Sex Ed 101 [S4C]

Factors that Contribute to and Support Behavior Change

-Sexuality information that is culturally relevant, honest, accurate, and balanced

-Information about the consequences of unprotected sexual intercourse and how to protect oneself

-Information about postponement and protection

-Community resources for condoms, dental dams, and needle exchange

-Community resources for survivors of sexual victimization and/or abuse

-Anonymous HIV testing, support groups, and peer education groups

- Seeking a positive outcome (causal)
- Talking with partners, respected adults, and peers
- Testing and/or treatment for HIV
- Using dual method protection
- Making future plans

- To resist peer pressure
- To negotiate safer sex
- To communicate with partner, peers, and parents
- To access services, including testing and treatment

- That abstinence is cool
- That it is okay for young people to enjoy sexual relationships
- That sexual intercourse should be safe and consensual
- That early treatment will make a difference
- That service providers will be helpful and nonjudgmental

- Relate to other teens on their own level
♥ Talk about problems that affect teens
♥ Explore new frontiers with peers
♥ Let people in power know youth’s point of view
♥ Bring essential information to other youth
♥ Help adults understand the way teens think and act.
&hearts Youth generally are well informed about transmission of HIV infection.
♥ Youth generally do not feel that they, as individuals, are at risk of HIV/STI and see no reason to change their behavior. On the other hand, youth who see themselves as being at high risk frequently see little reason to change their behavior because they believe infection with HIV is inevitable.

♥ Youth know how to prevent infection with HIV, but frequently object to using prevention methods consistently. For example, many teens reject the concept of abstinence until marriage. Many teens also feel reluctant to use condoms at every act of sexual intercourse.
♥ Many youth have negative views of condoms. For instance, research shows that some youth feel that using a condom would be perceived as indicative of infection with HIV/STI; such a perception makes it difficult for these youth to negotiate – or even mention – condom use. Other youth worry about loss of enjoyment, about condom failure, or about embarrassment when attempting to purchase condoms.

♥ Encourage teens to make safe and responsible decisions about when it is right for them to have sex.

♥ Encourage sexually active teens to adopt safer sex behaviors, including consistent and correct condom use.

♥ Encourage sexually active teens to limit the number of their sexual partners.

1. Adolescents are at risk for HIV/STI because many of them engage in sexual intercourse, and many do not use condoms. The statistics vary slightly from year to year.

♥ Nevertheless, about half of all U.S. high school youth report having ever had sexual intercourse – from less than 40 percent of those in 9th grade to over 60 percent of those in 12th grade.

♥ Some demographic subgroups of youth report higher rates of sexual activity than do other groups. For example, African American high school youth frequently report higher rates of sexual activity than Hispanic youth.

♥ A small but significant minority of sexually experienced high school youth – usually less than 20 percent – reports having had sexual intercourse with four or more partners. By their early twenties, the percentage of youth reporting four or more lifetime partners rises.

♥ While many youth engage in sexual intercourse, many do not use condoms. Studies show that from 40 percent to 60 percent of sexually active U.S. youth (varying by gender and race/ethnicity) report no condom use at most recent intercourse.

2. Drug use puts some adolescents are at risk for HIV/STI.

♥ While injecting drugs provides the most direct transmission route for HIV, the use of non-injection drugs and alcohol may impair a person’s willingness and ability to use condoms or to take other precautions while having sexual intercourse. Some illicit drugs, such as crack and ecstasy, may increase users’ desire to have sexual intercourse.

♥ Youth may engage in multiple risks. In one study,students who drank frequently, smoked cigarettes,and/or used marijuana were two to three times more likely to be sexually active than students who did not use substances. They were also more likely to report multiple partners than those who never drank.

♥ Among high school students surveyed in the late 1990’s, around 80 percent reported some use of alcohol. At the same time, about one-fourth of young women and one-third of the young men reported heavy episodic drinking and similar proportions reported marijuana use.

♥ In the same survey, about two percent of U.S. high school students reported having injected drugs,and about eight percent reported ever using cocaine. Although heroin and other drug use is undocumented among out-of-school youth, some experts believe that the rates may be considerably higher than among in-school youth.

3. Adolescents are at risk for HIV/STI because of the stage of their psychological development.

♥ Adolescence is a time of physical and psychological growth, and the developmental characteristics of adolescence may put teenagers at risk for contracting HIV/STI. For example, feelings of invulnerability and an inability to think abstractly characterize some stages of adolescence. These developmental characteristics increase teens’ need for factual information and risk reduction skills.

♥ Teens need both information and skills. Many teens need to learn new sexual health attitudes. Youth also need the skills to enable them to act on those attitude changes. TAP members deliver information and skills to other teens through creative, interactive exercises and activities that have the power to change youth culture in a school or in a community.

4. AIDS cases have been reported in every state. While not every community has been dramatically affected by HIV or AIDS, it is highly probable that a parent, teacher, or youth – or someone well known to them – has been or will be infected with HIV. Adults and youth must be prepared to deal with the situation when it happens. TAP helps educate youth and staff.

♥ The saying that an ounce of prevention is worth a pound of cure is nowhere more relevant than in the world of HIV prevention. Yet, human nature means that many people will not feel compelled to take precautions against HIV until personally affected by the consequences of not taking them. For example, a former Director of the United States Office of Personnel Management released a workplace policy on HIV/AIDS only after her son was greatly touched by getting to know a teacher with AIDS.

♥ HIV infection and AIDS will affect every school or agency – even if they haven’t yet. All agencies and schools should have a policy setting forth a compassionate, caring response to HIV seropositivity in staff, students, and clients. The policy should also emphasize a commitment to HIV/STI prevention education. Implementing Accurate Sexual Education means that a school or agency is powerfully committed to HIV/STI prevention education for young people.

5. HIV/STI prevention education is currently the only way to curb the spread of HIV among youth.There is no cure for HIV infection or for AIDS.Experts estimate that the world is years away from development and approval of a viable preventive vaccine. However, we do know how to prevent infection with HIV. Everyone who has significant contact with any young person should make sure that youth receives both

♥ Correct information about HIV and other STIs, including ways to protect against infection
♥ Opportunities to practice and improve skills in communication, negotiation, and refusal as well as in how to use condoms.

5. One of the most effective approaches for communicating essential HIV/STI prevention information to youth is teens talking with other teens.

♥ Teens often ask their friends health questions before—or instead of—asking their parents, teachers, or other adults in their lives. In fact, many teens have said that they would most likely seek HIV/STI prevention information from someone their own age.

6. Through teens, parents may become more knowledgeable about HIV/STI and AIDS, and communication between adolescents and parents may improve.

What it really comes down to is that sex is how you define it, as an individual, based on your experiences and feeling.

When most people say they have "had sex" or talk about "sex" they mean vaginal intercourse, but for many, that doesn't sum up what sex is very well, nor is that even ppart of what sex is for them. Many of us find it better to define "sex" as being whatever it is that arouses or satisfies us in a sexual way. For some, that is vaginal intercourse, but for others that may be oral sex, masturbation, digital (with hands) sex, anal intercourse, sex with toys like vibrators, or even kissing and petting. Because people and their sexualities are so different, definitions of what sex is or isn't also vary really widely.

It's really important that we not let someone else define what sex is for us -- after all, how can they know what sex is for anyone but themselves?

We can have the best sex if we find out for ourselves what makes us sexual, instead of letting another person tell us what does for them, and ascribe that to us. We are all very different people, with different bodies, experiences, desires and responses, and what sex is to one person, it may not be to another.

Having a more open defintion of sex also helps people to remember to have sex responsibly. if we say only vaginal intercourse is sex, then a lot of people think that having sex safely only need apply to that sort of sex, which isn't true at all.

Give your self time to explore what it really means to you. In my experience, the older you get, and the more diverse your sexual experiences are, the more you begin to realize that so many things can be sexual, trying to define which things they are arbitrarily is just plain silly.

Response – Research does not support this commonly heard and hotly argued point. In 1993, an extensive review of existing research found that sexuality education did not lead to earlier or increased sexuality activity. In fact, the study found sexuality education that included information about contraception actually delayed the onset of sexual activity, decreased overall sexual activity, and/or increased the adoption of safer practices by sexually active youth. Moreover, prominent scientific and medical organizations, such as the Institute of Medicine, flatly refute this argument.

Objection 2 – Adolescents are not at risk for developing AIDS. It’s a disease of adults.

Response – It is true that only a small percentage of AIDS cases occurs among teens. However, the real danger to teens is infection with HIV, the virus that attacks the immune system and eventually causes AIDS. Approximately 17 percent of AIDS cases are among those ages 20 to 29.9 The lengthy period between HIV infection and onset of AIDS – as much as 10 years – means that many of the young people in their twenties who are living with AIDS were probably infected with HIV when they were teens. Objection 3 – Parents will not support this program. It’s too controversial.

Response – A 1999 Advocates for Youth/SIECUS poll found that 93 percent of adults support the teaching of sexuality education in high schools, while 84 percent support sexuality education in middle/junior high schools. Another study showed that 79 percent of adults favor television advertising to promote condoms for HIV/STI prevention. Objection 4 – This school already provides ___ (fill in the blank) hours of HIV/STI prevention education in ninth grade health class. Therefore, we have no need for this program.

Response – The majority of adolescents receive some form of sexuality education in school, yet very few receive comprehensive sexuality education, which is proven to be more effective. Students need to learn HIV/STI prevention education within a larger context that includes making decisions, setting goals, and exploring values and gender roles. Students also need factual information about reproduction, physiology, contraception, and sexually transmitted infections. They cannot get this in one, two, or a few hours. The TAP training component provides the larger context and provides ongoing reinforcement of important HIV/STI prevention skills and information. Adults wouldn’t expect youth to receive all they would ever need to know about writing in a one-hour class in ninth grade. Why should anyone expect it about HIV/STI prevention?
As TAP members develop and implement educational activities for their fellow students, members and other youth receive both encouragement and support in avoiding risk behaviors for HIV infection.

Objection 5 – This organization provides ______ (outdoor, recreational, sports, etc.) activities for youth. It is not in the business of offering other types of programs.
Response – Community-based organizations are ideally situated to reach and engage youth who are frequently overlooked by other institutions – such as homeless youth, immigrant youth, and youth whose culture, race/ethnicity, or sexual orientation puts them at a disadvantage in dealing with local institutions. All youth need education about how to prevent HIV/STI because prevention directly relates to their physical well being. Wherever possible, organizations should join in a community-wide HIV/STI prevention effort so all teens can hear consistent messages from numerous sources. At the very least, this organization has an opportunity to reach some youth that urgently need this program. To do less is to turn our backs on a critical situation facing the youth we care about.

Objection 6 – The staff is already overworked. We cannot possibly implement another new program.

Response – We can integrate a TAP program into our current programs. The staff time needed to implement TAP is about 25 percent of a full-time position. Volunteers, including youth, from the community can do some of the training, oversee program development, and/or coordinate youth-led educational activities. If the organization will commit to hosting the program, we can find the resources for making TAP happen.

Objection 7 – Sexuality education and HIV/STI prevention education do not change behavior. They are not effective. Why bother to implement another program that will have no impact?

Response – Sexuality education programs that are comprehensive and that incorporate interactive exercises have been shown to be successful in changing sexual risk behaviors. TAP has been tested using a pre- and post-test experimental design. Evaluation of TAP found that the TAP training increased TAP members’ knowledge, changed their behavioral intentions to use condoms, and increased their sensitivity toward persons living with AIDS.
Although designers intend TAP ultimately to lead to healthy sexual attitudes and behaviors among all the youth reached by TAP members, program planners and sponsors must not expect immediate behavioral change among the target population. Rather, the TAP program alerts teens to their need to protect themselves from HIV/STI. Anyone – of any age, sex, race/ethnicity, or sexual orientation – can become infected. Promoting healthy behavior among youth begins with changing youth’s attitudes – that is the primary goal of TAP. Helping teens understand that they are vulnerable to HIV/STI is a significant first step in preventing HIV/STI.

Objection 8 – Teenagers cannot take on the amount of responsibility this program requires.

Response – American society too often describes adolescents negatively – as misguided, out of control, or self-absorbed. Yet, this stereotype overlooks the many powerful, positive qualities of teens: their loyalty, altruism, energy, leadership, and idealism. Adults perform a disservice to youth when they fail to recognize teens’ positive, important qualities and to empower youth to put their abilities to the service of the community. In fact, the very youth labeled troublemakers frequently become the most effective peer leaders. They already have solid leadership skills that other youth recognize. When those skills are applied to a positive goal and the issues involved are ones that personally affect them and their friends, these youth become powerful peer leaders for positive change.
In one presentation by a TAP group, an adult in the audience remarked that the teens were doing a great job and that they were very special youth. A TAP member responded.
We aren’t special youth. We have been given the opportunity to become involved in our school and our community. We have been encouraged to take control of the HIV/STI prevention education activities. Youth need the opportunity to create our own programs, and when given that opportunity, we can do great things!

Objection 9 – Youth are not interested in HIV or other STI, nor do they care about their peers.

Response – Youth care. They care a great deal, and they are interested. However, youth generate the most excitement and energy about a program that meaningfully involves them – not just as audience, but as designers, creators, managers, and performing artists. Planners should include youth in the planning from the beginning. Then, the youth will participate in crafting an exciting, exuberant, creative program.
Planners should also remember that youth have serious practical concerns and little money. After school, they are hungry, and the program should provide them with drinks and food. If youth have to travel to the program, they may need immediate reimbursement to cover their travel expenses. If interested youth need to work at a paying job after school and on weekends, then creative planners will build in flexibility to meet the time and energy constraints on the youth. Having other teens do the recruiting – through presentations, by word of mouth, or by developing creative flyers – will also encourage other teens’ interest. Personal testimony from one teen to another is very powerful. Teens can always explain why becoming involved in TAP is worth another teen’s valuable time.

Objection 10 – Teens will not listen to other teens because they have no authority.

Response – Some teens may initially think, “Why should I listen to you? You don’t know any more than I do.” But when teens have been trained in HIV/STI prevention and in public speaking, other teens listen. Confident teens quickly gain respect and attention when they speak directly to other teens and give them correct information. Teens gain more from HIV/STI prevention education that is peer-led than from education led by adult.

Youth, Advocates for “Guide To Implementing
TAP.” Advocates for Youth (2002). 19 Apr. 2007.
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Contraceptive Chart

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The Pill

Sesonale - Birth Control Pill - Periods only 4x a Yr!

Want Birth Control Plus Four Periods a Year?
By Jenna Levy, 18, Staff Writer
Originally Published: Jul 21, 2004
Revised: Oct 11, 2006

Hey girls, how would you like to get your period just four times a year? Think it's a pretty good deal, or would you hesitate to tamper with "the flow"? Well, a seasonal period is now one of your options.

The U.S. Food and Drug Administration recently approved Seasonale, a birth control pill that reduces your monthly periods to once each season while also preventing pregnancy.

Although some girls are hesitant to tamper with their bodies' natural functioning, others might be eager to reduce the annoyance of cramps, PMS, and monthly trips to the drug store for feminine hygiene products. Plus, Seasonale is 99.7-percent effective at preventing pregnancy, when taken properly. (The typical-use rate is 92 percent.)

Old Pill, New Method

Seasonale, manufactured by Barr Laboratories, was introduced to consumers in September 2003. But Seasonale is basically the same birth control pill that has been around for a long time, according to Anita L. Nelson, MD, professor of obstetrics and gynecology at the David Geffen School of Medicine, University of California , Los Angeles. The manufacturers are simply prescribing a new way to use it.

"This isn't a new pill," Dr. Nelson explains. "It's just a new way of taking a pill that's been around."

Seasonale contains estrogen and progestin, the same hormones found in the better known 28-day birth control pill. The Seasonale package includes two different types of tablets: pink and white. The pink "active" tablet contains estrogen and progestin, which prevent a woman's ovaries from releasing an egg, so she cannot get pregnant. As long as a woman takes these hormones, she also skips her period.

In the traditional approach, women took three weeks of active pills, followed by one week of "placebos," which have no hormones and are used to keep the woman in the habit of taking a pill each day. This cycle allowed her to get a monthly period. With Seasonale, you take the active hormones for 12 weeks (84 days), followed by one week (7 days) of the white placebo pills. That reduces your period to once every three months.

Proceed With Caution

Like other birth control pills, Seasonale does NOT protect against sexually transmitted infections, so to avoid disease, you have to use a barrier method of protection (like a condom), every single time you have sex.

And like other birth control pills, Seasonale can cause some side effects, including bleeding and/or spotting between periods. Smokers should steer clear of Seasonale, according to Laura Berman, Ph.D. and coauthor of For Women Only: A Revolutionary Guide to Overcoming Sexual Dysfunction and Reclaiming Your Sex Life. Cigarette smoking can increase the possibility of serious side effects of all oral contraceptives, including blood clots, stroke, and heart attack.

"Seasonale can be taken by any non-smoking female trying to prevent pregnancy and to control her menstrual cycle," says Dr. Nelson. "The only formal age requirement would be menstruation and sexual activity. Women in their teen years experience some of the most powerful and painful menstrual periods and should also be allowed access to Seasonale."

Getting Started

You need a doctor's prescription to get Seasonale. It can cost anywhere from $35 to $125, depending on where you get it. For example, if you go to your primary health care provider, chances are you'll be billed for the visit and the supply of pills, so it will cost more. But if you go to a family planning clinic, like Planned Parenthood, you may only have to pay what you can afford. (This is known as paying on a "sliding-scale fee.")

Like any contraceptive, you have to use Seasonale correctly for it to be 99.7-percent effective. That means taking one tablet every single day, at roughly the same time each day. If you forget to take the pill, even for one day, you can get pregnant, assuming you're sexually active.

Weighing Your Options

All methods of birth control have pros and cons. For some, getting a period only four times a year just feels too weird.

"It's an unnatural means of altering a normal and healthy bodily function," says Heather, 18, of Houston, TX. "A normal female has her period roughly once a month. That's all there is to it. By taking a pill that alters the balance of hormones in the reproductive system, there's no telling what the long-term consequences will be. Personally, I'm not going to be a guinea pig."

But studies have shown that long-term use of the hormones contained in most oral contraceptives, including those in Seasonale, pose no long-term threats to a woman's health.

Others see fewer periods as a real bonus.

"There is nothing wrong with making changes that will make the lives of women easier," says 15-year-old Mollie, of New York City . "This contraceptive gives girls less to think about and reduces stress."

Your Choice

Everyone is different. That's why you have to choose the contraceptive that best fits your lifestyle.

"Any woman who is interested in using Seasonale, whether because of the health options involved or simply because of convenience, should explore her options thoroughly with her doctor," advises Berman.

Editors' Note: For more on Seasonale, visit the official Web site or call 1-800-719-FOUR (3687).

No matter how old you are, tallking to your partner about sex isn't always easy. You'll probably feel better after you do though. If it's your first time together, it's a good way to get to know what you both expect, and if you have had sex before, you can talk about what you like and ways to make sex better.

But you'll probably want to talk about contraception too. It might seem like a mood-killer, but nothing will ruin sex faster than spending the whole time worrying about pregnancy or picking up some disease. It may feel awkward to talk openly at first, but in the end you'll both be glad that you did. And just think...wouldn't you rather have a talk about using condoms than the "whoops, I'm pregnant" talk? Or worse...get the "sorry, but I might have given you HIV" talk? Remember, your safety and health come first...do what you need to to make sure you're in control of it.