Staying Safe All Summer Long

Ahh summer… a time for picnics in the park, fun in the sun, and summer romance! With school getting out and summer in full swing many people will have a lot more time for a summer lovin’!

summer-love-sunflower

That being said, this week’s blog is all about how to keep yourself safe and protected from unintended pregnancy, STDs, and HIV.

First tip, consider stopping by New Gen (or your local sexual health clinic) to get some routine STD testing. All that is required is that you pee in a cup! The urine will then be tested for chlamydia and gonorrhea – two very common infections. These infections are passed from one person to another through female vaginal fluids and male ejaculatory fluids (cum and pre-cum) of people who are infected. Although it is most commonly passed through sexual intercourse (penis in vagina or penis in anus), it can also be transmitted (passed from one person to another) orally (mouth on penis/vagina/anus). Unfortunately, people with these infections don’t always know they have them because they often don’t have any symptoms. We recommend this test about once a year (under the age of 25) or if you have had any new partner(s) since your last test. The good news is that both infections are completely CURABLE with antibiotics (meaning after you complete the quick and easy treatment, it’s like you never had it in the first place). So why not take some time now to make sure you are tested and treated before any summer flings?

P.S. Want to know more about chlamydia? Click here! And I just realized I haven’t written about gonorrhea yet. Perhaps that’ll be the next post – unless there is something else you are dying to know about first. Let me know!!!

Okay, so although chlamydia and gonorrhea are totally treatable, they are also totally preventable (along with other sexually transmitted infections). You guessed it: condoms! Remember that condoms require special care in hot weather. Condoms need to be stored at room temperature away from direct sunlight to prevent the breakdown of the latex. For this reason, you should not store a condom in your wallet and definitely not in a hot car. Ideally you would carry your condoms in a bag or backpack but you can also keep a condom or two in a front pocket short-term without any keys or other items that may puncture the condom. If you haven’t used the condoms by the time you get back home, put them back in a cool, dry storage space. You can also buy a condom case or reuse items like mint tins (like the Altoids container) for this purpose.

altoids caseWhat about birth control? Well, many of you will have totally different schedules in the summer. For those of you using the pill, patch or ring, you may have to put some extra effort into remembering to take your pills or to change your patch or ring. If you usually take your pill in the morning before school, now you might need to set an alarm instead. Another option is to sign up at Bedsider.org/reminders to set up an email or text reminder to take your birth control. There are even apps for smartphones that will remind you– “myPill” and “Ring Timer” are some examples.  It’s important to keep on schedule with your birth control because if you don’t, it is less effective and you become more at risk for pregnancy.

bedsider_reminder

Summer is also a time that many people go on long trips. Pill, patch, or ring users need to make sure you have enough birth control to get you through your trip. You can call your pharmacy and see how many refills you have, and if you’re on your last refill, call the clinic to see about getting your prescription renewed. If the Depo shot is your birth control of choice, you will want to make sure that your next shot appointment isn’t scheduled when you are going to be out of town. If it is, give New Gen (or your shot provider) a call and see if they can schedule the appointment before or after your trip, so that you stay covered!

Summer Heart

To all the ladies with an Implant or IUD, you’re all set for the summer!  You have a low-maintenance form of birth control and don’t need to stress about it until your 3 years (Implant), 5 years (Mirena IUD), or 10 years (Paragard IUD) are up! Safe summer lovin’ y’all!

In happiness & health,

Shawna & Angela

Reviewed by Andrea Raider, NP

Keeping Yourself Out of a Text Wreck

when-i-get-in-a-argument-over-text--source

Keeping yourself out of a text wreck

About a month ago, I wrote a blog about improving communication in relationships.  There are some pretty useful tips you can check out, especially if you don’t want your relationship to be like a  Taylor Swift song.  After writing that blog, I felt like a huge piece was missing because I know how much people use social media and their phone to communicate with one another.  Communicating in a text is pretty different from talking face to face.  I know I’ve seen some train wrecks happen in relationships because of mishaps that happened in text arguments and I’m hoping we can come up with some ideas to help prevent that from happening to you.

First off, I’m not saying talking to a partner or a friend via text is bad.  It’s just a different way of talking.  You may want to pick and choose if you should have a conversation face to face or in a text.  There are pros and cons to every decision we can make.  If you read through this list and want to add something, do it in a comment or email at AskShawna@yahoo.com

Face to Face Conversation:

Pros:

  • Can judge a person’s reaction’
  • Can read their body language
  • Some people feel they can be more expressive
  • Can hear a person’s tone of voice

Cons:

  • Some people feel too much pressure and avoid conversations or shut down
  • May be difficult to find a perfect place and time to talk
  • Other people can know your business if they see or hear you
  • Might forget what someone said

Text Conversation:

Pros:

  • Fast
  • Easy
  • Can talk whenever
  • Some people feel less pressure when not face to face
  • Some people feel more connected getting pictures and texts even when they are far apart

Cons:

  • Difficult to read someone’s reactions
  • Subtleties (jokes, sarcasm, surprise, concern) are often misunderstood
  • May be limited in what you can say
  • Other person can “walk away” and not respond
  • Batteries can die in the middle of a discussion
  • Your setting might not match the conversations (i.e. hanging our with friends or family)

So like I said earlier, you might want to pick and choose which conversations are going to be best face to face or in person.  But let’s say you want to talk something out, right here, right now, and you’re going to bring it up in a text, here are some tips that might make things go more smoothly.

Text Pix

           Read the tips from the earlier blog (click here).
A lot of them apply to texts too.  You can arrange for a better time to talk things out in a text.  It can be as simple as, “I have to talk about something important with you.  Is now a good time or when should I text you?” or “I really need to talk to you about something important, can you get to someplace quiet so we can text now?” or “I need to talk about X,Y, and Z. Can we text or is it easier to talk face to face      

       Be as expressive as you can.
Remember that an estimated 70% of what we say comes from things other than our words.  Since you can’t express yourself through your tone of voice or body language try to really let the other person know what you are thinking and feeling.  Encourage the person you are talking with to do the same.
Write your thoughts thoroughly. Use emoticons. Say when you’re serious or when you’re joking. 

          Read their texting language.
Are there long pauses before a response?  Are there a lot of typos or missing words? So, ask them to text you when they have time.  If they stop texting completely, follow up later to see what happened.  Their phone might have died, they might have lost service, or had their phone borrowed or taken.

       Take a moment to breathe.
Remember that once you say it, you can’t take a text back.  It’s easy to get sucked up into a texting tornado where you text before you think.

Ask yourself if you will regret saying it in 5 minutes, in 5 hours, in 5 days, or in 5 years.  Read your text back to yourself before you send it.  Is it clear?  How would it feel to tell a friend you said that?

If the other person texts you something unbelievable, take a moment to breathe.  Could this have a different meaning?  Could there be other reasons why they seem to be acting a certain way?  Ask them questions to clear things up.

All right, I’m tapped out for now.  If any of you all have ideas or things that you do to make a texting conversation better, let us know at New Gen!

Mei-Lani
Volunteer Health Educator

Reviewed by Shawna : )

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Does Your Relationship Sound Like a Taylor Swift Song??? Then You Should Read This!

Hey Shawna,

My partner and I get into fight after fight.  Every time I try to talk to them about a problem in our relationship, I get nervous and shut down or I blow up and forget what started the fight.  How can we make it better? I know we can make it work if we talk it out.  I just don’t know how.

-HELP

Image

That is a very common question!  Fortunately, I know just the person to ask! Mei-Lani began at New Gen as an AmeriCorps member (super cool program you should check out by clicking here) and when her term ended she so graciously offered to continue here as a volunteer (we are very lucky).  Mei-Lani not only has tons of training but she also has counseled hundreds and hundreds of patients and answered this question many times.  There are so many knowledgeable people here at New Gen and I think it’s important to share them with you.  So without further adieu, here is Mei-Lani’s answer.

Hey there,

You know what?  You just asked one of the most common relationship questions we hear in the clinic.  Communication is very important for relationships.  It builds trust, understanding, and lets a relationship grow.  But it can still be very difficult for people.  That’s because there are many ways to communicate (with your words, with your body, with your phone…and many more) and many styles that people use to express their feelings (passive, aggressive, assertive, and many more!)

No matter how you are communicating or what you are talking about, there are some basic steps you can follow to make talking to your partner about the tough stuff easier.  Many of these tips are adapted from the sex educators at San Francisco Sex Information, but I’ve broken them down into three parts: plan it, do it, and follow up.

PART ONE: Plan It

Plan with your partner to make the conversation happen:  Many times people will want to wait for the right time to bring something up, but when the time comes, the place isn’t right.  The perfect time and place don’t just fall into your lap.  You might have to make it happen.  Plan this conversation with your partner.  Let them know the issue.  Let them have the time they need to think about things before the talk comes up.  Think about the times when you have had a big talk sprung onto you out of the blue.  It can suck.

Planning can be as easy as
“I have been feeling upset about ____this____.  Let’s plan a time when we can talk about it.”

Set the stage:  This means pick a good time and place to talk.  Make sure there’s enough time so no one gets rushed.  And try to pick a place that allows both people be comfortable and honest.  Talking right before class ends or before getting off the bus cuts the conversation short.  Plus being around a lot of other people can put pressure to act a certain way.

Think before you speak:  Now that you both have the time to think before the big talk comes up, make sure your own thoughts are clear.  What is really the problem? Think about what you truly want to come out of the conversation.  Do you want change?  Do you want support?  Do you want trust?  How will you know if the talk went well?  How will you feel? How will things change?  Asking yourself these questions before hand makes sure that if your partner asks you them, you already know how to say what you think.

PART TWO: Do it.

I know, easier said than done.  But… you have already thought about things and made the time and space to make this talk happen.  So go for it!

Use I-Statements:  Saying “I feel… when you….” “I think… because of….”  This lets you say what you think and feel without attacking the person you’re talking to.  Rather than  making assumptions for your partner with “You think, you feel, you do,” you can speak truth about what you know and feel.

Try it out and see how different these statements make you feel.
“You are always texting other girls.  Why can’t I have guy friends?.”
“I feel disrespected when there seems to be different rules for you than me.”

Listen:  Look at your partner.  Check your understanding by repeating some of the things they say back to them.  For example, you could say, “So I hear that you feel ____ because of __this and that___.”  If you are having a hard time understanding what your partner is saying, ask yourself why?  Are you already thinking of what to say next or making judgments?  Are you agreeing with everything they say before they say it or putting words and ideas into their mouth?

Pay attention to the non-words:  65% of communication is in our tone of voice and body language.  Make sure you aren’t speaking in Imagean angry tone when trying to say something nice.  Read your partner’s body language – are their arms crossed and are they facing away from you when they say “everything is okay.”  See if their body is speaking a whole different language than their words.

Ask questions:  If you don’t understand what your partner just said, ask!

Meet in the middle:  Relationships are about give and take.  Likely, you both will come up with some ideas to change your own behavior or things you want your partner to do differently.  Try to find ways to make changes that leave both people happy.  You might not come up with something that leaves you both happy.  That’s okay – you both at least said what you were feeling.  Sit with that and see where it takes you in a few days.

PART THREE: Follow up.

Bet you didn’t think there was more, right?  This conversation just brought up a lot.  You both shared how you felt.  You probably had some emotions come up and you both probably want to change some things.

Before you wrap up this conversation, make another date to check in.  This could be something like “okay, boo, we just said a lot.  I appreciate that we both could be honest.  I think this was good for us to talk, but I wanna make sure things are going right for us later on.  In a couple of weeks, let’s get some food and go for a walk and check in about this again.”

And speaking of wrapping things up, I have gone on way too long about talking.  I hope these tips are helpful for you.  It might seem like a lot of work, but start slowly.  You don’t have to try everything all at once.  Try one tip and see if it helps out.  If you have any questions, write me back at AskShawna@yahoo.com.

Cheers,

Mei-Lani
Volunteer Health Educator

Birth Control Bullies: When He Wants Your Method to Fail

So I was doing some research for this week’s post and came across an awesome article on birth control sabotage.  To my surprise,  it was written by none other than the Medical Director of New Generation Health Center Grace Shih!  Birth control sabotage “means someone is bullying or intimidating their partner into sexual situations that put them at risk for an unwanted pregnancy.”  This wasn’t what I had originally set out to write about for this week’s post but knowing how important and serious this issue is,  I didn’t think it should wait.

Birth control bullies: When he wants your method to fail

Messing with a partner’s birth control is abuse—and it may be depressingly common.

by Grace Shih, MD, MAS

When I was training to become a doctor,  one of my patients was a 25-year-old woman.  She already had one child and didn’t want to get pregnant again.  She’d been using the birth control patch,  but came to me because the patch wasn’t working for her.  When I asked her “why not?” she said,  “Because when my boyfriend sees it,  he pulls it off me.”

That was my first encounter with birth control sabotage.  Birth control sabotage is a form of reproductive coercion, which is a fancy term for a simple but disturbing idea… It means someone is bullying or intimidating their partner into sexual situations that put them at risk for an unwanted pregnancy.  It could mean that a partner is sabotaging a woman’s birth control,  like my patient.  It also includes a partner threatening violence or threatening to leave if a woman doesn’t get pregnant.

Reproductive coercion is abuse—and it may be depressingly common.

There is evidence that birth control sabotage is common,  although we need more research to understand exactly how common.  Birth control sabotage can take many forms.  For example,  women have reported:

  • Partners poking holes in condoms or taking condoms off during sex,
  • Partners hiding or throwing away birth control pills, and
  • Partners removing the ring , or even an IUD.

We do know that all types of reproductive coercion are more common in relationships that have physical or sexual violence.  In the U.S.,  approximately one in four women have experienced physical or sexual violence with a partner at least once during their lifetime.

So what can you do?

If your partner is controlling your birth control,  it is a sign of a larger relationship problem.  All women should be able to protect their bodies from an unwanted pregnancy without threats or sabotage.  You deserve to be with someone who respects you and your plans for the future—including when or whether you want to have a baby.

  • If you want support to get out of a violent relationship,  call the National Hotline anytime 24/7 at 800-799-SAFE, or talk to your healthcare provider about local resources.
  • If you have friends who can help keep you safe,  connect with them privately using the Circle of Six app on your smart phone.
  • There are also online projects like Know More, Say More that are designed to help stop birth control bullying and other types of reproductive coercion.

In the meantime, try tamper-proof birth control.

Ideally your partner should support your birth control choices,  but if you find yourself involved with someone who you suspect wants to get you pregnant against your will,  there are some methods your partner can’t mess with.

The Shot (a.k.a. Depo-Provera): Once you get the shot,  there is no way a partner can change or mess with it—or even know you’ve had it if you don’t tell them.  Each shot lasts for 3 months, so you have to be able to get to the clinic regularly if you want to keep using it.

The Implant: It sits just under the skin on the inside of your upper arm,  so your partner wouldn’t notice it unless he went looking for it.  If your partner does,  he might find it since insertion leaves a bruise for a few weeks.  The implant can last for up to three years,  so it could be more convenient than the shot.

The IUD:  It’s placed in your uterus,  where it should be discreet and difficult to tamper with.  It has small strings that can be tucked behind your cervix when the IUD is placed so that a partner won’t notice them during sex.  If you want an IUD but you’re concerned about a partner finding the strings,  talk to your doctor about possible solutions.

In a bind, there’s emergency contraception:  Actually, the most effective form of EC is the ParaGard IUD.  It is over 99% effective in preventing pregnancy up to 5 days after unprotected sex and it goes on to provide up to 12 years of protection from pregnancy.  The other forms of emergency contraception are pills like Plan B,  Next Choice,  and ella. You need a prescription for ella, but you may be able to get Plan B or Next Choice at your local pharmacy without a prescription depending on your age and where you live. (Insert from Shawna:  You can get Next Choice from us here at NGHC – no appointment necessary! As well as the above mentioned methods).

Grace Shih, MD, MAS, is an Assistant Clinical Professor in the Department of Family and Community Medicine at the University of California, San Francisco. She has a family medicine practice at the San Francisco General Hospital’s Family Health Center. When she’s not seeing patients, you can find her cooking, hiking, or salsa dancing.

Birthday Present

Hi Shawna,

You were recently at my school so this is how I got your email.  I have a situation:  It is almost my boyfriend’s birthday and I wanted to give him a present:  a BJ.   If he doesn’t wear a condom when I do it,  will I get an STD or anything?  I’m pretty sure he has never been “sexually active” with anybody else;  but I’m just a little worried.  Thank you and please reply soon!

-Anonymous

Hi,

Thanks for the question – it’s a good one!

I have to give you props for checking in about health stuff BEFORE actually doing anything.  So first let me clarify a few terms.  A ‘BJ’,  otherwise known as a blowjob,  is a term for giving a male bodied person oral sex (mouth to penis).  Oral sex is simply a term for mouth to genitals (penis or vagina).

Okay,  it is possible to get an STD (sexually transmitted disease or infection) from oral sex – both giving and getting.  To get an STD from giving oral sex – the person who is getting oral has to already have an STD in their genitals (penis or vagina).  To get an STD from getting oral sex – the person who is giving has to already have an STD in their mouth.  It’s also important to note that a very common disease that’s passed orally is not necessary always an STD but can become one:  herpes.  I know this can be a little confusing but I will try to explain.

Herpes is an infection that can affect both the mouth and genitals.  It can be spread mouth to mouth,  genital to genital,  or mouth to genital by skin to skin contact (unlike chlamydia or gonorrhea which are transmitted in fluids).  Herpes are blister like sores that may come and go throughout ones lifetime.  Many people who have oral herpes have had it since before they were sexually active,  usually getting it as a kid from someone in their family through a kiss for example.  Once someone has it on their mouth,  they can pass it to someones genitals through oral sex.  It is most contagious (easy to spread) when the sores are present.  So don’t engage in any kind of skin to skin contact if you or your partner have any kind of bumps or sores present (meaning, no kissing or genital contact, other stuff like holding hands and stuff won’t transmit the infection – only contact with the affected area).  I am hoping this is all making sense (feel free to email me back if you are still confused or have more questions).

Because herpes is transmitted skin to skin (so is HPV), condoms aren’t always 100% effective in preventing the spread of these infections because they don’t cover the entire genital area.  However, condoms do  greatly lower the chance of spreading these infections and PREVENT a lot of other types of infections.

If neither one of you has been sexually active (that means oral, vaginal, or anal/butt) with anybody else – then it’s not likely either of you have an STD  (but remember, oral herpes is not necessarily an STD but can become one.  It’s a good idea to talk to your partner about this).  But if neither of you have an STD or oral herpes,  then you can’t get or give it to one another.

You said you are ‘pretty sure’ he hasn’t been sexually active with anybody else – how do you know that?  Have you talked to him about sex and stuff?  Do you feel comfortable talking to him about stuff like that?  I ask because if you aren’t feeling comfortable talking about sex then maybe you want to reconsider your gift idea.  I also encourage y’all to come into the clinic together – you can talk to one of our counselors (which sometimes helps couples talk about sex).  The counselors can talk you about all this stuff and then some.  I say all this because when it comes to sex – it’s important to enjoy it as much as your partner.  I wouldn’t want you to do anything just for him – you know what I mean?  Anyway,  I hope this answered your question.  Please feel free to write back.

In happiness & health,

-Shawna

Please see the disclaimer in the ‘About’ section : )

Reviewed by Grace Shih, MD