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OK people. It’s that time again—we’re here to talk about STIs and why you don’t want to catch them all. Sure, you know what a condom is and how to use one (but don’t take that for granted—turns out many of us could improve). You may not know how gobsmackingly common STIs are among students and what that can mean for your health (and any future breeding plans you may have). Do your sexy parts a favor and click on each question.

Question 1

Which of these practices places you at high risk from STIs?

1. Unprotected oral sex

Oral sex (any gender/sexuality combination)

Each of these sexual practices ramps up the risk of STIs. The risk to you from these activities depends on your own sexual behaviors and health. Here’s what you need to know about each one.

Many sexually transmitted infections can be transmitted through unprotected oral sex. This is why condoms and oral dams are important for oral sex too.

Condom options

For oral sex involving a penis, you can use a dry, lubricated, or flavored condom. Putting lubrication inside the condom increases sensitivity for both partners and makes the condom easier to put on. Condoms are available on many campuses for free or at a low cost.

Oral dam option

An oral dam is a thin piece of latex placed over the vulva or anus for oral sex. Oral dams can also lower your risk of STIs (but not pregnancy). You can cut a condom, latex glove, or plastic wrap into an oral dam. Oral dams are available on some campuses for free or at a low cost. They are also available in some specialty stores, such as sex toy or condom stores, or online, for about $1.50 each.

Consistently using condoms and oral dams seriously reduces your risk of STIs. Safer sex practices do not entirely eliminate the risk. In the same way, hand washing and other precautions can reduce your chance of catching a cold, but you’re not 100 percent risk-free unless you entirely stay away from other people.

Orally-transmitted STI options

The following infections are among those that can be shared orally (and via vaginal and anal sex). This content was adapted from Bedsider, an online birth control support network:

  • Human Papillomavirus (HPV) is the most common STI in the US. Many strains are benign; others can lead to genital warts or cancer. The HPV vaccine effectively protects you (and others) from common, harmful strains of HPV via any method of transmission.
  • Herpes (HSV) is also common. The two herpes strains (HSV-1) and (HSV-2) can each cause symptoms in the mouth and genitals and raise your risk of other STIs.
  • Gonorrhea and chlamydia are notifiable infections, meaning the CDC collects data on diagnoses. In 2014, people aged 15–24 accounted for almost two in three cases. When transmitted via oral sex, these STIs can cause throat infections.
  • HIV can be transmitted via sharing bodily fluids, including during oral sex. That said, this means of HIV transmission is less common than via vaginal or anal sex—so it’s a less risky practice. If you may be at high risk of HIV infection, ask your health care provider about PrEP (see Question 4).

2. Sex when you have genital abrasions

Sex when you have genital sores or another STI

Having genital abrasions or another STI, with or without symptoms, makes you a lot more vulnerable to additional infections, including HIV. If you have HIV, being infected with another STI makes you more likely to transmit HIV, research suggests.

How to lower the risk of becoming infected with HIV and other STIs

When you have an STI, such as herpes, or a genital abrasion, and are sexually active, your risk of becoming infected with HIV is four times higher than if you did not have an STI, according to studies (Sexually Transmitted Diseases, 2005). To lower your risk of HIV infection, treat the STI, and avoid sex if you have a genital abrasion.

Lowering the risk of transmission if you have HIV
  • If you have a co-occurring STI, treating the STI decreases the amount of HIV particles in your bodily fluids (Sexually Transmitted Infections, 1999) and makes you less likely to transmit HIV.
  • Your risk of transmitting HIV is to a large extent determined by your viral load (the amount of HIV particles in your blood). A course of medication called Treatment as Prevention (TasP) can reduce your viral load to a low level, making you unlikely to transmit the infection to another person—including your sexual partners and your baby if you are pregnant or breastfeeding. There is still some risk of transmission, however, so you should continue to use condoms.

+ More info on TasP (Avert)

3. Multiple sexual partners

Sex with multiple partners or with a partner who has multiple partners

The more sexual partners you have, the greater your potential exposure to STIs.

If you have multiple partners (or your partner does), do this:
  • Consistently use condoms and/or oral dams.
  • Get tested for STIs every six months and/or every time you have a new partner so you can treat or manage any infections early and minimize the risk of health consequences to yourself and others.
Here’s why the risk is higher with multiple partners:
  • Even if you know a partner’s STI status from recent testing, you can’t know the status of that partner’s other partners.
  • Even recent testing has loopholes: Viruses (including HIV) can take several months to show up in your blood; for accurate results, repeat the test three months later. Herpes testing is most useful if it is carried out when symptoms are evident. And, by the way, anyone can walk out of a health care center and get infected with an STI later the same day.
  • You can’t know for certain whether each partner consistently practices safer sex.

4. Sex with someone exposed to Zika

Sex with someone who has been exposed to the Zika virus

If you’re pregnant or may become pregnant, and if you or a sexual partner could have been exposed to Zika, this may be the STI that you are most concerned about.

The Zika story is rapidly evolving. Here’s what the CDC is saying:
  • Zika is relatively benign to the fully formed humans who become infected with it; most don’t even show symptoms. But there is strong evidence that Zika can seriously damage the developing nervous system of fetuses, resulting in potentially severe disabilities in babies.
  • Zika is spread primarily via the bites of infected mosquitoes. Zika is also spread sexually via the semen and vaginal fluids of people who have been infected with Zika.
  • Zika can be spread by people who have no symptoms of the infection, or before, during, or after they experience symptoms.
  • If you (or your partner) are pregnant or could become pregnant:
    • Do not have unprotected sex with a person who has been infected with or exposed to Zika; this includes people who live in or have visited an area with Zika.
    • Use a male or female condom every time you have vaginal or anal sex.
    • Use a condom or oral dam every time you have oral sex.
  • People who have had Zika should wait before trying to get pregnant: women should wait eight weeks after exposure or the start of symptoms; men should wait six months after exposure or the start of symptoms (Zika appears to live longer in semen than in other bodily fluids).
  • In 2016, the US government for the first time issued a travel advisory about a US destination, saying pregnant women and their sexual partners should avoid nonessential travel to the parts of Florida where Zika has spread via mosquito.
  • Pregnant women who may have been exposed to Zika should be tested for Zika infection.

+ Zika: where it is and what to do about it (CDC)

5. Unprotected anal sex

Anal sex without a condom with a partner whose STI status you don’t know

Unprotected anal sex is high risk. The anus does not naturally lubricate; it tears more easily than the vagina, raising the risk of being infected with HIV, chlamydia, gonorrhea, and other STIs.

To reduce your risk:
  • Use a condom every time with every partner and plenty of lubrication to reduce microscopic tearing.
  • Use a condom even if you or your partner are on Pre-Exposure Prophylaxis (PrEP) or Treatment as Prevention (TasP); these are daily medications that reduce but do not eliminate the risk of HIV transmission (see Question 4).
  • Avoid ejaculating in or near the anus.
  • Switch it up: You’re a lot less likely to get HIV via oral sex—although oral sex also carries risk (see Oral sex, above). Do not go from the anus to the mouth without washing thoroughly in between.
  • Do not have unprotected anal sex unless you are in a mutually monogamous relationship and you and your partner are both getting regularly tested for STIs.

6. Sex with a needle sharer

Sex with someone who shares needles

Sharing needles puts people and their sexual partners at high risk. People may share needles for several reasons, including intravenous drug use; hormone-sharing (by some gender-transitioning people who do not have access to treatment); steroid use (by some body builders); and sexual stimulation.

The use of alcohol and drugs increases the likelihood of unsafe sex. Intravenous drug use introduces an especially high risk for STIs, including HIV. The STI risk among drug users is highest for young women, according to Sexually Transmitted Infections (2002).

Here’s why any drug use increases the risk of STIs:
  • Impaired judgment“Drugs impair judgment, making attempts to use condoms consistently or avoid high risk sexual behaviors difficult, even for the most motivated and well informed,” wrote researchers in Sexually Transmitted Infections, 2002.
  • Multiple sexual partners and needle-sharingThe sexual partners of intravenous (IV) drug users are at relatively high risk: In the 2002 study, IV drug users reported needle-sharing with more than one person. In addition, those with multiple sexual partners reported inconsistent condom use. Both practices place partners at high risk of HIV and other STIs.
  • Commercial sex workDrug use is closely associated with commercial sex work, raising the risk of exposure from multiple partners and needle-sharing.

Question 2

When you’re aiming to use condoms more consistently, what could help?

1. Learn how to enhance sensation for all

Know how to enhance sensation

Any and all of these actions can help us use condoms more consistently, research suggests.

This content is largely adapted from VeryWell.com, an evidence-based health website:

First, you may be all set for sensation: Sex feels good with a condom. That’s the message of a national survey in which adults rated their arousal, pleasure, and orgasm as positively with a condom as they did without (National Survey of Sexual Health and Behavior, 2010).

If your experience is different, try these options:
  • “Cock rings”—rubber, plastic, or metal rings placed tightly around the base of the penis and testicles—can help better sustain erections by restricting the flow of blood away from the erection. (To make one, take an unused, unrolled condom; poke a hole through the tip; and stretch the ring around the penis and testicles).
  • Lubricant on the outside of the condom, and a small amount of lubricant in the inside tip of the condom, can increase sensation.
  • A looser-fitting condom (such as Trojan Ecstasy) may help sex feel more natural and pleasurable, according to studies—but be sure it isn’t so loose that it can leak or slip off.
  • Male polyurethane condoms transfer heat more effectively than male latex condoms and may enhance sensitivity for both partners. In studies, men and women preferred polyurethane condoms to latex, in part because of increased sensitivity and stimulation.

2. Get tested for STIs

Get tested for STIs

If you don’t know your STI status: Getting tested may help you subsequently take better care of yourself and others—for example, by curing or managing an infection and/or using condoms consistently. Get tested every six months and with every new sexual partner.

If you test negative for STIs: Remember that viruses (including HIV) can take several months to show up in your blood. For accurate results, repeat the test three months later. Herpes testing is most effective when symptoms are evident.

Here’s some of the evidence:
  • In a 2010 study involving teens, those who tested positive for an STI and knew their status reduced their number of sexual partners and became less likely to have unprotected sex (Journal of Adolescent Health).
  • In a study by researchers at the Johns Hopkins Bloomberg School of Public Health, men who learned their HIV status subsequently reduced their risky sexual behaviors.

3. Polish your condom skills

Polish your condom skills

How to put on a condom may seem like a no-brainer. It isn’t necessarily so. Condoms are an easy scapegoat for accidental pregnancy and STIs, but most condom failures actually result from user error.

Here’s the evidence:
  • When people feel comfortable with their ability to use condoms correctly, they’re more likely to use them, studies show.
  • A study involving college men found common errors—such as putting on the condom after starting sex, taking it off before ejaculating, and not leaving a reservoir tip at the end—resulting in condom breakage and slippage (Journal of Sexually Transmitted Diseases, 2010).

+ 10 condom mistakes you should never make (VeryWell)

+ A 12-step guide to proper condom use (VeryWell)

4. Know your own infection risk

Get accurate info about your own infection risk

General risk information can seem pretty abstract and remote. What does it mean for you? That’s why it’s helpful to get information about people of similar age, race, sex, and sexuality.

To find accurate, relevant stats, talk to your campus health services, women’s health facility, or LGBTQ center.

Click on the link (right) for info on STIs in women and infants, teens and young adults, men who have sex with men, and racial and ethnic minorities.

Fact check from the Centers for Disease Control and Prevention:
  • Teens and young adults are the most at-risk demographic for STIs.
  • Americans become infected with 20 million new STIs a year; half of these infections occur among people aged 15– to 24. By age 25, most US adults have been infected with at least one STI.
  • Rates of reported chlamydia and gonorrhea are highest in people aged 20–24.
  • Rates of reported syphilis are highest among people aged 20–29, especially men who have sex with men; syphilis rates are also climbing among young women.
+ STIs in specific communities (CDC)

5. Use the female condom

Use the female condom

If you’re a sexually active woman and/or have a female partner, try dedicating an evening or two to discovering female condoms.

Here’s why:
  • You (or she) may get a pleasure boost: The female condom has an external rubber ring that can stimulate the clitoris during sex.
  • Female condoms are a great option for minimizing STI risk and avoiding unintended pregnancy.
  • Trying new things is part of sexual experimentation and empowerment. Inserting the female condom can be fun. Alternatively, it can be put in place up to eight hours before use.
  • Female condoms can also be used for anal sex (after removing the ring).
  • Female condoms may work well for women who have less power in a relationship. These women are more likely to have difficulty negotiating male condom use, according to a 2002 study (AIDS Care).

6. Have fewer sexual partners

Have fewer sexual partners

Having more sexual partners increases your exposure to STIs, including HIV. In addition, having more sexual partners correlates with riskier behavior, studies suggest.

Having fewer sexual partners is associated with more consistent condom use, more discussion about sexual health, and less sex with people you don’t know well See Question 1.

How to lower your risk: If you have multiple sexual partners, or your partner has multiple partners, be especially vigilant about these safer sex practices:

  • Consistently using condoms and/or oral dams
  • Getting tested for STIs every six months and with every new sexual partner
  • Discussing sexual health; practice first with your friends

7. Meet new partners offline

Finding sexual partners in person, not online

When we find sexual partners online, we’re prone to guessing their STI status, research suggests. As the online dating scene grows, so does the prevalence of some STIs.

Online dating profiles cannot tell you whether or not a person is infected with an STI. However you meet your partners, always discuss safer sex, online or in person.

Here’s some of what the studies are saying:
  • In one year in Rhode Island, syphilis rates increased 79 percent, HIV 33 percent, and gonorrhea 30 percent (2013–2014); the state Department of Health attributed the rise in part to apps such as Tinder and Grindr.
  • A 16 percent increase in HIV cases over seven years in 33 states was attributed to Craigslist (MIS Quarterly, 2013).
  • Among transgender women, meeting sexual partners online was associated with riskier sexual practices, including unprotected sex, in a 2016 study (Archives of Sexual Behavior).
Question 3

Who is at the highest risk of being harmed by STIs?

1. Young adults and teens

Young adults and teens

How we calculate risk and outcomes depends on a person’s likelihood of becoming infected, what impact that infection could have on their health and life, and how it might affect others. Let’s unpack this briefly.

Fact check from the Centers for Disease Control and Prevention:
  • Teens and young adults are the most at-risk demographic for STIs.
  • Americans become infected with 20 million new STIs a year; half of these infections occur among people aged 15– to 24. By age 25, most US adults have been infected with at least one STI.
  • Rates of reported chlamydia and gonorrhea are highest in people aged 20–24 (CDC).
  • Rates of reported syphilis are highest among people aged 20–29, especially men who have sex with men; syphilis rates are also climbing among young women (CDC).
How to minimize your risk of becoming infected:
  • Use a condom or oral dam every time.
  • Get tested every six months or with every new sexual partner.
  • Get comfortable talking about sexual health and STI prevention; practice first with your friends.
How students are using condoms:

Three in five heterosexual, sexually active students reported using a male condom for birth control the last time they had vaginal intercourse, according to a national, anonymous, randomized survey (NCHA, fall 2015). That said, some students are not using a condom (or other safer sex method) every time they have sex—allowing STIs to circulate and spread in the student population.

Why are teens and young adults at greater risk of STIs?
  • Behavior (e.g., not using safer sex methods, having multiple sexual partners, and not getting tested): You can control behavioral risks.
  • Culture (e.g., discomfort talking about sex and STI prevention, pressure to have sex, the perception and use of alcohol as a sexual lubricant, and expectations associated with gender roles): Being aware of these influences can help you counter them.
  • Biology The physical development of young adults can make you more susceptible to STI infection. For example, in young women the surface of the cervix is more exposed to sexually transmitted organisms than in older women.

2. Women

Women

  • Women are more easily infected with STIs than men, owing to their anatomy and the mechanics of penetrative sex.
  • Routine testing (including Pap smears) is vital; early treatment and management can prevent serious health outcomes.
  • Women who have sex with other women can be infected with STIs.
The danger for women comes from several factors:
  • Certain long-lasting or permanent consequences of STIs. For example, chlamydia and gonorrhea can cause pelvic inflammatory disease, infertility, and ectopic pregnancy.
  • The absence of symptoms. In women, up to 90 percent of chlamydia infections and up to 80 percent of gonorrhea infections are asymptomatic, according to the CDC.
  • The prevalence of certain STIs. For example, human papillomavirus (HPV) is very common; it can cause cervical abnormalities that can lead to cancer. HPV can also cause oral, throat, penile, and anal cancers.
  • Special circumstances affecting some communities. For example, black women have HIV at twenty times the rate of white women, although they do not engage in higher-risk behaviors. The mass incarceration of black men is a major factor in HIV infection among black women as well as black men, according to The Lancet (2016). Many women become infected via heterosexual sex (e.g., with partners who become infected in prison, where STIs are spread through consensual sex; coercive sex; and sexual assault).

3. Children

Kids

  • Some STIs can be transmitted to fetuses and infants during pregnancy and delivery, potentially causing serious disabilities.
STIs can seriously harm fetuses and babies:
  • Several STIs can be transmitted from a mother to her fetus or newborn, causing a range of issues including preterm births, blindness, and brain damage.
  • This risk can often be lowered, for example, by cesarean section delivery or HIV management.

4. Koalas

Koalas

Koalas are highly sexually driven, but they’re not just making babies; they’re also sharing a strain of chlamydia that is rendering many female koalas infertile. Up to half of Australia’s wild koalas have chlamydia, and that’s bad news for this already vulnerable species. Australian scientists are working on a vaccine, which so far is looking promising. Yay, koalas.

5. Ladybugs

Ladybugs

Ladybugs have a vibrant hook-up culture, especially when food is plentiful. Unfortunately, their hectic lovemaking spreads an STI that causes infertility in females, according to UK scientists. This means there are fewer baby ladybugs to eat the plentiful food, which seems a waste.

Question 4

Across our lifespan, we encounter various dangers. Which risk of an unpleasant outcome may be reduced 90+ percent through a certain behavioral change?

1. Sudden infant death syndrome (SIDS): using a pacifier at night

Sudden infant death syndrome: using a pacifier at night

In a 2005 study, using a pacifier when a baby was sleeping reduced the chances of sudden infant death syndrome (SIDS) by 90 percent, according to the journal BMJ.

2. Accident: taking public transport instead of driving a car

Accident: taking public transport instead of driving a car

Traveling by public transport is 10 times safer than traveling by car, according to a 2016 study published by the American Public Transportation Association.

Bonus: Commuting by public transport makes us happier than commuting by car. In a UK study, people who switched from driving to taking the bus or train (or cycling or walking) reported that they subsequently focused better at work and felt less stressed (Office for National Statistics, 2014).

3. HIV infection: taking daily preventive medication

HIV infection: taking daily preventive medication

Each of these risk-reduction strategies can provide around 90 percent protection (or more) from the specified danger, various mind-blowing studies suggest.

  • If you don’t have HIV
    Pre-exposure prophylaxis (PrEP) is a course of daily medication for people at high risk of becoming infected with HIV, such as men who have sex with men. When taken as advised by health care providers, the medicine lowers the risk of becoming infected with HIV by up to 92 percent, according to the CDC. If PrEP is not taken consistently, it is much less effective. People taking PrEP should continue to use condoms.
  • If you have HIV
    Treatment as Prevention (TasP)
    is a course of medication for people who are already infected with HIV. The medicine reduces their “viral load”; the amount of HIV particles in their blood. When taken as advised by health care providers, TasP means you are up to 96 percent less likely to pass the HIV infection on to others, according to the New England Journal of Medicine, 2011. People taking TasP should continue to use condoms.
  • Bonus And since we’re talking about dramatically lowering risk, three other STIs can be prevented by vaccines: Hepatitis A, Hepatitis B, and harmful strains of human papillomavirus (HPV). If you haven’t been vaccinated yet, talk to your health care provider about the options.

4. Type 2 diabetes: being active, eating healthy, not smoking

Type 2 diabetes: managing weight, exercising, eating health, not smoking

About 90 percent of cases of type 2 diabetes are preventable via healthier behaviors, according to a 2001 study in the New England Journal of Medicine.

5. Dementia: eating a healthy diet in midlife

Dementia: eating a healthy diet in midlife

People who at age 50 were eating diets high in certain foods (such as vegetables, fruits, fish, and unsaturated fats), and low in others (such as sausages, sugary drinks, and saturated fats) were almost 90 percent less likely than their peers to show signs of dementia in older age, a 2014 study found.

Own your sex life: How to talk about condoms and STIs Quiz: What's your STI risk? (New York Times)

At SH101, we’re amazing at conjuring the sexytime mood (sort of). Here goes:

  • Many STI infections have no symptoms but can have serious long-term health consequences.
  • Most people with an STI don’t know they have it.
  • Only condoms (male and female) can help prevent both STIs and pregnancy.
  • Oral dams (latex sheets placed over the vulva or anus) can also help prevent infection.
  • If you are sexually active, consistent safer-sex practices are absolutely key to minimizing your risk of STIs.
  • Students are using condoms frequently—but some don’t use them consistently. Without consistent use, you are not protected.
  • Research suggests many people guess a potential partner’s STI status. This doesn’t work.

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Article sources

Joleen Nevers, MA Ed, CHES, AASECT Certified Secondary Education, sexuality educator, health education coordinator, University of Connecticut.

Tara Schuster, MS, MCHES, coordinator of health promotion, Rensselaer Polytechnic Institute, New York.

Pierre-Paul Tellier, MD, director of student health services, McGill University, Quebec.

American Public Transportation Association. (2016, September). The hidden traffic safety solution: Public transportation. Retrieved from
http://www.apta.com/resources/reportsandpublications/Documents/APTA-Hidden-Traffic-Safety-Solution-Public-Transportation.pdf

Avert. (2016). Treatment as prevention. Retrieved from https://www.avert.org/professionals/hiv-programming/prevention/treatment-as-prevention#footnote2_wthsiya

Bedsider. (2015, July 13). Can you get an STD from oral sex? Retrieved from https://bedsider.org/features/734-can-you-get-an-std-from-oral-sex

Benotsch, E. G., Zimmerman, R. S., Cathers, L., Heck, T., et al. (2016). Use of the internet to meet sexual partners, sexual risk behavior, and mental health in transgender adults. Archives of Sexual Behavior, 45(3), 597–605.

Centers for Disease Control and Prevention. (2016). Pre-Exposure Prophylaxis (PrEP). Retrieved from http://www.cdc.gov/hiv/risk/prep/

Centers for Disease Control and Prevention. (2015). Gonorrhea. Retrieved from http://www.cdc.gov/std/stats14/gonorrhea.htm

Centers for Disease Control and Prevention. (2015). STDs in women and infants. Retrieved from http://www.cdc.gov/std/stats14/womenandinf.htm

Chan, J., & Ghose, A. (2013). Internet’s dirty secret: Assessing the impact of online intermediaries on HIV transmission. MIS Quarterly, 38(4), 955–976.

Cichocki, M. (2016, February 19). A 12-step guide to proper condom use. VeryWell.com. Retrieved from https://www.verywell.com/proper-condom-use-48686

Cohen, M. S., Chen. Y. Q., McCauley, M., Gamble. T., et al. (2011). Prevention of HIV-1 infection with early antiretroviral therapy. New England Journal of Medicine, 365(5), 493–505.

Egendorf, Laura, ed. (2007). Sexually transmitted diseases. New York, NY: Thompson Gale.

Fleming, D. T., & Wasserheit, J. N. (1999). From epidemiological synergy to public health policy and practice: The contribution of other sexually transmitted diseases to sexual transmission of HIV infection. Sexually Transmitted Infections, 75, 3–17.

Grinstead, O. A., Faigeles, B., Comfort, M., Seal, D. et al. (2008). HIV, STD, and hepatitis risk to primary female partners of men being released from prison. Women and Health, 41(2), 63–80.

Hu, F. U., Manson, J. E., & Stampfer, M. J. (2005). Use of a dummy (pacifier) during sleep and risk of sudden infant death syndrome (SIDS): Population based case-control study. BMJ, 332. http://dx.doi.org/10.1136/bmj.38671.640475.55

Indiana University. (2010). National Center for Sexual Health. [Website]. Retrieved from http://www.nationalsexstudy.indiana.edu/

Joffe, G. P., Foxman, B., Schmidt, A. J., Farris, K. B., et al. (1992). Multiple partners and partner choice as risk factors for sexually transmitted disease among female college students. Sexually Transmitted Diseases, 19(5), 272–279.

Johns Hopkins Bloomberg School of Public Health. (2013, March 13). Study identifies ways to increase HIV testing, reduce HIV infection and detect previously undiagnosed HIV infections. [Press release].
Retrieved from http://www.jhsph.edu/news/news-releases/2013/Celentano-HIV-Testing.html

National Institutes of Health. (2013). How do sexually transmitted diseases and sexually transmitted infections (STDs/STIs) affect pregnancy? Retrieved from
https://www.nichd.nih.gov/health/topics/stds/conditioninfo/Pages/infant.aspx

Nusbaum, M. R. H., Wallace, R. R., Slatt, L. M., & Kondrad, E. C. (2004). Sexually transmitted infections and increased risk of co-infection with human immunodeficiency virus. Journal of the American Osteopathic Association, 104(12), 527–535.

Office for National Statistics. (2014, February 12). Commuting and personal well-being, 2014. Retrieved from
http://webarchive.nationalarchives.gov.uk/20160105160709/http://www.ons.gov.uk/ons/dcp171766_351954.pdf

Pulerwitz, J., Amaro, H., DeJong, W., Gortmaker, S. L., et al. (2002). Relationship power, condom use, and HIV risk among women in the USA. AIDS Care, 14(6), 789–800.

Robertson, J. E. (2003). Rape among incarcerated men: Sex, coercion and STDs. AIDS Patient Care STDs, 17(8), 423–430.

Rosengard, C., Anderson, B., & Stein, M. D. (2004). Intravenous drug users’ HIV-risk behaviors with primary/other partners. American Journal of Drug and Alcohol Abuse, 30(2), 225–236.

Ryder, J. J., Pastok, D., Hoare, M. J., Bottery, M., et al. (2012). Spatial variation in food supply, mating behavior, and sexually transmitted disease epidemics. Behavioral Ecology, 2012. doi10.1093/beheco/ars209.

Sexton, J., Garnett, G., & Rottingen, J.-A. (2005). Metaanalysis and metaregression in interpreting study variability in the impact of sexually transmitted diseases on susceptibility to HIV infection. Sexually Transmitted Diseases, 32(6), 351–357.

Shrage, L. (2016). African Americans, HIV, and mass incarceration. The Lancet, 388(10049), e2–e3.

Sifris, D., & Myhre, J. (2016, September 9). 10 condom mistakes you should never make. VeryWell.com. Retrieved from https://www.verywell.com/condom-mistakes-to-never-make-49174

Sifris, D., & Myhre, J. (2016, September 22). The real reasons why people don’t use condoms. VeryWell.com. Retrieved from
https://www.verywell.com/the-real-reasons-why-people-dont-use-condoms-49669

Stacey, D. (2015, October 1). What are polyurethane condoms? VeryWell.org. Retrieved from https://www.verywell.com/polyurethane-condoms-906781

Sznitman, S. R., Carey, M. P., Vanable, P. A., DiClemente, R. J., et al. (2010). The impact of community-based STI screening results on sexual risk behaviors of African-American adolescents. Journal of Adolescent Health, 47(1), 12–19.

Tyndall, M. W., Patrick, D., Spittal, P., Li, K., et al. (2002). Risky sexual behaviours among injection drugs users with high HIV prevalence: Implications for STD control. Sexually Transmitted Infections, 78, i170–i175.

University of the Sunshine Coast. (2014, October 29). Koalas face brighter future thanks to vaccine field trial success. Retrieved from http://mysunshinecoast.com.au/news/news-display/koalas-face-brighter-future-thanks-to-vaccine-field-trial-success,36252

Wasserheit, J. N. (1992). Epidemiologic synergy: Interrelationships between human immunodeficiency virus infection and other sexually transmitted diseases. Sexually Transmitted Diseases, 19(2), 61–77.

Ybarra, M. L., & Mitchell, K. J. (2016). A national study of lesbian, gay, bisexual (LGB), and non-LGB youth sexual behavior online and in-person. Archives of Sexual Behavior, 45(6), 1357–1372.

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Lucy Berrington is a health writer, editor, and communications manager. Her work has been published in numerous publications in the US and UK. She has an MS in health communication from Tufts University School of Medicine, Massachusetts, and a BA from the University of Oxford, UK.