Alternate Sexual Behaviors STI Risks Definitions sexual behavior

Alternate Sexual Behaviors STI Risks

Definitions sexual behavior: bodily contact meant to give or derive sexual gratification. alternate sexual behavior: a sexual behavior other than vaginal intercourse (penis in the vagina)

Reasons Teens and Young Adults use Alternate Sexual Behaviors • To avoid pregnancy • To maintain virginity

1. To Avoid Pregnancy • Vaginal sex is the way most females become pregnant • Pregnancy does not occur with oral sex • Sexual behavior that deposits semen/sperm near the vagina, does carry some risk for pregnancy. Therefore, some types of mutual masturbation and anal sex carry some risk for pregnancy.

2. To Maintain Virginity How Teens Define Virginity Mutual Masturbation: 83. 5% say you are still a virgin Oral sex: 70. 6% say you are still a virgin Anal sex: 16. 1% say you are still a virgin Vaginal sex: 5. 8% say you are still a virgin Bersamin M. M, Fisher D. A. , Grub J. W. , “Defining Virginity and Abstinence: Adolescents’ interpretations of sexual behaviors. ”

Risky Alternate Sexual Behaviors • Anal Sex – Penetration by a sexual partner of the anus/rectum with the penis, tongue, hand, or an inanimate object • Oral Sex – Contact of one person’s mouth (active) with the genitals of another person (receptive) • Mutual Masturbation – Stimulation by a sexual partner of the genitalia with the hand or inanimate object

Is Anal Sex Safe? STIs Risk Viral Bacterial Parasitic Mod-high HIV Gonorrhea Hepatitis B Syphilis HPV Chlamydia Herpes Low Hepatitis C No evidence Trichomoniasis

Rectal Condylomata (HPV)

Is Oral Sex Safe? Risk Mod – High Viral Bacterial Hepatitis A Syphilis Herpes Gonorrhea HIV HPV Low Hepatitis B&C Chlamydia Parasitic

Syphilitic Chancre, Mouth

HPV of the Lip

Is Mutual Masturbation Safe? Risk Viral Bacterial Low – Mod Herpes Syphilis HPV No evidence Hepatitis Gonorrhea Chlamydia Parasitic

Syphilitic Chancre, Abdomen

Herpetic Whitlow of the Finger

Men who have sex with men (MSM) • No risk of pregnancy • High risk for STIs – 63% of all new HIV infections were in MSM in 2010. 1 – 2/3 of the cases of primary and secondary syphilis diagnoses in U. S. are MSM cases 2 – 2015 Treatment Guidelines include screening at least yearly for gonorrhea and chlamydia 2

Women who have sex with Women (WSW) • No risk of pregnancy • Risk of STD dependent upon sexual activity – CDC 2015 Guidelines: WSW should not be presumed to be at low or no risk for STDs based on sexual orientation. 1 – WSW at risk for acquiring bacterial, viral, and protozoal STDs from current and prior partners 1 – Risk from sex toys 2 – Risk of HIV transmission 2

Toilet Seats For nonsexual transmission of an STI to occur through a fomite (such as a toilet seat/rim) the following sequence of events would need to occur. • Infectious skin or organs touch the toilet seat • The organism could survive on a hard dry surface • Susceptible skin/organs contacts the surface before the organism dies • An “infectious dose” is reached Conclusion: Nonsexual transmission of STIs is extraordinarily unlikely

Risk Avoidance • Abstinence from vaginal, and oral intercourse is the only 100% effective way to prevent HIV, other STDs, and pregnancy. 1 1. Centers for Disease Control and Prevention