Sexual Health

Numerous studies report that about 75 percent of traditional-age college students have engaged in sexual intercourse at least once. Whether or not you are part of this percentage, it can be helpful to explore your sexual values and consider whether sex is right for you at this time. If it is the right time, you should choose a good birth control method and adopt some strategies for avoiding sexually transmitted infections (STIs) and unplanned pregnancies.

Sexually Transmitted Infections

The problem of STIs on college campuses has received growing attention in recent years as epidemic numbers of students have become infected. In general, STIs continue to increase faster than other illnesses on campuses today, and approximately 5 to 10 percent of visits by U.S. college students to college health services are for the diagnosis and treatment of STIs. The beliefs that it won’t happen to you and that you can’t catch these sorts of infections are inaccurate and potentially more dangerous than ever before. If you choose to be sexually active—particularly with more than one partner, but even if there is only one—exposure to an STI is a real possibility.

STIs are usually spread through genital contact. Sometimes, however, STIs can be transmitted through mouth-to-mouth or mouth-to-genital contact. There are more than twenty known types of STIs.

One particularly common STI is the human papillomavirus (HPV), a sexually transmitted infection that is closely linked to cervical cancer. In fact, the CDC estimates that currently 20 million people in the United States are infected with HPV. Gardasil, a vaccine that became available in 2006, provides protection for both men and women against the types of HPV that cause genital warts, anal cancer, and cervical cancer. For more information about this vaccine or to receive the three injection series, contact your college or university health services or local health care provider.

Negotiating for Safer Sex

If you are sexually active, it’s important that you talk with your partner about ways to protect against sexually transmitted infections and unwanted pregnancy.

Communicating with your partner about safer sex can be difficult and even embarrassing initially, but this communication can make your relationship stronger and more meaningful. The national organization Advocates for Youth offers these suggestions to help make this conversation easier and more effective:

  • Use “I” statements when talking. For example, you might say, “I think that abstinence is right for me at this time,” or “I would feel more comfortable if we used a condom.” Be assertive! Do not avoid talking about sex because you fear your partner’s reaction.

  • Be a good listener. Let your partner know that you hear, understand, and care about what he or she is saying and feeling.

  • Be patient with your partner and remain firm in your decision that talking is important.

  • Understand that success in talking does not mean getting your partner to agree to do something. It means that you both have said what you honestly think and feel and that you have both listened respectfully to each other.

  • Avoid making assumptions. Ask open-ended questions to discuss relationship expectations, past and present sexual relationships, contraceptive use, and testing for STIs.

  • Do not wait until you become sexually intimate to discuss safer sex with your partner. In the heat of the moment, you and your partner might be unable to talk effectively.

You can avoid STIs and unwanted pregnancies by avoiding sex entirely. According to national research, 25 percent of college students choose this option. For many people, masturbation is a reasonable alternative to sex with a partner.

If you’re in the remaining 75 percent, you’ll be safer (in terms of STIs) if you have only one partner. You might, however, think that you’re at a point in your life when you would prefer to have multiple relationships simultaneously. Whether you’re monogamous or not, you should always protect yourself by using a condom.

In addition to being a contraceptive, a condom can help prevent the spread of STIs, including HIV. The condom’s effectiveness against disease holds true for anal, vaginal, and oral intercourse. The most current research indicates that the rate of protection provided by condoms against STIs is similar to its rate of protection against pregnancy (90 to 99 percent) when used correctly and consistently for each and every act of intercourse or oral sex. Note that only latex rubber condoms and polyurethane condoms—not lambskin or other types of “natural membrane” condoms—provide this protection. The polyurethane condom is a great alternative for individuals who have allergies to latex. Use only a water-based lubricant (such as K-Y Jelly) to keep the condom from breaking.

Birth Control

Sexually active heterosexual students have to take steps to prevent unwanted pregnancy. Planning is the key. What is the best method of contraception? It is any method that you use correctly and consistently each time you have intercourse. The “Methods of Contraception” table compares the major features of some of the most common methods of birth control. The actual cost of some of these methods will vary depending on where you live; where you are enrolled in college; your employer, if you have one; and the kind of medical insurance you have.

Methods of Contraception
METHOD HOW EFFECTIVE IS THIS METHOD? DOES IT PROTECT AGAINST HIV AND STIs? DO I NEED A PRESCRIPTION?
Abstinence 100% Yes No
Cervical cap 84% No Yes
Contraceptive injection 99% No Yes
Diaphragm 94% No Yes
Female condom 95% Yes No
Intrauterine device (IUD) 99% No Yes
Male condom 97% Yes No
NuvaRing 99% No Yes
Oral contraceptive (“the Pill”) 99% No Yes
Ortho Evra (“the Patch”) 99% No Yes
Spermicide 94% No No
Tubal ligation (female sterilization) 99% No Yes
Vasectomy (male sterilization) 99% No Yes

Always discuss birth control with your partner so that you both feel comfortable with the option you have selected. For more information about a particular method, consult a pharmacist, your student health center, a local family planning clinic, the local health department, or your private physician. The important thing is to resolve to protect yourself and your partner each and every time you have sexual intercourse.

What if the condom breaks or you forget to take your birth control pill? Emergency contraception pills can reduce the risk of pregnancy. According to Planned Parenthood Federation of America, if the pills are taken within 72 hours of unprotected intercourse, they can reduce the risk of pregnancy by 75 to 89 percent. Most campus health centers and local health clinics are now dispensing emergency contraception to individuals in need. Emergency contraception does come with side effects, such as nausea, vomiting, and cramping. In rare cases, serious health complications can result from emergency contraception. Be sure to ask your provider what symptoms to watch for.