OF YOUR SEXUAL HEALTH
The aim of this guide is to give you knowledge and confidence to advocate for your own sexual health and sexual happiness.
ABOUT THIS PROJECT
WHAT YOU'LL LEARN HERE
Know your STIs: You will learn about the nine main sexually transmitted infections, or that you or anyone you know, regardless of age, socioeconomic background, gender, gender expression, sexual orientation, race, or ethnicity, can get from engaging in sexual activities.
Prevention: You will learn how to prevent becoming infected and infecting others.
Testing: You will learn about tests that tell you if you have an STI and where you can get these tests done.
Treatment: You will learn about how to treat each of these STIs and where treatments are available; where they are free or at low cost; and what your insurance should cover.
Talking with your doctor: You will learn what key points to discuss with your doctor or nurse about your sex life, so that you can be certain to get the services and information you need.
Talking with your partner: You will learn how to talk about STIs with your sex partner so that you and your partner can advocate for yourselves and reduce the risk of becoming infected with STIs or transmitting them to others.
WHAT DO WE MEAN BY SEXUAL ACTIVITIES?
Sexual Activities can be divided up under the headings of “oral,” “anal,” and “vaginal,” but often these activities happen together.
Oral activities occur any time the mouth of a person touches the penis, vagina, or anus of another person. In daily life, people may refer to oral sex as blow jobs, rimming, eating out, tossing salad… Medical professionals may refer to oral sex as fellatio, analingus, cunnilingus…
Anal sex refers to penis in the anus.
Vaginal sex refers to penis in the vagina. It can also refer to vagina on vagina.
While there are many other sexual activities, such as fingering and the use of sex toys like strap-on dildos, those activities are generally not associated with STI infection UNLESS cleaning of hands and toys does not occur between and among partners.
SEX AND COVID-19
WHAT ABOUT SEX AND CORONAVIRUS?
Covid-19 is transmitted though droplets from the nose and mouth when breathing or coughing. It has also been found in feces (poop) of people who are infected with Covid-19. While Covid-19 is not a sexually transmitted infection, direct contact with saliva through kissing and close contact with someone, including having sex, can pass the virus to another person.
What if I still want to have sex?
- If you or your partner are showing symptoms of Covid-19, you should limit or avoid close contact to reduce the spread of the virus.
- You are your safest partner! Masturbation poses zero risk of Covid-19 but remember to wash your hands (and any sex toys).
If you live in the same household as your sex partner, if neither of you have been exposed to another person diagnosed with COVID-19 in the last seven days and if neither of you are showing symptoms of COVID-19, you can continue to have consensual sex.
- Contact, including sexual contact, with people outside your household should be limited, and new sex partners, hookups and relationships should be considered carefully in terms of risk for Covid-19.
If you decide to have sex with someone outside your household, these tips can help with reducing Covid-19 transmission:
You and your potential sex partner should get tested for COVID-19 before having sex together.
- Wear a mask and have your partner wear a mask.
- Use condoms and dental dams during oral and anal sex to limit contact with saliva and feces.
- Continue limiting physical interactions with people by reducing the number of sexual partners you have.
SEXUALLY TRANSMITTED INFECTIONS (STIS)
Worried about what happens for testing?
We have created four quick videos explaining what to expect from home and office testing.
Just click the image to watch!
Interested in learning more about bloodspot collection? Check out this video for what to expect if you are having bloodspots collected and for tips if you are collecting them yourself!
HIV Testing Tutorial
Need help running your OraQuick HIV test? Watch this video to guide you through running the test and reading the results from your home!
At-Home STI Sample
Need help collecting and mailing samples for your myLAB Box STI testing kit? Watch this video to guide you through the process for your three-site (genital, oral, and anal) testing for gonorrhea, chlamydia, and HPV!
What To Expect When
You Come In for Testing
Unsure about what all CrescentCare’s testing process entails? This video details what will happen when you come in to CrescentCare for your HIV and HCV tests!
prep: Oral and injectable hiv prophylaxis
About PrEP (Pre-Exposure Prophylaxis):
- Pre-Exposure Prophylaxis (PrEP) is a medication taken regularly by people who do not have HIV in order to prevent contracting HIV. It is different than Post-Exposure Prophylaxis (PEP), which is a medication taken by people who do not have HIV, but who have been exposed to HIV within the last 72 hours.
- PrEP can be taken by anyone and is widely available, often at no or low cost.
- PrEP reduces the risk of getting HIV from sex by about 99%.
- Recent changes to insurances and accessibility will allow PrEP to be taken orally as a pill and as an injectable.
Oral pre-exposure Prophylaxis:
- Oral PrEP can be prescribed by a doctor and is a pill taken once a day.
- Most insurances, including Medicaid, will cover the cost of oral PrEP.
- Truvada and Descovy are the current medications approved for Pre-Exposure Prophylaxis in pill form.
- A negative HIV test is required to obtain a prescription for oral PrEP.
- A prescription for oral PrEP requires blood work to check liver and other measures. Blood work is taken in the first and third month and then every six months after that if there are no complications.
- Oral PrEP works best when taken every day. Missing one dose will not affect your level of protection but missing multiple doses can become an issue.
- Talk to your healthcare provider if you have trouble taking regular doses.
- The most common side effects are reported as headache, nausea, vomiting, rash, and loss of appetite. However, these side effects are extremely rare and if they do occur, they are typically mild and subside within the first few weeks.
Injectable pre-exposure prophylaxis:
- Injectable PrEP is a newer form of PrEP that has now become more readily available. Injectable PrEP is a gluteal muscle injection that can be prescribed by a doctor as one injection each month for the first 2 months and one injection every two months after that.
- Most insurances, including Medicaid, have recently begun to cover the cost of injectable PrEP.
- Apretude is the current medication approved for Pre-Exposure Prophylaxis in injectable form.
- A negative HIV test is required to obtain a prescription for injectable PrEP.
- A prescription for injectable PrEP requires blood work to check liver and other measures before the second injection and then every four months following.
- Injections every two months should be kept on a regular schedule and occur no later than 7 days past the due date for the second month.
- If you miss an injection, the pill form can be substituted in until the injection can happen. If too much time is missed, the process will revert to an initial injection and a 4-week injection, and then return to every two months.
- The most common reported side effects are soreness at site injection and raised temperature, which can be treated with over-the-counter pain reduction medication.
KEY POINTS TO BRING UP WITH YOUR DOCTOR OR NURSE:
- I have had unprotected sex.
- The gender(s) of my sex partners.
- The parts of the body I use for sex.
- The number of sex partners I have had.
- I think or know my partner(s) may have had other sex partners while with me.
- The last time I was tested was over a year ago or the last time I was tested was before I had unprotected sex.
- I know I have a right by law to get these tests as part of my wellness visit.
- I know I have a right by law to get these tests if I’ve had unprotected sex.
- Even if I don’t have symptoms, I want to know if I carry any of these infections, because I don’t want to pass infections on to other people.
AND if you have ANY discomfort during sex, let your doctor or nurse know. Sex should not be uncomfortable.
WAYS TO TALK ABOUT STIS WITH YOUR LOVER OR PARTNER
- Set your boundaries and expectations clearly.
- Be open from the start of a fling, affair, relationship, or one-night stand. The more people talk openly about STIs, the less people will feel ashamed.
- Tell them about your experience being tested and ask them if they have been tested themselves.
- Show them this guide. Feeling secure and safe can make sex far more pleasurable.
- Let them know that you believe in always using condoms until a lover or partner has been tested. Make it clear that this goes for everyone, regardless of who they are, what they look like, what they act like, etc..
- Invite them to exchange STI results with you.
- If someone is unwilling to engage with you about STIs or is unwilling to use protection, consider that they may not be ready to have sex with you.
- Consider that if someone is unwilling to use protection with you, they are likely to have been unwilling to do so with others before you.
- Always ask for consent before you engage in any sexual activities or foreplay and make it clear that you expect to be asked for consent as well. For example, you should ask, “Is it ok if I kiss you?” or “Is it ok if I touch you?” or “Is it ok if I put my hand on you?” Remember, just because someone says yes on one occasion, it does not mean that you are free to do what you want on another occasion. Asking for consent and communication about consent should be an ongoing process.
- 34 sexy ways to ask for consent (video):
Ideas on how to ask for consent
- Sexual Consent:
Guide to consent during sexual activities
- Understanding Sexual Consent (video):
A how-to on asking for and receiving sexual consent and why it is important
YOUTH AND SEXUAL HEALTH
- Choose the doctor who makes you feel most comfortable and see that doctor regularly. That person should help you feel that you can ask questions freely. If that doctor or health care provider makes you uncomfortable, ask to see someone else. A good, caring doctor will answer any question you have without judgment. Every question you have is a worthwhile question. You are in charge of your body and you have a right to knowledge about your body.
- Ask about any and all concerns you may have, about STIs, about pregnancy, or anything else you want to know more about.
- If you want to talk to your doctor or nurse one-on-one, don’t be hesitant to ask your parent to leave the room if it makes you more comfortable. Also, don’t be afraid to take someone with you, if having someone there will make you feel more comfortable.
- No one should touch you without your permission. If you’re not comfortable with something happening, you can stop it.
- Likewise, you shouldn’t touch someone sexually without their permission. Communication is sexy!
- This applies to kissing, hugging, and any other form of intimate contact.
- Only yes means yes.
- Use protection to stop the spread of sexually transmitted infections and to prevent pregnancy.
- This includes not only condoms, but also dental dams for oral sex.
- It’s important to use protection every time you have sex.
- Sex is more enjoyable when you can have it without worry, and taking precautions like these will help!
- If you’ve recently had unprotected sex, or you notice something unusual about your body, such as new sores, blisters, rashes, or discharge, you should get tested for STIs.
- It is recommended to get screened at least once a year, even if you have only had protected sex with one partner.
- Getting tested may seem scary, but there’s nothing more empowering than having the right information to make the right decisions about your health.
- About 2% of teen girls and people assigned female at birth between the ages of 15 and 19 will give birth.
- Even condom use can result in pregnancy, as condoms are only 98% effective with perfect use.
- Becoming pregnant can cut your chances of graduating high school by up to 50%.
- If you plan to become sexually active, ask your doctor or other healthcare provider to prescribe you birth control. Birth control pills are an option as well as progestin implants and IUDs. In fact, the American Academy of Pediatrics has declared that IUDs and progestin implants are birth control methods of choice for teens.
- No one can choose who they’re attracted to, and being gay is completely natural and normal.
- Sexuality exists on a spectrum. You can be attracted to men, women, non-binary people, or any combination. If you are asexual, you may not be sexually attracted to anyone.
- Likewise, gender is also a spectrum. You may identify as male, female, both, or neither. There is no wrong way to be you!
- Everyone’s expressions of sexuality and gender are different, and these differences should be celebrated and learned from.
- If you are a trans or non-binary youth, please check out http://tcher.cc for more helpful information.
- Consent and Sexual Assault:
Information for teens about personal consent in sexual engagement
- Female Reproductive System:
Anatomy of People Assigned Female at Birth
- Gender, Sexuality, and Expression:
Gender expression and sexuality
- How effective are condoms?:
Information on birth control effectiveness
- Male Reproductive System:
Anatomy of People Assigned MALE at Birth
- Reproductive Health: Teen Pregnancy:
Data about teen pregnancy and prevention
- Safer Sex Guidelines for Teens:
Safer sex guide for teens
- STD testing: What’s right for you?:
STI testing guide about the various options and types of testing that are available.
- Talking with Your Teens about Sex: Going Beyond “The Talk”:
Informational guide for teens about sex and proper preventions for STIs
- This Is How Often You Need To Get Tested For STDs, Based On Your Relationship Status:
Informational guide about what STIs you should get tested for and how often you should get tested.
AGING AND SEXUAL HEALTH
Sexuality does not disappear as one becomes older. Many people continue to need and to look for intimacy as they mature. Many people are sexually active well into their eighties and even beyond. Physical changes and health complications that come with age may make sexual activity more difficult and can increase susceptibility to infection. Older people can also transmit or be infected with STIs just as young people can. Understanding the changes in one’s body and risks and taking steps to address them will allow you to have a healthy, safe, and fulfilling sex life.
Some things to consider:
- Age does not naturally protect from STIs or HIV. You are never too old to be at risk. STI rates of people aged 65 and above are rising, specifically the rates of chlamydia and syphilis. Condoms and other safe-sex practices are still effective regardless of age.
- It is important to be open and honest with your healthcare provider about sexual health concerns, as otherwise they are more likely to attribute common STI symptoms, such as worsening eyesight or arthritis, to other underlying health issues associated with age.
- Medicare covers free annual STI screenings, and you have the right to request an STI test.
- If you are sexually active, have symptoms of an STI, or are concerned you have been exposed to an STI, do not hesitate to speak with your healthcare provider. You do NOT need to have symptoms to request an STI test.
- Many long-term care facilities, nursing homes, and assisted-living facilities are not equipped to test for STIs. It is important to request tests from your healthcare provider so they can help you access these services.
- Aging brings about physical changes for both men and women that can significantly affect sexual activity. Common issues such as hormonal changes, reduced natural lubrication, erectile dysfunction, pain or disability, illness, medication-related sexual side-effects, or surgery can significantly impact how and when you can have sex. It is important to talk openly and honestly with your partner or partners about these changes and how they are affecting you.
- Studies show that people over 50 are less likely to wear condoms during sex. This is likely why the number of STIs are increasing rapidly among older people.
- Older people are more likely to delay care seeking for STI symptoms than their younger counterparts. This can lead to worse outcomes for older people, because their infections go untreated longer.
- Health care providers sometimes wrongly assume that because you are older, you are either having only sex with one partner or are having no sex. Therefore, they may not ask you details about your sex life and without this information, they may not be able to diagnose you correctly. You have every right to volunteer this information, if your health care provider fails to ask you about it.
- CrescentCare Sexual Health Center:
LSU’s Sexual Health Center in New Orleans
- Let’s Talk About Sex … and Senior Citizens:
Sexual health in seniors and long-term care facilities
- Patients fifty years and older attending two sexually transmitted disease clinics in Baltimore, Maryland:
Study about patients over 50 and accessing sexual health clinics
- SAGE resources on Health Care and the Senior LGBTQ Community:
Resources for Trans elders and community
- Sexual Health in Older Adults:
Sexuality health and Aging
- Sexuality in Later Life:
Sexuality health and Aging
INSURANCE COVERAGE FOR STI TESTING AND TREATMENT
- The Affordable Care Act (ACA) ensures that your annual wellness visit is covered in full by any insurance you have. During the annual wellness visit, STI testing panels should be covered in full.
- Discussing any unprotected sex you have had can help ensure that your testing will be covered.
- Make sure you ask about coverage and cost for each and every test.
- Remind your health care provider that your tests should be covered under your annual wellness visit.
- A number of places offer free STI testing and treatment and/or sliding scales depending on income.
- Not all health care providers will ask you about your sexual history or recent unprotected sex you may have had. Make sure they know, because sometimes tests are only covered if a person is coded as "high risk."
Tell your health care provider exactly what you want to be tested for. Print this guide out if it helps or pull it up on your phone. Be ready to insist on tests that you want. You can quote this guide and point out the high rates of STIs in your local area.
- Medicaid Enrollment:
New Orleans resource to help individuals enroll in Medicaid
WHERE TO GET TESTED IN NEW ORLEANS
LSU-CrescentCare Sexual Health Center
3308 Tulane Avenue, 5th Fl. New Orleans, LA
- Confidential testing and treatment for chlamydia, gonorrhea, HIV, Syphilis, and other sexually transmitted infections, with testing and onsite provision of most medications.
- Medicare, Medicaid, and private health insurance accepted; sliding-fee scale available for those without insurance.
CrescentCare Wellness Services
1631 Elysian Fields Ave., 2nd Fl New Orleans, LA 70117
- For gay, bisexual, and queer-identified men and transgender individuals. FREE testing for Gonorrhea, Chlamydia, Syphilis, Hepatitis C, and HIV along with PreP services.
Prevention Department, CrescentCare Elysian Fields
1631 Elysian Fields Ave., 2nd Fl. New Orleans, LA 70117
- Free confidential rapid HIV and HCV testing, counseling, and referral to treatment as well as assistance in Medicaid enrollment.
4636 S. Claiborne Ave. New Orleans, LA
- STI testing, diagnosis and treatment, prevention services and education.
- Take Charge Plus and regular Medicaid accepted, as well as private insurance. Financial assistance available for your procedure. If you are eligible for financial assistance you may be asked to bring documentation with you to the health center.
Odyssey House Community Health Center
1125 N. Tonti St. New Orleans, LA
- STI testing, diagnosis and treatment. HIV testing and treatment through HIV Focus program.
- Accepts Medicaid/Medicare/private insurance and sliding scale payment for non-insured; you will not be denied treatment on inability to pay.
Priority Health Care
4700 Wichers Dr. Marrero, LA
- STI/HIV testing, diagnosis and treatment. PreP services.
- Accepts all forms of insurance.
- Assistance with medicaid applications available.
Tulane Community Health @ Covenant House
- Free HIV/STI testing and treatment for people 13-24 years of age.
- Do not have to be living at Covenant House.
Delgado Personal Health Clinic- LA Dept of Health
1676 Gravier St. New Orleans, LA
- Offers free HIV testing and low-cost STI testing, including Gonorrhea, Chlamydia, and Syphilis. By appointment only; call first.
2714 Canal St. New Orleans, LA 70112
- Free HIV/STI testing by appointment only.
Daughters of Charity (now DePaul Community Health Center) – multiple locations
- Free and low-cost STI/HIV testing by appointment only; accepting new patients.
St. Thomas Clinics ( all 7 locations)
- All locations have STI/HIV testing after referral from in-house doctor.
- Medicaid, insurance, and self-pay with sliding scale.
University Medical Center Infectious Disease Clinic
2000 Canal St. New Orleans, LA 70112
- Only STI/HIV testing for patients referred by doctor.
Multiple locations in Louisiana
- Testing for HIV/HCV/Chlamydia/Gonorrhea/Syphilis, out-of-pocket expense: $299.
- Testing also including Hepatitis A & B, blood count, urinalysis and Trichomoniasis, out-of-pocket expense: $499.