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9th grade Health Course

A. Kotsev

on 9 October 2015

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Safer Sex and Birth Control
Why do people have sex?
Once again: human sexual behavior is a very broad topic. This presentation shows only basic information, so please review the suggested links. The most important thing is to not approach this matter irresponsibly. People can have all the positive aspects of sex with a minimum risk if they wait till they are completely ready to start their sex life, choose partners wisely, test frequently for STI's, use condoms and/or prescribed birth control methods.
(acquired immunodeficiency syndrome) is the
most dangerous and deadly
STI - for now there is no cure nor a vaccine for it.
It is caused by a virus called
(human immunodeficiency virus).
AIDS breaks down the immune system and the T-cells— our body's protection against disease.
It causes people to become sick with infections that normally wouldn't affect them. They become progressively sicker from the infections until the body can't fight them anymore.
having vaginal, oral or anal intercourse without a condom with someone who has HIV/AIDS
sharing needles or syringes with someone who has HIV/AIDS
being deeply punctured with a needle or surgical instrument contaminated with HIV
getting HIV-infected blood, semen, or vaginal secretions into open wounds or sores
babies born to women with HIV/AIDS can get HIV from their mothers during birth or from breastfeeding
HIV is not transmitted by simple casual contact such as kissing, sharing drinking glasses, or hugging.
A person can be infected with HIV by:
Some people develop HIV symptoms shortly after being infected. But it usually takes more than 10 years.
There are several stages of HIV disease, and the danger is that the first stages can develop without alarming symptoms.
The first HIV symptoms (called acute retroviral syndrome or ARS) may resemble the flu. These symptoms may last for only a few weeks.
Then there are usually no HIV symptoms for many years. That is why it can be hard to know if a person has HIV.
There are people who have HIV and spread the virus
AIDS symptoms appear in the most advanced stage of HIV disease. In addition to a badly damaged immune system, a person with AIDS may also have numerous other serious physical symptoms.
Prevention and testing
As HIV can be carried and spread without symptoms, people who have sex should test at least once per year. The most popular test requires a blood sample and the results are ready for several minutes. You can find a center for anonymous and free tests for HIV here (in bulgarian): http://www.aidsbg.info/articleDisplay.aspx?aid=73

Keep in mind that there is a window period after primary HIV infection when the screening test is usually negative. That is why the test should be repeated on the 3 and the 6 month after the unprotected contact.
Other ways of protection against HIV:
abstinence from sex before entering in a serious relationship
very time you have sex
choosing your partners carefully
Like with the other animal species, sex is the nature's way for humans to create new life. Although there are artificial means of creating an embryo, the vast majority of people have sex so that the male sperm can fertilize the female ovum.
Instinctual drive
Although people in the developed world have 1-2-3 children, most have sex many more times during their life. The sex drive is a powerful instinctual urge which is governed by the sex hormones and the nervous system. This instinctual energy seeks to be released through sex or sublimated through creativity.
Sex is often described as one of the experiences in life that bring the sense of pleasure. Consensual sex changes the biochemistry in the body and activates the pleasure centers in the brain. For most people, sex with the right partner is connected with a sense of emotional well-being.
Means to an end
Sex has many social aspects and people do not always engage in it for it's own sake. Due to its powerful effect on human behavior and motivation, the sexual energy can be used to achieve something else. Imagery connected with sex is widely used in advertisement. Some people use other people's sex drive to reach their own goals (material or social benefits, power, etc.)
Apart from the reproduction, the physical relief and the sense of pleasure, human beings engage in sex because of their capacity for intimacy and love. Sex is often an important part of connecting with a partner on a deeper intimate level.
Peer pressure
and personal issues
People can have sex because of other social and psychological factors such as peer pressure and risk-taking. Sexual behavior is very dependent on our 'state of mind' and sometimes people have sex because they are bored or stressed out. Some people get addicted to it. Some people use it as a way to prove their self-worth or to feel better when they are moody.
Teenagers sometimes feel pressure by their peers to experience sex before they are psychologically ready for it. The human reproductive system matures much earlier than the mind and the emotions - in order to have a good start of one's sex life, it's best to wait for the right moment and partner.
Human sexual behavior is complex and depends on many biological, emotional and social factors. Although it's often associated with positive things as the sense of well-being, love and the creation new life, sex can be unhealthy and destructive if approached in an irresponsible way. There are negative sides to it: like sexually transmitted infections and unwanted pregnancy.
Chlamydia is an infection caused by a kind of bacteria that is passed during sexual contact.
Chlamydia is spread by vaginal and anal intercourse. Rarely, it is spread during oral sex or by touching the eye with the hand. It can also spread from a woman to her fetus during birth.
It is the most common sexually transmitted bacterial infection.
Usually, chlamydia has no symptoms. Most people are not aware that they have the infection — especially women.
People who have symptoms may experience pain or a burning feeling while urinating, abdominal pain, bleeding or pus-like discharge from the genitalia, itching, or pain during having sex.
It can be cured with antibiotics.
Because chlamydia has few or no symptoms, it can sometimes go untreated for a long time and become a serious threat to a person's health. Chlamydia may cause PID — pelvic inflammatory disease - which is a dangerous condition that can also lead to infertility.
Gonorrhea is similar to chlamydia in some ways. It's an infection caused by another kind of bacteria that is passed during sexual contact and often has no symptoms.
Gonorrhea is spread by vaginal and anal intercourse, and oral sex. It can also be passed from a woman to her fetus during birth.
People who have symptoms may experience similar physical conditions to chlamydia.
It can be cured with antibiotics.
Because gonorrhea has few or no symptoms, it can sometimes go untreated for a long time and become a serious threat to a person's health. It too may cause PID — pelvic inflammatory disease - which is a dangerous condition that can also lead to infertility. Gonorrhea can also cause pregnancy complications and arthritis.
Pelvic Inflammatory Disease
Syphilis is another STI which is caused by a bacteria. It was deadly in the past, but today is rarer and is cured with antibiotics.
Often, syphilis has no symptoms or has such mild symptoms that a person doesn't notice them.
There are also several stages of syphilis, which may overlap. The stages may be separated by latent stages, or times when no symptoms are present.
Primary Stage — A painless sore or open, wet ulcer, which is called a chancre, appears. A person may have just one chancre or a few.Without treatment, they last 3–6 weeks. Chancres can appear in the genital area, on the cervix, lips, mouth, breasts. Swollen glands may also occur during the primary phase.
Secondary Stage — Other symptoms often appear 3–6 weeks after the sores appear. These syphilis symptoms may come and go for up to two years. They include body rashes that last 2–6 weeks — often on the palms of the hands and the soles of the feet. There are many other symptoms, including mild fever, fatigue, sore throat, hair loss, weight loss, swollen glands, headache, and muscle pains.
Late Stage — One out of three people who have syphilis that is not treated suffer serious damage to the nervous system, heart, brain, or other organs, and death may result. This can occur 1–20 years after the start of the infection.
Although nowadays syphilis can be cured, any damage caused by it in the later stages cannot be undone.




PID is a serious infection that harms a woman's reproductive organs. It develops when an infection spreads up from the genitalia into the fallopian tubes, uterus, and ovaries.
It is usually caused by untreated chlamydia or gonorrhea. But it may be caused by other infections.
Symptoms include: unusually long or painful periods, and unusual discharge from the genitalia; spotting and pain between menstrual periods or during urination; pain in the lower abdomen and back; fever, chills; nausea, vomiting; pain during sex.
If PID is not treated, it can cause serious problems, such as infertility, pregnancy in which the fertilized egg starts developing outside of the uterus (fatal for the baby and dangerous for the mother), and chronic pain. The more times a woman has PID, the greater are her chances of becoming infertile.
If pelvic inflammatory disease goes untreated, it may result in serious, life-threatening complications.
(caused by viruses)
(caused by bacteria)
Hepatitis B
Genital Herpes
Human Papillomavirus (HPV)
Sexually transmitted infections
The male and female condoms are the
way of protecti
n against STI when people have sex (not 100%, that's why it's called safe
sex). Condoms prevent pregnancy with a 98% reliability
if used correctly.
Condoms are worn on the penis during intercourse. They are made of thin latex or plastic that has been molded into the shape of a penis.
Condoms are available in different styles and colors, and are available dry, lubricated, and with spermicide.
Condoms prevent pregnancy and reduce the risk of STI by creating a barrier between the sex organs, so that no bodily fluids can pass from one partner to the other.
Condoms are inexpensive and easy to get, lightweight and disposable, and do not require a prescription.
If the condom breaks during intercourse, pull out quickly and replace it. If any fluids are exchanged, emergency contraception and tests for STI are advisable.
How to use a condom correctly
The female condom is a pouch that is used during intercourse to prevent pregnancy and reduce the risk of sexually transmitted diseases.
It has flexible rings at each end. The ring at the closed end holds the pouch in the vagina. The ring at the open end stays outside the vaginal opening during intercourse.
The female condom allows women to share responsibility for preventing infection.
It stays in place whether or not a man maintains his erection.
Barrier methods - Diaphragm and Cervical Cap
Hormonal methods
Oral contraception - The Pill
Emergency Contraception - The Morning-after Pill
The birth control pill is what most people think of as "the pill". The pill is the most common BC method and is highly effective if taken every day.
Birth control pills are made of hormones. Some birth control pills contain two hormones — estrogen and progestin. These are called combination pills. Some are progestin-only pills. Most women on the pill take combination pills.
The hormones in the pill work by keeping female eggs from leaving the ovaries. Pregnancy cannot happen if there is no egg to join with sperm.
For most types of BC pills the female swallows one pill every day for three weeks. The last week she either takes a pill that has no hormones – a “reminder” pill to keep her in the habit of taking a pill each day - or take no pills for one week. This is when the female gets her period.
They are 92-99% effective.
They should be taken only after a consultation with a medical doctor and with a prescription.
Emergency Contraception is a pill a female can take if she had unprotected sex or there was a condom failure.
It is a hormone pill that prevents the release of an egg.
It is most effective if taken in 12 hours after unprotected sex, but can be taken up to 5 days afterwards with a lessening efficacy.
The diaphragm is a soft silicone cup with a flexible ring that’s worn inside the vagina covering the cervix (the opening of the uterus).
The cervical cap is similar to the diaphragm, but smaller. It is also worn over the cervix.
Both barrier methods block the sperm from getting to the egg. They are always used with a spermicide and both come in different sizes.
Spermicides can come in the form of creams, foams, films, suppositories and sponges. They contain chemicals that kill sperm.
Can be put in up to 6 hours before sex and safely remain in place for up to 24 hours (diaphragm) or 48 hours (cervical cap).
Long-Acting Reversible Methods
The IUD (intrauterine device) is a tiny “t” shaped plastic device, about the size of a quarter, which works by changing the lining of the uterus so that sperm can't make their way to an egg to cause pregnancy.
A clinician places it inside a person's uterus during a simple procedure where it can stay and remain effective for 5-12 years.
There are two types of IUD - hormone-free and hormone-based.
The IUD is more than 99% effective as a birth control method.
Why is birth control important?
Teenage pregnancy changes young people's live and makes it much more difficult. Raising a child when you are a teenager, giving him/her for adoption or having an abortion can have a very negative impact on teenagers physical and emotional well-being and future life. Here are some statistics by the World Health Organization:
About 16 million adolescent girls give birth every year – most in low- and middle-income countries.
An estimated three million girls aged 15-19 undergo unsafe abortions every year.
In low- and middle-income countries, complications from pregnancy and childbirth are a leading cause of death among girls aged 15-19 years.
Stillbirths and newborn deaths are 50% higher among infants of adolescent mothers than among infants of women aged 20-29 years.
Infants of adolescent mothers are more likely to have low birth weight.
All of the following methods of birth control DO NOT prevent from sexually transmitted infections. If people decide to use any of these as a method of contraception (besides the condom), they should talk with their doctor. Most of these methods involve intake of hormones and should not be taken irresponsibly.
Hepatitis B is a virus that infects the liver.
The hepatitis B virus lives in body fluids like blood, semen, and vaginal fluids. If a person comes into contact with a hepatitis B-infected person’s fluids through unprotected oral, vaginal, or anal sex, he/she could get hepatitis B. People also get hepatitis B by sharing needles, drugs, nail clippers, razors, or toothbrushes with someone who has the virus, or by getting a tattoo or piercing with infected tools.
Many people who have hepatitis B don’t know it – they may feel fine, or they may just feel like they have the flu. Some people have these symptoms:

There is no cure for hepatitis B, but in some people, it goes away on its own. Some people have it for the rest of their lives. There is medicine that can help the liver of people who have chronic hepatitis. However, chronic hepatitis can lead to liver damage, cancer, or even death.
Yellow skin or eyes
No appetite
Feeling extremely tired
Brown or dark urine
Light or gray stools
Pain in the stomach, muscles or joints
There are over 100 different types of Human Papillomavirus (HPV), but only a few of those can cause serious problems.
There's a vaccine for HPV viruses.
Most people fight off the virus on their own, but about 1% of all HPV-infected people develop genital warts. An even smaller number of women with HPV develop cervical cancer if the HPV is untreated.
This cancer is a serious disease which can be cured successfully if diagnosed at earlier stages. That's why doctors recommend a simple and fast prophylactic test - PAP smear for cervical abnormalities.
Genital herpes is an infection caused by a virus, which is similar to the virus of the Oral herpes.
As many as 90% of people with Genital herpes are unaware that they have the virus.
Other people who have herpes get blisters or sores in their genital area. These blisters or sores are different for everyone – some people only get them once; other people have "outbreaks" many times over their lifetime.
There's no cure for it - once a person has herpes, he/she has the virus for the rest of one's life. But there are medicines that help the sores heal more quickly and decrease the partners’ risk.
Condoms may reduce the risk of passing herpes to a partner, but since it can be passed by touching, condoms aren’t 100% effective.
Herpes infection increases people's likelihood of getting HIV. Pregnant women who have Herpes can pass it on to their babies during birth, which could make them really sick.
Trichomonas vaginalis
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