Category Archives: STDs/STIs

Communication, Dating, Protective Barriers, Relationships, Sex Positivity, STDs/STIs

Hookup Hopeful: On the Pursuit of Casual Sex

Dear Sexpert,

I’ve realized that I want to pursue something casual and am not looking for a relationship right now. While I’ve had some hookups, I haven’t found a consistent situation that works for me. I know that finding something casual can be difficult, but at the end of the day I know it is what I want. How can I approach this in a healthy manner and keep what I want in mind?

– Hookup Hopeful

Dear Hookup Hopeful,

It’s great that you’ve come to know yourself well enough to realize that a casual relationship is truly what is best at the moment. Being self-aware of your own wants and needs is one of the fundamental steps involved in seeking out experiences that both feel good and are good for you. 

When engaging in casual sex or intimacy, communication becomes all the more crucial  in finding a partner (or partners) and maintaining a healthy, respectful relationship. Before you do anything physical, have an open and honest conversation about expectations, boundaries, and comfort levels. Make sure you and your partner(s) are on the same page about what a casual relationship means, whether it is a one-time thing or an on-going arrangement. Not everyone will share the same definition of “casual,” and different expectations can lead to confusion or hurt feelings. Being honest about your desires and listening to what the other person wants creates a zone for mutual understanding and respect. It’s perfectly okay if this conversation is uncomfortable to have, as learning how to discuss sex and boundaries in open terms is often a skill we are not taught, and thus, need to learn.

When engaging in casual sex, taking care of your sexual health is as important as  your emotional boundaries. Getting regular sexually transmitted infection (STI) tests is also a responsible self-care measure you can take to protect yourself and your partner(s), even if you have no signs of concern. Many STIs, including chlamydia and gonorrhea, may remain asymptomatic but can have permanent health effects if left untreated. Other STIs, including syphilis and herpes, are also common and can be transmitted through oral sex or skin-to-skin contact. Prevention of HIV is also a high priority, and  having protection and researching preventative options like PrEP can prevent transmission. Remember that protection doesn’t just mean external and internal condoms– dental dams and other barrier methods also reduce risks from oral sex. University Health Services offers STI testing as well as regular exams to support your sexual and reproductive healthcare needs.

Keep in mind that risks will depend on the kind of sexual activity you and your partners are engaging in (and not just with each other). Having a conversation with your partner about whether either of you are having sex with other people, and using barrier methods or other forms of prevention, is another important discussion to promote health and safety. Taking responsibility for your health not only makes you healthy, but it’s also respectful and caring of your partners’ health.

Another aspect to keep in mind is how these casual hookups are initiated. Not always, but often “hookups” commonly occur in the setting of eating clubs, pre-games, and parties in which substances (such as alcohol or other drugs) are present. These substances can impair decision-making, impact attention to interpersonal cues, and challenge clear consent. You should check in with yourself and your partner(s) to ensure that you and they are able to consent. If you ever are unsure if someone is in the right state of mind to give consent or if you are being pressured and feel uncomfortable, it’s always better to back out of the situation. Hookup culture can be exciting, but physical and emotional safety always comes first.

Lastly, remember that feelings change with time, and that is completely normal. What feels right for you now might evolve as you continue to explore your likes and reflect upon experiences. You could start out wanting something casual and find that you require something deeper, or you might feel more certain that a casual relationship is ultimately what you want. Your partners have similar autonomy to change their feelings, so open discussion is required to navigate through changes. Check in with yourself regularly and have honest conversations with your partner(s), if something starts to feel different. If the relationship is no longer what you want or if your partner shows a change in feelings, being respectful and direct about it will make it easier for both of you. Casual sex, as with any other form of intimacy, is a two-way street, and should be comfortable for everyone involved.

Casual sex can be a positive and enjoyable experience when approached with honesty, awareness, and sensitivity. By making clear communication your priority, practicing safe sex, being mindful of hookup culture dynamics, and being open to change, you can create experiences that fit what you desire. Whatever path you take, make sure it’s one that centers your well-being and is respectful of those you engage with.

You got this!

– The Sexpert

Information for this article obtained from Sexual Harassment/Assault Advising, Resources, and Education (SHARE), UMatter, and University Health Services (UHS).

Communication, Relationships, STDs/STIs

PrEParing Partner: PrEPping for your relationship

Dear Sexpert,

I’ve started to see a guy, and I’ve been struggling to talk to him about the possibility of me or both of us going on PrEP. I myself haven’t had former sexual partners, and he claims he hasn’t had sexual partners since he was last tested, but we aren’t yet exclusive in our relationship. I’m worried that going on PrEP — or suggesting he do so also — will breach trust in our relationship, but I also want to prioritize safety. 

— PrEParing Partner

Hi PrEParing Partner, 

It’s normal to have concerns and questions about using PrEP and discussing your use of it with your partner. Taking PrEP (like other preventative medications) is an indication of investment in your — and your partner’s — health, not a barometer of your trust. Hopefully with a little preparation (pun intended) and well-timed conversation, you can prioritize safety for both of you! 

First, let’s discuss what PrEP is. PrEP (pre-exposure prophylaxis) is a prescription medication that reduces the risk of getting human immunodeficiency virus (HIV) from sex by 99 percent when taken properly. It is intended for HIV-negative individuals and available in oral pill-form, Descovy and Truvada, and a bimonthly injection, Apretude. The latter two of these options have been approved for individuals with vaginas in addition to individuals with penises. These drugs block the enzyme HIV needs to replicate in the body, reducing the risk of contracting the virus when used as prescribed. 

PrEP could be worth exploring if:

  1. You’re in a serodiscordant relationship, meaning one partner is HIV-positive and the other is negative. 
  2. One or more partners engage in activities that increase HIV transmission risks, such as having multiple sexual partners, lack of or inconsistent condom use, and sharing needles. 
  3. You do not know a partner’s HIV status. 

Before starting oral PrEP, patients get an HIV test. Patients either take PrEP as one tablet per day for seven days before contact and every day following as needed, or immediately before having sex — a method called “on-demand.” Taking oral PrEP requires a visit to a healthcare provider every 3 months for HIV testing, prescription refills, and a follow-up; for injectable PrEP (Apretude), patients will need to see a provider for their first injection. They receive another injection in one month, returning every two months for testing and the injection.

Sexual health appointments, sexually transmitted infection (STI) testing, and barrier methods such as condoms are available through Sexual Health and Wellness at University Health Services. Remember that if you and/or your partner decide to go on PrEP, it is only effective against HIV; condoms should be used to lower the risk of contracting other STIs. Consistent condom use and regular testing are essential to ensuring sexual health. 

Sharing what you’ve learned about PrEP can be a productive way to frame your conversation with your partner. You will want to emphasize shared responsibility, collaboration, and trust in your discussion. Start by finding a good time and place to discuss this where your conversation won’t feel rushed or distracted. Lead with your feelings and invite his perspective on exploring PrEP together. 

Be prepared to reassure him that your interest in PrEP stems from a desire to protect yourself and him, not from mistrust. Taking PrEP is about taking care of each other, and it does not suggest a high-risk lifestyle for either partner. Rather, it serves as an additional tool for promoting sexual health, just like using condoms.  

Be prepared, too, to discuss any barriers to accessing PrEP, such as cost or time. The Student Health Plan (SHP) insurance covers emtricitabine/tenofovir (generic Truvada) and Apretude (injectable PrEP) at no cost to students. Other insurances may not cover every PrEP option, or a co-pay may be needed, so speak to your insurance provider to find out more information. Keep in mind that consistently taking the daily pill without missing doses and committing to routine testing and check-ups may be difficult lifestyle adjustments at first. But with time and tricks to help create a routine (e.g., calendar reminders, app tracking), keeping up with PrEP can easily become second-nature.

If your partner is fully supportive of your decision to begin treatment with PrEP, great! You can discuss next steps and work through solutions to any remaining concerns or issues accessing the drug and maintaining the regimen. If he’s hesitant, you might provide more resources, or suggest you see a healthcare provider together to learn more. If he resists or dismisses your concerns, consider your own values. Just remember that protecting your health is paramount. 

— The Sexpert

Information in this article obtained from University Health Services,HIV.gov and Healthline.

STDs/STIs

Tentative Test-taker: STI Testing

Dear Sexpert,

I have been sexually active with multiple partners for three years now. Though I am not currently experiencing symptoms nor know of exposure to anyone with an STI, I am really nervous that I may have contracted one. I remember learning that many STIs may have no signs or symptoms, so I am getting really anxious that I may have one, and it will be too late. I feel too embarrassed and scared to talk to my friends and family to ask about testing, however, I am concerned for my health and want to get checked out ASAP. Do you have any guidance for where I can get help?

— Tentative Test-taker

Dear Tentative Test-taker,

I am sorry to hear you are feeling anxious. You are being very proactive by reaching out with your concerns. To alleviate some of your anxiety, I want to first remind you that all sexually transmitted infections, when identified early enough, can be treated (i.e., those caused by viruses), if not cured (i.e., bacterial infections). So even if you test positive for an STI, medications can manage symptoms or even clear up infection entirely. You can still have healthy and fulfilling sexual experiences in the future. You also noted that you may be asymptomatic and have had no known exposures. If you have been practicing safer sex by doing things like using barrier methods consistently and properly, the chances of contracting an STI are very low.

One of the first steps that you may want to take is to communicate with your sexual partner(s). Ask them if they have any STIs that they are aware of or if they have recently had testing and share that you are concerned about transmission. Initiating the conversation will allow both you and your partner(s) to make well-informed decisions about the next steps to take. If you have not already discussed your partner(s) being non-monogamous, this is also an important conversation to have, as it can increase risk for your partner(s).

STI testing recommendations vary and depend on multiple factors, including behavioral and identity-based risks. Finding out more about whether you need testing is a smart decision, and you should not feel embarrassed about it. There are indeed resources right here on campus that can help you get answers.

Your MyUHS online portal features a new online STI testing program for asymptomatic testing, designed to include evidence-based educational information and enable you to make an informed decision about the type of testing you wish to pursue. Additionally, this testing is confidential, so you do not have to be concerned with other individuals, such as your family, finding out from UHS.

It is important to note that self-directed STI screening will be sent through Quest Laboratory and billed through insurance. If you wish to avoid using insurance (where an Explanation of Benefits will be mailed to the insurance holder [e.g., parent, guardian] and may result in questions about the procedure/testing), you should make an appointment with a nurse for a screening. Read more about costs if you choose not to use insurance — see “STI Testing” and “Lab Tests” on this page. Positive results for some STIs may be shared with state or city health departments for tracking purposes, but there are laws preventing health departments from sharing your test results with your family, friends, or employer.

To begin the STI testing process, follow the steps below:

  1. Log into your secure MyUHS online portal and choose “Princeton University” if prompted.
  2. Navigate to the Forms page.
  3. Scroll down to the Sexual Health and Wellness section and click on “Self-directed STI Testing.”
  4. Use the educational materials provided and/or access the application: STD Wizard, to decide what you want to be tested for and which body parts should be tested.
  5. Order your desired labs.

Once you receive a notification that your labs are ordered, you can go to the reception desk at McCosh Health Center during a time that is convenient for you (Monday–Friday, between 9 a.m. and 3 p.m.), to collect your specimen(s). 

According to the UHS website, lab test results are typically available within 24–48 hours. The UHS electronic health record automatically releases normal lab results to students via the patient portal. Positive lab results are reported to students by a nurse, enabling a discussion of any needed treatment. UHS is currently processing approximately three to ten online STI tests requests daily. This means that your peers are also taking advantage of this offering, even if they aren’t talking about it openly.

If you would prefer to go to an off-campus resource, such as an urgent care or Planned Parenthood, to get tested, that is also always an option. Thank you so much for reaching out about your concern. You are doing the right thing for your health by getting tested, and we are glad to be able to highlight this convenient UHS resource for you. If you have further questions or concerns, feel free to reach out to any of the PHAs.

We wish you all the best,

— The Sexpert

Communication, Dating, Personal Health & Hygiene, Protective Barriers, STDs/STIs

Flavorful Fluid: Addressing health concerns regarding oral sex

Dear Sexpert,

Things are getting kind of hot and heavy with this guy I’m seeing. We’ve only made out so far, but I have recently been thinking about trying oral sex. I’m worried about the taste of my bodily fluids. I’ve heard pineapple juice might help oral sex be more enjoyable for the giver: Is this true?

— Flavorful Fluid

Dear Flavorful Fluid,

Thank you for reaching out with your question! It’s completely normal to have questions and occasional insecurities about our bodies when it comes to sexual experiences, especially new ones. Regarding any type of sexual activity, including oral sex, it’s important to reflect on your personal wants and needs and to have open and respectful communication with your partner(s).

Oral sex encompasses a range of activities: cunnilingus, the oral stimulation of the vulva; fellatio, the oral stimulation of a penis; or anilingus, colloquially called “rimming”, oral stimulation of the anus. It’s common for the person giving oral sex to encounter various tastes and sensations as every body has its own unique flavor profile, and it can change depending on many variables — including diet, hydration, supplements or medications, hygiene, or infection. As for your question about pineapple juice, there’s a belief that consuming pineapple juice may make penile and vaginal secretions taste “better” — less bitter —, though it’s important to understand that many factors contribute to these tastes. Penile secretions are slightly alkaline, with a pH ranging between 7.1 and 8, which can lead to a slightly bitter taste. On the other hand, vaginal secretions are slightly acidic, with a pH between 3.8 and 4.5, resulting in a tangy taste. Your diet plays a significant role in the flavor of any bodily fluid, whether it be saliva, sweat, urine, seminal, or vaginal fluid.  For example, foods such as garlic, onions, dairy, red meat, smoking, and alcohol can contribute to a more “bitter” taste. In the case of penile secretions, sugary liquids or foods, such as pineapple juice, can alter the fructose and glucose content, making them less alkaline and potentially less “bitter.” The taste of vaginal secretions is also strongly affected by the menstrual cycle. During menstruation, the presence of blood may give a “metallic” taste, while during ovulation, the release of cervical mucus can result in a “muskier” taste. In addition to diet, being on medications, such as antibiotics, or having an infection affect your pH levels, and impact your natural smell and taste. 

Let’s also address this message that bodies and bodily secretions should taste or smell like something other than what they are. This strategy, used to sell products that promise to mask your natural scent or unique flavor, contributes to feelings of shame or insecurity about our naturally-existing bodies. Practicing general hygiene, like taking regular showers, wiping after using the bathroom, and wearing proper-fitting, breathable, clean underwear should ensure that your unique taste is natural. If your partner(s) makes comments about not liking your taste or uses it as an excuse to not give oral sex, a conversation might be in order. Together, with open communication, you can hopefully come up with creative and mutually-pleasing solutions.

It is also important to note that engaging in oral sex comes with risk for sexually transmitted infections (STI), like gonorrhea, chlamydia, syphilis, herpes, etc. To reduce risk, use a dental dam — a sheet of latex or polyurethane placed over the anus or vulva — to prevent skin-to-skin contact during cunnilingus or anilingus, or an external condom during fellatio. Condoms, dental dams, and water-based lube can come in different flavors, which can make things more exciting —chocolate mint, anyone? — and cover the taste of latex while simultaneously reducing risks. Many STIs are asymptomatic, meaning you can spread an STI without knowing it, so the best option is for you to use barrier methods, and/or get screened for STIs with your partner(s) and s hare your results with one another. You can do self-directed STI testing through UHS, since you are asymptomatic, or you can make an appointment with Sexual Health and Wellness at UHS through your MyUHS online portal.

Ultimately, personal preferences and sexual experiences can vary widely. Open and honest communication with your partner, respect for each other’s boundaries, and consent in all activities are most important. If your partner notices a change and brings it up in a considerate manner, it’s an opportunity to have a conversation about your well-being. However, if you find yourself in a situation where your partner constantly makes disparaging comments or uses this as an excuse to avoid certain activities, it’s important to prioritize your own self-respect and comfort. Partners should approach these topics with empathy and respect for each other. 

Warm regards,
The Sexpert

Information obtained from Healthline, National Library of Medicine, Men’s Health, University Health Services, and Mayo Clinic.

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? →