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Several recent threads in different places have raised questions about sexual health and sexually transmissible infections (STIs). I thought it might be worthwhile to review and discuss some basic information. 1. Perfectly nice, respectable and trustworthy people can carry STIs without knowing it because they may have no symptoms. They can infect other equally reliable people without intending to cause any harm to them. 2. Everyone is responsible for their own sexual health. Only you can ensure that you are practicing safe(er) sex and that you are not at risk of being infected, actually infected or transmitting infections. 3. Free and trustworthy confidential sexual health testing is available in every major centre in Canada. If you're not comfortable asking your doctor for tests, you can go to a free clinic where you will not be questioned or judged. I do this, myself, every two months. The staff are friendly, pleasant, efficient and easy to work with. 4. STI test results are only a "snapshot" of your sexual health status when the tests were performed. They are not a guarantee that you do not have an STI a few weeks later. In fact, since some STIs incubate for weeks or months before producing symptoms, markers in blood samples or showing up in vaginal swabs, even though your STI test results are clear, you can still be harboring an infection that has not yet made its presence known. 5. STI tests should be repeated for at least six months before you can consider yourself likely to be infection-free, assuming that you have not changed sex partners during that time and that your partner(s) also have not had new partners. 6. Most STIs are easily treated with antibiotics. Some, such as herpes, cannot be cured but can be managed with antiviral medication. HIV/AIDS is increasingly becoming a manageable infection in Canada's larger cities. 7. HIV/AIDS is probably the most-feared STI. It is also a very fragile virus that does not communicate easily. You can't get HIV from doorknobs, sharing a plate or a glass, from kissing or from doing someone's laundry. HIV needs easy entry to one's bloodstream, usually via a cut, a tear in one's vaginal or anal mucous membrane, or a contaminated injection needle. In North America, heterosexuals who do not use illegal injectable drugs are at low-risk for having or transmitting HIV/AIDS. The problem, of course, is that because we cannot be certain about our sexual partners' other partners, it is not safe to assume that there is no HIV risk when having sexual contact with anyone. 8. Condoms offer the best protection against STIs. Condoms are effective for oral sex as well as vaginal and anal sex. Non-latex condoms are available and effective for those who are allergic to latex. Female condoms are not made of latex and are also effective for those who have allergies. Condoms made of sheep intestines and other materials are effective for preventing pregnancy, but not effective for preventing STIs. Sperm are significantly larger than viruses and bacteria, which can slip through the membranes of these "natural" condoms. 9. There really is no such thing as "safe" sex. Things such as condoms, dental dams and gloves can make sex safer, however. Even so, the herpes virus is "shed" by up to 5% of infected people even when they are not experiencing outbreaks. This means that one may transmit or contract herpes unknowingly. 10. Some STIs are more prevalent in some parts of Canada than in others. For example, a syphilis epidemic has been going on in Vancouver since the early 1990s. Syphilis is one of the viruses that can inhabit a human throat for months without any symptoms. Nonetheless, even if you and your companion both live in Saskatoon, it may be difficult to be sure that neither of you has had contact with anyone who may have come in contact with syphilis recently. 11. Common wisdom about STIs is usually inaccurate and untrustworthy. For example, one will hear that "everyone knows" there is only negligible risk in oral sex performed on a man. In fact, giving and receiving oral sex places both parties at high risk of STI transmission for all infections other than HIV, in which case the risks are lower. 12. Sexually active people have a responsibility to ensure that they have the best, up-to-date information about STI risks. Only with accurate information can we make informed choices about our sexual behaviour and infection risk. You can get this information many places including the Health Nurse's Sexual Health Information website and the B.C. Centre for Disease Control's STD Resource website.