Reducing Risks for Pregnancy and STIs

1. Reducing Risks for Pregnancy and STIs Analyzing Different Contraceptive Methods

2. Contraceptive Methods Which method is the most effective in preventing pregnancy and STIs? 2nd most effective? Which method is the least effective in preventing pregnancy and STIs? Male/female condom Double Dutch Abstinence Birth control pills IUD/IUS The patch The shot Diaphragm Emergency contraceptive pills Withdrawal

3. Abstinence Most effective method of preventing pregnancy and STIs when used consistently Have a back up method in case you get caught in the “heat of the moment” Benefit: can encourage people to build relationships in many ways other than sex

4. Double Dutch Using a condom and hormonal contraceptive together Second most effective contraceptive method for preventing pregnancy and STIs Both protect against pregnancy Condoms protect against HIV and STIs

5. Classifying Contraceptive Methods Barrier Methods – put up a block, or barrier, which keeps the sperm from reaching the egg Hormonal Methods – prevent pregnancy by interfering with ovulation, fertilization, and/or implantation of the fertilized egg Implanted Devices – inserted into the body and can be kept in place for a few years Emergency Contraception – should not be used as a regular form of birth control

6. Barrier Method: Diaphragm Requires an exam, a fitting, and a prescription from a doctor Requires the use of spermicidal gel 94% effective in preventing pregnancy if used consistently and correctly

7. Diaphragm Benefits: • Non-hormonal device • Can be effective for up to 6 hrs after insertion Disadvantages: • No protection against HIV • Minimal protection against gonorrhea and chlamydia (because of the cervical barrier) • Increased risk of bladder irritation or infection • Increased risk of Toxic Shock Syndrome (TSS) if worn longer than 48 hrs

8. Barrier Method: Condoms • Work by creating a barrier between mucous membrane and pathogen (STI) • Very effective against several STIs; less effective (but still of value) against STIs transmitted by “skin to skin” contact • Must be used correctly and consistently every time! • Check the expiration date • Store in a cool, dry place

9. Effectiveness of Condoms Male Condoms – 85-95% effective in preventing pregnancy depending on consistent and correct use Female Condoms – 79-95% effective in preventing pregnancy depending on consistent and correct use Male/Female Condoms – the only technology available to prevent the sexual transmission of HIV Breakage Rate – less than 2% in the U.S. due to incorrect use rather than to the condom’s quality

10. Condom accessibility Widely available, low or no cost Local health department or family planning clinic Drug stores and chain stores No age restriction Both males and females can get condoms Get them before they are needed

11. How to use a condom • Open new condom package with hands (not scissors or teeth). There is a correct and an incorrect way to put on a condom. Check to see which direction the condom will roll before contacting the penis. • Roll the condom down to the base of the penis. Being sure to leave a reservoir at the tip (space must be left at the tip to hold the ejaculated semen). Pinch tip and roll out any air bubbles. • After ejaculation has occurred, unroll the condom. Then, be sure to hold the base of the penis (to prevent spilling of the semen, the condom must be held at the base while withdrawing from the partner's body). Throw used condom away.

12. Use assertive communication • Practice assertive communication • Respect yourself & others • Be a good listener • Attentive, responsive • Use confident body language • Good eye contact • Keep body straight and hands at side or in lap • Remember that body language is more important than what you actually say!

13. Negotiating use

14. Pressure & Negotiation examples Excuse: Sex doesn’t feel as good with a condom. Response: There is plenty of feeling left, and I would not feel safe without it. Excuse: Condoms are unnatural and turn me off. Response: There is nothing natural about getting a disease either. Excuse: Why do I need to use condoms if we’re using the pill. Response: So you can protect your health. The pill does not help prevent infection with STDs, including HIV, . . . but condoms do.

15. Hormonal Method: Birth Control Pills Work by releasing hormones (estrogen and progestin), which stop your body from releasing an egg, so that there is no egg to be fertilized Also work by causing cervical mucus to thicken, which can stop sperm from getting into the uterus 99.7% effective in preventing pregnancy if taken every day and at the same time every day Can be ineffective if taking anti-biotics

16. Birth Control Pills Benefits: Regular and lighter periods with fewer cramps Clearer complexion with some types Protection against ovarian cancer, endometrial cancer, ovarian cysts, iron deficiency

17. Birth Control Pills Disadvantages: Does not protect you against HIV or STIs Cigarette smoking increases the risk of serious cardiovascular side effects May experience nausea, breast tenderness, or spotting between periods *A change in pill prescription can help decrease side effects

18. Hormonal Method: The Patch A thin, stick-on square patch that allows hormones to enter the bloodstream through the skin Placed on either the abdomen, buttocks, lower back, upper outer arm, or upper torso Effectiveness – 99.7% effective in preventing pregnancy if used correctly (must be replaced on time) Cycle of Use – 3 wks on, 1 wk off

19. The Patch Benefits: Only have to change it once a wk and can be worn in a different place each wk Stays on while you shower, swim, bath, or exercise Warm, humid conditions do not decrease its sticking power Can see it – don’t have to worry about whether you took your pill or not

20. The Patch Disadvantages: • Nausea, vaginal spotting and menstrual cramps • Skin irritation under and around the patch • Will not give you protection against HIV or STIs • Cigarette smoking increases the risk of serious cardiovascular side effects

21. Hormonal Method: The Shot Depo-Provera® (Depo) – injectable method of contraception given every 3 months/12wks/4 per yr(releases progestin) Effectiveness – 99.7% effective in preventing pregnancy if you get your shot on time

22. The Shot Benefits: You don’t have to remember to take a pill every day Private and convenient May have very light bleeding or no periods and no cramps after several months of use Lowers risk of endometrial and ovarian cancer, anemia, ectopic pregnancy, and pelvic infection

23. The Shot Disadvantages: Irregular spotting or bleeding during the first 6 months Increased appetite and slight weight gain Mood changes, nausea, occasional heavy menstrual periods Lowers natural estrogen levels – might decrease strength of bones No protection against HIV and STIs

24. Implanted Devices: Intrauterine Contraceptives (IUD & IUS) IUD – Intrauterine device: a small plastic device wrapped with natural copper IUS – Intrauterine System: a T-shaped plastic device that releases a low dose of progestin Stops sperm from reaching the egg (stops fertilization) Effectiveness – IUS = 98.9% effective; IUD = 98.4% effective

25. IUD & IUS Benefits: Offer effective, long-term, private, reversible protection against pregnancy IUS can be left in for 5 yrs; IUD can be left in for 10 yrs

26. IUD & IUS Disadvantages: Discomfort during insertion No protection against HIV and STIs The insertion process can introduce infection from the vagina into the uterus

27. Implanted Device: Implantable Rod A thin, matchstick-sizedrod that containsthe hormoneprogestin It is put under your skin on the inside of your upper arm Effectiveness – more than 99% effective

28. Implantable Rod Benefits: Offer effective, long-term, private, reversible protection against pregnancy Lasts up to 3 yrs

29. Implantable Rod Disadvantages: May not work as well for overweight or obese women Does not protect against HIV and STIs Acne Weight gain Cysts of the ovaries Mood changes/depression Hair loss Headache, upset stomach, dizziness Lower interest in sexual activity Sore breasts, changes in your periods