What are some alternatives to the condoms that are in the dispensers on campus for different kinds of sexual activity?

AG: Thanks for the great question! A lot of people think that external (or sometimes known as the “male” condom) is one of the only options if they’re using a barrier method to prevent pregnancy and/or STIs, but this is totally not true! There are lots of safer sex supplies out there for all different kinds of sex for people to try.

AA: As AG mentioned there are many different options for safer sex supplies. To begin there are many different types of external condoms including latex-free, glow-in-the-dark, ribbed, flavored (check ingredient list to make sure they do not contain sugars which would not be suited for vaginal or anal intercourse), larger size, and ultra thin to name a few.

AG: If you and your partner(s) are using external condoms, it can be a good (and fun!) idea to try some of these different kinds to figure out what feels the best for you! Also, it’s important to remember that external condoms aren’t just used on a penis; they can be put onto sex toys both to protect against STIs and to help keep them clean.

AA: The other barrier method used to protect against pregnancy and/or STIs during penetrative sex are internal condoms (or what is sometimes known as the “female” condom).  The benefits of using an internal condom over an external condom is that it can be inserted into the vagina or anus up to six hours before initiating sex. It also covers a larger surface area around the vagina or anus to protect against STIs that are transmitted through skin-to-skin contact such as HPV. Make sure that if you are using an internal condom for anal sex that you make sure to remove the plastic ring that is found inside the internal condom. This ring is used to hold the condom in place when it is inserted into a vagina, but doesn’t serve the same function in the anus.

AG: Even if you’re not having penetrative vaginal or anal sex, and pregnancy isn’t a possible outcome, there are still other barrier methods that reduce the transmission of STIs! For example, dental dams can be used for oral sex on a vulva or anus, and finger cots or gloves can be used if you or your partner(s) have any warts or cuts on your hands. And again, if you’re having oral sex with a penis, you can use any type of external condom, including flavored, to reduce the spread of STIs! With all of these options, like we wrote about a few weeks ago, don’t forget to use lube!

AA: There are many places on campus where you can access many of these different types of safer sex supplies for free. Check out our interactive map below for the locations on campus. If you have any questions don’t hesitate to email us at harvard.sexual.literacy@gmail.com.

AG: Hope you find an alternative that works for you!

AG

Student

Amanda Ayers

Health Educator

What are some alternatives to the condoms that are in the dispensers on campus for different kinds of sexual activity?

AG: Thanks for the great question! A lot of people think that external (or sometimes known as the “male” condom) is one of the only options if they’re using a barrier method to prevent pregnancy and/or STIs, but this is totally not true! There are lots of safer sex supplies out there for all different kinds of sex for people to try.

AA: As AG mentioned there are many different options for safer sex supplies. To begin there are many different types of external condoms including latex-free, glow-in-the-dark, ribbed, flavored (check ingredient list to make sure they do not contain sugars which would not be suited for vaginal or anal intercourse), larger size, and ultra thin to name a few.

AG: If you and your partner(s) are using external condoms, it can be a good (and fun!) idea to try some of these different kinds to figure out what feels the best for you! Also, it’s important to remember that external condoms aren’t just used on a penis; they can be put onto sex toys both to protect against STIs and to help keep them clean.

AA: The other barrier method used to protect against pregnancy and/or STIs during penetrative sex are internal condoms (or what is sometimes known as the “female” condom).  The benefits of using an internal condom over an external condom is that it can be inserted into the vagina or anus up to six hours before initiating sex. It also covers a larger surface area around the vagina or anus to protect against STIs that are transmitted through skin-to-skin contact such as HPV. Make sure that if you are using an internal condom for anal sex that you make sure to remove the plastic ring that is found inside the internal condom. This ring is used to hold the condom in place when it is inserted into a vagina, but doesn’t serve the same function in the anus.

AG: Even if you’re not having penetrative vaginal or anal sex, and pregnancy isn’t a possible outcome, there are still other barrier methods that reduce the transmission of STIs! For example, dental dams can be used for oral sex on a vulva or anus, and finger cots or gloves can be used if you or your partner(s) have any warts or cuts on your hands. And again, if you’re having oral sex with a penis, you can use any type of external condom, including flavored, to reduce the spread of STIs! With all of these options, like we wrote about a few weeks ago, don’t forget to use lube!

AA: There are many places on campus where you can access many of these different types of safer sex supplies for free. Check out our interactive map below for the locations on campus. If you have any questions don’t hesitate to email us at harvard.sexual.literacy@gmail.com.

AG: Hope you find an alternative that works for you!

AG

Student

Amanda Ayers

Health Educator

What can I do on a daily basis, in my classes, etc, to make a safer environment?

RC: Wow, this is such a great question!  AG and Meera spoke to a piece of this conversation three weeks ago in a post about reducing sexual assault here at Harvard, but I always love the opportunity to think about the variety of ways we can all contribute to creating a community that is more accessible for all people.  When thinking about this, it helps me to use the Social Ecological Model (SEM), which basically posits that individuals and their well-being are impacted by the various spheres or levels through which they move (relationships, communities, and society) and they, likewise, impact the well-being of those around them.

On an individual level, we can all strive to be intentional about the language we use and the way we interact with others around us.  It can be really hard to know when and if we have hurt someone, especially in a place like Harvard, where people have so many different identities and ways of expressing themselves and their feelings.  Because of this, I find it’s really helpful to consistently practice checking in with those around me; we know that neural pathways become strengthened the more we use them.

AG: Basically the more you try to check in with the people you’re interacting with the easier it becomes to do so without it feeling totally forced or awkward. Checking in, and checking in regularly, can give you such a better sense of how your actions and words  impact those around you regardless of what your intentions might have been.

RC: For example, one of my friends grew up in a place with a lot of traffic and gave up on being punctual long ago.  For them, being respectful means it’s ok to be a little late, as long as they get there.  I, on the other hand, grew up in the Midwest, where being on time meant you got somewhere 10 minutes early.  For me, being respectful means being super punctual.  We would constantly be in conflict if we didn’t check in with each other about when it matters to be on time and when I can practice being a little more flexible.

AG: In this example, it gives both people an opportunity to check in and see how the other feels about either meeting right at a set time or having that be a little less rigid. This might seem like a super trivial example, but little things can build up and impact relationships if they don’t get a chance to be addressed. Sometimes these smaller things can be easier to check in about, and then when something bigger might come up, you can be more comfortable and skilled at having those conversations.

RC:  Another key piece of this is taking ownership when you realize that something you did hurt someone else, whether you meant to or not.  

AG: I like to think about this as kind of a series of steps. First, it’s important to validate their feelings, even if at first you don’t know why your actions would have had the effect that they did. Then, just like Ramsey said, you can try to understand their experience and then take ownership of your actions. Once you have a better sense of how something was interpreted, you can start working to make amends and then to incorporate their feedback moving forward.

RC: When I think about moving outward across levels of the SEM,  I find that reducing harm often involves creating systems of accountability and intentional group norms: how can people call each other out; how supportive are the leaders in groups when that happens; what are group understandings (explicit and implicit) about what is and isn’t acceptable.

AG: We know that all of this can be really hard. But honestly, by starting with the little things we talked about earlier like checking in and taking ownership, it already becomes easier to have these conversations and understandings with each other. With this though, it’s also really important for group leaders to have meetings at the beginnings of the semesters and talk about all of this frankly. Often a clear discussion like that is great at setting norms and helping people feel empowered to carry them out.  

RC: This process can sound daunting; like AG said, starting with check ins about the small things can be a good way to develop the skills and confidence so that when the harder conversations or conflicts arise, we each are more equipped to receive feedback, validate other people’s experience, take ownership for our part, and learn.  All of this goes a surprisingly long way toward reducing harm.

AG: If you have more questions about this please feel free reach out to us or OSAPR. Good luck!

AG

Student

RC

Ramsey Champagne

Community Advocate, OSAPR

Should I be using lube? If so, when and how?

AG:  Thanks for the questions!  Everyone, no matter what kind of sex you’re having, should be using lube! You’ll never know what you’re missing until you at least try it once. Many people, even if they don’t have a hard time getting wet, still love using lube.

AA: The packaged lubrication on condoms isn’t meant to be used as lubrication for penetration. It is meant to lower the risk of the condoms breaking inside of the package due to friction. Using additional lubrication will increase sensitivity and pleasure while using internal or external condoms, dental dams and gloves.

AG:  A few straightforward things:  First you should know that there’s a few different kinds of lube. Oil based lube shouldn’t be used with condoms because it can disintegrate the latex. Water and silicone lubes are both good for condoms although water-based lube is easier to clean off (silicone lube is generally the best if you’re having sex in the shower or something like that). There’s also both liquid and gel forms of lube available - honestly it’s the best to just try around a bit first and find one that works best for you!

AA: Also, make sure to keep in mind whether or not the type of lubricant ingredients are safe for the type of sex that you are enjoying. If you are having sex with someone who has a vagina be cautious of ingredients including glycerin, parabens, fragrances, benzocaine, and antibacterials as these may cause irritation and increase the risk for yeast infections. As AG mentioned earlier it’s important to know which type of lubricant to use with the type of sex you’re having. If you are using a sex toy that is made out of silicone make sure you are using only water-based lubricant as both silicone and oil-based lubricants can compromise your sex toys.

AG:  When you’re actually using the lube (either on yourself or a partner) remember to warm it up a bit in your hands first. Next, basically just add a little bit of lube at a time. If you’re having sex with a condom, a drop or two can be put on the inside for increased sensation and then again, a few drops on the outside. Otherwise, just adding lube around the genitals can help make things feel better and also to decrease friction! You can keep reapplying lube throughout the rest of the sexual activity.

AA:  There are many places on campus to get free lube and safer sex supplies.

AG: Have fun!

AG

Student  

Amanda Ayers MPH

Health Educator

 

How does a sexually active person prevent UTIs?

AG: Great question! Urinary tract infections are basically when any part of the bladder, kidneys, or urethra gets infected and they are an incredibly common - and painful! - infection. Sexually active people are also at a higher risk for UTIs than those who aren’t having sex.

AA:  Thanks for asking this very common question! Female bodied individuals are more likely than male bodied individuals to contract a UTI. Anatomy has a lot to do with this. Female bodied individuals have a shorter urethra making it easier for bacteria to enter the bladder. This doesn’t mean that men can’t get UTIs. Though, when they do they are generally more serious and should be seen by a doctor right away.

AG: UTIs definitely aren’t fun but the good news is that they’re treatable and that there are things everyone can do to lower their risk! A pervasive myth is that cranberry juice helps treat UTIs. This is not true! If you do have one, see your PCP and you can get prescribed antibiotics. A hot compress can also help to relieve the pain.

AA: You can also go to the pharmacy to pick up some over the counter medication like Pyridium or Phenazopyridine which can help relieve some of the symptoms of UTIs which include persistent urge to urinate, burning during urination, and pelvic pain just to name a few.

AG:

For everyone, whether or not you’re sexually active:

Make sure you’re drinking enough water and not holding in your pee - this can make it easier for bacteria growth. Also, try to wear cotton underwear and loose fitting pants because tight jeans can trap moisture. Lastly, limit bladder irritants like coffee or alcohol.

If you’re having vaginal sex:

The first thing is to remember to always, always pee after having vaginal sex.

AA: Additionally, using unlubricated condoms or spermicides can increase the risk of UTIs. If you are using one of these methods and find yourself having recurring UTIs I would recommend having a conversation with your PCP about your barrier and birth control methods.

AG: Just a reminder that the anus and the vagina are different environments and you should never move penetrative objects (sex toys, penis, fingers) from the anus to the vagina without cleaning them off or changing condoms! Lastly, don’t worry - oral sex alone doesn’t increase the risk of UTIs!

AA: Check out the mayo clinic and the NIH websites for more info on UTIs!

Good luck,

AG

Student

Amanda Ayers

Health Educator

What can I do on a daily basis to reduce sexual assault at Harvard?

AG: Thanks for writing to Sexual Literacy! This is a really important question. Change will happen when people--students, faculty, administrators--come together and actively work to make our campus safer and more supportive to survivors. This is hard and takes effort but it is possible. The first thing we can do is just to be aware of the reality of sexual assault on college campuses. The most recent sexual climate survey showed that 25.5% of both Harvard women and TGQN (trans, genderqueer, and gender nonconforming) individuals as well 6.5% of Harvard men have experienced some kind of nonconsensual sexual activity during their time here. Of the female undergraduates who reported experiencing non-consensual penetration by force or incapacitation, 87% reported the incident took place in a House or Dormitory. This is not some urban myth--it is happening and it is happening way too frequently.

MS: AG, thank you for speaking to the importance of creating trauma-informed environments, and the role each of us play in acknowledging our attitudes and actions as well as their impact on community norms. Trauma-informed responses, environments, and policies consider the historical and cultural context of how trauma is experienced, and is often created and provided in partnership with the person or groups seeking care. It is a holistic approach that can be implemented by administrators, students, staff, faculty, friends and family, as long as there is a commitment to collaboration, transparency, empathy, and compassion.  A piece of being trauma informed is recognizing that all members of communities are impacted by interpersonal violence, whether firsthand or vicariously, and may have different experiences or responses.  

AG: I do think it’s important to understand that to completely eliminate the risk of sexual assault we would all basically have to lock ourselves in our rooms. It’s not realistic. But you’re right - there are tangible things that we can do to confront it and to make our campus safer.

MS: A crucial first step is to recognize that we all are capable of experiencing harm and of causing harm.  Without that understanding, it is really hard to communicate openly and to practice accountability when we do harm someone, even if unintentionally.

AG: Talk about it. Engage with your friends and peers. Having these hard conversations with each other about the structures and mentalities that allow sexual assault to exist is a hugely important starting place. Remind each other about the importance of communication during hook-ups and then continue to hold yourselves accountable.  

MS: Yes! In order to safely and respectfully explore ourselves and others, understanding our own beliefs and biases surrounding sexuality, consent, and gender is important. The more information and context we have about someone we are interested in - whether for a casual hook-up or a longer term sexual and/or emotional relationship - the better we are able to set expectations, navigate conflict, and have more fun! Consider a staff or peer-facilitated workshop that deconstructs the culture that we live, work, and play in here at Harvard - what are the cues we are giving out and receiving, and how do we know someone is down for…whatever?

AG: But then don’t let the conversations end there. Take this awareness to parties, to other dorm rooms and final clubs, and be a vocal and active bystander. If you see something that doesn’t seem right, please say something. Check in and look out for your friends (and if something does happen, please listen and believe and support them).

MS: Being an active bystander can be difficult if we don’t feel supported and validated by our communities when we take action - we know from the AAU Sexual Climate Survey that while more than 34.3% of Harvard women and 24.8% of Harvard men reported having witnessed someone acting in a sexually violent or harassing manner, 52.5% of those women and 51.5% of men reported not taking any action. Active bystander behavior is difficult if you don’t know what to look for, and don’t have established community norms around standards of behavior and accountability to validate checking in - whether it’s harmful beliefs, language, or actions.

AG: Acknowledge when or if you are in places or positions that allow you to exercise power over another person and think about the ways that this can affect the dynamic or their sense of comfort. Ask for consent without demanding a certain response and then accept the answer that’s given to you.

MS: Yes! Also, participating in conversations that examine where you have social influence and access, where you are modeling behavior for other students as a leader, and where you have capital to create policies and procedures that facilitate more equitable, comfortable environments is critical to changing campus culture.

Keep talking,

AG

Student

MS

Meera Seshadri, MSPH

Associate Director, OSAPR

Does getting an IUD hurt?

EXPERT ANSWER:

Thank you so much for asking about IUDs (Intrauterine devices). IUDs are one of the most effective forms of birth control on the market. There are now four different kinds of IUDs that you can choose from, each meant to fit different needs. These IUDs are Paragard (non-hormonal), Mirena, Skyla, and Liletta

IUDs themselves don’t hurt while they are in place. This is a misconception. The only time a IUD user may feel any sort of pain would be during the insertion process which usually only takes a couple of minutes to complete. Most people obtaining an IUD say they feel minimal to moderate pain. There are many things that you can do to reduce any pain that you might feel. It is recommended to take 2 ibuprofen (Advil) before the procedure. Some doctors also tell their patients to schedule the appointment for during their period. The pain from insertion comes from opening the cervix for placement. While a person has their period, their cervix is already slightly opened which can aid in reducing any possible pain.

The pain (if any) usually does not last long. It can sometimes be followed by cramping which will go away within a few hours to days. I know that any sort of pain can feel very intimidating but think about the ease afterwards. Mirena can last up to 5 years and ParaGard can last up to 12 years. Having a long-lasting form of birth control can save you time, money, and mental space.

I hope that you will consider an IUD as your form of birth control.

If you ever have other questions about IUDs or other contraceptive options don’t hesitate to contact me at 617-496-2053.

Amanda Ayers, MPH

Health Educator


STUDENT ANSWER:

Thanks for the question! IUDs are awesome. They last anywhere from 3-12 years, can reduce or even eliminate periods, and are over 99% effective at preventing pregnancy. Once they’re in, you can basically forget about it other than a quick monthly self-check to make sure it’s still in place.

BUT, it’s the classic question, how much do they hurt? IUDs are inserted (by a healthcare provider) into the uterus which means they must pass through the cervix. Though the insertion is incredibly quick (only a few minutes) it can be painful for female bodied individuals who have never had children. While it’s usually done without anesthetic, like Amanda said, having the appointment while you’re on your period and taking a few Advil can make the procedure more comfortable.

Fear of pain is one of the biggest deterrents for people in choosing to get an IUD but the truth is that it’s just a few moments of discomfort (and shouldn’t hurt more than some period cramps). I’d suggest trying to convince yourself that it won’t hurt too much and trying to focus on other things during the insertion. Maybe bring a friend to the appointment and have them distract you and squeeze your hand.

After the insertion itself, you may feel cramps, mild discomfort and experience some spotting for the next few days. This should go away pretty quickly although your periods can take a few months to get back on a normal cycle.

It is important to remember that the IUD does not prevent against any STIs and that condoms should still be used if you start sleeping with someone new. However, IUDs are the highest rated form of contraception and - especially if you don’t want to deal with taking a daily pill - can be a great, great option!

AG

Student

What should one do if they know they don't want their relationship to last "forever" but don't want it to end in the moment?

EXPERT ANSWER:

Dearest Not Forever,

While not ALL good things must end, many do.  And that doesn’t make them less good!  There are endless reasons we might not see a future with someone we are dating.  Maybe we feel like we’re too young to be settled down, or we don’t know where we’re going in life and how a significant other will fit in, or maybe we’re seeing someone whose values don’t align with our own in terms of long term relationship (LTR) goals such as whether you want children, to get married marriage, or  belief system but aren’t in conflict with the immediate reality.  Whatever the reason, that doesn’t preclude you from dating someone at all.  If we didn’t date people who were wrong for us, we mostly wouldn’t date at all!  

There are a few things I’d recommend keeping in mind:

First, figure out what you DO want, both in terms of a LTR and in terms of this current relationship.  What are limits or boundaries you can identifying for when a relationship has run its course or is no longer working for you?  Knowing these things in advance will help give you some clarity about how to approach your current situation with confidence and kindness.

Second, communicate honestly with your current dating partner about your needs and expectations.  It may be that your partner is likewise not looking for anything serious and this aligns perfectly with their needs and expectations.  It may be that they feel really disappointed because they were hoping for something more long-term or even something with the possibility of a future.  If they aren’t totally on board with your thinking, it is important you respect their needs and wants as well as your own.  Dating ‘for now’ has to be a good option for you both.

And what if the other person wants something long term, but would rather keep dating than break up, in spite of your differing goals?  Well, that’s not an easy answer.  It’s possible to make an argument that we are all adults and capable of making our own decisions - even when they aren’t in our best interest - and we should respect that at face value.  It’s also possible to argue that we can hold ourselves to only pursue relationships that we understand as mutually beneficial, meaning if I want short-term and they want long-term, I can understand the ‘for now’ as only benefiting me and determine that that’s not the sort of relationship I want to be in.  There isn’t a single right answer.  Pursue this question with kindness, empathy, and respect, and make a decision that feels right for you.

Happy Dating!

Alicia

Director of OSAPR


STUDENT ANSWER:

Hi hi,

Thanks for writing! Honestly, this is a really mature and self-aware question. It’s impressive that you realize the distinction between right now and “forever” and are acknowledging that your relationship might only fit in that first category.

I want to start by stressing that this is completely okay. Something can be right for right now without being right forever, and it definitely doesn’t make you a bad or dishonest person for knowing that.

This can get a little complicated if the other person isn’t on the same page as you. Maybe they think this relationship is “the one”, but maybe they also totally just think it’s great for the time being. It’s impossible to know until you talk about it!   

Of course, this is pretty situational and depends on the type of relationship you have, how long you’ve been together, and the type of people you are. You might feel the need to have a long-term conversation with someone you’ve been dating for a month or maybe it feels more appropriate once you’ve been together for six months. The timing is a personal choice but the point is that after awhile it will be a productive and probably pretty necessary discussion to have. It might be hard to explain that you see the relationship as having an expiration date, but honesty is important and it can help the other person from being blindsided or hurt (and help alleviate stress you might have about the situation!).

At some point, if you don’t want the relationship to last forever, then one of you will have to end it. But for now, just enjoy the relationship that you have. What’s important now is whether you are making each other happy and enjoy spending time together. And once that’s no longer true, or if your lives and priorities change so that it doesn’t feel right to stay together anymore then you can reevaluate. The question of whether you two will stay together for the rest of your lives shouldn’t need to dictate what happens today.

Good luck!

AG

Student

How and where do I get tested for STIs at Harvard?

EXPERT ANSWER:

Dear Anonymous,

Thanks for asking about locations for STI testing. There are a couple of options so I’ll categorize them.

At Harvard:

  • STI testing is covered for all Harvard students under the Student Health Fee

  • Call 617-495-5711 to make an appointment OR go to huhs.harvard.edu and log into your patient portal. Make sure to click STI testing as the reason for your appointment

Outside of Harvard (fee-for-service):

  • Planned Parenthood

    • Located at 1055 Commonwealth Avenue Boston, MA 02215

Outside of Harvard (free services):

  • MGH

    • Located at MGH Cox Building, 5th Floor, 55 Fruit Street Boston, MA 02114

  • Project Trust

    • Located at 721 Massachusetts Avenue, Boston, MA, 02118

  • Fenway Community Health Center

    • Located at 1340 Boylston Street Boston, MA 02215

If you ever have any more questions regarding getting tested please stop by our office on the 6th floor of HUHS.

Best,

Amanda Ayers, MPH

Health Educator

Health Promotion & Educatio


STUDENT ANSWER:

First off, props for trying to figure this out! Honestly the hardest part of getting tested is just taking the initiative to go do it. If you’re choosing to have sex, it’s good practice to get tested about once (or more!) a year. Thankfully, at Harvard this doesn’t have to be a huge hassle. If you just google UHS patient portal and log in you can make an appointment with University Health Services online. Under the “Primary Care” tab, select “Sexually Transmitted Infection Testing” and pick a time that works for you.

The test itself may include a genital exam, a saliva swab, and a urine or blood sample. It can definitely be awkward, but try to be as honest as possible with your provider about your sexual habits so they know what to test for. Like Amanda said, STI testing is completely free at UHS through the student health fee, and you’ll usually get your results within a week (check your secure messages on the patient portal!).

UHS doesn’t inform parents about the tests and they won’t show up on your insurance although your parents might get a notice that you had “lab work” done (this is because the testing itself is done through Quest diagnostics and though Harvard asks Quest to bill the college rather than your insurance company, occasionally mistakes do happen).

Stigma against getting help for an STI, worry about seeing someone you know at UHS, and concern about providers not being queer or trans friendly are all incredibly valid barriers to getting tested. Testing looks and feels different for everyone and if you don’t feel comfortable getting tested here at Harvard, as Amanda mentioned, there are definitely other options!

Good luck!

AG

Student