Sexual Health

Communication and sexual decision-making

When it comes to sexual health, decision-making and communication are key. It is important to understand if you feel ready to have sex and, if so, be able to communicate your desires, needs, and personal boundaries to potential sexual partners.

Below are some considerations for effective communication for all types of relationships, sexual or otherwise. Communicating with potential partners about engaging or not engaging in sexual activity, personal boundaries, using protection, getting tested, etc. will lead to better intimacy and sex.

There are 3 basic tenets of good communication:

Active Listening

To be an active listener: 

  • Intently pay attention to what someone else says.
  • Acknowledge that you are listening and really hearing what the person is saying.
  • Avoid interjecting or waiting for your chance to respond.

Using "I statements”

When we start off by telling someone what they are doing wrong, it can feel like an attack. To allow for a more open and fruitful discussion:

  • Express observations.
  • Validate what you like, especially before mentioning something you don't like.
  • Use the “sandwich” method by saying something negative in between two positives.

Finding the right time

Decision-making, especially about sexual health, is best done when you are not in the heat of the moment or when you are stressed, upset or angry.

  • Try to find appropriate time to have the conversation (i.e., when not engaging in sexual activity, relaxed time).
  • Consider planning what you want to say beforehand.  

Abstinence

Abstinence is abstaining from sexual activity, whether it is from a certain act or multiple acts, or from all sexual activity.

  • Being abstinent is a personal choice. What it means to each individual varies.
  • You can be abstinent for any reason and for any length of time. You can choose to be abstinent after previously being sexually active.

Given that sexual activity is never 100% safe from sexually transmitted infections (STIs), complete abstinence from all sexual activity is the only way to fully protect yourself from contracting a STI and/or becoming pregnant or causing a pregnancy.

Sexually Transmitted Infections (STIs) and barrier methods

Sexual activity (which includes manual sex, oral sex, anal intercourse, vaginal intercourse, and sharing sex toys with a partner) is never 100% safe from sexually transmitted infections (STIs), and STIs have been diagnosed among Princeton students. Learn more about clinical information on common STIs among college students.

It’s important to understand how to protect yourself against STIs when engaging in sexual activity. Complete abstinence from all sexual activity is the only way to fully protect yourself from contracting an STI, but there are a number of barrier methods that can help reduce your risk.

Some common barrier methods (available at UHS and the Gender + Sexuality Resource Center) include:

  • External (male) condom
  • Internal (female) condom
  • Dental dam
  • Gloves/finger cots (available at the GSRC or from Peer Health Advisers)

If you or your partner(s) are allergic to latex, there are alternatives (e.g., polyurethane, nitrile). Free safer sex supplies are also available from Residential College Advisers, Peer Health Advisers (PHAs) and for purchase at the U-Store, C-Store, or CVS.

Explore each barrier methods, watch videos on proper use and learn about the benefits of each. 

Specific STIs and Testing 

Familiarize yourself with symptoms of common STIs so you know when to be concerned and can get tested. Some STIs can produce no symptoms, so regular testing is recommended for individuals with certain risk-factors. Sexual Health and Wellness provides testing for:

  • Chlamydia and Gonorrhea
  • Human Immunodeficiency Virus (HIV)
  • Other STIs, as indicated

Since it is possible to be infected without experiencing symptoms, if you do not know your STI status from testing or you are even questioning whether you might have an STI, avoid engaging in sexual activity with a partner until you know your status.  

Pre-Exposure Prophylaxis (PrEP) and Post-Exposure Prophylaxis (PEP)

Prescription medications for the prevention of human immunodeficiency virus (HIV) transmission. Both are available through University Health Services. 

PrEP

A combination of two medications, tenofovir and emtricitabine, when taken daily and consistently, this pill can reduce the risk of contracting HIV from sex by about 99% and from intravenous drug use by about 74%.

It is recommended for people of all sexual orientations and gender identities who are HIV negative and:

  • don't regularly use condoms
  • have a sexual partner who is HIV positive
  • do sex work (including anal or vaginal sex) 
  • have a sexual partner who is high risk for HIV
  • recently had a sexually transmitted disease (STD)
  • inject drugs and share needles or equipment, or have recently been in treatment for drug use

Individuals taking PrEP are required to get an HIV test every 3 months.

PrEP is covered by most insurance plans, including Medicaid and the Student Health Plan (SHP).You might also be able to get help with other expenses, like copays, coinsurance, and deductibles, though Gilead (the company that makes PrEP).

PEP

A medicine to prevent HIV after a possible exposure. If taken within 72 hours (3 hours) after possible exposure, PEP is highly effective in preventing HIV. The sooner the medication is started, the better. It is taken daily for a course of 28 days. 

It is recommended for people of all sexual orientations and gender identities who are HIV negative and:

  • may have been exposed to HIV during sex (e.g., condom broke)
  • shared needles, syringes, or other equipment to inject drugs
  • experienced sexual assault

It is recommended only in emergency situations, not as a regular HIV prevention method. It also does not prevent transmission of other STIs.

Methods of Contraception

Contraceptive methods, or birth control, help prevent pregnancy. When these methods are combined with barrier methods, such as internal or external condoms, it provides the best protection against both STIs and pregnancy. Abstinence is the only 100% way to protect yourself from pregnancy and STIs.

There are many different types of birth control:

  • Long-acting reversible contraception (LARCS) includes intrauterine devices (IUDs) and subdermal implants. All LARCs, excluding Paragard IUD, are hormonal. These methods last from 3 to 12 years, depending upon the type.
  • Other hormonal methods include birth control pills, vaginal rings, contraceptive patches, and the Depo-Provera shot.
  • Barrier methods, such as condoms and diaphragms, are also options. They are non-hormonal.

Learn more about contraceptive methods, many of which are available at Sexual Health and Wellness at UHS. You can make an appointment to explore what option might be best for you. 

Emergency contraception is available 24/7 at UHS, by appointment during regular hours and through the Infirmary after business hours.

Emergency Contraception ("Morning After Pill")

  • It can be taken within a 3-5 day window, depending on the type. The earlier it is taken, the more effective it will be.
  • The Paragard, Mirena and Liletta IUDs can also be used as emergency contraception.

Resources

On-Campus Resources

Sexual Health and Wellness (SHAW): information, support, referrals and services related to sexual and reproductive health

Peer Health Advisers: peer education and programming, and safer sex supplies

Off-Campus Resources

Planned Parenthood: sex education, and preventive and primary care for reproductive health

Online Resources

SexPositive App: a sex education mobile app available for iPhone and Android.

Healthy Bodies, Safer Sex: a useful resource for trans*, non-binary and gender nonconforming people and their partners.

Bedsider.org

Scarleteen