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What You Can Do

You can take responsibility for your health and contribute to a general reduction in the incidence of STIs in three
major areas: education, diagnosis and treatment, and prevention.

Education

Video: Who's Worth the Risk?

Click here to view a transcript of this video

Many schools, universities, and colleges have STI counselling and education programs. These programs allow
students a chance to practise communicating with potential sex partners and negotiating safer sex, among other
skills. You can find information about STIs online and at health clinics and physicians' offices. National hotlines
provide free, confidential information and referral services to callers anywhere in the country (see the For More
Information section at the end of the chapter).

Educational campaigns about HIV/AIDS and other STIs have paid off in changing attitudes and sexual
behaviours. Levels of awareness about HIV infection among the general population are quite high, although
some segments of the population are harder to reach and continue to engage in high-risk behaviours. Learning
about STIs is still up to every person individually, as is applying that knowledge to personal situations. Once you
know about STIstheir symptoms, how they are transmitted, and how they can be preventedyou are in a
position to educate others. Providing information to your friends and partners, whether in casual conversation or
in more serious decision-making discussions, is an important way that you can make a difference in both your
own wellness and that of others.

QUESTIONS FOR CRITICAL THINKING AND REFLECTION

Have you ever had sex and regretted it later? If so, what were the circumstances, and what influenced you to
engage in the behaviour? Were there any negative consequences? Based on this chapter, are there any steps you
could take now to avoid possible negative consequences? What preventive strategies can you use in the future to
make sure it doesn't happen again?

Diagnosis and Treatment

Video: Immunizations, Physicals, and STD TESTS?

Click here to view a transcript of this video

Early diagnosis and treatment of STIs can help you and your sex partner(s) avoid complications and help prevent
the spread of infection.

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Get Vaccinated

Every young, sexually active person should be vaccinated for hepatitis B; vaccines are available for all age
groups. In Canada, immunization against hepatitis A is recommended for anyone at risk for infection, including
people who plan to travel internationally, men who have sex with men, and those who use drugs. Men and
women ages 926 should also be vaccinated for HPV.

Be Alert for Symptoms

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If you are sexually active, be alert for any sign or symptom of infection, such as a rash, a discharge, sores, or
pain. Although only a physician can make a proper diagnosis of an STI, you can perform genital self-
examinations between checkups to look for early warning signs of infection. Use a mirror to view your entire
genital area. Remember, though, that many STIs can be asymptomatic, so a professional exam and testing are
recommended following any risky sexual encounter.

Get Tested

If you are sexually active, be sure to get periodic STI checks, even if you have no symptoms. If you have a risky
sexual encounter, see a physician as soon as possible (see the Take Charge box for more information).

Take CHARGE
Don't WaitEarly Treatment of STIs Really Matters

If you have had a recent risky sexual encounter, visit your physician, student health centre, or local STI clinic
and ask for testing. Don't wait for symptoms to developyou may never have any. Permanent damage from
STIs, including infertility, can occur even if you have no symptoms. Treating some STIs, such as chlamydia and
gonorrhea, within a few days of infection is very likely to prevent complications, such as PID and infertility. You
will also be much less likely to pass the infection on to anyone else.

Unsafe sex with a person who is infected with HIV meets the criteria for post-exposure prophylaxis (PEP)
treatment, which involves taking antiviral medication as soon as possible. If you are treated within 72 hours of
possible exposure, PEP will significantly reduce your risk of HIV infection. If you develop flulike symptoms in
the days or weeks following risky sexual or drug-taking behaviour, see your physician immediately. If HIV
treatment is started within the first weeks of the infection, there is still a good chance that damage to the immune
system can be reduced or even prevented. Many physicians will not think of primary HIV infection when you
describe flu-like symptoms, so be sure to speak up about your recent risky activities and your concerns about
HIV.

If tests come back positive for a particular STI, you need to be tested for others, including HIV infection.
Infection with any STI means that you are at higher risk for all others. Women should also have a pelvic exam
and a Pap test. If you are given medication to treat an STI, take all of it as directed. Incomplete treatment can
result in an incomplete cure, thereby contributing to the development of drug-resistant organisms.

Do not have sexual intercourse until your treatmentand your partner's treatmentis complete. If your partner
still carries the infection, you are likely to be reinfected when you resume sexual activity. If you have an
incurable STI, such as herpes or HPV infection, always use a condom and make sure your partner is fully
informed of the potential risks of being intimate with you, even if you are using condoms.

Inform Your Partners

Telling a partner that you have exposed him or her to an STI isn't easy. Despite the awkwardness and difficulty,
it is crucial that your sex partner(s) be informed and urged to seek testing and/or treatment as quickly as
possible. You can get help telling your partner if you need it. Public health departments will notify sex partners
of their possible exposure while maintaining your confidentiality and anonymity.

Get Treated

Generally speaking, treatments for STIs are safe and (with the exception of AIDS treatments) fairly inexpensive.
If you are being treated, follow instructions carefully and take all the medication as prescribed. Don't stop taking
the medication just because you feel better or your symptoms have disappeared. Above all, don't give any of
your medication to anyone else, including your partner. If you have an STI, your partner needs to be tested and,

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if necessary, treated. Taking a few of your pills is unlikely to cure your partner, and may make your treatment
incomplete, leaving you both at risk for reinfection.

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Prevention

STIs are preventable. As discussed earlier, the only sure way to avoid exposure to STIs is to abstain from sexual
activity. But if you choose to be sexually active, the key is to think about prevention before you have a sexual
encounter or find yourself in the heat of the moment. To identify your STI risk factors, see the Assess Yourself
box at the beginning of this chapter. Find out what your partner thinks before you become sexually involved.

Condoms protect against STIs and should be used even if another form of contraception, such as birth control
pills or an IUD, is being used.

Most people don't want to think, talk, or ask questions about STIs for a variety of reasons. They may think it
detracts from the appeal and excitement of the moment, that it takes away from the spontaneity of the
experience, or that it will be perceived as a personal insult. For others, simply not knowing how to talk about
STIs and safer sex may prevent them from bringing up the issue with a partner. (For advice on communicating
with potential sex partners, see the Take Charge box.)

You may find that your partner is just as concerned as you are. By thinking and talking about responsible sexual
behaviour, you are expressing a sense of caring for yourself, your potential partner, and your future children.

QUESTIONS FOR CRITICAL THINKING AND REFLECTION

Have you ever thought about where you get your behaviours and habits related to STIs? Many factors can
influence our behaviours and habits, some not as obvious as others. Did you have comprehensive sex education
in high school? Do the significant people in your peer group use condoms and practice safer sex? Have you been
influenced by a partner who didn't want to use protection?

Take CHARGE
Talking About Condoms and Safer Sex

The only sure way to prevent STIs, including HIV infection, is to abstain from sexual activity. If you choose to
be sexually active, you should do everything possible to protect yourself from STIs. This includes good
communication with your sex partner(s). The time to talk about safer sex is before you begin a sexual
relationship. But even if you have been having unprotected sex with your partner, you can still practise safer sex
now.

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There are many ways to bring up the subject of safer sex and condom use with your partner. Be honest about
your concerns and stress that protection against STIs means that you care about yourself and your partner. You
may find that your partner shares your concerns and also wants to use condoms. He or she may be happy and
relieved that you have brought up the subject of safer sex.

However, if your partner resists the idea of using condoms, you may need to negotiate. Stress that you both
deserve to be protected and that sex will be more enjoyable when you aren't worrying about STIs (see the
suggestions that follow). If you and your partner haven't used condoms before, buy some and familiarize
yourselves with how to use them. Once you feel more comfortable handling condoms, you will be able to use
them correctly and incorporate them into your sexual activity. Consider trying the female condom as well.

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If your partner still won't agree to use condoms, think carefully about whether you want to have a sexual
relationship with this person. Maybe he or she is not the right person for you.

Click here for a description of Table: Take Charge, Talking About Condoms and Safer Sex.

Source: Dialogue from San Francisco AIDS Foundation. 1998. Condoms for Couples (IMPACT AIDS, 3692
18th Street, San Francisco, CA 94110). Copyright 1998 San Francisco AIDS Foundation. All rights reserved.
Used with permission.

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