Why It’s Good to Wait

I’ve mentioned before that contraceptives are great. They can prevent unwanted pregnancy 99% of the time. I’ve also mentioned that condoms are great, too. Proper use of a condom can prevent pregnancy AND transmission of STDs 97% of the time. But there is only one way to reduce your risk of unwanted pregnancy and STDs by 100% and that is abstinence.

Abstinence simply means not having sex, and it’s very common for people who were sexually active to go through periods of abstinence. In my case, abstinence means not having sexual intercourse until I am married. For others, it means refraining from sexual intercourse until they are in a monogamous, committed relationship. Abstinence can be an ongoing thing, or it can happen at various points in a person’s life.

While I believe that it is crucial for everyone to be informed about their options when it comes to birth control and protection, my personal belief is to practice abstinence. This is for a variety of reasons in addition to the obvious reasons of preventing STDs and pregnancy.

The first is that it is my religious belief. As a member of the Church of Jesus Christ of Latter Day Saints I have been taught to abstain from sex before marriage. This isn’t unusual for most religions, since sex is seen as something sacred and special.

I also believe in abstinence because of personal reasons. I want to make sure that when I do have sex with someone, it’s for a good reason. Not because I just feel like it or because I feel lonely, but because it means something more than just sexual pleasure. I want it to be emotionally strengthening and healthy. I had a very good friend when I was in high school who I could talk to about anything. We were talking one day about why waiting to have sex can be a positive thing in a world that often influences us to think otherwise. He told me something that stuck with me all of these years. He said, “I think that one of the main reasons why we (as Latter Day Saints) are told to not have premarital sex is because that when you do have sex with someone, it creates an emotional connection that you just can’t handle unless you are married.” Sex is an extremely complicated thing and can sometimes be destructive to a relationship and an individual if it isn’t emotionally and physically healthy.

I found this article from the LDS church website that explains the benefits of abstinence until marriage from a background of counseling and social psychology. The author, Steve Gilliland, does a very effective job of combining logical reasoning and spiritual reasoning in the decision to wait until marriage to have sex.

Abstinence is an incredibly difficult thing, because sex is such a desirable thing. There are many young people who intend on waiting until marriage to have sex or abstaining from sex until they feel ready, but due to a variety of reasons, make the decision to have sex before marriage or before they are ready. There many social barriers that make the decision to remain abstinent so difficult. But, and I really do believe this, if you make the decision to wait to have sex until you are ready, you will be glad you did. Health benefits go beyond STD prevention, there are emotional and social benefits as well.

Me and my fiance, Jarom. 🙂

Facing the Problem by Putting a Face on the Problem

I found this website that gave some pretty shocking statistics about the prevalence of STDs in young adults and adolescents worldwide. Here are a few that really stood out to me:

• The highest reported rates of STDs are found among young people aged 15-19 and 20-24.
  
• In the developed world, two-thirds of all reported STD infections occur among men and women under the age of 25. In developing countries the proportion is even higher.
• Adolescents represent a large proportion of overall chlamydia infections worldwide — at least one-third.
• Rates of gonorrhea are often highest among adolescents.
• About one-half of all human immunodeficiency virus (HIV) infections occur among men and women 24 and younger. Up to 60 % of new infections in developing countries occur among 15-24-year-olds.

When I read this I couldn’t help but feel very overwhelmed, very disgusted, and very outraged. Why are rates so high among adolescents and young adults? Why are young people getting these preventable diseases? We have the means and knowledge to protect and inform them, why isn’t it working?! In this blog I’ve blamed the media and I’ve blamed the society and culture that we live in. But then I stumbled upon this article which suggested that another reason teens have sex is that sex is seen as a way to gain intimacy in a relationship.

A lot of times public health professionals and researchers seem to forget that sex is more to people than a means of reproduction and pure sexual pleasure. Sex can be a comfort and a bonding experience for two people. It can be emotionally healing or emotionally destructive depending on the situation. A survey conducted said, “Teens want their relationships to bring them intimacy, social status, and sexual pleasure — and they have a strong expectation these goals will be fulfilled if they have sex.”

The article then concluded with this statement: “….Programs to dissuade early teen sex usually focus on the negative — the risks of STDs and pregnancy. Teens might heed the message better…. if the positive expectations — ‘developing a sense of intimacy, achieving social skills and goals, and experiencing sexual pleasure’ — are recognized and alternative ways to achieve those goals suggested.”

That’s something that I hadn’t really thought about. I have these health classes and sometimes I get caught up in all of the negative. I know that I did while writing this blog, with most of my posts focusing on teenage pregnancy, social and cultural barriers, STDs and complications. But perhaps we, as public health professionals and students, get too caught up in this. Maybe I’ve focused too much on the big numbers and the shocking statistics and I haven’t fully realized that all of these numbers represent people. Young teens and young adults very much like me. Putting a more personal face on the problems of STDs and pregnancy on young adults can sometimes offer a fresh perspective that has been forgotten in the slew of scientific journals and articles we wade through.

These are some pictures of me when I was in high school. Sometimes it’s good to go back and remember how I thought and behaved as a teenager when discussing health topics of this nature. It reminds me that when trying to target teenagers or children in relation to a health problem of any nature, that they are more than just “the target population.” They are real people!

Hepatitis B

A hepatitis B campaign has been launched in San Francisco, urging Asian Americans to get tested. 1 in 10 Asian Americans are chronically infected with Hepatitis B and can lead to liver disease and even liver cancer.

So, why bring this up in a blog that is related to sexual health? Because hepatitis can be sexually transmitted. The Hepatitis B virus can infect people when their mucous membranes or blood are exposed to an infected person’s blood, saliva, semen, or vaginal secretions. Even though most Asian Americans become infected at birth, those who engage in risky behaviors like unprotected sex and intravenous drug use, can become infected. The good news is that there is a vaccine to prevent hepatitis A and B and there are treatments available to those infected. The problem is that people won’t talk about it.

In most Asian cultures, it’s considered extremely taboo to talk about anything that would bring disgrace or dishonor on the family. The concept of “face” (meaning honor, dignity, and prestige) controls what is dictated as appropriate discussion. Because of this, there is a large sense of denial when it comes to even addressing problems in Asian communities.

This issue is  more personal to me because I am an Asian American. My mom is Korean and many of her traits and mannerisms are related to this idea of “face.” When I told her that I had chosen sexual health as the health topic of my blog, she gave me a scolding look and said, “Lynn…” in a you-better-watch-what-you-say tone of voice. Stigmatized controversial topics and issues are things that she just isn’t comfortable discussing in public. (Or maybe she’s just not comfortable with me talking about them!)

Alex Wang, an anchor for ABC Channel 7 news, has teamed up with the program “B A Hero” to address the problem in San Franciso, whose population is 1/3 Asian American. In an interview, he said, “I have Hepatitis B, my brothers and sisters do. By talking about it, you take away the stigma. I’m not a drug user. I’m not a prostitute. In fact, most of the people who carry Hepatitis B are like me (infected at birth), and so we’re here to encourage you just to get tested.”

The prevalence of Hepatitis B is just another example of how cultural/societal beliefs and norms can sometimes be a barrier to protecting people against a harmful disease and preventing further transmission. The program implemented in San Francisco is a good example of trying to overcome these barriers to protect the Asian American population.

For more information on Hepatitis B and other forms of viral hepatitis, visit the CDC’s webpage on hepatitis.

Misconceptions of Oral Sex

I read another article today that brought up an interesting point of view. According to this article, “Most young adults agree penile-vaginal intercourse is sex, but less than one in five think that oral-genital contact counts as “having sex,” according to a 2007 survey of undergraduate college students.”

Sex is often a blurry line with different people and groups having different definitions. In a purely reproductive and biological standpoint, oral sex wouldn’t have anything to do with intercourse. But in the realm of public and personal health, it becomes more difficult.

The problem with the blurry line and oral sex, is that many people have misconceptions about oral sex and how safe it is. While the risk of STD transmission is much lower in oral sex than traditional intercourse, there is still a risk! The article reads, “Oral sex has become increasingly acceptable among youths in recent years, perhaps because it’s viewed by some as a less risky alternative. But experts say oral-genital contact can lead to sexually transmitted diseases. Such diseases include HIV, herpes, syphilis, gonorrhea, and human papillomavirus (HPV), which has been linked to cervical cancer.” It may come as a shock to some people that use of a condom is recommended when engaging in oral sex, and that both males and females are at risk. Time magazine reported that a study conducted in the New England Journal of Medicine showed that, ” men and women who reported having six or more oral-sex partners during their lifetime had a nearly ninefold increased risk of developing cancer of the tonsils or at the base of the tongue.”

Dr. Robert Haddad, who is the clinical director of the Head and Neck Oncology Program at the Dana-Farber Cancer Institute, says in the report that there is an increase in the number of younger people developing HPV. He attributes it to a change in sexual behavior over the last decade.

If there has been a change in sexual behavior, that brings a change in sexual health problems. The question to now ask ourselves is, “Are we changing our preventative and educational methods to address these problems?” In my opinion, no, we aren’t. For the most part, we are still a society that refuses to step up and address sexual health problems and issues face on. A good example would be the poor sexual education that teens and adolescents receive in school. Sex ed is different depending on state, school district, and type of institution. Many schools advocate abstinence only sexual education and do not even address methods of birth control or STD prevention. If, or rather, when teens or young adults, under this type of education system, engage in sexual behaviors, they do so without being properly prepared to protect themselves and their partners.

Let me leave you with one more quote from Dr. Haddad, and it sums up nicely the point that I am trying to make. “The idea that oral sex is risk-free is not correct. It comes with significant risks, and developing cancer is one of them.”

To learn more about HPV, visit the CDC website.

Virtual Reality: Electronic STDs

I like to play video games. I’m not a huge gamer, but I love The Legend of Zelda, Mario Kart (well, that’s a love/hate relationship), and have started Super Mario World. But if there is one thing that I loved about the new video games on more up-to-date consoles, it’s how they try to emulate the real world.

I stumbled across this article discussing STDs in pop culture and was surprised to find out that while the movie and music industry pretty much massively fail on promoting safe sex practices, the video game industry has addressed the problem in the form of Fable II.

Fable II is an action role-playing game on Xbox 360. Like the original Fable, the game allows you to morph your character based on the decisions you make.  In essence, you can become either good or evil. The game is more than just fighting bad guys and defeating dungeons, in Fable you can interact with people not directly related to quests or missions. You can get drunk, get into fights with civilians, and interact with every person in the game, even if they appear just to be a background space filler. Now, this is where it gets interesting, because this little webpage informed me that  in Fable II you can choose your sexual preference, get married (including same-sex marriage), commit adultery and do all sorts of kinky things. Female characters can become pregnant and have children, even if you, the main character, is a female. You can even chose to have protected or unprotected sex. And guess what? You can get an STD if you don’t buy a condom!

Yes, a virtual reality condom.

While I don’t think the video game show your character experiencing the lovely side effects such as burning while urinating or abdominal pain, I honestly think it’s an interesting way of, perhaps unintentionally, teaching young adults about the perils of unprotected sex. Even if it’s just a video game, the character has consequences for his or her behavior. Even if it’s meant to be humorous or entertaining, this video game is light years ahead of other forms of media entertainment. I don’t think I will ever live to see the day when a chick flick or an action film, before the hot and steamy (and probably completely unnecessary) sex scene, the beautiful, overpaid actress whispers, “Wait… do you have a condom?” and Robert Pattinson repsonds, “Of course, what kind of guy do you think I am?”

I could ramble on about sex scenes in movies, but I won’t. Moral of the story, Fable 2 has electronic STDs. And that’s pretty wicked. Major pwnage.

On a more personal note…

I recently got engaged (oh thanks for congratulating me!) and, in preparation for marriage, went and visited a gynecologist for birth control. (I would recommend for every woman getting married to go see a gynecologist, even if you have never had sex. They can help out a lot with the dirty little questions people are sometimes too embarrassed or ashamed to ask.) Anyway, I went to talk about my birth control options, and a few weeks later I started taking Loestrin, a version of the pill that contains a lower dose of hormones. When I got my prescription the nurse gave me a regurgitated list of side effects. Weight gain, cramps, irregular bleeding or spotting, etc. She very briefly mentioned that I would have changes in mood, but didn’t elaborate.

Week 1 I experienced some nausea and an upset stomach as my body tried to adjust to the new levels of hormones I was ingesting. It was mildly irritating, but nothing that interrupted my daily life. Week 2, however, was much worse. Not because of any physical side effects, it was the mental side effects. Maybe it was just me and my body, but my mood changed DRASTICALLY. It wasn’t that I felt a little down or a little irritated. I got extremely depressed and would get uncontrollably angry for no reason. I started to wonder if it was really just the birth control that was making me feel like this and my fiance started to worry, too.

So, I did some searching on the internet (utilizing the skills that I have learned in my Technology in Health Promotion class! wink wink!) and found this article that reviewed the results of a study that compared depression symptoms among users and non-users of the pill. The article reads:

“Results showed women using the Pill had an average depression rating scale score of 17.6, compared to 9.8 in the non-user group. The women involved in the study were aged over 18, not pregnant or lactating, had no clinical history of depression and had not been on anti-depressant medication in the previous 12 months.” “…57 percent of respondents reported mood swings, 63 percent were irritable, 65 percent experienced irrational crying, and 69 percent felt anxious and depressed after taking hormonal contraceptives.”

The article doesn’t go into detail about how the survey was conducted or even how many people were involved in the study, but many times it is relieving to know that you are not the only one experiencing something like depression as a result of taking the pill. While searching I found discussion forums where women would say, “I am so glad that I am not the only one going through this! I thought there was something wrong with just me!”

It’s been about a month since I’ve started taking the pill, and even though I’ve just started I can tell that the best way to control the side effects of birth control is to make sure that I take it at the same time every day. And when I mean the same time, I mean THE SAME TIME EVERY DAY. I’ve set an alarm on my cell phone to remind me to take it, and I even keep my pills in my wallet so it doesn’t matter where I am. Perhaps, the end note is just to say that hormones to effect your mood, and while companies that make oral contraceptives may not warn you of the emotional side effects, be aware that there are some! Your partner should be aware too, so they can prepare themselves as well. 😉

The Trendy Teenage Pregnancy

Trends are a part of society. When I was growing up, I remember begging my mom to buy me a pair of platform shoes so I could look like the members of my favorite band ever (The Spice Girls). Needless to say, I wore them for maybe half a year. The trend faded, and my purple sparkly platform shoes became majorly lame. That is the thing about trends, they come and then they go, replaced by something else. Platform shoes, oversized sunglasses, tiny handbag dogs, kabbalah… all of these things have their moment in pop culture, then they fade. At that point, you can stop wearing your bug eye glasses, throw away your frosty pink lipgloss and move on. But there is one surprising trend that you can’t throw away, the trend of teenage pregnancy.

This article says that teen girls have been using the rhythm method (timing their sexual intercourse around their ovulation cycles) as as form of birth control. The article reads, “[Teenage girls] may have been using another form of birth control at the same time. But the increase is considered worrisome because the rhythm method doesn’t work about 25 percent of the time, said Joyce Abma, the report’s lead author.”

This raises some concerns, the report goes on to say that, “The increase in the rhythm method may be part of the explanation for recent trends in the teen birth rate. The teen birth rate declined steadily from 1991 through 2005, but rose from 2005 to 2007. It dropped again in 2008, by 2 percent, to about 10 percent of all births.”

Shockingly, attitudes towards teen pregnancy have changed as well. The teenagers that were surveyed in this report conducted by the CDC showed that it’s become more acceptable for an unmarried girl to have a child. “Nearly 64 percent of teen boys said it’s OK… and more than 70 percent of teen girls agreed…”

This raises the question as to why it is considered more acceptable? The answer lies in the trends of pop culture. Jamie Lynn Spears announced she was pregnant at the time the survey Recent films and TV shoes like Juno and 16 and Pregant/Teen Mom have gained popularity. 16 and Pregnant and Teen Mom are both aired on MTV. While the show tries to illustrate the difficulties and challenges of being pregnant and raising a baby while in high school, perhaps acceptance is a side effect of such a show.

Is that such a bad thing? There is no doubt that there is a stigma associated with girls who have a child outside of marriage. Oftentimes these stigmas are unhealthy, leading to prejudice and extra hardship on the teen mother and her child. But what if this new found acceptance of teen mothers leads to an increase in teenage girls becoming pregnant?

Shows and movies like these can be quite disillusioning. You can argue that these MTV shows are “reality” TV shows, but reality TV is very, very fake. In the end, MTV is not trying to raise awareness about the dangers of teen pregnancy, they are trying to make money and get high ratings. For crying out loud, they have had MULTIPLE SEASONS of the show! Doesn’t that say something about MTV’s priorities right there?! The same goes for the story of Juno. It is a movie, a movie that won Academy awards and made a lot of money. The story of Juno even has a happy ending to satisfy the audiences. Juno, the teen mother, gives her baby up for adoption in a healthy, loving, and wealthy home while Juno ends up with the boy of her dreams. Needless to say, this can be something that most teen girls would want. To end up with a sweet, charming, good looking guy. Would teenage girls emulate Juno’s behavior to get that?

It’s a hard thing to figure out, isn’t it? On one hand, we could be supportive of teenage girls who become pregnant and not stigmatize them. On the other hand, teenage pregnancy is not something that should be advocated. Can we be a society that can do both?

But, going back to our starting point of trends. While it may be considered acceptable to be a teenage parents, and while it may be trendy and while there may be pregnancy pacts and baby showers in the beginning, babies don’t stay trendy, cute babies forever. They are people, they grow up and will one day be teenagers themselves.

Clever Condoms

Clever, clever condoms. Readily available and cheap, these little things are 97% effective at preventing pregnancy and are the most effective way to protect yourself and your partner against HIV and other STDs. You can buy them at drugstores, gas stations, and sometimes even vending machines in questionable bathrooms. Not only that, but they come in a cornucopia of sizes, colors, materials, textures, and even flavors. Talk about creative expression!

These candy colored packages can prevent unwanted pregnancy and illness. So why don’t people use them every time they have sex? It’s not just unavailability or ignorance. It is mostly cultural and social views of condoms as being a negative thing. Condoms are considered to interrupt sex and make it less pleasurable, since you have to put them on when the penis is erect. In some cultures, a condom is also seen as emasculating.

So, why the big fuss? Why should we try and get people to use condoms when they just don’t want to? According to a survey conducted by the CDC “about 40 percent of births in the United States in recent years are to unmarried women.” So while a condom might interrupt you when you’re trying to get busy, a screaming baby can do that too. You know what else can interrupt your special night? A herpes flare-up. However, the survey did have some good news, showing that there is an increased use of contraceptives, including condom usage. And this increase of use has decreased the number of unwanted pregnancies in the US. Still, 40 percent is a little too high. That’s a lot of lives forever changed because someone didn’t take a pill or slip on a condom.

Here is a random thought. There is literally millions and millions of dollars poured into advertising in the United States. Why don’t we get some of those same advertisers who spend all their energy trying to sell the youth of America soft drinks, American Eagle clothing, and Smirnoff Ice to give condoms a flashy, new ad campaign? Well,  Trojan released a commercial several years back trying to do the same thing, and it sparked a lot of controversy. Fox was one of the networks that refused to air the commercial (CBS was the other) stating, “Contraceptive advertising must stress health-related uses rather than the prevention of pregnancy.”

So many things wrong with this statement, but we will focus on one, which is brought up by Mark Miller, a media critic at NYU.“It’s so hypocritical for any network in this culture to go all puritanical on the subject of condom use when their programming is so salacious. I mean, let’s get real here. Fox and CBS and all of them are in the business of nonstop soft porn, but God forbid we should use a condom in the pursuit of sexual pleasure.”

Is there a problem in society and in the media when, in trying to protect young people from having unsafe sex because of pressure from society and the media to have sex, society and the media are unwilling to cooperate? No one can say it better than Carol Carrozza, vice president of marketing for LifeStyles condoms.

“We always find it funny that you can use sex to sell jewelry and cars, but you can’t use sex to sell condoms.”

And many more…

About 2 weeks ago, something turned 50 years old. If you guessed some washed up celebrity on VH1, you were wrong. But if you guess the birth control pill, you were right! The pill turned 50 on Mother’s Day of this year, and I’m guessing if the pill was actually a washed up celebrity, she would look something like this…

Why Madonna? Because like Madonna, the pill was more than just something special wrapped in hard plastic, it was a revolution! While the pill was originally intended to prevent pregnancy, it sparked controversy in almost every aspect of life. This article goes into detail about how the pill was credited for starting the women’s liberation movement, giving women the freedom to choose when they wanted to become pregnant, how long they wanted to work and in essence, take charge of their reproductive abilities.

The FDA approved the first oral contraceptive, known as Enovid, in 1960. Even then, it was only available for women who were married or engaged. Hormone levels in the pill were 4 to 5 times higher than levels found in modern day oral contraceptives, leading to a variety of health problems like blood clots and high blood pressure. Those these risks are still unfortunate side effects of birth control pills today, hormone levels are much lower and the pill is much safer.

The pill, today, does more than just prevent pregnancy. Birth control is used to control and regulate menstrual cycles, treat acne, reduce cramps and heavy bleeding, and even prevent ovarian, uterine and endometrial cancer. Modern birth control pills come in both generic and brand name forms, offering a variety of estrogen and progestrin levels, so any woman can choose the birth control pill right for them.It is 99% effective and reversible, after you stop taking the pill it only takes a few cycles in order to become pregnant.

If you want to learn more about the history of the pill, click here or watch the following video.

Syphilis has accepted your friend request.

I found this article online, that showed a link between social networking sites like Facebook and a resurgence in syphilis. The article reads,

“The virus has increased fourfold in Sunderland, Durham and Teesside, areas of Britain where Facebook is very popular, as it has given people a new way to meet multiple partners for casual sexual encounters.”

If any of you have ever used craigslist, you will know that sexual encounters can be obtained online. Very, very easily. But for me, I had never thought of facebook as a means for some people to get some booty. For me, facebook is something I use to just keep in touch with friends that I already know in life and have met in person. I’m sure we have all gotten a random friend request from someone who we have NEVER seen before in our whole lives, and this request is usually from a barely 18 girl showing a lot of cleavage and asking if we want to “chat sumtime lolz.” There has been a lot of press about facebook’s privacy settings and how our personal information is sold off to advertisers, and now we have more to worry about! Does our online behavior effect our individual health?

Besides STDs, another potential problem with networking sites like facebook is the new channel for junk mail. Every now and then an email will slink past your “Spam” folder into your inbox, promising amazing cures for erectile dysfunction or some other pornographic website. Will the same happen to facebook? What if this 18 year old girl requesting your friendship is actually part of a large, internet pornography site trying to entice new users?

So, my dear readers, be smart about who you accept as your facebook friend. Do they really want to be your friend, or do they want to use you?

If you have a facebook page and have privacy concerns, click here.