A Compact Guide to Sexual Health - HE1438
This resource relates to the following topics:
Student booklet for teachers to order as class sets to use with the school’s sexual health materials. Covers a range of issues including contraception, condoms, STIs, HIV, AIDS, peer pressure, and sexuality.
The full resource:
Contents
INTRODUCTION to A compact guide to sexual health
PART ONE Taking care of your sexual health
Finding out about yourself sexually
When should I have sexual intercourse for the first time?
Sex is an expression of love and intimacy
Where can you get information or talk to someone about sex?
Sexual intercourse and pregnancy
What actually happens during sex?
INTRODUCTION to Parts two and three
PART THREE Sexually transmissible infections (STIs) including HIV, the virus which leads to AIDS
Signs and symptoms of STIs and HIV
How to protect yourself and your partner from infection
What to do and where to go for tests and treatment
Where to go for help and advice
INTRODUCTION to A compact guide to sexual health
This booklet provides information to help you understand about sexuality.
It has information on sexual health, relationships, safer sex, contraception, sexually transmissible infections (STIs) including HIV, and where to go for advice.
You need to know about sexual health so that you are able to make decisions about sex in your relationships.
Young people in New Zealand have a high rate of unplanned pregnancies and STIs.
The factual information in A compact guide to sexual health is not intended to promote or increase young people’s sexual activity, but to assist you in making responsible decisions.
It is important that you know what choices you can make about sex (sexuality, sexual intercourse and safer sex including contraception and condoms) before you are sexually active.
It is also important that you know about the choices you can make if you are sexually active.
A compact guide to sexual health provides information so that you can make decisions about:
- delaying sex
- what to talk about with your partner before having sex
- how to protect yourself and your partner from unplanned pregnancy and sexually transmissible infections including HIV, the virus which leads to AIDS.
PART ONE
Taking care of your sexual health
Know your body
- As well as the physical changes that accompany puberty and growth there are emotional, social and behavioural changes. You may find it like a roller coaster ride.
- The hormones that kick into gear will affect your emotions as well as your body development.
- Some of the changes that occur may lead to questions about yourself, and your relationships.
- You become more aware of the sexual influences in the world around you as well as the changes in yourself as a young man or young woman.
- It is normal to have an increase in sexual feelings, to be attracted to someone, to dream about them, to want to get to know them.
Relationships
- There are different kinds of relationships such as those with friends, parents, teachers etc.
- Then there are the male/female, male/male, female/female relationships. These relationships are about:
- getting to know each other
- being able to talk about your feelings
- wanting to be together
- doing things together and having fun
- enjoying each other’s company and
- being able to trust and love each other.
- Relationships may lead to a desire for physical intimacy.
Self-esteem and sexuality
- Self-esteem is feeling good about yourself and feeling okay about making decisions for yourself.
- We sometimes forget to be kind to ourselves. It is natural to like some things about ourselves more than others. Remember others like us the way we are.
- Sexuality is more than just sex. It is:
- how you feel about yourself as a young woman or as a young man
- how you feel about yourself and those around you
- how you express those feelings
- whether you are seriously attracted to young women or young men
- every part of you, your mental and emotional, physical, social and spiritual dimensions – your hauora.
- being comfortable about your body size and shape. Everyone is different and
- there is no one way you should look.
- feeling good about being with another person.
Self esteem is feeling good about yourself
Peer pressure
Peer pressure is when you feel stress from friends or school mates to act, behave, think and look a certain way.
This kind of pressure can cover everything from fashion through to sex and dating.
If your friends are true friends they will respect what you want to do.
Be who you want to be and don’t change because of peer pressure
Finding out about yourself sexually
- It is normal around the time of puberty and in the teenage years to have strong feelings for someone. It can be a crush on an older student, teacher or pop star or you may be attracted to another student.
- You may feel confused about your sexuality. There is no right way to work out exactly what your feelings are. Pay attention to your feelings and sexual urges, and eventually you will feel clearer.
- A component of sexuality is a person’s sexual orientation. This means the sex of the people you are attracted to.
- Some teens are sure early that they are gay and others take time to work out their feelings. This is all part of discovering your sexual orientation:
- straight – attracted to people of the opposite sex
- gay – attracted to people of the same sex (takaatapuia)
- bisexual - attracted to people of both sexes.
- There are many sexual activities that you can enjoy before making the decision to have sexual intercourse, for example:
- kissing
- cuddling
- touching and feeling that increases sexual arousal
- masturbation – touching yourself for sexual pleasure. Masturbation is a normal healthy way of exploring your body. It is a safe way of finding out what your body likes and how you respond.
- Find out what feels OK for you. Not all the sex and sexual behaviour shown in movies or on TV, or read about in magazines or books is realistic or honest.
- We are born with our sexuality and we learn to understand it.
When should I have sexual intercourse for the first time?
- Do you feel that you are ready to have sex? If you are not sure then delay sex.
- What is most important is that the sex you have is right for you and for your partner at that time, and that you do not put yourselves at risk of unplanned pregnancy and STIs.
- You may wish to wait until you are:
- older
- in a serious relationship
- sober (not wasted).
- You can say no to sex. It is your decision when to have sex. Don’t let someone else decide for you. You don’t need to have sex just because your friends are, or your partner wants to.
- Before having sex, talk and plan with your partner about what you feel comfortable doing. If you are not comfortable talking about what you want to do, then you’re probably not really ready to have sex with this partner.
- Before having sex plan to have safer sex. This means protecting yourself or your partner from becoming pregnant or catching a sexually transmissible infection (STI), including HIV.
Sex is an expression of love and intimacy
- Ask yourself – is this the right person and the right place?
- Get to know your partner first so that you feel comfortable talking about sex. This will take time.
- If you do decide to have sex, then plan it, eg, where is it to take place and have you got your condoms?
- If you talk about having sex or plan sex, it does not mean you have to have sex if you don’t want to. You can change your mind and say no.
- If you have had sex once it doesn’t mean that you agree to sex at another time. You can say no.
- If you are not sure about sex or do not want to have sex, then it’s your choice whether it is right for you to be in a relationship that includes sex.
Any sexual activity should only happen if you want it and feel okay about it
Where can you get information or talk to someone about sex?
- You may be able to talk about safer sex with your parents, whānau, health teacher, form teacher or guidance counsellor.
- Does your school have a peer support group (sexuality) that can help you?
- Friends may be helpful and supportive, but they may give you information that is not quite right.
- Other people you can talk to confidentially are your doctor, school nurse, family planning clinic, sexual health service, or youth service. Your partner or friend may go with you for support.
- What goes on between you and your doctor is confidential. No one else will be given your name, told about what is discussed or what treatment is given.
Communicating about safer sex
One of the most important parts of sex is communication.
- Knowing what you want or don’t want (your boundaries) and expressing this clearly and with determination (assertiveness) will make the experience better for you and your partner.
- It can be hard to talk about so think about your boundaries and what you want to say when the issue comes up. Maybe practise with a friend.
Communication is just as important if you choose not to have sex.
- You can say no to sex and any unwanted sexual activity or touching.
- No-one has the right to touch you or do anything you don’t want them to do sexually.
- If you get into a situation where you feel someone is pressuring you into having sex, being assertive will put you in control.
- They may say: If you loved me you would have sex with me. You don’t have to offer any explanation if you say no but the following are some examples of what you could say.
- You may say:
- I’m not ready.
- If you loved me you wouldn’t pressure me.
- I don’t know you well enough.
- Kaore – No way!
- I want to have a good time with you and be friends with you but I don’t want sex.
- Don’t touch me – keep your hands off me.
- Don’t feel pressured into doing something you don’t want to do, eg, having sex without a condom.
Keeping safe
- What is important is that the sex you have is right for you and for your partner at the time; that it is what you both want to do; and that you are careful not to put yourselves at risk of an unplanned pregnancy and STIs.
- It’s your responsibility to prevent an unplanned pregnancy. Condoms also protect you against STIs and are particularly effective against HIV.
- Alcohol and/or drugs may make you feel relaxed and sexually aroused. You may not be able to think clearly about what you are doing. If you then have sex you may regret it the next day.
- When you are out:
- it is safest not to drink alcohol or accept any drugs
- watch your drink as someone could slip some powder or a tablet into it without you knowing
- stay with your friends or people you can trust in safe areas. If someone forces you to have sex – that is rape or sexual violation and it is against the law.
Be assertive! Work out your boundaries and stick to them
Sexual intercourse and pregnancy
- A young man is able to father a child when he can produce semen.
- Semen, the fluid from the man’s penis, contains sperm which can fertilise a woman’s egg.
- A young woman can become pregnant as early as her first period, if unprotected intercourse has taken place.
- A woman ovulates (releases an egg) every month at the mid stage of her menstrual cycle.
- Pregnancy (conception) occurs when a sperm fertilises an egg by joining with it.
- This can happen when a man and woman have sexual intercourse, an egg has been released from one of the woman’s ovaries, and neither partner uses contraception. That is, they have sex without a condom or other contraception.
What actually happens during sex?
-
Before sexual intercourse, sexual activity including kissing, touching, massaging and stroking takes place. - During these early stages of sex both partners may become aroused with feelings of sexual pleasure.
- As the woman becomes aroused the vagina moistens (feels wet) and this makes it easier for the man’s penis to enter.
- During sexual arousal the man gets an erection - the penis fills with blood so that it becomes larger, stiff and erect.
-
It is possible for a woman to become pregnant even before intercourse if the fluid from the man’s penis enters her vagina. - This fluid is called semen and contains sperm which can fertilise a woman’s egg.
- When both partners are aroused, penetration of the vagina by the penis becomes easier. The man slides his penis into the woman’s vagina.
- One partner may move or both partners may move together. This causes friction on the man’s penis inside the woman’s vagina.
- This may lead to orgasm.
What is an orgasm?
- This is the climax of sexual excitement in both men and women.
- At the peak of sexual pleasure in the body, the sex organs contract in a series of muscular spasms, followed by a feeling of release.
- A woman is more likely to have an orgasm if she is highly aroused before intercourse takes place.
- A woman does not have to orgasm to become pregnant.
- When a man reaches orgasm he ejaculates (comes) and semen containing millions of sperm is released.
Conception
- Without a condom or other form of contraception to prevent it, the sperm swims up into the womb (uterus) and along the fallopian tubes.
- If an egg has been released from one of the woman’s ovaries, and a sperm penetrates the egg, fertilisation has taken place.
- Once the egg is fertilised it moves into the uterus, where it attaches itself to the lining of the uterus and its cells begin to divide and grow into a baby.
- When this happens the woman is pregnant.
INTRODUCTION to parts two and three
Safer sex and condoms
- Talk with your partner and plan before you decide to have sexual intercourse.
- To protect against pregnancy you will need to use a form of contraception, usually a condom or the oral contraceptive pill.
- For protection against sexually transmissible infections including HIV, the virus which leads to AIDS, you should always use a condom.
How to use a condom
-
Use a new condom each time you have sex. - Check the condom pack. If the expiry date has passed or the wrapper is torn, get another one. Condoms should be stored in a cool dry place, eg, not in inside pockets or the glove box of a car.
- To open the condom foil – carefully tear along the serrated edge with your fingers. Fingernails, rings and teeth can tear the condom. If the condom is damaged use a new one.
-
Make sure the penis does not touch the vagina, mouth or anus before being covered by a condom. - Check that the condom is the right way up. Hold the tip of the condom to squeeze out the air, and then roll it onto the erect penis all the way to the base.
- Only use a water-based lubricant (eg, KY Jelly,
Wet Stuff, Sylk, and Glyde) on the outside of the latex rubber condom. Do not use oil-based lubricants and oil-based medications such as Vaseline as they can weaken latex rubber condoms and cause them to break. Water-based lubricants help to prevent condom breakage. This is particularly important with anal intercourse. - When pulling out hold the condom firmly at the base
of the penis, so that no semen is spilt. - Wrap the used condom in tissue or toilet paper and put it in the rubbish.
- Practise putting on a condom, with your partner, before you have sexual intercourse for the first time, eg, during masturbation.
PART TWO
Contraception
What is contraception?
- Contraception means the things you can do to make sure that you (or your partner) do not become pregnant when you have sexual intercourse.
- Having some contraception ready doesn’t mean you are "easy" or even mean you are going to have sex.
- It means you are taking responsibility for your actions. You are protecting yourself against an unplanned pregnancy or possible infection.
- You can then safely choose whether you want to have sexual intercourse, and when.
The condom and the pill work well for young people.
Condoms – effectiveness 90-98%
- Condoms are very effective contraceptives when used properly (see How to use a condom).
- A condom is a thin latex rubber or polyurethane sheath which is fitted over the penis. It collects the semen when the man comes and prevents the semen, containing sperm, from entering the vagina.
- Condoms can be purchased in different sizes and shapes. Try different types to find those that suit you best.
- Only buy condoms that are tested and approved. You can tell if the condoms you are going to use are safe (approved) by checking the packet to see if it has the New Zealand Standard logo on it.
Be prepared! Have you got your condoms?
- Whatever your age, you can buy condoms from pharmacies, some supermarkets, pubs, clubs, service stations and dairies and on prescription from your doctor and Family Planning centres. They are free from sexual health services and your school health nurse.
- Condoms are the only contraception that protect against pregnancy and also protect against STIs, particularly HIV.
- Condoms put the responsibility for contraception and safer sex on both the woman and the man.
- Condoms have no side effects.
- Using a water based lubricant with condoms helps to prevent them from breaking, eg, a woman may have a dry vagina if not sufficiently aroused.
The pill – effectiveness 95-99%
- The pill is one of the most effective methods of contraception.
- The pill is a small tablet taken by the woman. It contains hormones which stop her from releasing eggs so there is no egg for the sperm to fertilise.
- The pill must be taken at the same time every day. Some pills, however, have a seven day break in each month.
- A woman can become pregnant as soon as she stops using the pill.
- Women taking the pill have regular, shorter, lighter and less painful periods.
- You can get the pill on prescription whatever your age, if your doctor agrees. Discuss this with your doctor or the doctor at a family planning centre or school health clinic.
- Talk to your doctor about possible side effects such as bleeding, breast tenderness, feeling sick or changes in weight. More serious side effects such as blood clots are rare.
- If you have concerns about side effects talk to your doctor. Your doctor will need to know your medical and family history to help decide which pill will be best for you. There are several types of pills and another brand may suit you better.
- Health risks involved with being pregnant are usually much greater than any side effects from the pill.
- If you are taking other medicines such as antibiotics, or if you have vomiting and diarrhoea, the pill may not prevent pregnancy. You need to use another contraceptive. Talk to your doctor.
The pill does not protect against STIs so you will also need to use a condom
If you don’t feel happy with one method of contraception talk to your doctor about another
Emergency contraceptive pills
(used to be called ‘the morning after pill’)
- Emergency contraceptive pills are for use in times such as:
- if you have had unprotected sex
- when a condom breaks
- when you have missed a contraceptive pill
- when you are on the pill and have been sick or vomiting.
- Emergency contraceptive pills should be taken within 72 hours of unprotected sex (but the sooner the better).
- You can get these pills on prescription after talking to your doctor, or the doctor at a Family Planning Centre or Sexual Health Service. They are also available directly from some pharmacies and nurses.
- The emergency contraceptive pill does not protect against HIV or other STIs. See your doctor for tests if you are concerned.
- Side effects may include feeling sick and vomiting. Talk to your doctor if you are concerned.
- Have a pregnancy test two weeks after you have taken the emergency contraceptive pill to check if it has worked.
- If you are concerned that you may be pregnant, see your doctor early for a test and to discuss your options, ie, what you can do.
Other contraceptives
- The Depo Provera injection, an injection given every 12 weeks to prevent pregnancy, may be recommended for young women. Talk to your doctor about the best contraception for you.
- There are other forms of contraception such as the diaphragm, the intrauterine contraceptive device (IUD), sterilisation, the withdrawal method or fertility management (Natural Fertility New Zealand). However, these methods are not usually recommended for young people.
If you are not happy with one method of contraception talk to your doctor about other options.
Use condoms for safer sex
PART THREE
Sexually transmissible infections (STIs) including HIV the virus which leads to AIDS
The major STIs are:
- chlamydia
- genital warts
- genital herpes
- hepatitis B
- gonorrhoea
- HIV
- syphilis
Chlamydia, genital warts and gonorrhoea are the STIs most common in sexually active young people in New Zealand.
STIs are serious infections which are caused by bacteria, viruses or other micro-organisms.
- These organisms can infect and live in or around the sex organs, anus and in the mouth and throat.
- Some are curable with antibiotics, eg, chlamydia, gonorrhoea and syphilis. They should be treated as early as possible to avoid any long-term health problems such as infertility.
- Genital warts and genital herpes are incurable although their symptoms can be treated with drugs.
HIV is a virus which gradually weakens the immune system and causes AIDS
- HIV is incurable.
- The outcome of people living with HIV can be significantly improved through antiretroviral drug therapy, especially if treatment is initiated early.
- Some of these drugs have side effects.
- HIV can lead to AIDS and death.
Unprotected sex can lead to STIs, HIV and unplanned pregnancies
How STIs and HIV are spread
STIs and HIV are serious infections spread by unprotected sexual contact (ie, sex without a condom) with an infected person. They can be passed on during sex.
HIV and hepatitis B can be passed on:
- through unprotected sexual contact
- in blood and other body fluids
- from mother to baby during birth.
If you are having any tattooing or skin piercing make sure new needles are used. Anyone who injects drugs should use a new needle and syringe every time.
Genital warts and genital herpes are also spread by unprotected sex and by skin on skin contact with an infected person.
Signs and symptoms of STIs – how will you know if you have an STI?
Signs of infection may show up on or around the sex organs such as:
- sores, itching, rashes, bumps, or blisters
- an unusual discharge from the vagina or penis
- a burning feeling when ‘peeing’
- pain low down in the abdomen (women).
Men and women often don’t notice anything. There may be no signs or symptoms in either sex.
The Human Immunodeficiency Virus (HIV)
- HIV infection is a very serious STI and is a major health problem.
- HIV is present worldwide in both men and women.
- As yet there is no vaccine or cure but drug treatments can delay the progression to AIDS in HIV infected people.
- Infection with HIV may be followed by a mild illness. Then there may be no signs or symptoms for many years.
- In the meantime HIV is attacking the body’s immune system and becomes a permanent part of the cells in the body.
- This gradually weakens the body’s immune system.
- It becomes more and more difficult for the body to fight certain infections and cancers.
- When a person has HIV and one or more of these infections or cancers, they are said to have Acquired Immunodeficiency Syndrome (AIDS).
- People who have HIV infection may remain healthy for many years but throughout this time they can pass HIV on to other people.
- If people are worried about HIV, a blood test is recommended.
- It may take up to three months following exposure to HIV before a test becomes positive and shows that a person has HIV infection.
Condoms will help keep you safe from STIs
How to protect yourself and your partner from infection
- The best way to avoid all risk of STIs is not to have sex.
- If you are sexually active, you can avoid HIV infection in particular and reduce your chances of getting other STIs by always practising safer sex, ie, sex with a condom (see How to use a condom).
- Always use a condom when having vaginal sex.
- Always use a condom when having anal sex.
- Cover the penis with a condom during mouth (oral) sex in order to avoid STIs. Flavoured condoms are especially designed for this.
- Avoid vaginal, anal and oral sex with someone who has sores, rashes, bumps, or blisters around the mouth, sex organs or anus, or who has an unusual discharge from these areas. These are often signs of an STI.
- Condoms will help keep you safe from STIs and will protect your fertility.
- Condoms will protect you from HIV.
- Immunisation is the best way to protect yourself from hepatitis B.
Other protection
An oral dam is a thin square of latex rubber which acts as a protective barrier between the mouth and sexual parts during oral sex.
It can be obtained from Sexual Health Services, Family Planning, and from some pharmacies.
What to do and where to go for tests and treatment
- If you think you have an STI or may have been exposed to HIV, see your doctor or go to a Sexual Health Service, the New Zealand AIDS Foundation, or Family Planning for tests and treatment.
The service is confidential and friendly and there is no charge at a Sexual Health Service. The service is also free at Family Planning if you are under 22 years of age and are a New Zealand resident.
If you are worried that you may have an STI or HIV GET CHECKED
- Chlamydia and gonorrhoea which are caused by bacteria can be treated with antibiotics.
- Those STIs caused by viruses such as genital warts and genital herpes cannot be cured but their symptoms can be treated.
- As yet there is no vaccine or cure for HIV but drug treatments can delay the progression to AIDS in HIV-infected people.
- Without treatment STIs can cause serious health problems later.
- Chlamydia and gonorrhoea can cause a chronic infection and may prevent a woman from having a baby.
- Genital warts have been linked to cervical cancer.
- Although syphilis is rare in New Zealand, it can lead to death if left untreated.
- You can pass an infection on to your partner. Your partner will need testing and may need treatment. Your doctor or clinic will advise you how your partner can get tested and treated.
- If you don’t feel comfortable with one doctor you can go to another.
You can get condoms from:
- pharmacies
- supermarkets
- some service stations
- some dairies
- your doctor
- Sexual health services (small quantities are free)
- Family Planning.
If you have an infection your partner(s) will also need to be tested and treated
Where to go for help and advice
- if you want contraception
- think you might be pregnant
- think you may have an STI
- or want advice.
Look in the:
- front of your phone book under Registered Medical Practitioners for your doctor.
Look under:
- Family Planning in the white pages for your local clinic.
- Sexual Health Service in the white pages for your local clinic.
All helplines exist to give you help at the end of a telephone line.
0800 or 0508 numbers are free and confidential and will not appear on your phone bill. The great thing about helplines is that you can stay anonymous and ask questions you may be afraid to ask face to face.
For advice ring:
- Healthline 0800 611 116
- Youthline 0800 376 633
- Family Planning 0800 INFOLINE (0800 4636 5463)
- The AIDS Hotline – 24-hour 0800 80 AIDS (0800 802 437)
- The Herpes HPV helpline 0508 11 12 13
Web sites
| Sexual Health Services | listed at www.hpv.org.nz/help/where.htm |
| Family Planning | www.familyplanning.org.nz |
| The Word | www.theword.org.nz |
| New Zealand AIDS Foundation | www.nzaf.org.nz |
| Youthline | www.youthline.co.nz |
| Rainbow Youth | www.rainbowyouth.org.nz |
| Needle exchange NZ | www.needle.co.nz |
Code HE1438.