Sexual Health FAQ

Vulva is the scientific term for the external genitals between the legs of about half of the world’s population. Some people say the vulva looks like two folds of skin, with parts in between. Vulvas come in a variety of shapes, sizes, and colours—our own vulva is almost as unique to us as our fingerprints!

Some parts that vulvas typically include, are: two outer folds of skin called the outer labia, two inner folds of skin called the inner labia, and the external parts of an organ called the clitoris, along with two (not just one!) openings—the urethra and the vagina. Lots of people call a vulva a vagina. If we are being scientifically accurate, the vagina is actually a stretchy, muscular tube inside of the body, and the vulva is on the outside, where the opening to the vagina is (the vaginal introitus, if you’re really curious 😉 ).

There is lots to know about vulvas, and when it comes to pleasure, many people find that parts of their external genitals/vulva, are more sensitive than the vagina due to the high concentration of nerve endings—especially on the glans (tip) of the clitoris.

Most, but not all, women have a vulva, and people of all genders can have a vulva. Some people prefer to have a different name for that part of their body—it’s your body, so it’s your choice! Getting to know our vulva or external genitals is one way to heart our parts and take care of our sexual health!

If you have more questions about the vulva or other anatomy, contact Sex Sense (1-800-739-7367 or SexSense.org) for more information.

One of our favourite resources on the vulva is Innies & Outies: The Vagina, Clitoris, Uterus and More from Scarleteen.

Yes! In terms of biology, masturbation is as normal as sneezing, coughing, laughing, and yawning. Masturbation in private can be a great and safe way to release sexual tension and desire and have sexual pleasure without involving anyone else. People of all ages and genders masturbate.

Masturbation, whether a person masturbates twice a month or twice a day, does not in any way harm the person practicing it, either physically or mentally. In fact, masturbation has been linked with some beneficial health effects such as releasing mood elevating hormones which generally make a person feel happier, relieve stress, help with insomnia, and stimulate the immune system.

Some people wonder if they masturbate too much. There is no set number of times we would say is too much. How much you masturbate is only an issue if it is interfering with other parts of your life such as your work, school, or relationships or if you are masturbating in a way that involves another person without their consent. You can learn more about consent here: https://www.scarleteen.com/article/disability_quickies/quickies_sexual_consent_basics

Very rarely, a person who masturbates frequently in a vigorous or rough way may experience some chafing or irritation. If this occurs, see a health care provider if you’re concerned, or if it just some minor irritation then take a break to allow for healing. Using lubricant during masturbation can also sometimes be helpful:  https://www.scarleteen.com/article/bodies/lube_101_a_slick_little_primer or https://smartsexresource.com/topics/lubricants .

Here are some good articles on masturbation in general, in case they’re helpful:
http://www.scarleteen.com/article/gender/is_masturbation_okay_yep

https://www.scarleteen.com/article/bodies_sexuality/going_solo_the_basics_of_masturbation

This is a question we get a lot, so we’ve got some good information right on our website! You can learn how effective different methods of birth control are here: https://www.optionsforsexualhealth.org/facts/birth-control/

You might see different numbers listed in different places for how effective your method is. This is because different studies come up with slightly different numbers and so these numbers are all approximate. They do however give a good sense of how birth control methods compare to each other and which ones provide the strongest protection (spoiler alert: the most effective reversible birth control method currently available in Canada is an IUD!).

The statistics we use are based on “actual use”. In other words, they show how many people out of 100 are likely to get pregnant when using it as their only method of birth control for a year. Some places talk about the effectiveness of birth control with “perfect” or “theoretical” use, which is how effective a birth control method could be if used perfectly in perfect conditions. We don’t tend to do that, because it doesn’t reflect real life all that well. Whose life is perfect?!

That said, we know that some people who use a method consistently and correctly will get higher protection than the actual use statistic, which includes human error (like missing a pill or getting a Depo shot late). If you want to learn how to use your birth control method correctly so that it can be as effective as possible, check out our website.

Some people also choose to use more than one birth control method at the same time, such as both the birth control patch and condoms. This increases their level of pregnancy protection while also providing protection against sexually transmitted infections (STIs)! Check out this great article from Scarleteen about doubling up on birth control.

More questions about birth control? Our Sex Sense team are here for you!  Sex Sense is available Monday-Friday 9 a.m. to 9 p.m. by phone 1-800-739-7367 or by email at SexSense.org to answer your questions about birth control, or any other questions about sex, sexuality, or sexual health.

That is a question no one else can answer for you. Many people wonder about their sexual orientation sometime during the course of their life. Sexual orientation refers to who we are attracted to romantically and sexually. People can be attracted to people of any gender. Different sexual orientations can be found in every part of society, every group, or job, in every country or culture, any body type or level of ability, every faith, and every time in history.

The world certainly puts a lot of pressure on individuals to figure out a sexual identity and be able to describe and justify that identity. For many, finding a word that fits them, like queer, lesbian, Two-Spirited, pansexual, bisexual, asexual, gay etc. means finding a community and feeling less alone. These words and the pride, community, and voice that they provide can be really important and precious and empowering.

For others, a label can feel limiting. Some might find choosing a label so other people will recognize their sexuality as valid can feel like way too much pressure or too narrowly defining. It may be difficult to know what to call the sexual feelings that they have. Sexual identities can also develop over time. Some people know for sure that they are straight, gay or lesbian, asexual, or something else, but others are not so certain.

One way of thinking about sexual identity that works for many people is to think of it as a scale or a spectrum: from “completely straight” at one end to “perfectly bisexual” in the middle and to “completely homosexual” at the other end. Most people don’t land exactly on either end (or exactly in the middle) but rather are somewhere in between. Sexual orientation is fluid and can vary over time.

You can also think about different aspects of your sexuality: there’s how you identify yourself (“I’m panromantic and demisexual…”), there’s what you fantasize about (“… I think about having sex with girls sometimes…”), and there’s what you do (“… and I have sex with my boyfriend”).

There are also folks who identify as asexual or “ACE”, which can mean different things to different people. Qmunity puts it this way “Someone who does not experience sexual attraction for other individuals. Asexuality can be considered a spectrum, with some asexual people experiencing desire for varying types of physical intimacy. This desire may fluctuate over time.” https://qmunity.ca/wp-content/uploads/2019/06/Queer-Glossary_2019_02.pdf

OK, I know this is a lot! The good news is:

• Only you get to decide which identity words feel right to you. No one else gets a vote.
• You get to change your mind about it. Extensive research shows that sexuality is fluid, meaning it changes over time, and you’re allowed to choose different identity words if and when you need to.
• No one gets to be the sexual orientation police—if someone says they identify as gay, pansexual etc., then that’s the truth for them, and as per point #1, no one else gets a vote.
• You get to choose no label at all, or innovate a new term to describe yourself. You don’t have to explain or justify your sexuality to anyone, and you don’t have to talk about it unless you want to.

If you’re wanting to explore different identity terms and the communities they represent, here are some resources for that:
http://www.scarleteen.com/article/gender/the_rainbow_connection_orientation_for_everyone
http://www.scarleteen.com/article/sexual_identity_sexuality/the_answers_for_now
http://www.scarleteen.com/article/sexual_identity/hi_my_name_is_polyqueergenderqueer
http://www.scarleteen.com/article/politics/q_is_for_questioning
http://www.scarleteen.com/article/relationships/the_bees_andthe_bees_a_homosexuality_and_bisexuality_primer

https://qmunity.ca/wp-content/uploads/2019/06/Queer-Glossary_2019_02.pdf

After reading this you may find you have some additional questions. Sex Sense is here to help! Our Sex Sense Team is available Monday-Friday 9 a.m. to 9 p.m. by phone 1-800-739-7367 or by email at SexSense.org to answer your questions about birth control, or any other questions about sex, sexuality, or sexual health.

Yes, an STI can be passed through oral sex, especially if it is unprotected oral sex. There are different chances of getting an STI through oral sex depending on whether you are the giver or receiver and depending on whether the contact is oral-genital or oral-anal. Please see this link for more information on what STIs can be passed through oral sex.

Safer sex barriers like condoms or oral dams can be used during oral sex to help prevent STIs.

External condoms can be placed over a penis* for oral sex, and flavoured condoms were designed for this purpose. External condoms can be found for free at local clinics (including at our Options for Sexual Health clinics) and for purchase at pharmacies. You can learn more about how to use them here.

An oral dam (also called an oral barrier) is a thin rectangular piece of latex or polyurethane that is placed over a vulva** or anus to help prevent STIs from passing during oral sex. They are often called “dental dams” because they were originally designed for dentists working on patients’ teeth.

We sell oral dams at our Options for Sexual Health clinics for $1.75 each and they can also be purchased at adult stores and online. If you do not have an oral dam you can make one by cutting the ring end off an unused external condom and cutting up the side of the condom to create a flat rectangle. For the best results, use unlubricated condoms, or flavoured, thin-latex condoms. Lubricated condoms can make placement harder to control. You can also make a dam by cutting up a latex glove.

Specifically, herpes is one of the STIs that can be passed on through oral sex, from mouth to genitals or from genitals to mouth. Herpes is more likely to be passed on during an outbreak so we’d recommend not having oral sex when a person has symptoms present, whether those symptoms be on a person’s genitals (so no receiving oral sex for that person during an outbreak) or on a person’s mouth as cold sores (so no giving oral sex during an outbreak).

STI testing is another great way to take care of your sexual health. Let your health care provider know that you’ve had oral sex so that they can make sure you get all of the tests you need. For example, sometimes a throat swab will be needed to check for an STI passed through oral sex. You can learn more about STI tests here.

For more information on safer oral sex please visit:

https://smartsexresource.com/topics/oral-sex
https://smartsexresource.com/about-stis/prevention

*This word may not fit for all people when talking about their bodies. You choose the word that fits for you.
**Vulva refers to the external genitals around the vagina. You can learn more about what a vulva is here. This word may not fit for all people when talking about their bodies. You choose the word that fits for you.

After reading this you may find you have some additional questions. Sex Sense is here to help! Our Sex Sense Team is available Monday-Friday 9 a.m. to 9 p.m. by phone 1-800-739-7367 or by email at SexSense.org to answer your questions about birth control, or any other questions about sex, sexuality, or sexual health.

The answer is probably yes! If you are sexually active, or may be one day, chances are the vaccine is recommended for you. Here’s why:

HPV is passed through skin to skin contact (specifically genital to genital skin contact, or mouth to genitals) so although using barriers like condoms and oral dams does reduce the chances of it passing, those barrier methods only cover a portion of the skin that comes into contact during sexual activity (so it’s not as effectively protected against as those STIs that are passed through body fluids such as chlamydia, gonorrhea and HIV). For this reason, HPV is very common in people without the vaccine and the vaccine is likely the most effective form of protection.

Luckily most of the time HPV doesn’t cause us any harm or even symptoms, and we won’t even know we have it, and our bodies will clear it on its own within a few years. However, some strains of HPV do cause genital warts and other strains cause cancer. The vaccine protects against those most common strains. Gardasil 9, the most recent version of the vaccine, protects against 90% of genital wart and cervical cancer cases as well as providing protection against several other kinds of cancer.

Right now in BC, people of all genders get the HPV vaccine for free in grade 6. If you have a cervix and were born in 1994 or later or have a penis and were born in 2006 or later, there is a good chance you received the vaccine in school, unless your parent(s) decided otherwise. If you didn’t receive it, you can still get it for free as long as you get the first shot before your 19^th birthday and your last one before you turn 26. You can also get it free through MSP (your Care Card) in a few other circumstances, which you can learn about here: https://immunizebc.ca/hpv

The HPV vaccine is also recommended but not provided for free through MSP for people with a cervix up to age 45, and for people with a penis up to age 26 or at any age if they have sex with other folks with a penis. That said, many health care providers believe that the vaccine can be helpful for people of any gender and age, and may prescribe it for you if you are outside these categories. It’s always worth having a conversation with your health care provider or local sexual health clinic about whether the vaccine makes sense for you.

Gardasil 9 is given in 3 doses spread over 6 months and is available by prescription and directly at some clinics. You can go to a family doctor, walk-in clinic, travel clinic, or see a doctor at an Options clinic, youth clinic or other sexual health clinic. The cost (for those who aren’t eligible to have it for free) ranges from $176/dose (at our Options for Sexual Health clinics that carry the vaccine) to over $200 through pharmacies. There may be coverage under an extended health plan if you have one.

You can find information about clinics close to you at the following sites:

https://www.optionsforsexualhealth.org/providers
https://smartsexresource.com/get-tested/clinic-finder

Learn more about HPV and the vaccine here: https://www.hpvinfo.ca/

After reading this you may find you have some additional questions. Sex Sense is here to help! Our Sex Sense Team is available Monday-Friday 9 a.m. to 9 p.m. by phone 1-800-739-7367 or by email at SexSense.org to answer your questions about birth control, or any other questions about sex, sexuality, or sexual health.

Consent is an informed, freely-given, ongoing, and enthusiastic “YES!” between people to do something together. It is important to have consent for any sexual activity with another person. Consent can be verbal or nonverbal (for example, communicated through body language). However, if there is any doubt, ask.

In the Criminal Code of Canada, “consent means voluntary agreement to participate in sexual activity. Consent is legally required for all sexual touching. Sexually touching a person without their consent is sexual assault, a criminal offense.” Here are some good things to know about the laws of consent in Canada:

• Consent is needed for any sexual touching, not just touching the genitals.
• You can only consent for yourself and in order to be able to fully consent, you must be conscious and not significantly impaired by drugs or alcohol.
• It is illegal for people in positions of authority (i.e. a teacher or boss) to use that power to pressure others into sexual activity.
• If someone implies no through their behaviours, that is just as good as saying no verbally. Silence does not equal consent.
• You have the right to change your mind and stop anytime for any reason during sexual activity.
• Legally, 16 is the age of consent in BC (meaning it is the age at which a person can consent to have sex). A 16 or 17 year old is able to agree to sex with older people UNLESS the older person is in a position of authority, trust or dependency (such as a coach, teacher, guardian, etc. – in these situations it is the older person in a position of authority who is in trouble, not the young person). Sexual exploitation (sexual activity that uses people under the age of 18 for things like prostitution or pornography) is illegal for anyone under the age of 18 (again it’s the exploiting person who is trouble).
• For people ages 12-15, there are different “close in age exceptions” for sexual activity. What this means is that a 14 or 15 year old can consent to having sex with someone who is less than 5 years older than them. For 12 and 13 year olds, the sexual partner must be less than 2 years older. In cases where sex did happen that was illegal, it is the older person who would be charged with a crime, not the young person. These laws are meant to protect young people as they are often in a situation where older people have more power.
• Some other things that do NOT equal consent are: flirting, being in a relationship, being married, having had sex before (even if it’s with you – you have to get consent every time you have sexual activity with someone), if someone has consented to one kind of sexual activity (this doesn’t mean they’ve consented to other kinds of activity), or if someone doesn’t feel free to say no or has been pressured, convinced or manipulated into saying yes.

For more information on what consent means legally in Canada please see the following: http://www.westcoastleaf.org/wp-content/uploads/2018/10/v5-FAQs-on-law-of-consent.pdf

Once we know what consent is (and isn’t), there is still the question of how do we behave in a consensual way? How do we build consent into our relationships and interactions with others? How do we DO consent?

Consent is about communication. The most important ingredients of consent are listening and asking. What is our partner telling us with their words, body language and behavior? Are they communicating a clear yes? Do they seem to be enjoying themselves? Do we have any doubt? If so, then ask if what is happening is OK or if it’s OK to do something else. Still have doubt? Ask if they want to stop. Still some doubt? Then stop. Ask them if they’re OK and what is going on for them.

Even if you feel sure that someone is giving you an enthusiastic yes, it’s always good to check in, even if it’s just with a simple whispered “Can I…..?” or “Do you want me to….?” “Would you rather I….?” You fill in the blanks. Trust us, consent can be sexy!

Scarleteen, one of our favourite websites, has a couple of great articles on consent and how to navigate it with a sexual partner(s) that we recommend:
https://www.scarleteen.com/article/disability_quickies/quickies_sexual_consent_basics

https://www.scarleteen.com/article/abuse_assault/drivers_ed_for_the_sexual_superhighway_navigating_consent

Happy Valentine’s Day! Some of us may be indulging in some amorous congress today! And we want it to be good congress!  Communicating about sex can be challenging for a lot of us. But it can also be well worth it, because when we do, we get to express what we like or don’t like, and what we do or do not feel comfortable doing, and pleasure and intimacy can increase.

If we don’t have a clear idea of what we like or feel comfortable doing, we may be less clear about what to tell our partners. Masturbation and self-reflection, along with sexual exploration with people we trust, can be great ways to figure out what gives us pleasure and what our boundaries are. Everyone is different. Here are a few resources that may be helpful:

https://www.scarleteen.com/article/bodies_sexuality/going_solo_the_basics_of_masturbation
https://www.scarleteen.com/article/advice/yes_no_maybe_so_a_sexual_inventory_stocklist

And because we are all different, the only way for us to know what a partner enjoys is to ask! All those “10 ways to please your partner” lists in magazines can only give us broad ideas. They don’t let us know what our partner(s) actually enjoy. We always say, different strokes for different folks! In fact, what we want or enjoy can even change from day to day, so this makes communication even more important.

If we want to talk to someone about pleasure or anything about sex, it can be good to consider timing. It may sometimes be easier to talk about sex when you are not about to have it or in the middle of having it! Pick a private moment when you have time to talk. If you can, choose a time when you and your sexual partner(s) are feeling positive and relaxed rather than a time when you or your sexual partner(s) are tired, having a bad day or are feeling rushed.

Now that said, some of the communication about what we like and don’t like can happen during sex. It doesn’t always have to be more than a few words or even verbal at all! It can be as simple as “yes, more of that please!” or “don’t stop!” or “can we try this instead?” It might also be the noises we make, or how we guide the other person’s hands, mouth, or body.

If we’re the person trying to figure out what our partner likes, it can be as simple as paying attention to the other person’s reactions or simple prompts like “do you like this?” or “show me where/how to touch you”. It can be tempting for us to say we like things even when we don’t because we don’t want to hurt our partners’ feelings – try telling your partner that you want to learn more about what they like. Showing them that you are curious and won’t take feedback personally can go a long way!

Here are some articles with more tips on how to communicate with a partner about sex:

Talking About Sex: https://www.optionsforsexualhealth.org/facts/sex/talking-about-sex/

The Whys Whats and Hows of Talking About Sex with a Partner: http://www.scarleteen.com/article/relationships/be_a_blabbermouth_the_whys_whats_and_hows_of_talking_about_sex_with_a_partner

What I want to do handout: http://www.autostraddle.com/you-need-help-here-is-a-worksheet-to-help-you-talk-to-partners-about-sex-237385/

Yes, but it is rare. If semen or pre-ejaculate (pre-cum) comes into contact with the opening of the vagina or the vulva, the sperm may survive and travel up the vaginal canal, through the cervix, uterus and fallopian tubes. If a person is ovulating, or about to ovulate, there is a possibility that the sperm can fertilize an egg in the fallopian tubes, resulting in pregnancy. The best way to keep sperm from fertilizing an egg cell is to make sure that no semen comes in contact with the genitals (vulva and vaginal opening). For more information about various methods of preventing pregnancy (birth control options), click here.

The anus is part of the digestive system. This system begins in a person’s mouth, and ends with the anus. Since the reproductive system and the digestive system are not connected, sperm that enters the anus cannot swim through the body to reach an egg cell in the reproductive system.

It is possible to get pregnant if someone has anal intercourse and the semen or ejaculate leaks out of the anus and into the vagina; or if ejaculated semen is near the opening of the vagina and that semen happens to work its way deep into the vaginal opening. So if the person who ejaculates does not wear a condom, or it slips off, or is worn incorrectly, there is a chance that some sperm may get into the vagina and a pregnancy could occur.

For tips on safer anal sex, click here.

There is no risk of pregnancy associated with oral sex. This is because when semen enters the mouth and is swallowed (which is not a necessary step), it enters the digestive system. The digestive system is completely separate from the reproductive system, which is the part of the body responsible for pregnancy. For some tips on safer oral sex, click here.

Yes, this is technically possible, and has to do with the life cycle of the sperm and egg cells. The egg cell can live for about 24 hours after it has been released from the ovary (this is called ovulation). On the other hand, sperm can live from five to seven days inside of a vagina, particularly in the presence of fertile cervical fluid (this looks like egg-white).

Sometimes, fertile cervical fluid can be present towards the end of someone’s period. Since sperm can live up to seven days in this fluid, it is possible for pregnancy to occur if they ovulate within that time frame. For example, if someone has unprotected sex on Sunday and still has their period with some fertile cervical mucus present, sperm can live in their body until the following Saturday. If they ovulate during that week, there could be sperm available to fertilize the egg, which could result in pregnancy.

Sometimes people are worried that they could possibly get pregnant from sitting in a hot tub that someone may have ejaculated in. The good news is that sperm die once they hit the hot tub water, before they could reach someone’s vulva and vagina.

However, having actual intercourse in a hot tub, hot shower, or in any kind of watery environment does not protect against pregnancy or sexually transmitted infections.

Yes; emergency contraception lowers the risk, but does not completely eliminate it.

The Emergency Contraceptive Pill (ECP) usually refers to a progestin pill like Plan B, Contingency 1, Norlevo, Next Choice, or Option 2. These pills can prevent a pregnancy from occurring if taken within five days after having unprotected sex (or any other incident that might result in sperm entering the vagina), but the sooner someone takes them after sex the more likely they are to work.

Plan B and other pills like it can reduce the risk of pregnancy by approximately 50%. They will not work if someone is already pregnant or if too much time went by after unprotected intercourse.

A prescription is not needed to purchase emergency pills like Plan B. They are available for free at youth clinics, or at low cost at Options for Sexual Health clinics, walk in clinics, and doctor’s offices. They are also available from a pharmacy without a prescription for approximately $40.

There is also a new kind of emergency contraceptive pill available in Canada called Ella. It is available by prescription and can also be taken up to 5 days after sex. It is approximately 60% effective and does not lose effectiveness as quickly over time as progestin based emergency pills like Plan B.

If someone has had unprotected sex, and is concerned about the risk of pregnancy, an emergency insertion of a copper IUD is the most effective method of emergency contraception (99% effective when inserted up to 7 days after unprotected intercourse). For more information on emergency IUD insertion click here.

To learn more about Emergency Contraception please click here.

Yes, it is absolutely possible to become pregnant after having vaginal sex for the first time. It has been a long standing myth that someone cannot get pregnant the first time they have sex, and this has led to many unplanned pregnancies.

Anytime a person with sperm and person with an ovum (egg cell) have penis-vagina intercourse, it is possible for pregnancy to occur – all that needs to happen is for a sperm to get to an egg cell. The risk of pregnancy is greatly reduced through the use of birth control.

Yes. This is called the withdrawal method of birth control, but it is only ~73% effective in actual use because the person with a penis may not pull out in time before ejaculating; also, there may be sperm in the drops of fluid that comes out of the penis before ejaculation (pre-cum).

It is more likely that sperm will be present in pre-ejaculate if a man has ejaculated in the last few hours. This is because leftover sperm may still be present in the urethra. If ejaculation has occurred prior to intercourse, the person who ejaculated should urinate and wipe off the tip of their penis before intercourse to remove any sperm from the previous ejaculation, as sperm could have been trapped in the urethral lining or folds of skin and can therefore be present when subsequent acts of intercourse take place.

No matter what position a couple is having sex in, if ejaculate enters into the vagina, there is the possibility of pregnancy. The effect of gravity will not affect a person’s risk of pregnancy. However, couples can enjoy sex in any position that feels good for them and use condoms and other methods of birth control to prevent a pregnancy from occurring.

Thankfully, no! Pregnancy can only occur if there is sperm to meet the egg cell. By touching genitals for pleasure with hands or toys, someone is not at risk for becoming pregnant (unless there is fresh wet ejaculate that has been recently ejaculated onto their hand or toy).

Missed Pill Guidelines: https://www.sexandu.ca/contraception/stay-on-schedule/

When used correctly during penetrative sex (inside the genitals including anal sex) external condoms are a great option to help reduce the transmission of STIs, however, it is important to know that not all STI transmission can be fully prevented with condoms.

Some STIs are transmitted differently than others. Some STIs are transmitted through genital fluid, anal fluid and/or blood, but others are transmitted through skin-to-skin contact.  A condom can act as a barrier for fluids but it does not eliminate all skin-to-skin contact.

Transmission of STIs such as herpes, HPV, syphilis, pubic lice, or scabies could occur even if a condom is used during genital sex as a condom cannot cover all skin-to-skin contact. However, even with these infections, using an internal or external condom will help to protect some skin areas that are covered by the condom. For instance, internal condoms that are used during penetration can also cover more genital surface area.

Sometimes a condom may not be used correctly, is used after initial sexual contact, or a condom may fail by breaking, tearing, or falling off. In these instances, the risk of getting an STI is the same as if a condom is not used. In these instances, getting tested can be a helpful way to know your sexual status.

Condoms when used correctly during penetrative sex (inside the genitals including anal sex) are an effective way to practice safer sex in helping to prevent most STIs.

Condoms (whether internal or external): can be used on body parts and/or sex toys or sex supplies that are being shared during penetration inside the genitals.

Remember that for an STI to pass, an STI must be present in the first place. For example, if people have sexual activity and no one has chlamydia, then chlamydia cannot just pass. However, because we can’t always know if sexual partners have an STI as STIs often do not have symptoms and people may not have been tested or know their sexual status, condoms and other safer sex barriers, can be helpful in protecting and preventing most STIs.

There are some STIs that cannot be fully prevented even if a condom is used.

Some STIs are transmitted differently than others. Some STIs are transmitted through genital fluid, anal fluid and/or blood, but others are transmitted through skin-to-skin contact.  A condom can act as a barrier for fluids but it does not eliminate all skin-to-skin contact.

Transmission of STIs such as herpes, HPV, syphilis, pubic lice, or scabies could occur even if a condom is used during genital sex as a condom cannot cover all skin-to-skin contact. However, even with these infections, using an internal or external condom will help to protect some skin areas that are covered by the condom. For instance, internal condoms that are used during penetration can also cover more genital surface area.

The helpful thing to note is that with the STIs that can still pass through skin-to-skin contact, most are treatable. For example, syphilis, pubic lice, and scabies are all treatable. With HPV, there are many different viral strains and most strains are not serious, have no symptoms and in a majority of people who are non-smokers and who do not have a compromised immune system, HPV infections can clear on their own within 2 years. Some people also consider the HPV vaccine for additional protection and getting regular Pap screening. While herpes is a virus that cannot be cured, symptoms can be managed and in most cases herpes is not a serious condition but rather a non-serious skin condition/sores (although this is not to take away from the fact that herpes can carry a social stigma and can have an emotional impact on people). For more information about herpes, please click here: https://smartsexresource.com/topics/herpes-simplex-virus.

Sometimes a condom may not be used correctly, is used after initial sexual contact, or a condom may fail by breaking, tearing, or falling off. In these instances, the risk of getting an STI is the same as if a condom is not used. In these instances, getting tested can be a helpful way to know your sexual status.

Even if safer sex barriers are always used, it can be helpful to have STI testing to know your sexual status. You can check with your health care provider about how often you should be tested.

Remember that most STIs are treatable, do not have always have symptoms and if left untreated, could cause more problems down the road.

For more information, please visit: https://smartsexresource.com/sites/default/files/Anal-Vaginal-Sex-Table-v3.png

Alternate links:

• http://teenhealthsource.com/birthcontrol/external-condom/
• http://teenhealthsource.com/sex/how-to-external-condom/
• https://smartsexresource.com/topics/dental-dams-and-other-barriers

For harm-reduction tips on safer sex when condoms are not able to be used: (we should include a paragraph on safer sex tips when condoms cannot be used or when people make a choice to not use them. To acknowledge that the use of safer sex supplies can be complicated by various factors such as: knowledge of STIs and transmission, access to safer sex supplies and knowing how to use them, perceptions of risk, willingness to use, safety in sexual relationships/with clients in order to use supplies, lack of pleasure/sensation or other factors that may make safer sex supplies less likely to be used, use of drugs/alcohol during sexual activity which may make safer sex supplies more difficult to use, relationship status-for instance, people may be in sexual relationships where everyone has been tested outside the window periods and are deciding not to use safer sex supplies.

Harm-reduction tips for safer sex (when safer sex barriers are not used) can include (these tips can help reduce chances of contracting STIs but are not as effective as using safer sex supplies):

• Choosing less risky sexual activities
• Oral sex: not brushing, flossing before as gums may bleed, avoiding oral if major dental work has just been done
• Genital sex: avoiding areas where there may be cuts/abrasions, damage to skin, bleeding, avoiding a person ejaculating inside the genitals if possible
• Getting tested after the window periods
• PrEP and PEP
• Use lube on genitals to help prevent skin tearing which can sometimes make it easier for STIs to pass
• Knowing where to obtain clean needles and other drug equipment
• Communication about sexual histories: whether safer sex barriers are used or not, it may be helpful to check in with the sexual partner(s) about their sexual history. For more information please visit: http://teenhealthsource.com/sex/talking-partners-stis/

If possible while things are getting sexual, have a look to see if your sexual partner(s) has any signs of a rash, sore, redness or discharge. While this may not necessarily indicate an STI, it may be helpful to avoid those areas. 

Yes.  As mentioned above, some STIs are transmitted just through skin-to-skin contact where penetration is not necessary. Also, abstaining from penetrative sex but engaging in other types of unprotected sex, such as unprotected oral sex, can pose a risk for infections, although the risks are lower for oral sex.

Different sexual activities carry different risks or chances of contracting STIs. For more information please visit:

• https://www.optionsforsexualhealth.org/facts/sti/risk/
• https://smartsexresource.com/sites/default/files/Other-Sex-Table-v3.png

Yes, an STI can be passed through oral sex, especially if it is unprotected oral sex. There are different chances of getting an STI through oral sex depending on whether you are the giver or receiver and depending on whether the contact is oral-genital or oral-anal. Please see this link for more information on what STIs can be passed through oral sex.

Safer sex barriers like condoms or oral dams can be used during oral sex to help prevent STIs.

External condoms can be placed over a penis* for oral sex, and flavoured condoms were designed for this purpose. External condoms can be found for free at local clinics (including at our Options for Sexual Health clinics) and for purchase at pharmacies. You can learn more about how to use them here.

An oral dam (also called an oral barrier) is a thin rectangular piece of latex or polyurethane that is placed over a vulva** or anus to help prevent STIs from passing during oral sex. They are often called “dental dams” because they were originally designed for dentists working on patients’ teeth.

We sell oral dams at our Options for Sexual Health clinics for $1.75 each and they can also be purchased at adult stores and online. If you do not have an oral dam you can make one by cutting the ring end off an unused external condom and cutting up the side of the condom to create a flat rectangle. For the best results, use unlubricated condoms, or flavoured, thin-latex condoms. Lubricated condoms can make placement harder to control. You can also make a dam by cutting up a latex glove.

Specifically, herpes is one of the STIs that can be passed on through oral sex, from mouth to genitals or from genitals to mouth. Herpes is more likely to be passed on during an outbreak so we’d recommend not having oral sex when a person has symptoms present, whether those symptoms be on a person’s genitals (so no receiving oral sex for that person during an outbreak) or on a person’s mouth as cold sores (so no giving oral sex during an outbreak).

STI testing is another great way to take care of your sexual health. Let your health care provider know that you’ve had oral sex so that they can make sure you get all of the tests you need. For example, sometimes a throat swab will be needed to check for an STI passed through oral sex. You can learn more about STI tests here.

For more information on safer oral sex please visit:

https://smartsexresource.com/topics/oral-sex
https://smartsexresource.com/about-stis/prevention

*This word may not fit for all people when talking about their bodies. You choose the word that fits for you.
**Vulva refers to the external genitals around the vagina. You can learn more about what a vulva is here. This word may not fit for all people when talking about their bodies. You choose the word that fits for you.

After reading this you may find you have some additional questions. Sex Sense is here to help! Our Sex Sense Team is available Monday-Friday 9 a.m. to 9 p.m. by phone 1-800-739-7367 or by email at SexSense.org to answer your questions about birth control, or any other questions about sex, sexuality, or sexual health.

Even people who are in long term monogamous relationships who are having unprotected sexual activity can get STIs. For example, STIs often do not have symptoms. So if partners in long-term monogamous relationships have not been tested for STIs and within the right time frame before having unprotected sex in the relationship, they may not know their sexual status and if STIs are present, they may unknowingly pass them to each other.

If sex is protected this will definitely help to reduce most STIs. However, some can still pass through genital skin-to-skin contact even if protection is used (please see ‘we use a condom’ above), although using protection that covers the genital area will help to lower the risks.

(reference: “Correct and consistent use of latex condoms can reduce the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected. While the effect of condoms in preventing human papillomavirus infection is unknown, condom use has been associated with a lower rate of cervical cancer, an HPV-associated disease.”
—CDC. Male Latex Condoms and Sexually Transmitted Diseases. Atlanta, GA: CDC, 2002. http://www.advocatesforyouth.org/publications/publications-a-z/416-condom-effectiveness

Also some STIs, such as herpes or HPV, can lie dormant in a person for months or years and may be passed to another person at any point in the relationship. A person may have one or more of these viruses and not know it until their partner shows symptoms (although we can never really know which partner we may have contracted herpes or HPV from). Herpes and HPV are very common for a majority of people (most Canadians will have at least one type of the herpes virus in their lifetime and not know it) and with HPV (at least 75% of sexually active Canadian will get one HPV infection in their lifetime but most people with healthy immune systems will clear this). Also HPV and herpes often do not have symptoms. There are not always ways to test for all types of HPV and herpes testing is not standard practice. The most common test for herpes is a swab of a suspected lesion. To learn more about herpes and HPV please visit https://www.optionsforsexualhealth.org/sexual-health/sexually-transmitted-infections

Sometimes STIs are spread in ‘monogamous’ relationships because one or both partners is having sex outside the relationship without the other partner(s) knowledge and/or consent (sometimes called ‘cheating’). The sexual activity could result in an STI that is then passed on to the monogamous partner.  

Regardless of how long you have been in your relationship, regular annual screening for STIs is recommended.

Sex can mean different things to different people so it’s important to clarify what that means in answering this question.

If both of you have never done any of the following with another person:

• Oral-genital contact
• Hand-genital contact
• Genital-genital contact
• Sharing sex toys/equipment without a condom or not cleaning them in between
• Rubbing bodies against each other sexually with no clothes on the genital/boxer short area (thighs, lower abdomen, buttocks, rectum) or clothes that do not fully cover the genital/boxer short area (http://plannedparenthood.tumblr.com/post/98654135885/can-dry-humping-with-clothes-on-transmit-stds)

Then it is highly unlikely to have STIs through sexual activity.

(Please note that if someone has been sexual with the activities noted above, there are different levels of risk or chances for STIs and chances also vary in terms of whether protection is used or not. For more information please visit: https://smartsexresource.com/about-stis/know-your-chances-0)

If there is kissing, herpes, if the virus is present, may pass (https://smartsexresource.com/sites/default/files/Oral-Sex-Table-v3.png). Herpes is a very common non-serious (in most cases) skin infection. This is not to take away from the fact that herpes can carry a social stigma and can have an emotional impact on people.

Some STIs (such as HIV, Hep B, Hep C) can also pass through blood to blood contact with infected blood (even if there is no sexual activity) through: sharing needles or drug equipment, unsterilized tattoo/piercing equipment, needle stick injury, blood or blood product transfusions with contaminated blood, sharing toothbrushes, razors, nail files etc.

Some STIs such as scabies, pubic lice or molluscum contagiosum (most common in children) can also pass through non-sexual means such as in sharing infected towels, bedding, clothes, etc.

Hep A can also pass outside of sexual activity if someone consumes food, water or ice contaminated with Hep A and does not have the Hep A vaccine.  

Oral herpes which presents as cold sores on the mouth are most often obtained from non-sexual means. Oral herpes is often acquired in childhood, and is frequently the result of an adult with oral herpes kissing a child (non-sexually).

Some STIs can also pass through non-sexual means such as pregnancy, childbirth, breast/chest feeding.

Please visit:

• http://www.catie.ca/en/practical-guides/safer-sex-guide/other-activities-and-chances-gettingpassing-stis
• http://www.catie.ca/sites/default/files/CATIE_SaferSexGuide_2016_English_WEB.pdf

Testing negative for STIs is a good indicator that you do not have an infection.  Sometimes false negative results can occur when testing is performed too soon after exposure. It is important to make sure that you are testing after the window periods for each STI. Please see the following for more information:

• https://smartsexresource.com/topics/window-period
• https://smartsexresource.com/topics/hiv-window-periods

Also, make sure to ask which STIs your health practitioner is testing for you.  Some infections like HPV, genital warts, and herpes are not routinely tested. Also, do not assume that if you are receiving either an anal and/or cervical pap smear that it is the same as being tested for all the STIs. Please check in with your health care provider so that you are informed on what testing is being done. There are different ways of testing for STIs. To learn more please visit: https://smartsexresource.com/get-tested/tests-and-exams

If your recent STI test results are negative, it can be helpful to have new testing done anytime you:

• Have a risk of infection (unprotected sex, condom broke/slip, sharing needles, etc.)
• You notice changes in your body
• Sexual contact with a person who told you they have an STI
• You have a new sexual partner/client (if you have multiple new partners/clients every so often, it can be helpful to test every 3-6 months if the sex is always protected. If the sex is unprotected or the safer sex barrier broke/slipped, consider testing sooner)
• If you are in a monogamous sexual relationship with the same partner and have both been tested, consider testing annually
• You or your partners have other sexual partners (where sex is protected and/or people have been tested) and it’s been more than three to six months since your last test.
• Have been sexually assaulted
• You are pregnant (regardless if you are planning to continue the pregnancy or have an abortion)
• It is best to check in with your health care provider on how often they recommend you testing based on your sexual life and other activities.

Resources:

• Trans clients: https://smartsexresource.com/topics/transgender-resources
• Resources for gay/bi men*: http://checkhimout.ca/testing/
• Resources for sex workers:
  • http://librarypdf.catie.ca/PDF/ATI-20000s/21180.pdf
  • http://www.pace-society.org/

* “we recognize the word “men” may not be inclusive of how people identify and use this word to reflect the same language of the resource.

The transmission of STIs that are caused by viruses and bacteria are highly unlikely through the shared use of a toilet, clothes, towels, or utensils with someone who has an STI.  

The bacteria and viruses that are responsible for causing STIs require a living host in order to “live” and multiply. Depending on the type of bacteria or virus, direct skin-to-skin contact or the passing of bodily fluids such as blood, genital fluids or breast milk between an infected person and another person is required for the transmission of an STI.

 The only STIs that can be transmitted by sharing personal items like infected clothes and linens are those caused by parasitic insects. These two STIs are called pubic lice (or crabs) and scabies. Both of these STIs are non-life threatening and can be easily treated.

For more information: https://smartsexresource.com/ask-us/questions/can-u-only-catch-through-sex-just-concerned-u-may-b-able-to

It is highly unlikely/difficult to get an STI through kissing, no matter the type of kissing, whether it’s a peck or deep kissing with tongue. However, there is a risk of being exposed to the herpes virus as the virus can be transmitted through direct skin-to-skin contact. The risk is highest if your partner has an open sore or lesion on their mouth.  However, the virus can also pass when there are no symptoms. Remember that the herpes virus is a very common non-serious (in most cases) skin infection. Although herpes is not a serious STI, it can carry a social stigma and have an emotional impact on people.

Please visit:

• http://plannedparenthood.tumblr.com/post/173580409346/can-you-get-stds-from-kissing
• https://smartsexresource.com/sites/default/files/Oral-Sex-Table-v3.png
• https://smartsexresource.com/ask-us/questions/hey-can-i-get-syphilis-making-out-someone-who

As long as you are only masturbating with your own sexual fluids, there is no risk of STIs. Masturbation, if it is something you like to do, is a very healthy and safe way of practicing sex. Masturbation is one of the most common sexual acts.

To keep masturbation safe for your body, avoid using any fragile, sharp or unclean objects with the genitals as this may cause tearing or infection.

For more information on masturbation: http://www.goaskalice.columbia.edu/answered-questions/masturbation-healthy-0

Fact: In January 1988 the Supreme Court of Canada made the decision that any law that restricted a woman’s* right to life, liberty, and security of person, as guaranteed under the Canadian Charter of Rights and Freedoms, Section 7, was unconstitutional.  This is called the Morgentaler Decision. Since this ruling there have been no laws regulating abortion or protecting rights to abortion in Canada.

*Although the Morgentaler Decision noted women, we recognize that people with a uterus do not always identify as a woman, and may need to access abortion services.

Fact: The decision to have an abortion is not, for most people, a trivial matter.  This, combined with the reality that abortion is inaccessible to many in Canada prevents it from being a chosen or viable primary method of birth control.

Fact: Access to contraception is a challenge for many people with a uterus in Canada. Even among those who do have access, no birth control method is 100% effective, and all cis women, trans men, and gender diverse folx with a uterus experiencing pregnancy have the right to choose among the options of parenting, adoption and abortion.

Fact:  Physicians performing abortions are governed by medical practice guidelines and legislation. Canadian Medical Association (CMA) policy permits abortion after 20 weeks only under exceptional circumstances.  Less than 0.4% of abortions occur after this point.

Fact: Access to abortion is not available equally across Canada. Thus, someone may have to wait to obtain an abortion, resulting in her being in the second term of their pregnancy.

Fact: Abortion procedures do occasionally have complications, just as pregnancy and delivery are not without risks to the health of both the pregnant person and the foetus. But current Canadian data (2004) reports no deaths as a result of surgical abortion performed by an accredited physician. Abortion is safer than carrying a pregnancy to term and giving birth.

Fact: Abortion procedures do occasionally have complications, just as pregnancy and delivery are not without risks to the health of both the woman and the foetus. But current Canadian data (2004) reports no deaths as a result of surgical abortion performed by an accredited physician. Abortion is safer than carrying a pregnancy to term and giving birth.

Fact: Mifepristone and misoprostol have been formally studied and used safely. Abortion does not affect future pregnancies and fertility returns immediately unless there is an extremely rare, serious complication (which can happen also with surgical abortions, or even in normal, healthy pregnancies).

Fact:  Abortions performed by qualified physicians have a very low rate of serious complications.

Fact: People who have had an abortion experience these pregnancy complications at rates similar to those who have never had an abortion.

Fact: There is no evidence to suggest that there is any impact on a someone’s ability to conceive and carry a pregnancy to term based upon their therapeutic abortion history.

Inability to conceive or carry a pregnancy to term is based on many factors (i.e. sexually transmitted infections, genetics, environmental factors) and abortion is not a risk factor for infertility or miscarriage.

Fact: In March of 2003 the National Cancer Institute (NCI) declared emphatically that recent studies consistently show no association between induced and spontaneous abortions and breast cancer risk.  Nevertheless, while no causal relationship between abortion and breast cancer has been scientifically established, anti-choice groups attempt to dissuade people from choosing abortion by exploiting their fear of breast cancer.

Fact:  Since the early 1980s, groups opposed to abortion have attempted to document the existence of “post-abortion syndrome” which they claim has traits similar to post-traumatic stress disorder.  The American Psychological Association (APA) conveneda panel of experts to review the data and they reported the studies with the most scientifically rigorous research designs consistently found no “post-abortion syndrome”.  The American Medical Association(AMA) and Centre for Disease Control (CDC) concur that no such syndrome is scientifically or medically recognized.

Fact: Evidence regarding the capacity for foetal pain is limited, but indicates that foetal perception of pain is unlikely before the third trimester.

Fact: The Religious Coalition for Reproductive Choice (RCRC) is a coalition of national Christian, Jewish, and other religious organizations that support a woman’s right to decide when and whether to have a child.  RCRC educates the public about abortion and teaches that it can be a religiously responsible decision.

Fact: Catholics For a Free Choice (CFFC) gives a voice to the many Catholics who respect a pregnant person’s right to make sound and moral decisions concerning their own body, and who support reproductive choice.

Fact: Abortions for youth are legal, and can be provided to youth under the age of 16 without parental consent, but with informed consent of the patient.  At abortion clinics in British Columbia, extensive counselling takes place prior to, and following, the procedure.