Contraceptives and STI Prevention: Pre-emptive

First of all, there are a few things I need to make clear.

·   Even if you are both virgins—a pretty flimsy definition, anyway—either of you can still carry STIs. 

·   In fact, you can still get STIs without having sex.

·   Even if he pulls out, even if it is one of your ‘safe’ days, there is still a chance, however slim, that you could become pregnant.

·   No birth control is 100% effective against pregnancy.  However, many forms of birth control can greatly reduce the chances of pregnancy, especially when used correctly.

·   Urban legends like having sex standing up or urinating after sex are completely false.

·   Even abstinence is not fail proof, if you still engage in activities like outercourse. 

It is safe to say that as long as body fluids are swapped, the chances of pregnancy (depending on what kinds of fluid) and passing along of infection or disease increase.  Using a contraceptive or other form of protection will greatly reduce the chances of either from happening.

I’ve outlined a few of the more common and effective forms of birth control UCLA students use below.  Do your research and figure out which method will work best for you and your partner.  If you are sexually active, you should be seeing a doctor regularly—have your physician consult you about birth control and STI protection. 

Condoms

            Condoms are free and readily available to UCLA students.  They are effective against both pregnancy and STIs because they block contact with body fluids.  However, in order to be effective, a condom must be used consistently and correctly, put on prior to genital contact, and used throughout contact.  Most condoms are made of latex, including the ones most commonly distributed on campus and in student housing.  Latex is by far the safest and cheapest material, but for people with latex sensitive allergies, there are also condoms available made of polyurethane and sheepskin (traditionally, sheep bladder) that are effective against preventing unwanted pregnancy and have varying degrees of protection against STIs.  There is a condom for pretty much every size and shape and kink.

·   40% of sexually active college-aged men surveyed reported that, within the previous three months, they had put on a condom incorrectly, not leaving enough space for ejaculate at the tip.

·   Men who use condoms are at a 30% less risk of infertility due to STIs.  (Note:  I will be using STI and STD interchangeably.  They mean Sexually Transmitted Infection and Sexually Transmitted Disease)

·   Women whose partners use condoms are also less likely to contract HPV (what a pap smear checks for), which can lead to cervical cancer, which can lead to infertility.

While condoms also help prevent pregnancy, they primarily serve to prevent the intermingling of bodily fluids, which easily facilitates the transmission of many infections and diseases.  Even if you are on birth control, condoms still make sex safer.  (And easier to clean up, too.)  Also, using condoms during oral sex can protect you from various STDs in the mouth and throat, such as gonorrhea or even throat cancer.

There is also a female condom available that is a bit more expensive and a bit less protective.

Never use an expired condom, an opened condom, a melted condom, an inside-out condom, or a (ick) used condom.  Do not stack condoms--the resulting friction will lead to ripping.  Do not use lotions with glycerin or petroleum in them as lube--they will break apart the condom like ketchup on aluminum foil.  Some yeast infection medications will also hurt condoms.  Don't forget to leave some space at the tip and be careful when taking it out.

I've struck up a deal with Undercover Condoms.com, where if you use the coupon code ACESLUX, you can get free shipping on your order.  Their pricing is often cheaper than in retail stores around Westwood, so if you have a preference for a particular brand, this is a good place to buy 12, 24, or 100 at a time.  All proceeds that I get from you guys using the coupon will go to the hosting and maintenance of this website.

Dental Dams

Dental dams are a square piece of latex that can be used when performing cunnilingus (oral sex on a female) or analingus (oral sex on the anal region) to prevent the transmission of STDs.  They are called dental dams because dentists actually use them in their practices when they operate on teeth (so it is actually not a pun!)

It's funny how people take plenty of precaution protecting their genitals by using condoms, but aren't afraid of protecting their mouths.  If you get genital warts in your crotch, nobody will see em.  If you get genital warts on your mouth?  Everyone will be like O_O    Hence, it is actually very smart to use a dental dam, since many diseases of the mouth can pass to the genital region and vice versa.  Besides, some of them are minty!

The FDA appears to have approved three brands.  Glyde, Line One Labs, and Hot Dam!  Meaning the kind that dentists normally use, cut off condoms, saran wrap, etc, are not known to be effective.  But hey, it's better than nothing, and it is a latex barrier still!  The CDC recommends any of these barrier methods, since they are better than no protection at all!

OBVIOUS NOTES:  Do not turn the dental dam around and use both sides.  Do not move the dental dam from the opening of the vagina to the opening of the poop chute.  If you have a sore on your mouth, or they have a sore on their crotch, then definitely use a dental dam--although it is best to abstain entirely until it goes away!  It might also be a really really good idea to use the dental dam during menstruation!  Most importantly!  Do not BITE the dental dam.

Dental dams should be on sale in most major pharmaceutical chains.  If possible, purchase the Glyde brand, since they're FDA approved, and probably the most comfortable to use.

To make the bootleg dental dams, you can cut off the tip of a condom, and then cut down lengthwise, to make a dental dam.  Even latex gloves can work--just cut off the finger tips.  Alternatively, non-microwaveable (this is important!) saran wrap works.  Microwaveable saran wrap does not work since it has pores to allow air to pass so it does not explode things in your microwave.  NON MICROWAVEABLE.  (Although, non microwavable saran wrap makes for a shitty condom.  Don't do that.)

For more information on what the FDA thinks/how they approve and classify dental dams, go here

Additional Barrier Methods: Diaphragm, caps, and shields are made of soft latex or silicone barriers; they cover the cervix and are used with spermicidal cream or jelly.  These shields physically block the opening to the uterus and chemically disable the sperm.  Your physician will perform a pelvic examination and then fit you with the correct size. 

Spermicide

            Spermicide is a chemical designed to immobilize sperm to keep them from traveling to the egg.  It comes in many types—foam, cream, jelly, film, suppository—and is inserted deep into the vagina before intercourse.  Some condoms may also have spermicidal chemicals in their lubricant.  A type of spermicide, nonoxynol-9, can irritate tissue and increase the chances of HIV or other sexually transmitted diseases, if over used.

Prescribed Contraceptives: Birth Control

            It is easy for female students at UCLA to access these contraceptives through very confidential means—just talk to your physician.  There are many benefits to prescribed contraceptives.  Generally speaking, prescribed contraceptives—especially hormone treatments like birth control pills—are more effective and reliable for preventing unwanted pregnancy.  However, these contraceptives provide little or no protection against STDs, and should always be used with a condom.  Smoking and antibiotics can also reduce the effectiveness of hormonal birth control.  Pills that have been exposed to direct sunlight or high temperatures may also lose efficacy.

·   The Pill:  Hormonal birth control comes in many brands and dosages; usually a combination of estrogen and progesterone or simply progesterone—used to regulate the menstrual cycle to prevent ovulation.  The estrogen part of the Pill is what makes your body "think" it is pregnant so that it doesn't release eggs. The progestin part of the Pill prevents the ovulation. Other alterations include cervical mucus which prevents the movement of sperm. This serves as a backup to prevent pregnancy even if an egg is released.

   The pill is one of the most effective reversible methods of birth control.   Many women take the pill because it has added health advantages; it can decrease acne and excess body hair and make a menstrual period more regular, reducing PMS symptoms.  Your physician will determine which kind of birth control is best for you, generally speaking the pill is taken daily.  Studies have found that taking vitamin C increases the effectiveness of some birth control pills and can prevent side effects like depression.  Some common brands are OrthoTriCyclen-Lo, Mircette, and Yasmin.  A new pill, Seasonale, limits menstruation to four times a year.

·   The Patch:  Also known as OrthoEvra, the patch is about 2x2 inches and placed like a sticker somewhere on the body (either the upper arm, torso, abdomen, or butt).  The patch releases hormones into the skin that are absorbed into the bloodstream.  It is changed every week (on the fourth week there is no patch and the woman has her period.)  The upside of this method of birth control is that there is no daily pill, but unlike the pill the patch is visible and can fail to work if it becomes loose or if it isn't changed after a week.  A recent study has found that side effects of the patch are sometimes worse than that of the pill since women receive a higher amount of hormones and the hormones are directly absorbed subcutaneously and not through digestion. 

·   The Ring: The Nuva-Ring (warning, stupid website plays annoying song) is a one a month birth control method.  It's a small flexible ring that is inserted into the vagina for 3 weeks.  Although no studies have been published yet, it is assumed to be more effective than the pill (no chance of forgetting to take the pill, for starters).  The ring may lose effectiveness if it slips out of the vagina and is not replaced in 3 hours, or if it is not kept in the vagina for 3 weeks in a row.

·   The Shot:  Also known as DMPA, Depo-Provera or its milder, updated kid Depo-SubQ-Provera104, this is a progestin-only shot in the butt or arm that is taken once every 3 months.  That's it.  One shot and you're covered for 3 months--and some perks include no periods and an extremely high success rate.  It is very hard to get pregnant while on Depo-Provera.  However, Depo-Provera cannot be used continuously for more than two years.  And, unlike the patch or the ring or the pill, once it's in you you can't stop taking the pills or take anything out--side effects will last the entire duration of the three months, if you have any.

Other methods include the implant, but I don't think anyone at UCLA will want to get it since it involves a scalpel and anesthetics and sticking matchstick-sized hormone capsules in your arm.  If you are for some reason interested in the implant, look for info on it on Planned Parenthood or another site.

For a Ashe Center Birth Control Price List, Click Here

 Testing/Examinations

UCLA offers FREE HIV/AIDS testing!  It's paid for in your student fees and offered at the Ashe Center year round.  If you have had unprotected sex, or even if you are just sexually active, consider going in to get tested just so you know your status.  (I know for a fact that this is free for SHIP students, for non-SHIP insured students it is either free or comes with a very cheap copayment of $10.  It beats waiting in line for the van come World AIDS Week.  They will even email you your results.)

           Ideally, sexually active men and women should see a physician every six months for screenings and exams.   If not, you should certainly be examined during your annual check up.  Do not lie to your doctor about being sexually active.  If you feel the need to lie, you need to find a better doctor.

            In addition to medical examinations, men should perform monthly testicle self exams and women should perform monthly breast examinations.

            Women should have a pelvic exam and pap smear done yearly until three years of consecutive negative results.

            You should be open about your STI status with your partner and hope that they are also open with you.  Papers showing solid proof of negative test results are always reassuring.

            If you care about your partner, and if your partner cares about you, both of you should be completely open about your sexual health and able to comfortably discuss all pertinent issues.

For more info on testing and the types of test, check out the AFTER section of this website.

Vaccines

Human Papillomavirus (HPV) is the virus that causes genital warts, and cervical cancer in women.  75% of women will contract some form of HPV in their lifetimes.  Many of them will die from cervical cancer.  Condoms do not offer very much protection.  In fact, any skin to skin contact can spread this STD, so you can get it from outercourse, too.  Unfortunately, it is especially asymptomatic in men.  Guys can have it, and not know they have it, and give it to women.

One type of genital wart makes your dick look like cauliflower.  Trust me.  U DO NOT WANT.

I once met a guy who has HPV, but does not show any symptoms.  He still likes to have sex with women without a condom.  (Why?  I don't know.  You'd think he'd learn after catching the STD to begin with, right?  This means that he is giving all of the girls HPV.  I don't know what type of HPV, but I hope it's not the kind that gives you cancer and kills you.)

It is difficult to test for HPV in men, unless there is a very obvious wart.  (Sometimes, the warts can grow inside your penis.  This is supposed to hurt.  A lot.) More than half of all men who have sex with men carry this virus in their anal canals--these warts may be precancerous or cancerous.

Doctors recommend that women get tested for HPV annually--the pap smear.  Read up about that in the After section on this site.

Anyhow, thankfully a vaccine has been developed to immunize women from HPV.  270,000 women died of cervical cancer worldwide in 2002.  Hopefully, as the vacine becomes more and more widespread, no one will have to die of cervical cancer in the future.  It's called GARDASIL, and it's three shots over the course of six months.  The Ashe Center currently has GARDASIL for $405,($135 each time) or $265.50 with SHIP.