Does it hurt to get an IUD? —Concerned

AA: We are so glad you asked, Concerned. For today’s post I’ll be writing as the content expert regarding intrauterine devices (IUDs). TL;DR: While level of pain varies from person to person, yes. There are a number of factors that inform the physical experience of getting an IUD.

SM: I’ll be the context expert for today. Some factors that can play a role include where you are in your cycle, whether or not you’ve ever given vaginal birth, your personal anatomy (i.e. the shape of your uterus, thickness of your cervix), and pain tolerance.

AA: Some of these factors you may not be able to control but there are some things that you can do to manage the pain. Pain that is experienced during IUD insertion comes from a speculum specially designed for dilating your cervix. If you have flexibility with when you are able to schedule your IUD appointment, try to aim for near the tail end of your period. During this time, your cervix is more open than at other times of your cycle.

SM: Another way to manage pain during an IUD insertion is to take ibuprofen or another NSAID approximately 20-30 minutes before your appointment. This can help reduce the pain from cramping during and after the insertion. If you do choose to take ibuprofen, be sure to not do so on an empty stomach.

AA: Studies have shown that expectations of pain can influence experience of pain. Talking with your clinician about your concerns and what to expect may have a positive impact on your experience. Here are some talking points to possibly bring up with your clinician:

  • Do you prefer to have a step by step explanation of what is happening in the moment or would you prefer less verbal information?

  • Do you have any diagnoses that may have an impact?

  • Have you experienced interpersonal harm, which may inform how much or little information is helpful, the pace at which the procedure goes, and other coping strategies?

SM: There are other things that people have found really helpful during the procedure itself, including bringing a book, listening to a relaxing playlist, bringing a friend or loved one into the appointment, practicing breathing exercises, or zoning out on your phone. After the procedure, some people find snacks, tea, a hot water bottle, or just taking time to relax can help.

AA: If you have any questions, concerns, or pain after your procedure don’t hesitate to reach out to your provider. Thanks again for your question!


Do I need to wear a condom during a blowjob?

AA: This is a great question—we’re so glad you asked! The short answer is yes, although we recognize that this is a very multilayered topic. We know from the 2018 HUHS health assessment that only about 2.7% of sexually active Harvard undergraduates self-report “mostly” or “always” using a barrier method (e.g. condom or oral dam) during oral sex (including oral sex on a penis, vagina, or anus).

SM: Despite low rates of using a barrier method during oral sex, we also know from the HUHS health assessment that over half of Harvard undergraduates believe that their peers are using a barrier method during oral sex. This is largely in conflict with broader societal norms, and can make negotiating barrier method use during oral sex difficult.

AA: Since it can be hard to have these types of conversations, here are some strategies that we’ve heard can be successful for some folks:

  • Having the conversation about protection before the sexual act—in the heat of the moment, it may be more difficult to initiate the conversation.

  • It’s always ok to ask your partner(s) why they’re not willing to use a barrier method, or what specific concerns they may have.

  • Making sure to have the supplies on hand, so that you don’t agree to use a condom and then suddenly find yourself without one.

  • Exploring different ways to use the supplies to maximize pleasure for all parties—making it a fun and pleasurable exploration.

SM: We hope that these strategies can be useful tools, but also know that context and interpersonal dynamics might make any of these strategies hard or unavailable. If you’re concerned about having these types of conversations with your partner, you can always reach out to OSAPR.

AA: Using a barrier method is always a personal choice. That being said, we do want to make sure that people have the information to make informed choices for themselves. It’s possible to transmit STIs (sexually transmitted infections) through all types of oral sex (blowjobs, and oral sex on a vagina or anus). Here is a handy table summarizing the STIs that can be transmitted through oral sex acts.

Oral-Sex-Table-v3.png

(Table from British Columbia Centre for Disease Control: https://smartsexresource.com/about-stis/know-your-chances-0)

SM: As you can see, using a barrier method greatly reduces your chances of transmitting an STI. However, we recognize that the context of each relationship will impact how often and in which situations a barrier method is used. Also, be sure to check out our recent roundup of free places to get barrier methods on campus. Thanks again for your question!

I’m interested in purchasing my first sex toy(s), but there are so many options! Where and how should I get started?

LM: Great question! When you first start looking at sex toys, the variety can be overwhelming. There are sex toys out there for pretty much every conceivable purpose, so one starting point might be thinking about what you (and/or your partner(s)) are looking for in your sex toys. Do you want a penetrative toy? A vibrating toy? Something that is made for two people to use at once? (Also, remember that how a sex toy is advertised isn’t necessarily the only way you can use it—feel free to be creative!)

AA: It’s great to begin thinking about these different questions before you decide to buy one (or more) particular toys. If you decide that you’d like to use a toy with a partner(s) it can be good to involve them early on in the conversation regarding which is the best toy for you to purchase. This will depend on how it might be used, what are both of your wants, needs, and non-negotiables and where those overlap for you both or where they do not overlap. Finding the answers will help determine which is the best to for you (and/or your partner(s)).

LM: Once you have an idea of what general type of toy(s) you’re interested in purchasing, the next step is to narrow it down to a specific product. A couple of factors may come into play at this point: price, quality, material, aesthetic, and color are just a few things you may want to consider. You can get high-quality sex toys at a range of price points, but it’s important to remember that with sex toys, in some cases low price may mean low quality, which can sometimes be unsafe. For instance, some toys on the lower end of the price range may be made of porous materials, which can harbor bacteria even after washing. However, if you’re not ready to spring for a slightly higher-end sex toy, it is possible to use condoms on your sex toys.

AA: Sex toys can come in many materials including silicone, plastic, metal, glass, rubber, and others. It’s important to think about these materials when deciding which to buy. In addition, a great option to add to a sex toy is lube! It can enhance the experience and pleasure for you and/or your partner(s). The type of lube you’ll want to use depends on the material of your sex toy: If you decide to purchase a silicone sex toy it is not recommended to use silicone lubricant as this type of lubricant can break down degrade your silicone sex toy. If you are using condoms on any sex toy it is important to make sure not to use oil-based lube as this type of lubricant will degrade the latex condom.

LM: This can be a lot to keep in your mind as you’re making your purchase. It can sometimes be helpful to go to an actual store when shopping for sex toys, where the employees will be able to help you balance all of these factors when you’re choosing your sex toys. We highly recommend Good Vibrations, a store with locations in Harvard Square and Brookline; the employees are friendly and highly knowledgeable (they’ve gone through a comprehensive training). If you’d rather not go to a physical store, you can also order from Good Vibrations online. Another great thing about Good Vibrations is that they explicitly do not gender their products and are inclusive of all identities. There are also many other places to order sex toys on the internet, including Amazon; whatever you choose, make sure to read the reviews and do your research about materials and safety.

AA: Once you’ve purchased your sex toy, have fun trying it out and getting familiar with it. If you are choosing to use the toy with a partner(s) make sure to talk with them about use before you jump into the experience. It’s always important to continually check in with your partner(s) while using your sex toy even if it’s not both of your first times using this toy. Communication is key to ensure you and your partner(s) are both continually enjoying your fun-sexy-play-time. Again as we have mentioned there are many choices to make when purchasing a sex toy. If the first toy you purchase is not working out for you it may take time and trial and error to find the right toy for you and/or your partner(s).


How do I get STI tested in UHS?  Can I keep my parents from finding out?  How much does it cost?

LM: We are so glad you asked! It’s important to make sure that all Harvard students know that they can receive free STI (Sexually Transmitted Infection) testing at HUHS. There are a few ways to make this happen. If you are currently experiencing symptoms that you think are related to an STI, please call or go to Urgent Care. If this is a preventive visit, you can either call 617-495-5711 or follow the steps below to make an appointment (it is somewhat click-intensive):

  • Log into the HUHS Patient Portal with your HarvardKey.

  • Choose the “Profile” tab on the left, and check who your Primary Care Clinician is.

  • Choose the “Appointments” tab on the left and then click the “Schedule an Appointment” button.

  • Choose the “STI (Sexually Transmitted Infection) Testing option and click continue.

  • Choose the “Continue to schedule your STI Testing with your Primary Care Team” option and click continue.

  • Select your Primary Care Team and click continue.

  • Type a few words into the text box. You can just put “STI testing” if that feels right. Click continue.

  • Check that your information is correct, then click continue.

  • Type your phone number, then click continue.

  • The system will look for available appointment times. Unfortunately, it only checks for appointment availability within your “Primary Care Team,” so you just have to hope that your team has some appointments available!

  • If not, you can try picking a date farther out, or start the process over and try again with a different care team.

AA: When you go in, you’ll meet with a clinician and they may ask you about your specific concerns and sexual practices. This is just so they can get a sense of what to test you for so try to be honest. Then, based on this, they’ll take either a blood or urine sample and do an exam of the possibly affected area. Also, it’s worth mentioning here that tests are often unable to detect STIs immediately after a sexual encounter. If there’s one specific sexual experience you think might have exposed you to an STI then you should wait two weeks before getting tested so that the test is actually accurate.  

We do want to note that in the case of sexual violence, HUHS does not provide SANE kits. If you would like more information about SANE kits, please call OSAPR’s hotline at 617-495-9100.

LM: Moving on to your next question, anonymity is a really common concern when people think about getting STI tested at HUHS.

AA: Lab tests are processed by Quest Diagnostics, which is located in the HUHS basement. Confusingly, Quest is a separate company with their own billing system. To protect students’ anonymity since STI testing is a sensitive topic, HUHS has requested that Quest bill HUHS directly for STI testing, rather than billing the student’s insurance.

Because of that, there are a few recommended steps for students to take to ensure anonymity:

  • Remind the lab tech to bill HUHS for the sample;

  • For greater confidence, you can also call your insurance company to request that your Explanation of Benefits is sent to your campus address (this is on the unlikely off-chance that your insurance does get billed due to human error).

LM: The tests may take up to a week to be completed and then you will get the result over your HUHS secure messages. If you test positive for an STI then they will follow up with you for next steps about treatment options. We want to end by affirming that there are outside providers that may be more accessible for some individuals. Some outside options for STI (including HIV) testing are:

Fenway Community Health Center

  • (617) 267-0900

  • Located at 1340 Boylston Street, Boston, MA 02215

Mount Auburn Hospital, Center for Women

  • Located at 330 Mount Auburn Street, Cambridge, MA 02138

  • (617) 499-5151

AA: We know that STI testing can seem daunting but it’s a really great thing to practice regularly. If have further questions don’t hesitate to contact us or HUHS. Thanks for your question!

Where can I get free condoms on campus? Do I have to prove that I’m a student?

AA: Thanks so much for writing in to ask this question. We’re really proud that here at Harvard we provide (for free!) a variety of types of condoms and other barrier methods, such as oral (dental) dams, finger cots, and gloves.

LM: One of the most popular forms of birth control is the external (or male) condom. In addition to preventing pregnancy, external condoms can also protect against sexually transmitted infections (STIs), because they provide a physical barrier. There is also the internal (or female) condom, which is inserted into the vagina or anus before sex.

Below is a list of places on campus you can get free safer sex supplies, as well as a map.

Houses & First-Year Dorms: Most Houses and dorms have dispensers with external (male) condoms. These are generally located in laundry rooms, gender-neutral bathrooms, or near building manager’s office.

Health Promotion Office (6th floor Smith Campus Center): internal & external condoms, oral dams, finger cots, gloves, lube, & educational materials

Office of Sexual Assault Prevention & Response (Smith Campus Center, 6th floor): internal & external condoms, oral dams, finger cots, gloves, lube, & educational materials

Women’s Center (Canaday Basement): internal & external condoms, oral dams, & lube

Office of BGLTQ Student Life (Grays Basement): internal & external condoms, oral dams, & lube

AA: In answer to your second question, nope! No questions will be asked when you show up for condoms!  If a staff person is available and you have questions or you don’t see something you’re looking for, please feel free to ask!

LM:  Thanks again for your question!





Winter 2018 Update

This past semester, we at Sexual Literacy have been taking time to reflect on and critically examine our work and our mission--specifically, how well we’ve been reaching and connecting with our desired audiences in the Harvard community. We wanted to step back and get an understanding of how we’ve been utilizing the resources we have, and who our content was actually reaching. It’s been a very helpful process for us, and we’ve come away from it with whole bunch of exciting new ideas.

Next semester, we’ll be taking some of those ideas and using them to inform how we engage with the Harvard community. Our primary goal is to interact on a more personal level with our audiences than we have in the past, so we’ll be developing some new initiatives, outreach, and educational opportunities. Keep an eye out for pilots of some of these programs—we hope to see you in the spring!

❤ 

The Sexual Literacy Team

An Update from the SL Team

We here at Sexual Literacy are excited to share that we are taking this semester to intentionally reflect about how to best utilize this platform. We will be revisiting our best-practice frameworks, assessing what has and hasn't worked so far, and thinking creatively and strategically about how we can use Sexual Literacy to the greatest benefit of our community. We are constantly looking for feedback and will be asking folx to join us for focus groups later this semester. If you have any thoughts, suggestions, or want to check in, please email us at harvardsexualliteracy@gmail.com!

We are happy to continue replying to questions directly, so please continue to reach out.

Thank you for being members of our community and for all that you do to make our community a better place!

❤ 

The Sexual Literacy Team

I’m about to graduate! There’s been a ton of resources available while I’m at Harvard. Do you have any tips about how to find things once I’m out of the college bubble?

RC: Building off last week’s post, this week we are going to speak to some national resources that folks might find of interest when thinking about sexual and interpersonal wellbeing.  We will start with a quick run-through of resources that address sexual health and then look at some that address interpersonal wellbeing.

AG: One awesome thing about the digital world we live in today is that there are an amazing array of great online informational resources. Of course, that means that there’s also a lot of not-so-great information online, but some websites that we recommend if you are looking for sexual health information include:

Many of these have Q&A boards similar to our website, as well as informational articles. None of these offer direct healthcare services, which we talked a bit about last week. But just a reminder that places like Planned Parenthood or community health clinics can be a good first stop for accessing health care.

RC: When thinking about interpersonal wellbeing, it’s really important to note that there is no set formula or map that will define relationships.  We try to stress that understanding interpersonal wellbeing is less about understanding objective symptomatology and more about understanding the felt- and lived- impact of the interpersonal dynamics.  Because of this, interpersonal practices that might help me thrive might really not work for someone else, and vice versa. That being said, there are some important resources for folks who are interested in learning more about interpersonal harm, health, and how to be a mutual and equitable person.

AG: You can also find even more resources, broken down by category, via OSAPR’s website! Navigating this world of information can be overwhelming but there are definitely a ton of amazing organizations out there doing great work and publishing really useful content. Good luck!

RC:  Wow, we made it through a whirlwind academic year!  For those of you who are graduating, including the person who wrote in with this question, we wish you nothing but the best as you move into the next phase of your lives.  For those of you who we will see around campus in the Fall, have a great summer, and we will see you soon! Thanks for reading!

I’m about to graduate! There’s been a ton of free resources available while I’m at Harvard. Do you have any tips about how to find things once I’m out of the college bubble?

RC:  That’s a great and complicated question!  For anyone who has been in a workshop with me, y’all will know that my whole way of thinking is organized around access to resources and this is a shining example of that.  Depending on employment status, access to health insurance, income level, geographical location, and a number of other contextual factors, a person’s access to free and/or reduced-cost health and wellness resources will likely vary.

AG: A benefit to being employed in some organizations is access to employee assistance programs. These are programs that can “offer free and confidential assessments, short-term counseling, referrals, and follow-up services to employees who have personal and/or work-related problems.” This can include things like childcare access, mental health counseling, interpersonal violence resources, substance use resources and more. If you are employed, it is worth checking in with someone from Human Resources to see if you have access to a program like this.  

RC: Building off that, some health insurance providers offer incentives for preventative health initiatives, which might include things like defraying the cost of a gym membership, supporting exercise classes and/or weight-management programs, or subsidizing the cost of massage, acupuncture, etc…  

AG: Again, check in with your insurance provider to see what kinds of incentives you may have access to. We recognize that these types of programs are not common across all sectors and regions; in addition, if you are not employed they are inaccessible. However, there are often still community-based resources that may be available to you. Some examples of these may be: Planned Parenthood, community health clinics, and other mobile clinics.

RC: In many smaller towns, the Chamber of Commerce maintains a list of (generally) reduced-cost health resources that may be useful.  It’s really important to reiterate here that the availability of resources is very much based on the the community in which you find yourself.  It can feel onerous to navigate when moving to a new community; often people find that word-of-mouth and/or connecting with trusted resources for recommendations.  Finally, it may be worth googling and then following up to vet free health resources in your community.

AG: Next week we will give an overview of some national resources and will focus on post-grad interpersonal health! Congrats on graduation!!