If you decide to have sex, here's a few things you need to know

By Lauren Coyle
Athens NEWS Campus Reporter

As students make the decision to become sexually active, they should bear in mind the possible physical consequences -- namely sexually transmitted infections (STIs) and pregnancy.

Char Kopchick, director of Health Education and Wellness at Ohio University, said statistics are not available for STIs on campus, but possible trends can be recognized by the cases that are seen at OU's Hudson Health Center.

"I can say that we've seen more cases of chlamydia and gonorrhea this fall than in previous years," she said. "But it is important to realize that many infected people don't show symptoms. As much as 90 percent of those infected with chlamydia are asymptomatic."

Chlamydia is the leading bacterial STI among individuals in the age group of 15 to 30, according to Kopchick. "Chlamydia is also the leading cause of sterility for men and women," she said.

Chlamydia is transmitted through unprotected oral, anal and vaginal sex, according to informational leaflets distributed by the Health Education and Wellness. Gonorrhea is also passed through unprotected oral, anal or vaginal sex, the brochures warn.

Chlamydia and gonorrhea, both bacterial infections, are treatable by antibiotics if detected. They are ordinarily tested for together, and a test for both men and women is available at Hudson Health Center for $26.

"We test for chlamydia and gonorrhea as part of women's annual exams," Kopchick said. "But this is not done everywhere. Women should be conscious of asking for these tests."

Kopchick said genital warts and herpes are the most common viral STIs. "The Centers for Disease Control and Prevention estimate that one in five college-age students are living with the virus that causes genital herpes, and one in 4.9 are living with the human papillomavirus (HPV), which causes genital warts," Kopchick said.

Herpes is transmitted through unprotected sex, including oral sex, according to information Health Education and Wellness. It is incurable, but medication can help to treat the symptoms.

Tests for herpes are available at Hudson. A culture may be taken from an open sore or lesion, which costs $27. A blood test is also available for $32, but people may test positive if they have ever been exposed to a cold sore.

Genital warts are caused by skin-to-skin contact, even if the infected individual has no visible signs of infection, according to the brochures. "Depending on where the person is infected, a condom may not prevent transmission," Kopchick said. "And certain strains of HPV are linked to cervical cancer."

Genital warts are difficult to diagnose in the absence of an outbreak, but cell irregularities can be detected in women's annual Pap tests. If an irregularity is found, further testing is ordinarily done.

The Human Immunodeficiency Virus (HIV), which causes Acquired Immune Deficiency Syndrome (AIDS), is a very serious threat to an individual's health. Through gradually breaking down an individual's immunity to infections and disease, HIV ultimately may progress to AIDS and result in death.

HIV is less common than other STIs, but it is not as uncommon as one might think. "The Centers for Disease Control and Prevention estimate that one in 250 college-aged students is living with HIV," Kopchick said.

HIV is transmitted through semen, vaginal fluids and blood. Sharing needles as well as unprotected sex can result in transmission.

There are two types of tests for HIV -- confidential and anonymous. Confidential testing means that the test and the results show in your confidential medical records. Anonymous testing, for which a person is merely given a number, means neither the test nor the results are ever linked with the person's name.

Confidential testing is available at Hudson for $23.50, and anonymous testing is available at Planned Parenthood, with sliding-scale costs adjusted according to income.

It may take three months after infection for a person infected with HIV to test positive.

Kopchick stresses that protection is of paramount importance in any sexual activity. "Most of these infections are transmitted through bodily fluids. That's why latex is so important," Kopchick said.

She said that condoms, dental dams and latex gloves are all necessary. "Condoms greatly reduce risk, but they are not 100-percent effective. However, greatly reducing the risk is better than no protection at all," she said. "Abstinence is the only true protection."

Many students make the mistake of thinking STIs are transmitted only through "penal-vaginal intercourse," Kopchick said. "People forget that you can get infections in other places, like the throat. For example, you can get an infection of chlamydia in the throat.

"Sometimes people may think they just have a cold sore in their mouth, but it could actually be a form of the herpes simplex II," she said.

Latex gloves are important for "digital manipulation" because bacteria and viruses can enter your system through hang nails, dry cuticles or any other opening on your hands, Kopchick said. Dental dams are important for protection during oral sex on women and during oral activity with the anus.

Kopchick said that OU's Department of Health Education and Wellness has found that there is much misunderstanding about sexually transmitted infections among college students.

"We have made the assumption that college students are knowledgeable about these things, but they're not. We find that they get most of their information from their friends, who also have incorrect information," Kopchick said. "There's a lot of misinformation out there."

Kopchick pointed out that many students mistakenly think that condoms are unnecessary during oral sex. "A lot of people think that if the man doesn't ejaculate, then they aren't at risk for a [sexually transmitted] infection, but they are," Kopchick said. "They forget about the pre-ejaculatory fluid."

Kopchick cautioned that many people are unaware that they are infected because they have never shown symptoms. "There are a lot of people who walk around and think they have a healthy reproductive system, but in reality they could be a carrier and infect a partner," Kopchick said.

People should be aware that they are at risk even if they are only active with one person, Kopchick added. "Students need to know that, in choosing to be sexually active, they are susceptible to STIs, even if they are in a monogamous relationship with someone they trust," she said. "You don't know if other people even know about their reproductive health because you're dealing with infections that can be asymptomatic."

PREGNANCY, OF COURSE, IS another possible outcome of sexual intercourse. Other than abstinence, oral contraceptives used in conjunction with condoms offer the best protection against pregnancy, according to Planned Parenthood.

Kopchick said that the number of unintended pregnancies seen in the clinics in OU's Department of Health Education and Wellness has seemed to decline recently. This, she said, is possibly due to the clinic offering "Plan B," an emergency contraception hormone complex that can be taken within 72 hours of sexual activity to prevent pregnancy.

"Over the past three years, we haven't seen as many unintended pregnancies," Kopchick said. "Now that we have 'Plan B,' the cases don't seem as frequent."

Kopchick explained that "Plan B" is much like the morning-after pill, but it is less taxing on your body. "However, it is not recommended that one uses this as a contraception method. It's meant to be used as an intervention method," she said.

More information on these and additional STIs, contraception methods, methods of safer sex and pregnancy can be found at Hudson Health Center in the Department of Health Education and Wellness on the second floor. The department also offers a "sexual health seminar." Information also can be found at Planned Parenthood of Southeast Ohio at 280 E. State St.

Source:The Athens News 11-18-04

Singapore Will Not Promote Condoms To Fight AIDS

15 Nov 2004 - Source Straits Times

Singapore will not sponsor a "publicity blitz" to promote condom use in order to prevent HIV transmission "out of respect" for residents who hold "conservative views" on sexual behavior, a senior health minister said on Sunday, AFP/Yahoo! News reports (AFP/Yahoo! News, 11/14).

Balaji Sadasivan, senior minister of state for the country's Ministry of Health, said that an "in-your-face" approach is not the best option to educate people about condoms use and HIV/AIDS in the country, Singapore's Straits Times reports (Quek, Straits Times, 11/14).

Sadasivan last week announced that Singapore is facing an alarming AIDS epidemic and that if efforts to fight the disease are not implemented, the number of HIV cases in the country would reach more than 15,000 by 2010 (Kaiser Daily HIV/AIDS Report, 11/12).

"Sexual behavior is a private thing, it's something people don't want to talk about. It's not discussed in polite society," Sadasivan said (Straits Times, 11/14).

He added, "To educate people, you don't have to be offensive" (Channel News Asia, 11/13).

However, Sadasivan did not rule out a public campaign promoting sexual abstinence and proper condom use, the Khaleej Times reports (Khaleej Times, 11/14).

Action For AIDS criticized the government for not publicly promoting condoms despite the success of such campaigns in Thailand and Cambodia, the Straits Times reports.

"We need a massive campaign to let people know that it is all right to use condoms. We need to de-link condom use from promiscuity," AFA Vice President Brenton Wong said (Khalik, Straits Times, 11/13).

Action for AIDS Dispute

Sadasivan last week criticized AFA for not taking a tougher approach to HIV/AIDS education in the country and for using "misleading information" about HIV/AIDS on its Web site, according to the Straits Times (Straits Times, 11/14).

Wong defended the group, saying, "Over the last 16 years, AFA has tried to address the multitude of issues surrounding AIDS as comprehensively as possible" (Khaleej Times, 11/14).

Wong said that AFA had been limited by a lack of resources, adding, "We're all not doing a good enough job in tackling the AIDS problem in Singapore." Wong said that AFA would "welcome more partners and the chance to sit and talk to the health ministry on expanding our role." The statement on AFA's Web site -- which says, "Not everyone who has sex contact with an infected person will get infected" -- could "actually make things worse by promoting unsafe sex," Sadasivan said last week (Straits Times, 11/13).

AFA said that although the statement was supported by medical and scientific research, the group will review the wording because of Sadasivan's concern (Straits Times, 11/14).

Government Subsidies

Wong recommended that the government provide subsidies for antiretroviral medications to reduce the cost burden of proper treatment for HIV-positive people, according to the Straits Times.

Wong added that subsidies also could help with HIV/AIDS prevention efforts, as many people refuse to undergo HIV testing because they cannot afford treatment, the Straits Times reports.

"People will be more ready to step forward to get screened if they can get help," Wong said (Straits Times, 11/13).

However, Sadasivan said that HIV/AIDS is not a "privileged disease" and that HIV-positive patients are entitled to the same subsidies as patients with other diseases. "There is no reason why an AIDS patient should be more special than a heart or kidney patient," he said, adding, "We treat all equally" (Khaleej Times, 11/14).

Lack of Experts

There are only 11 infectious disease specialists in Singapore, which doctors say is "not enough" to adequately address the growing HIV/AIDS problem in the country, the Straits Times reports.

More money, research and expertise is needed to tackle threats from HIV/AIDS and other infectious diseases that are "becoming rampant," Dr. Leo Yee Sin, the clinical director of the country's Communicable Disease Center, said. Sadasivan last week called for the country's CDC to become more involved in HIV/AIDS prevention to tackle the epidemic, but Leo said that the agency does not have the "expertise to do the job right now," according to the Straits Times (Basu, Straits Times, 11/15).

Infectious disease public health has been a "neglected field" for years, Leo said, adding that the center needs "many more" specialists to continue its work, Agence France-Presse reports.

In order to step up prevention efforts, the center also would have to review its current strategy, which focuses only on treatment (Agence France-Presse, 11/14).

"Treatment has been our forte. What we've been trained for is patient care and that will remain our focus," Leo said. To expand into prevention and "draw up and implement strategies," the group would need additional resources and would not focus only on HIV/AIDS, Leo said, according to the Straits Times (Straits Times, 11/15).

Illinois health department criticized for distributing flavored condoms

Some Illinois lawmakers and government officials are criticizing the distribution of free flavored condoms by the state health department, saying the "exotic" condoms hamper efforts to promote abstinence, the Chicago Sun-Times reports. The department has spent about $115,000 in federal funds on the condoms since January and plans to purchase a total of 2.4 million for the year. Most are basic lubricated condoms. But about 360,000 are flavored condoms, in orange, lemon, grape, and cherry flavors. About 910,000 others are red, orange, green, and blue in color. Health department spokesman Tom Schafer says the flavored condoms were purchased because clients at health clinics in the state say they wanted the flavored products to use for oral sex. "The taste of lubricated condoms is such that they wouldn't encourage use," he said. Encouraging condom use for oral sex is important because studies have shown that rising syphilis rates in the state, particularly among gay and bisexual men, have been linked to oral sex and other unprotected sex acts.

But Republican lawmaker Steve Rauschenerger says he is "bothered" by the distribution of flavored or brightly colored condoms. He also said the unique condoms may encourage young people to have sex and undermine efforts in the state to promote abstinence as a way to prevent HIV, STDs, and unwanted pregnancies. "The concept of providing readily available condoms to prevent transmission of disease is one thing," he told the Sun-Times. "But when you're talking about French ticklers and attractive colors, it seems to border on enticement. If we're buying condoms, I'd expect us to buy Army-green, utilitarian, low-priced condoms for people who, for whatever reason, don't feel comfortable buying them on their own." He said he plans to demand that state health department officials show data showing that flavored condoms reduce sexually transmitted disease rates. Other state lawmakers said they were unaware flavored and colored condoms were being distributed by the health department but said they don't object to it if the costs are the same as distributing standard condoms.

Source: Advocate.com 11-04-04