Your Sexual Health 20 March 2015

Overview of Sexual Health What is Sexual Health? Benefits of Good Sexual Health Detailed Benefits of Good Sexual Health Five Action Steps

Sexual health is a key part of our overall health and well-being. It is important no matter your age or the relationships you choose. What is Sexual Health? Being sexually healthy means being able to enjoy a healthier body, a satisfying sexual life, positive relationships, and peace of mind. It also means taking care of yourself and your partners. Sex is a natural part of life; it can bring you pleasure, intimacy & joy. Talking openly and honestly with your partners and healthcare providers is key.

Overall Benefits of Good Sexual Health There are many benefits to taking care of your sexual health Feeling Good About Yourself and Having Peace of Mind A Satisfying Sexual Life Positive Relationships A Healthier Body

Detailed Benefits of Good Sexual Health Feeling good about yourself and having peace of mind Be in control of your sexual choices Feel confident Be comfortable with yourself, body and sexual identity Feel positive about practicing safer sex, including use of condoms/contraceptives Reduce stress, worry, and regrets related to sex/sexual health There are many benefits to taking care of your sexual health (both physical and emotional) Positive relationships that are: Based on open and honest communication Respectful, pleasurable, comfortable and safe Free of fear, pressure or violence Where you experience love, intimacy, and affection Balanced and fair A healthier body Protect your health and your partners’ health Avoid STIs and HIV Prevent cancers caused by STIs Good sexual functioning and performance Overall health and well-being Have planned and healthy pregnancies when wanted Protect your ability to have children (your fertility) A satisfying sex life That is right for you and your partners That is pleasurable Based on your personal values, desires, and boundaries Includes your choice to be sexually active or not Allows you to explore and feel comfortable in your choices

Five Action Steps to Good Sexual Health Take charge of your sexual health. These five action steps can help you achieve good sexual health. Make sexual health part of your healthcare routine Get smart about your body and protect it Value who you are and decide what’s right for you Treat your partners well and expect them to treat you well Build positive relationships

Value who you are and decide what is right for you Action Steps Benefits Value yourself—what’s on the inside and outside, including your body and sexual identity. Be in control of your sexual choices. Feel comfortable with yourself, your body, and your sexual identity. Feel confident. Have peace of mind, and reduce stress, worry, or regrets. Have a sex life that’s right for you and your partners. Enjoy a pleasurable sex life. Think about what you want—define your personal values, desires, and boundaries. These might change over time. Understand what you want before you get involved with someone. Recognize that we are all sexual beings; it’s a natural part of life Know that sex can bring you pleasure, intimacy, and joy.

Treat your partners well and expect them to treat you well Action Steps Benefits Be with someone who makes you feel good about yourself, comfortable, and safe. Have relationships based on open and honest communication. Have relationships that are respectful, pleasurable, comfortable, and safe. Experience love, intimacy, and affection. Be free of fear, pressure, or violence in relationships. Have relationships that are balanced and fair. Partners should respect your boundaries and not pressure you. Partners should care about your health and well-being. Partners should make you happy.

Build positive relationships Action Steps Benefits Respect your partner and make decisions together. Have relationships based on open and honest communication. Have relationships that are respectful, pleasurable, comfortable, and safe. Experience love, intimacy, and affection. Be free of fear, pressure, or violence in relationships. Have relationships that are balanced and fair. Have open and honest conversations about your relationship, desires, and sexual health. If your partner is violent, pressures, or tries to control you, seek help. Value yourself, and what’s right for you.

Get smart about your body and protect it Action Steps Benefits Learn about your body and how it works (anatomy, sexual expression, pleasure, and safer sex). Prevent HIV and other sexually transmitted infections (STIs). Reduce risk of male and female cancers related to STIs (cervical, anal, throat, and penile). Maintain healthy sexual functioning/performance. Enjoy good health and well-being. Feel positive about practicing safer-sex. Have planned and healthy pregnancies, when wanted. Protect your ability to have children (your fertility). Choose if and when you want to be sexually active. Practice safer sex to prevent STIs and unplanned pregnancies. Plan ahead and be prepared with condoms and/or other contraceptives. Take steps to protect yourself and your partners.

Make sexual health part of your health care routine Action Steps Benefits Find a health care provider/clinic that’s right for you and makes you feel comfortable. With vaccines, protect yourself from some STIs, such as HPV and Hepatitis. With screening, detect STIs and get treated early. Help avoid serious problems from developing. Get advice on the best contraceptive options for you. Improve sexual functioning/performance. Have planned and healthy pregnancies, when wanted. Get regular sexual health wellness check-ups (screenings for STIs, vaccines, and contraceptive options). Have open and honest conversations with your provider. Discuss any concerns about sexual functioning or other problems. Check out the new guide, “Take Charge of your Sexual Health: What You Need to Know About Preventive Services.”

Make sexual health part of your health care routine HPV vaccination (men and women up to age 26) Chlamydia screening annually (women up to age 25) Highly-reliable birth control options Hormonal IUD Non-hormonal (copper) IUD Nexplanon sub-dermal hormonal implant Emergency contraception Periodic pap test (women age 21 and older) HIV test every year for men who have sex with men HIV PrEP: pre-exposure prophylaxis HIV PEP: post-exposure prophylaxis SPEAKER NOTES: Posters, fact sheets and films are available on-line: http://www.med.navy.mil/sites/nmcphc/health-promotion/reproductive-sexual-health/Pages/sexual-health-resources.aspx HPV vaccination The HPV vaccine is FDA approved for males and females aged 9-26. The HPV vaccine is very safe and highly effective. The Garadsil HPV vaccine protects people from the HPV virus types that cause 90% of genital warts, 70% of cervical cancer and reduces the risk of other cancers of the head, neck, throat, anus and penis. Three shots are needed over a 6-month period. The HPV vaccine does not protect against STIs other than HPV. Vaccinated women still need a periodic pap test because some cervical cancers are caused by things other than HPV Sailors and Marines are no longer offered HPV vaccination during boot camp, and, in some cases, they may not be offered HPV vaccination during their PHA – so it’s important for each person who wants it to ask their Navy doc. Chlamydia screening annually Women up to age 25 are at the highest risk of being infected with chlamydia and should ASK their Navy doc about the each year. Most women who have chlamydia will not show symptoms. Most infected men will show symptoms and will typically seek treatment. Untreated chlamydia can result in serious health consequences in women such as infertility and chronic pelvic pain. Tell you recent sexual partners if you test positive for chlamydia. Highly-reliable birth control options Only 1 of 3 Navy enlisted women say her last pregnancy while in the Navy was planned. Unplanned pregnancies among Marine Corps enlisted women may be even more common. About half of the women who experience an unplanned pregnancy AND were using birth control were using birth control pills, condoms or both. Birth control pills and condoms greatly reduce the risk of a pregnancy BUT they are less reliable than some other methods such as the hormonal IUD , the non-hormonal (copper) IUD and the Nexplanon sub-dermal hormonal implant. The hormonal IUD , the non-hormonal (copper) IUD and the Nexplanon sub-dermal hormonal implant are available from your Navy doc and are very safe and highly effective. Emergency contraception If a woman has had sex without using birth control or if something happened (such as a condom broke), she can use emergency contraception to reduce her risk of becoming pregnant. In the U.S., there are three types of emergency contraceptive pills (ECP), sometimes called the "morning after pill“ Plan B One-Step is sold on the shelf of drug stores (check the family planning aisle) with no age restrictions. That means anyone can buy it without having to show ID. Plan B One-Step is also available at no cost and without a prescription (a DoD identification card is required, as with any health care service) in Navy pharmacies, and is available some on Navy ships Emergency contraception pills containing progestin only, such as PLAN B One-Step, reduce the risk of pregnancy by up to 81 to 90% - which means the number of women who would be expected to become pregnant after unprotected sex drops from 8 of 100 without any contraception to about 1 of 100 when PLAN B® is taken within 72 hours of the unprotected sex. Use of ECPs containing combined estrogen and progestin reduce the risk of pregnancy by 75%. Timing is important – these types of emergency contraception pills are more effective when taken sooner. Ella remains highly and equally effective through day 5 after the sexual encounter. The mechanism of action of emergency contraception pills is not fully understood. They may work by disrupting ovulation, fertilization, or implantation. The best available scientific evidence indicates the emergency contraception pills prevent pregnancy by mechanisms that do not involve interference with post-fertilization events. Emergency contraception pills available in the U.S:  • are not effective if the user is already pregnant. • do not induce abortion. • will not harm an existing pregnancy. • do not protect against sexually transmitted infections. • are not intended for frequent use because they are less effective than other birth control options. • should not be taken before unprotected sex. • are not recommended as the primary form of contraception, because ECPs are not as effective as many other forms of contraception Periodic pap test Women, starting at age 21, should ask her doctor about her periodic pap test. - HIV test every year for men who have sex with men Another active duty Sailor or Marine is diagnosed with HIV about every 4 days. Men who have sex with men are 40X more likely to be diagnosed with HIV compared to men who have sex with women only. Men who have sex with men should speak with their doctor and ask for an HIV test every year. Although the test will not protect them from HIV, knowing you have HIV enables you to get into HIV care sooner and enables you to take actions to protect future partners. - HIV PrEP: pre-exposure prophylaxis HIV PrEP is a pill that can be taken every day to greatly reduce the risk of getting HIV. HIV PrEP is available from your Navy doc and is most appropriate for men who have sex with men and people who have a regular sex partner who has HIV. HIV PEP: post-exposure prophylaxis HIV PEP is medicine you can take after being exposed to HIV that will greatly reduce the likelihood that HIV infection will occur. HIV PEP is available from your Navy doc BUT must be started within 72 hours of the exposure.

Questions? Learn more from the Navy Sexual Health and Responsibility Program (SHARP) http://www.med.navy.mil/sites/nmcphc/health-promotion/reproductive-sexual-health/Pages/sexual-health-resources.aspx