful in quelling your fears. In short, masturbation is a healthy and safe way to enjoy sexual pleasure. Unless it’s interfering with your daily life, keep doing what feels good!

-Sexpert

Information retrieved from Go Ask Alice. 

STDs/STIs

Curious and Careful: About PrEP

Dear Sexpert,

Pill icon

I’ve seen a couple of ads for a drug for people at risk for HIV. What exactly qualifies as “at risk” and how safe/effective is this drug?

Signed,
Curious & Careful

Dear Curious & Careful,

You’re right, PrEP, or Pre-Exposure Prophylaxis, can be used in prevention of human immunodeficiency virus (HIV). PrEP is a prescription pill (commonly sold under the name Truvada®) designed for daily use by people who are HIV-negative and at substantial risk for HIV exposure. PrEP is a combination of two drugs, tenofovir and emtricitabine. If used correctly and consistently, it has been shown to reduce risk by up to 92%. Additionally, many health insurance plans cover PrEP.

There are several situations that can qualify a person to be considered at substantial risk. The Centers for Disease Control and Prevention (CDC) recommend PrEP for anyone who meets any of the following circumstances:

  • is in an ongoing relationship with an partner who is HIV-positive;
  • is not in a mutually monogamous relationship with a partner who recently tested HIV-negative;
  • is a gay or bisexual man who has had anal sex without a condom or been diagnosed with an STD in the last six months;
  • is a heterosexual man or woman who does not regularly use condoms during sex with partners of unknown HIV status, who are at substantial risk of HIV infection (e.g., people who inject drugs or have bisexual male partners); and
  • has injected illicit drugs in the past 6 months and who has shared injection equipment or been in drug treatment for injection drug use in the past 6 months.”

If you fall into any one of these categories, or feel that you may benefit from PrEP, schedule an appointment at Sexual Health and Wellness (SHAW) or your primary health care office to discuss with a clinician whether this is an option for you. It’s important to keep in mind this is solely a preventative drug for people with on-going risk of being infected with HIV, and is not recommended for those who have had a single incidence of potential, high-risk exposure.  (There is a different medication, called PEP, or post-exposure prophylaxis, in those instances.)

Additionally, PrEP is a drug that needs to be taken on a daily basis. Like birth control or other daily-prescribed drugs, irregular use will decrease its effectiveness. Anyone prescribed PrEP should return

to their health care provider every three months for consistent HIV monitoring and follow up. PrEP is not 100% effective at preventing HIV acquisition and does not protect you from other sexually transmitted infections (STIs). Precautions should still be taken to reduce your risks, including using a condom with every intercourse, getting HIV tested with your partner(s), practicing less risky sexual behaviors (e.g., oral sex while using a barrier method), reducing your number of partners, and/or sterilizing injection equipment or joining a substance treatment program.

Best of luck and be safe,
The Sexpert

Information regarding PrEP retrieved from Centers for Disease Control and Prevention (CDC).

Communication, Protective Barriers, Relationships, STDs/STIs

Expanding My Horizons: How do I tell my partner I’m ready for oral sex?

Two heads facing away from each other with question marks followed by two heads facing each other with heartsDear Sexpert,

My relationship with my partner has become pretty serious and we’re ready to be more intimate with each other. While I’m interested in experimenting with oral sex, I’m still not ready to do more than that. How do I explain this to my partner without offending them?

—Expanding My Horizons

Continue reading Expanding My Horizons: How do I tell my partner I’m ready for oral sex? →

Communication, Protective Barriers, Relationships, STDs/STIs

Confused Club Member: This my first time having casual sex–what should I do?

Dear Sexpert,

I just joined an eating club, and I’m already excited about all the new friends I’m making! I’ve also started hooking up with someone I recently met in the club. Our relationship is pretty casual, and for the most part, physical. In fact, when we’re eating dinner in a group or hanging around the club during the day, I feel like I’m barely acknowledged. We are both enjoying the physical side of our relationship, but I also feel confused about having casual sex. What should I do?

–Confused Club Member

  Continue reading Confused Club Member: This my first time having casual sex–what should I do? →

Dating, Relationships, STDs/STIs

Looking for Someone: What’s the best way to use apps like Tinder and Grindr?

Dear Sexpert,

There are a lot of preconceived notions about Tinder and Grindr, and similar “matchmaking” apps. With all the hype surrounding Tinder and Grindr, I’m interested in trying them out. I think I know how these apps all work, but have concerns about their impact on my sexual wellness. Do you have any tips before diving in?  

–Looking For Someone

Continue reading Looking for Someone: What’s the best way to use apps like Tinder and Grindr? →

Communication, Protective Barriers, Relationships, STDs/STIs

Silent Sam: How do I tell my partner that I have an STI?

Dear Sexpert,

I just started hooking up with this girl I have been interested in for a while, which is great! The bad news is that I just got some results from an STI test I got just before this all happened and it looks like I might have a minor STI. I need to tell her because we didn’t use protection the last time we got together, but I don’t know how! I like this girl, and I don’t want to screw things up right off the bat with this. What do I do?

–Silent Sam

Continue reading Silent Sam: How do I tell my partner that I have an STI? →

STDs/STIs

Trying Something New: Can girls give other girls STDs?

Leave a comment

Dear Sexpert,

I just got out of a long-term relationship with a guy and I am looking to experiment with girls. I don’t think I am a lesbian, but I think college is as good a time as any to broaden my horizons. My boyfriend and I used a condom in the beginning, but once we got serious and I went on the pill, we stopped using one, because both of us had been tested and we’re both clean. Since I plan on only engaging in sexual activity with other girls, I don’t need to worry about protection right? I mean, I’m obviously not going to get pregnant, and my friend told me girls can’t catch anything from each other.

–Ready to Try Something New

 

Dear Ready,

That is great that you got tested previously—knowing your STI status is always a good thing, especially when engaging with a new partner. While you are right that you do not have risk of pregnancy with other women, there is still risk for contracting sexually transmitted infections. However, your level of risk varies depending upon what kind of activities you and your partner engage in.

Low risk activities include french kissing, massages, frotting, mutual masturbation, fingering (insertion of fingers into the vaginal canal) and performing oral sex on another woman through a protective barrier, like a dental dam.

Moderate and higher risk activities then include oral sex or rimming without a dental dam, fisting, and sharing dildos or other toys without thoroughly disinfecting between uses.

Fortunately, both UHS and the LGBT Center have a number of different protection implements available. Condoms are the most common method of protection, and they are available at McCosh for free. You may not think you need to use a condom if you are not engaging in sexual activities with a man, but you can use them on sex toys such as dildos to prevent the transmission of STIs and other infections. Latex condoms are most effective for the prevention of STIs, but if you or your partner has an allergy, polyurethane condoms are also available.

The Reality Condom, or internal condom, is available at the LGBT Center. Made of polyurethane, it can be inserted several hours before use. This can protect you and your partner from STI-transmission during fingering, fisting, and similar activities.

Latex gloves and finger cots are a good form of protection for activities where your fingers or hands come into contact with your partner’s bodily fluids, and vice versa. Cuts, lesions, and any other breaking of the skin can that comes into contact with your partner’s bodily fluids puts you at risk for infection.

For both vaginal-oral sex and anal-oral sex, the best form of protection is the dental dam. Dental dams are available at both McCosh and the LGBT Center. In a pinch you can use non-microwavable Saran Wrap (check the label), for protection during these activities, but latex or polyurethane dams provide the best protection.

While abstinence is the only way to ensure protection against STIs and pregnancy, the barrier methods I just mentioned are the best forms of protection available.  So have fun trying them out and finding what works best for you and your partner.

~The Sexpert