How is HIV different than AIDS? An HIV primer

This year marks 35 years since AIDS was first recognized by the CDC. News of the highly-fatal AIDS epidemic was initially met with profound concern, panic and confusion. Still today, there are plenty of misconceptions about what HIV and AIDS are, and who is affected.  In honor of World AIDS Day, we’ll provide an abbreviated history of the discovery of HIV and AIDS, discuss how they’re different, and talk about how you can get tested for FREE!

AIDS and HIV: A super-duper brief history

In 1981, the Centers for Disease Control and Prevention (CDC) received several reports of a rare cancer, typical only among those with severely compromised immune systems and the elderly, among young gay men. Suspecting that there may be other factors at-play, the CDC began an investigation. At this stage of the epidemic, there was no identifiable cause and no single name for the phenomenon. Various organizations referred to it with different names, among them “gay-related immune deficiency” (GRID).  As the epidemic spread, it became clear that several groups were affected, including injection drug users, hemophiliacs and Haitians.  The CDC proposed using a unifying name for the condition, as there was mounting evidence that it was not limited to the gay community. In 1982, with over 400 cases reported globally, the CDC proposed the term “Acquired Immune Deficiency Syndrome” or (AIDS). Around the same time, cases of mother-to-child transmissions of AIDS were reported, and a child who had received blood transfusions also appeared to have developed AIDS. Cases of AIDS among women who have sex with men were recorded. All of these cases provided evidence that an infectious agent was likely responsible for AIDS, and suggested several possible routes of transmission: through blood, breast milk, and sexual activity. In 1986, at least five years after AIDS cases were initially reported, the name for the virus that causes AIDS was born: “Human Immunodeficiency Virus”, or HIV.

AIDS vs. HIV?

The history of AIDS and HIV helps clarify how and why they’re different. Contrary to the widespread belief, HIV is not a disease. It is a virus – but a pretty serious one. Our bodies are able to fight off other viruses like the common cold, but for some reason, we just can’t rid our bodies of HIV. Our immune system is comprised of various types of cells, each having special roles to fight off infections. HIV attacks one such cell, the CD4 cell. The higher your CD4 cell count, the stronger your immune system is and the better you are at fighting infections. HIV attacks our CD4 cells by entering them and becoming part of their life cycle. Think of…mind control. When HIV takes over a CD4 cell, it no longer thinks it is a CD4 cell. When the CD4 cell (with its brain taken over by the virus) tells itself to ‘replicate,’ HIV replicates. This leads to an increase in HIV, a decrease in CD4, and a compromised immune system. If the CD4 cell count drops significantly, an individual has AIDS, or Acquired Immune Deficiency Syndrome.

https://i1.wp.com/aids.gov/images/aids-infographics/what-is-hiv-aids-2.jpg

Image from http://aids.gov

AIDS refers to a syndrome, meaning the presence of clinical features or phenomena (example:  weakened immune system). HIV is a necessary but not sufficient cause of AIDS. In other words, HIV infection always precedes AIDS, but HIV doesn’t always develop into AIDS. HIV can be detected with a variety of tests that identify either HIV itself or circulating HIV antibodies. AIDS diagnosis is more complicated, and requires the presence of certain signs and symptoms, such as decreased white blood cell count and certain  AIDS-defining illnesses.

Who gets HIV?
Given that HIV can be transmitted through sex, contaminated sharp instruments or breastfeeding, almost all individuals are at risk. HIV transcends geographic, socioeconomic, political, racial, and gender boundaries. Some individuals have a higher risk than others depending on how often they are exposed to the following four fluids that transmit HIV: blood, vaginal fluid, semen and breast milk.

A person’s sexual network (a group of people one individual is connected to through sexual contact), which may be influenced by race, socioeconomic status, and sexual orientation, may also influence his/her/zir risk for contracting HIV. Think of it in terms of probability. Let’s say Person A is an African American man who has sex with other men, and Person B is a White man who does not have sex with other men. Person A has a smaller number of potential sexual partners than Person B. In other words, Person A has a smaller sexual network. In terms of numbers, this means that if someone in Person A’s network becomes infected with HIV, he has a higher chance of also becoming infected even if he engages in the exact same level of “risky sexual behavior” as Person B.

HIV Prevention and Treatment
The key to prevention is education. With a lack of education about the truth, millions of individuals become infected because they believe HIV can’t impact them. In reality, specific communities have higher infection rates due to historical inequitable access to care and modern institutions that keep these communities at a lower socioeconomic status which maintains unequal access to care. Treatments for HIV exist, but are expensive.

Other than breaking down myths (which the Center for Aids Research is excellent at doing!), everyone needs to understand risks of sexual transmission BEFORE they put themselves in high-risk situations. The four fluids of HIV transmission (do you remember what they are? Blood, vaginal secretions, semen, and breast milk) along with education on proper condom use help prevent the spread of sexually transmitted infections and diseases -and (bonus!) unintended pregnancy. Everyone who has sex should get tested once a year or before embarking on a new sexual encounter, whichever comes first. Testing should be a regular part of healthy relationships.

HIV Testing

In honor of World AIDS Day, Student Wellness is hosting a FREE, walk-in HIV testing event in the Carolina Union from 10AM-4:45PM on December 1st (TODAY!). Please see our event page for more information. Additionally, at UNC Campus Health Services, we offer a rapid oral test (results available in about 20 minutes), and a blood test available every weekday. More information about HIV testing at UNC is available on the Campus Health webpage; for more information about making an HIV appointment with Student Wellness call 919.962.9355.

 

This post was compiled and updated based on two previous Healthy Heels blog posts, one written by Diana Sanchez, a PhD student in Public Health Epidemiology in 2012 and the other written by Jani Radhakrishnan, a MPH and City and Regional Planning Master’s Student. Both writers served as graduate student staff with wellness at UNC. 

So Yes Means Yes, But How Do I Ask?

This blog post was originally published on June 16, 2015.

Photo:
Photo: “Communication” by Joan M. Mass, Flickr Creative Commons.

As many of us know, UNC-Chapel Hill adopted a new affirmative consent standard in August 2014, meaning that, rather than “no means no,” UNC enforces a “yes means yes” standard—where consent is defined as the clearly conveyed, enthusiastic, conscious, non-coerced “yes.” It is the responsibility of person initiating the activity to receive affirmative consent, and being under the influence of drugs or alcohol does not lessen that responsibility. Consent can’t be treated as binding; if your partner and you say that next Friday you plan to have sex, you should still check in with your partner next Friday to make sure they consent. If, next Friday, your partner decides they do not consent, you cannot try to hold them to what they said the week before or make them feel guilty in any way for changing their mind. Also, consent to one activity is not consent to another (so, for example, consent to oral sex is not consent to vaginal sex).

I’ve found in my experience conducting One Act trainings that a lot of students struggle to understand the affirmative consent standard, and have a lot of questions about how it works in practice. Many of us are much more comfortable relying on body language, so enforcing a policy that heavily relies on verbal communication can be daunting.

But how do I ask? Won’t it kill the mood? Isn’t that awkward? Don’t you just know when someone wants to have sex? Is it really necessary to ask permission every step of the way? Does this mean that anytime I don’t explicitly ask permission, they can just regret it and call it rape?

Those are all questions I’ve been asked, on several occasions, by several students. A lot of those questions stem from a “but I just want to have sex” mindset, when the mindset should revolve around what both you and your partner enjoy doing. Affirmative consent isn’t about making things awkward, it’s about making sure your partner really does want to do what you want to do.

So how do you ask? Here are some suggestions:

“I’d really like to do ____, do you want to?”

“How do you feel about trying/doing   ____?”

“Does this feel good to you?”

“Are you interested in doing ___?”

“Are you enjoying this?”

“I like doing _____. What do you like to do?”

The possibilities are endless, so have fun with it! Remember that sex should be an ongoing conversation, where you check in with your partner to make sure they are excited about and are enjoying everything that is happening.

But what about just knowing when someone is consenting to sex? Why this change? Why use an affirmative consent standard, when, for years, relying on body language has been considered acceptable?

It’s simple: there has been new research  that indicates people are likely to freeze up when they feel scared, threatened, or traumatized. While most of us are familiar with flight or fight, there is actually this third chemical reaction in our brains – “freeze.” Because of neurobiology, people may not be able to speak up and say “let’s stop,” so they just disengage and wait for it to be over. Using an affirmative consent standard takes into account what happens in our bodies on a cellular level. Beyond biology, social norms may impact some a person’s ability to speak up. Statements like “maybe later,” “I’m tired,” “not right now,” “let’s just watch a movie,” or even silence are indicators that a person doesn’t actually want to have sex, despite none of those being an explicit “no.”

If you ask someone if they want to have sex with you (or do any other activity) and they say no, you didn’t “kill the mood.” You simply gave that person an opportunity to tell you that they didn’t want to have sex. Rejection usually doesn’t feel good, but neither does hurting someone. Affirmative consent is sexy. So play around with how you ask for consent, figure out what way is most comfortable to you, and practice good communication with your partner(s)! Being able to talk about what you are interested in doing together gets easier, and affirmative consent is sexy! Remember: even if you do find it awkward, a few seconds of feeling awkward is worth preventing harming someone.

If you’re worried that your partner may confuse regret with sexual assault, here is a great blog explaining why that likely won’t happen.

Can you think of any more ways to ask for consent? Post below in the comments!

Minute Monday: Get to Know Your Sexual Health Educators

Ever wonder what you get at a sexual health appointment at UNC Student Wellness? Our Sexual Health Educators tell you here.

Students can make a free appointment with Student Wellness by calling (919) 962-WELL(9355).

Niranjani Radhakrishnan received her BSPH from the Gillings School of Global Public Health at UNC Chapel Hill in 2013. She is currently a Program Assistant for Health Promotion and Prevention Initiatives at Student Wellness. She is also in graduate school at UNC Chapel Hill pursuing two masters degrees: Health Behavior and City and Regional Planning with an emphasis in environmental justice, health equity, and spatial analysis using GIS.

Mary Koenig is a Program Assistant for Health Promotion & prevention Initiatives at Student Wellness and a first-year Masters in Social Work student at UNC. She is interested in sexual health, media literacy, and interpersonal violence and sexual assault prevention.

The HPV vaccine for men- is this a thing?

Yes, it is. You may have heard of the HPV or Gardasil vaccine for young women to prevent cervical cancer, but young men should get it too!

4 men studying and drinking coffee

The HPV vaccine is a series of 3 injections over a 6-month period. Ideally it should be given before a person ever has sex, but it is recommended for men from age 11 through 21 years regardless of sexual activity, and through age 26 years for men who have sex with men and men who are immunocompromised (including those who are HIV positive).

Why should men get vaccinated? Vaccination helps to:

  • Prevent genital warts
  • Prevent penile, throat, and anal cancers caused by HPV
  • Prevent spread of HPV to future partners

Human papillomavirus (HPV) is the most common sexually transmitted infection (STI).  The virus is spread through anal, vaginal, or oral sex, and can even be spread through close skin contact during sexual activity. A person doesn’t have to have signs and symptoms to spread the virus.

All sexually active people are at risk for HPV.

Almost all sexually active people get infected with HPV at some point in their lives. Most people will clear the infection without more serious issues.  However, if an infection does not go away on its own, symptoms may develop months or even years later.

If HPV does not go away on its own, it can cause genital warts and some types of cancer.

Warning symptoms: new or unusual warts, growths, lumps, or sores on the penis, scrotum, anus, mouth, or throat.

Genital warts usually appear as a small bump or group of bumps around the penis or anus. They may be small or large, raised or flat, or shaped like a cauliflower. The warts may stay the same or grow in size or number. They can come back even after treatment but warts caused by HPV do not lead to cancer.

HPV infection is not cancer, but it can change the body in ways that lead to cancer. Cervical cancer can occur in women, penile cancer in men, and anal cancer in both women and men. Cancer at the back of the throat, including the base of the tongue and tonsils (oropharyngeal cancer), is also a concern for both men and women.  All of these cancers can be caused by HPV infections that do not go away.

three pie charts show types of HPV for men and women 

Figure: Average Number of New HPV-Associated Cancers Overall, and by Sex, in the United States from 2005-2009

HPV-related cancers are not common in men, but certain men are more susceptible:

  • Men with weak immune systems (including those with HIV) who get infected with HPV are more likely to have complications
  • Men who receive anal sex are more likely to get anal HPV and develop anal cancer

There is no approved test for HPV in men at this time, and there is no specific treatment. Genital warts can be treated by healthcare providers and HPV-related cancers are more treatable when diagnosed and treated early.

The HPV vaccine lowers the risk of getting HPV and HPV-related diseases.

 Using condoms for every sexual encounter lowers the chance of getting all STIs, including HPV.

 If nothing else, consider protecting your future sexual partner(s) from HPV by getting vaccinated!

The HPV vaccine is available at Campus Health Services.

For more information on HPV visit cdc.gov/hpv.

FLASHBACK FRIDAY: Condom effectiveness: What’s brand name got to do with it?

This blog was originally posted on April 25, 2012 and was written by Diana Sanchez.

Condoms are one of the most commonly used contraceptive/STD prevention products used worldwide. The United Nations Population Fund estimated that over 10 billion condoms were used in 2005.  Here on campus, Campus Health Services provides thousands of condoms to students each year.

As a sexual health counselor, I have noticed that many people’s preferences for certain condom brands are based (almost entirely) on their perception of that condom brand’s effectiveness. We offer a variety of condom brands for free to students through Campus Health Services. Occasionally, when people check out the condoms we have available, they’ll ask: “are those safe to use?”, and “don’t those break more than [other condom brand]?”.

So, do some condoms in fact perform better than others in terms of STD/pregnancy prevention?

The answer is no, not really. Condoms are regarded by the United States Food and Drug Administration (FDA) as “Class II medical devices”, a designation that includes pregnancy tests and powered wheelchairs.  Products in this category have to meet special labeling requirements and performance standards. For condoms, the FDA standards include systematic “water leak” tests to ensure that no fluid can leak out of the condoms. To meet standards, all condoms must have at least 996 out of 1,000 condoms, on average, pass this test. This means that FDA-approved condoms must be at least 99.6% effective in laboratory tests to be available to consumers.

In a 2004 publication, Walsh and colleagues used condom use data from trials of three bands of condoms, including Trojan, LifeStyles and Ramses – all of which are FDA-approved condom brands. Out of 3,677 condom-protected sex acts analyzed in the study, the authors found that 55 condom acts failed, either due to breaking (16 condoms broke; break rate = 0.04%) or slipping (39 condoms slipped; slip rate = 1%). The likelihood of condoms breaking during sex was not statistically associated with condom brand.

FDA-approved condoms are all quite effective at preventing pregnancy and STD, and performance is probably not related to brand type. You might be wondering if the condoms you’re using are FDA-approved. With the exception of novelty condoms (which are pretty uncommon), just about all of the condoms you’ll come across in the United States are approved by the FDA.  All the condoms we provide through Campus Health Services are FDA-approved, and same goes for places like Planned Parenthood and local STD/HIV clinics. If you’d like to be certain, you can check the condom packet to look for wording about STD and pregnancy prevention. If it’s on the packet, those condoms meet federal regulations for quality and safety.

Check out the following pictures to see how we’ve looked for this language on some condoms we provide at Campus Health Services:

If you can’t find language about STD/HIV prevention on condom packaging, then it’s not FDA approved.
If you can’t find language about STD/HIV prevention on condom packaging, then it’s not FDA approved for STD/HIV and pregnancy prevention.

All of this said, although condoms must be at least 99.6% effective in safety trials, testing conditions do not necessarily mean 99.6% real-life effectiveness for any condom brand. But here’s the good news:  there’s a lot you can do to increase the effectiveness of condoms. One of the biggest challenges to condom effectiveness is correct use.  Some of the most common errors with condom use are: using the wrong lubricant (water-based, NOT oil-based, lubricants should be used with condoms); incorrect storage (ie, storing a condom in a hot place, like a glove compartment, or in a place with lots of friction, like a wallet or pocket); and not checking the expiration date.

So Yes Means Yes, But How Do I Ask?

Photo:
Photo: “Communication” by Joan M. Mass, Flickr Creative Commons.

As many of us know, UNC-Chapel Hill adopted a new affirmative consent standard in August 2014, meaning that, rather than “no means no,” UNC enforces a “yes means yes” standard—where consent is defined as the clearly conveyed, enthusiastic, conscious, non-coerced “yes.” It is the responsibility of person initiating the activity to receive affirmative consent, and being under the influence of drugs or alcohol does not lessen that responsibility. Consent can’t be treated as binding; if your partner and you say that next Friday you plan to have sex, you should still check in with your partner next Friday to make sure they consent. If, next Friday, your partner decides they do not consent, you cannot try to hold them to what they said the week before or make them feel guilty in any way for changing their mind. Also, consent to one activity is not consent to another (so, for example, consent to oral sex is not consent to vaginal sex).

I’ve found in my experience conducting One Act trainings that a lot of students struggle to understand the affirmative consent standard, and have a lot of questions about how it works in practice. Many of us are much more comfortable relying on body language, so enforcing a policy that heavily relies on verbal communication can be daunting.

But how do I ask? Won’t it kill the mood? Isn’t that awkward? Don’t you just know when someone wants to have sex? Is it really necessary to ask permission every step of the way? Does this mean that anytime I don’t explicitly ask permission, they can just regret it and call it rape?

Those are all questions I’ve been asked, on several occasions, by several students. A lot of those questions stem from a “but I just want to have sex” mindset, when the mindset should revolve around what both you and your partner enjoy doing. Affirmative consent isn’t about making things awkward, it’s about making sure your partner really does want to do what you want to do.

So how do you ask? Here are some suggestions:

“I’d really like to do ____, do you want to?”

“How do you feel about trying/doing   ____?”

“Does this feel good to you?”

“Are you interested in doing ___?”

“Are you enjoying this?”

“I like doing _____. What do you like to do?”

The possibilities are endless, so have fun with it! Remember that sex should be an ongoing conversation, where you check in with your partner to make sure they are excited about and are enjoying everything that is happening.

But what about just knowing when someone is consenting to sex? Why this change? Why use an affirmative consent standard, when, for years, relying on body language has been considered acceptable?

It’s simple: there has been new research  that indicates people are likely to freeze up when they feel scared, threatened, or traumatized. While most of us are familiar with flight or fight, there is actually this third chemical reaction in our brains – “freeze.” Because of neurobiology, people may not be able to speak up and say “let’s stop,” so they just disengage and wait for it to be over. Using an affirmative consent standard takes into account what happens in our bodies on a cellular level. Beyond biology, social norms may impact some a person’s ability to speak up. Statements like “maybe later,” “I’m tired,” “not right now,” “let’s just watch a movie,” or even silence are indicators that a person doesn’t actually want to have sex, despite none of those being an explicit “no.”

If you ask someone if they want to have sex with you (or do any other activity) and they say no, you didn’t “kill the mood.” You simply gave that person an opportunity to tell you that they didn’t want to have sex. Rejection usually doesn’t feel good, but neither does hurting someone. Affirmative consent is sexy. So play around with how you ask for consent, figure out what way is most comfortable to you, and practice good communication with your partner(s)! Being able to talk about what you are interested in doing together gets easier, and affirmative consent is sexy! Remember: even if you do find it awkward, a few seconds of feeling awkward is worth preventing harming someone.

If you’re worried that your partner may confuse regret with sexual assault, here is a great blog explaining why that likely won’t happen.

Can you think of any more ways to ask for consent? Post below in the comments!

FLASHBACK FRIDAY: Barriers to using barrier methods?

This blog is a guest blog from Ruth Abebe, a UNC graduate interested in HIV and sexual health, and was originally published on April 1, 2013.

College is a time when many students are discovering and exploring ourselves and the condomsworld around us. This world may include sexuality.

Many college students choose to be sexually active, and college-aged students are particularly likely to engage in risky sexual behaviors and are disproportionately affected by negative sexual health outcomes such as STI or unintended pregnancy.  According to national surveys, many college students are engaging in sexual activity without protection. In a 2011 survey of undergraduate students across the US, approximately 70% of sexually active students reported using condoms inconsistently or not at all during sex in the last 30 days. With all the information out there regarding sexually transmitted infections (STI), unintended pregnancy and ways to prevent them, why do college students still put themselves at risk?

As a college student myself, I have heard several of my peers talk about why they don’t use condoms.  But, there are ways to go beyond these barriers and make sure sexual experiences are safe and pleasurable.

1. Cost — Most of us are on a budget, and the cost of safer sex supplies like condoms is still an obstacle for students when deciding to use protection. However, this is a problem that can be easily remedied. Here at UNC, we have access to free safer sex supplies. Condoms, both male and female, and dental dams, as well as lube, are available to us through UNC Student Wellness and at several residence halls around campus. Furthermore, with the introduction of Wellness’s free condom dispensers, cost will be even less of an issue (update: These condom dispensers are now in service! They are located around campus, including in the Union and the Rams Head Recreation Center, and are refilled frequently). Click here for more information on where you can currently access safer sex supplies throughout Campus Health Services.

2. Many consider only pregnancy risk—Some students only consider pregnancy as a possible consequence of unprotected sex. For this reason, many believe they will be able to protect themselves using prescription contraceptives (examples: the pill, patch, ring, IUD, etc.). However, STI risk and protection should be considered in every sexual partnership.  Aside from abstinence, condoms are the only method which can protect against both pregnancy and STIs, including HIV/AIDS. They can also be converted to a dental dam.

3. “Oral sex isn’t sex.” – Many are under the false impression that oral sex is “safe sex.” Oral sex, just like anal and vaginal sex, carries a risk for STI transmission.  Condoms and dental dams can protect against the risk of STI transmission during oral sex.

4. Pleasure Factor— Some college students don’t use condoms during sexual activity because they believe “it doesn’t feel the same.”  But you can do things to make sex with condoms feel just as good. Plus, knowing that you have the protection of a condom can help you to relax and enjoy the moment.  There are several kinds of condoms out there, including “ultra-sensitive” condoms that enhance the feeling of both parties during sex. Using lube can also make sex more pleasurable for both partners. In addition, there are condoms and other safer sex supplies geared toward making sex more pleasurable. Explore different condom styles and protect yourself!

5. “It’ll ruin the moment.” – Some college students are not protecting themselves for fear of ruining the mood of the moment. There are ways around this too. If you are having sex with someone, you can talk about condom use beforehand. Of course, I realize that not all sexual activity will be between two people in either a romantic or ongoing sexual relationship. In these cases, it’s important to place your sexual health above any potential awkwardness. Cases of STIs are on the rise, and aside from the dangers to your health, having an STI can make your sex life more difficult in the future. So, why not protect and enjoy yourself?

Despite these barriers, there are several ways to allay your fears and hesitations about using protection. As college students, preventing against STIs and pregnancy by using condoms is essential to protecting our sexual health.

Talking about sex… with a healthcare provider?

In the Healthy Heels blog, we’ve talked lots about communicating with partners about if and when one may engage in sexual activity, various methods for practicing safer sex,  talking with partners about STIs, and even the benefits of open communication around sexual health with your peers.

In honor of our “Let’s Talk About It, UNC” (LTAI – which we’re pronouncing, “la-tay UNC”) program this month, we ask: “what about talking to your healthcare provider about sex?”

Sexual health is a personal topic and oftentimes a very sensitive subject to talk about with anyone, so when you are asked sensitive questions in an exam room with a healthcare provider you’ve only met a few times, it can be a little uncomfortable.  This blog post is dedicated to de-awkwardizing those discussions: we’ll cover why it’s important to talk about sex and sexual health with a provider, expectations for some questions to anticipate, and questions you may want to ask.

Why talk about sex?

Sexual activity and sexuality are normal parts of our lives, and sexual health is an important part of overall health.  As such, it can be important for both the healthcare provider and patient to talk openly and candidly about sex and sexual health during clinical appointments or exams.

From a healthcare provider’s perspective, talking about sex during an appointment is a normal part of talking about one’s general comprehensive health behavior.  In most settings, a health care provider will ask about sexual activity routinely. IMPORTANT: This does not mean that talking about sexual behavior necessarily relates to a specific health concern or to you! Even if you have not previously engaged in sexual behaviors, or are currently abstinent for a variety of reasons, it may seem unrelated to talk about sex, but it’s important to remember that your sexual health as an integrated component of your overall health and wellness is related to other areas of health in your body and life.  Here are some examples:

  •   Some nutritional supplements or drugs that you might take for infections may have an interaction with prescription contraception.
  •   Some drugs may influence one’s sexual health – like anti-depressants influencing sexual libido.
  •   Some drugs or supplements may change body chemistry and increase risk for yeast or other infections, particularly when regular sexual activity is involved.

Healthcare providers may also ask about the type of sex you’re having and the birth sex and gender of sex partners in order to give personalized screening and prevention recommendations. For example, if someone is only having oral sex with females, they may recommend using dental dams, but if someone is having vaginal sex with males, they may recommend using condoms.

From a patient’s perspective, clinical appointments are an opportunity to voice health concerns and get reliable, personalized information on sexual health questions or concerns.

Questions to anticipate

Providers frequently ask about the following during a clinical appointment:

  • Sexual activity – whether or not you’ve had sex before
  • Number of sex partners in some period of time (currently, in the last year, etc.)
  • Types of sex (oral, anal, vaginal, other)
  • The gender of sex partners (if you have specified a sexual orientation, this question may still be asked because a person’s orientation may not always correlate with their sexual partners)
  • Use of contraceptives or barrier methods (hormonal birth control, condoms, or dental dams, for example)
  • Testing history for HIV/STIs
  • Appearance of symptoms such as rash, sores, fever, etc.
  • Alcohol or other drug use around sex
  • Pap history, including whether you have had an abnormal pap and subsequent tests
  • Pregnancy history (if you have been pregnant before and whether those pregnancies resulted in a live birth, miscarriage, c-section, or abortion)
  • Some providers will ask about sexual satisfaction too

It’s important to note that there are no right or wrong answers to any of the above, though it is important to be honest about your responses. Remember, everything you talk about with a provider is protected information.

Things to bring up or ask about

A provider may ask you lots of questions, but it’s important that you feel comfortable speaking up about sexual health during appointments as well! Even if a health care provider doesn’t ask questions about sexual health, you should feel free to bring up any of the following:

  • Any changes since your last appointment (ex: appearance of symptoms, changes in lubrication or sensation)
  • Problems or challenges using contraceptives or barrier methods (side effects, itching or burning with condoms, etc.)
  • Results of any previous tests
  • HIV/STI testing recommendations, if not already offered by the provider
  • Any questions you may have about HIV/STI testing or prevention
  • Concerns you have about any prescriptions suggested by your doctor (ex: negative experiences in the past, fear of side effects). If something affects your willingness or ability to start or complete a treatment, speak up!

Didn’t get all the answers to your questions? If you have questions about sexual health, you can always ask a trained sexual health educator at Student Wellness by using our confidential online C.H.A.T.S feature, or by emailing sexualwellness@unc.edu. You can also make an appointment to talk to staff in Student Wellness in a face to face  setting by calling 919-962-WELL.

Having The Talk……

No, not the awkward sex talk with your parents.  But the talk you have with your partner to tell them about you, your likes, desires, wishes and needs, and to maybe learn more about theirs! Open communication is a cornerstone of any healthy relationship, and this applies to telling your partner that while you love them cooking for you, you really just don’t like olives in everything, to telling your partner what you like in the bedroom.

Telling your partner about your sexual likes and dislikes can be a little scary, but just ltalkingcouplesike talking about condom usage, it’s just as important.  There are a million and one different ways that people can have sex, and a million and one fantasies that each individual has, and letting your partner know what you want is an important part of your relationship, and your sexual well being.

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