I’m trying to buy condoms but am a little overwhelmed by the options. How do I know which condom is right for me?

ML: Thanks for asking this important question! Absolutely—when purchasing condoms, there are a multitude of options from which you can choose. From various sizes to ribbed vs. unribbed, flavored vs. glow-in-the-dark, this decision may feel like a daunting one. In this post, we are going to talk through a number of the factors that impact efficacy, comfort, and personal preference that will allow for the best experience at the end of the day.

AG: One straightforward way to start getting a sense of what condoms might be right for you is to measure your erect penis. You’ll want to measure both the length (from the pubic bone to the tip) and the girth (the width of the penis which you can get by dividing the circumference by 3.14). Condom manufacturers sell snugger fit, regular fit, and larger fit condoms which will fit different penises depending on these two measurements.  

ML: In addition to the fit of the condom, there are other things to consider when finding a condom that’s best for you and your partner(s). Some of these may include: ribbing, or texturization of the condom, flavor, color, material, thickness/thinness, added sensation, and amount of lubricant on the condom or in the packaging.

AG: A lot of variation! It’s worth remembering too that though most condoms come with some lubricant in the packaging this is generally just to prevent the condom from tearing as it is unrolled and so more lube can always be added! Again, we know this list can feel overwhelming. Finding the perfect condom isn’t always super quick, and can really just be more of a process of experimentation. It can be worth trying on the condom before the sex act to ensure that it fits well enough to be effective and comfortable, but you’ll get the best sense of what works the best for you with time and through trying different options.  

ML: Here on campus, there are multiple locations at which you can pick up a variety of condoms and other safer sex supplies for free. Feel free to stop by the sixth floor of HUHS in the Center for Wellness & Health Promotion, the Women’s Center, the BGLTQ Office, or at SHARC Office Hours in house dhalls where you can also ask any additional questions as it pertains to sex and sexual health. Here’s a map that points out these places!

AG: We wanted to end by briefly noting some of the pressures and expectations that may come with buying condoms. Many people may feel that they need to use larger sized condoms. In fact, studies show that 25% of men have tried magnums (extra-large condoms) when in reality these are really not necessary for most people. The average penis size is 5.16” long while a magnum condom is made for penises that are 8.07” long...so a big difference! The truth is that sex will feel better and that the condoms will work the best when they fit your penis appropriately. For some people it can feel that others may judge their condom choices however, picking something that fits well will really result in the best and safest experience for you and your partner(s). If picking up or buying condoms in public is nerve wracking, there are also certainly ways to buy them discreetly online!

April is Sexual Assault Awareness Month!

RC: Hello! This week’s post is not going to be a Q&A; instead, we are going to give a brief description of why Sexual Assault Awareness Month (SAAM) matters and write a shameless plug for April’s Sexual Assault Awareness Month events.

AG: Yes! The tough reality is that sexual assault happens and that it happens frequently. National statistics show that 1 in 5 women and 1 in 4 LGBTQ+ individuals experience sexual assault during college. However, we also want to stress that it’s not just women and LGBTQ people that experience sexual violence. Recent research from Columbia University indicates that 12.5% of men will experience sexual assault throughout college. Rates were noticeably higher for members of single gender organizations (like fraternities or sororities) regardless of gender.

RC: These statistics generally map onto lifetime prevalence data as well; national data indicate that 1 in 5 women and 1 in 6 men are likely to experience sexual assault throughout their lifetime. It’s really important to highlight that folks who have identities at the margins often experience much higher rates of sexual violence and often face significant barriers to reporting and accessing resources; for instance, 27.5% of Native American/Alaska Native women report experiencing sexual assault in their lifetime, compared to 20% of white women, and the Human Rights Campaign reports that “among people of color, American Indian (65%), multiracial (59%), Middle Eastern (58%), and Black (53%) respondents of the 2015 U.S. Transgender Survey were most likely to have been sexually assaulted in their lifetime.”

AG: Though of course, consideration and conversation about sexual violence ought to happen throughout the year, SAAM is an opportunity for us to come together in solidarity. We can use this month to think about ways to support people who have experienced or been impacted by sexual violence, to educate ourselves about the ways in which sexual violence shows up within our communities, and to hold ourselves accountable for change.

RC: The original SAAM awareness events began with Take Back the Night marches in the late 1970’s. These started in England and quickly spread.  In the 1980’s, while October was already recognized as Domestic Violence Awareness Month, activists identified a week in April for sexual violence awareness-raising, which quickly turned into the Month. Since then, advocacy organizations, coalitions, and states have had varying levels of SAAM engagement. Notably, in 2001, the U.S. observed its first National SAAM. To learn more about the history of SAAM, please visit: https://www.nsvrc.org/saam/history.

AG: One piece of SAAM that we hope people begin to embrace is working to reframe our conversations about sexual violence. Historically, we have used rhetoric that dichotomizes victims and perpetrators. We find that it is more accessible to frame conversations about interpersonal harm in a way that is reflective of how harm can be complex and dynamic.  In service of that, we try to use language like: person who experienced harm, person who caused harm, etc.

RC: Ok, events!  To learn more about SAAM programs, please visit the OSAPR website.  For all undergraduates, there will be a weekly Yoga for Restoration class offered in the Dunster JCR on Wednesdays at 7.  Hear Me Now: A Take Back the Night event will be hosted in the Dudley Lounge on April 19th at 6pm. Our Voices, a student production, will be in the Leverett Library Theater on April 20th and 21st.  And, as always, Harvard Wears Denim will take over the Science Center Plaza from 12-2:30 on April 25th. We hope to see y’all there!

 

I’m in a new monogamous sexual relationship. I heard you should get tested regularly for STIs, and I want us to but I’m worried my partner will be offended. How do I navigate this conversation?

AA: Thanks so much for sending in this question. It’s great that you’re wanting to be open and communicate with your partner your desire for the both of you to get tested for STIs (sexually transmitted infections). These conversations can bring up a lot and it’s great to think through in advance how you want to navigate given what you know of you and your partner.

LM: Communication is a really important part of any relationship, and having a conversation about STI testing can be a great way to normalize open and mutual communication in your relationship. You mentioned that this is a new relationship, too, and beginning to have these conversations early can create relational practices that support ongoing dialogue.

AA: The CDC recommends that sexually active individuals get tested between every three months to every year depending on your sexual activity and partners. More detailed testing recommendations can be found here. As we’ve mentioned in previous posts, the most common symptom of most STIs is actually no symptoms at all. Thus, getting tested in accordance with the recommendations is worthwhile even if you aren’t experiencing any symptoms.

LM: These could be some useful facts to bring up in your conversation with your partner. Since it’s recommended to get tested every so often, even if you don’t have symptoms, this can show your partner that your desire tcalo get STI tested may not stem from any particular concern about them, but rather that it’s a positive healthcare practice.

AA: It’s important to note that each relationship has its own communication style; only you can fully determine how to navigate conversations that might be loaded with your partner. That being said, there are some ways to engage in these conversations that others have found helpful. For instance, as LM mentioned, starting with the medical recommendations can be a low-threshold way to begin a conversation about STI testing with your partner. Generally people find that these conversations are more effective when they are framed using “I” language. The more each one of us can make our relational requests about our own needs rather than about the relationship itself, the more folks tend to be able to engage. When I think about a potential way to do that, it might look like: “I have decided to make STI tested a part of my preventive healthcare routine. I would like to have a conversation about whether this can become a practice in our relationship.”

LM: If you and your partner do decide to get STI tested, we at SL have previously written about getting STI tested at HUHS if you’re interested in finding out what the process looks like. Again, I want to emphasize how productive it can be to have conversations like these right off the bat. Like AA said, it can be helpful to communicate your own needs to your partner, and this can apply not just to STI testing but to the relationship as a whole.

AA:  I want to make sure that all Harvard students know that they can receive free STI testing at HUHS. You can schedule a STI test online via the HUHS patient portal, you don’t even need to call. First head the HUHS website and log into your patient portal. Once you are logged in fully, click on “appointments” and then “schedule an appointment.” When the next choices appear you’ll need to select Primary Care and choose the location option that corresponds to your PCP's name, then type in STI testing and complete the rest of the form. Appointment time options will pop up and you will be able to choose the time that is best for you.

If the clinician orders a test that requires a blood sample they will most likely send you to Quest Diagnostics which is in the basement of HUHS. Since Quest is a separate company, who does their own billing, it is important for you to remind them to bill HUHS for this blood sample. HUHS pays for all student STI testing, including any tests done through a blood draw. Sometimes, but rarely, there is a small margin of error as billing is done by humans. If a bill is sent to your insurance it will generally just say “lab test” and not the specific type of test. If this is still of concern to you we recommend that students call their insurance company (most phone numbers can be found on the back of your insurance card) and ask that their Explanation of Benefits (EOBs) be sent to their address on campus.

Amanda Ayers
Health Educator

LM
Student

I’m a Harvard undergraduate and just found out that I’m pregnant. I haven’t decided what I want to do yet and was wondering, what options are available for me?

AKG: Thanks so much for sharing your question! While SL is often a forum to talk about sex, sexuality, and relationships, we get that this aspect of reproductive health is sometimes left out of the conversation. Seeking information about options is a big step, and only the person experiencing the pregnancy is able to say what will work best for them and their wellbeing. Very generally, there are three choices you can make:

  • Abortion: ending the pregnancy

  • Adoption: continuing the pregnancy but placing the child(ren) with someone else permanently

  • Parenting: giving birth and raising the child(ren)

Depending on your identities, background, experiences, and future goals, any of these may be an option.

ML: Thanks for submitting this question! As college students, we are often inundated with information about preventative sexual health, but rarely talk about what happens when these events occur. While pregnancy may or may not have been a part of your plan here at Harvard, there are a multitude of services to help you through this experience regardless of the option you choose.

AKG: I agree, ML. Unintended pregnancies account for about 45% of all pregnancies in the US. Because this is a common experience, there are many places to get support and information out there to help folks walk through the decision-making process. A favorite service would be the All Options hotline (1-888-493-0092), which provides “unconditional, judgment-free support for people in all of their decisions, feelings, and experiences with pregnancy, parenting, abortion, and adoption.”

ML: Each state has different laws, policies, timelines, and procedure options. Because of this variety, we’re only going to take a bird’s eye view of methods. For more information about what may be available in your state, please check out the websites at the end.

AKG: Thanks, ML! So, let’s talk about one option: abortion. According to data from 2014, about one in four women will have an abortion by the age of 45. While it is a common procedure, the decision is personal.

The two ways to end a pregnancy in Massachusetts are medical abortion and surgical abortion. Medical abortion is available the first 10 weeks after the first day of a missed period. It’s a two step process where someone would take the first dosage generally at a medical provider’s office, and then they are able to take the second medication at home, usually within two days of the first one. Many folks report feeling severe menstrual cramps and experiencing bleeding or spotting that can be heavier than their normal period. This means that it may be helpful to have support with you including a friend or someone from Boston Abortion Support Collective (BASC) and/or take a break from your normal routine.

Surgical abortion in Massachusetts is available generally until 23 weeks after conception, though there are select instances where abortion may be performed past this point. There are two types of surgical abortions; both are in-clinic procedures that happen at Planned Parenthood League of Massachusetts in Boston, Women’s Health Services in Brookline, and at some area hospitals. Some clinics require that someone else picks you up from the appointment, so know that it may be necessary to have a friend or a member of BASC with you.

At Harvard, if you are covered through the Student Health Insurance Plan, and electing for a surgical abortion, you will be expected to pay a $75 copayment. A medical abortion should be entirely covered. If you have private insurance, but it will not cover an abortion or you do not wish to ask your insurance company if they’ll cover it, the student health fee (which all undergraduates pay) will provide a $350 voucher. The Eastern Massachusetts Abortion (EMA) Fund is also available should you require additional financial or additional support.

ML: Thank you, AKG. It’s very important to understand the different routes one can take should pregnancy not be a choice you want to make. If abortion is not an option or not the right choice for you, adoption is another route you can take. Through either a private or public adoption agency, you will be guided through the process of choosing caregivers. You will want to speak with an adoption counselor that you can find through your medical provider to learn more about agency-specific procedures and state particular rights; however, a broad overview is that you can choose to have an open or closed adoption. An open adoption is where you can choose to receive some information about the child and their family as they grow up, whereas a closed adoption would involve receiving little to no information post-delivery.

One option for talking to an adoption counselor is the National Pro-Choice Adoption Collaborative, a non-discriminatory, secular, non-profit agency that aims to provide unbiased information about adoption and services related to adoption nationwide. Like All Options, it’s another place to have a conversation with someone outside of your immediate environment to talk through the options that you have.

AKG: If you will be going through the birth process, HUHS can provide OB/GYN services to you, and the birth will take place at Mount Auburn Hospital. Undergraduates are able to live in the Harvard dorms while pregnant. However, if you choose to carry out the pregnancy and parent the child(ren) then you will not be permitted to remain in the dorms. In Cambridge, there are a number of resources and daycares that offer services, although pricing and availability may vary.

ML: While the breadth of information presented above provides a snapshot of your options should you find out that you’re pregnant, there is more information available about each option. It is important to note that each person’s experience will be different, and that there is no one right choice or answer to this question.

Mentioned Services:

My partner and I are considering pregnancy; I’m nervous about the process of giving birth. What does it usually look like to go through a labor and delivery?

RC: That is a great question!  For each person/process, it may go differently.  In this post, unlike most, I am actually going to be writing as the IRL or Context Expert and will speak from my own experience delivering two babies.  As AG mentioned in a prior week’s post, 45% of pregnancies in the United States are unplanned.  That was certainly true of both of mine.  One of the most important things that my partner and I had to consider upon finding out that we were pregnant was where we hoped to deliver.

AG: There are many different options when thinking about the birthing process that you want to have. First, you may decide where you would like to give birth: in a hospital, at home, or in some other location (for example, a birthing suite). Depending on the state, home births are generally attended by midwives; some people choose to include doulas, pets, children, relatives, and/or friends in the process as well. If you choose to give birth in the hospital, you can either give birth vaginally or via a caesarian section. People will make these decisions for many different reasons and it’s important to consult with a healthcare provider in the process.

RC:  Many providers offer the option of completing a birth plan, which lays out the ideal labor and delivery and often includes details about back-up preferences.  These may include questions about epidurals, c-sections, music, choice of lighting, people in the room.  I did write one for the birth of my first child--many of the elements I named went somewhat as I had hoped; some did not.  With my second labor and delivery, I made sure that I had clearly communicated about my wants, needs, and non-negotiables with my partner and birth team in advance, so felt that my process would be honored without a formal birth plan.  Again, for each person and each process, it may look different.  Please note, if, at any point, complications arise, your birthing team will be able to advise you regarding the best ways to ensure the safety of you and your baby(ies).

AG: Typically during the third trimester of pregnancy (and as early as the second trimester), people may experience something called Braxton Hicks contractions, which are basically the uterus “practicing” for the birthing process. They are generally infrequent/irregular in pattern (unlike actual labor), and for some the sensation may be intense.

RC:  One of my favorite takeaways from one of the books about mindful birthing that I read before my first child was born offered a different framework for thinking about contractions and the accompanying sensations.  Rather than describing the muscular contractions as painful or not painful, the book offered that we use the language of strong versus less strong sensation.  This does not add a value judgement or prime our brains to anticipate the physical sensation as anything other that whatever it is in the moment.  I found this really helpful; as an athletic person who really enjoys noticing what’s happening in my body, this reframe allowed me to observe and delight in the activation of a muscle I had never used in that way before.

AG: The process of actual labor can be mapped onto several stages, which correlate with the dilation of the cervix (it is considered fully dilated at 10 centimeters) and what is happening with the baby. The first stage of labor can be broken into early (the cervix is 0-3 cm dilated), active (3-7 cm), and transitional phases (7-10 cm). As these phases progress, contractions often become more frequent and more intense. The water may (or may not) break anytime within this first stage of labor.

RC:  With my first child, born on January 1st, we were celebrating New Year’s when my contractions began.  A friend actually decided he wanted to be responsible for tracking them, which was great!  They began around 8:30 pm on December 31st and after ringing in the new year, everyone left, my partner and I went to sleep, and I slept until 5:30 am, at which point the intensity and frequency of the contractions kept me from sleeping.  I don’t think I called any of our birth team until 8:30 or 9 that morning.  It’s important to note that there is no set timeline for the duration of a labor and delivery.  In both mine, my water didn’t break until much later in the process.  With my second, my water broke as I delivered. Some people report that they didn’t notice their water breaking at all, later to discover that it had.

AG: After the cervix is dilated to 10 cm the “active” stage of labor begins. In this stage, the person generally feels compelled to push so that the baby(ies) can move from the uterus through the vaginal canal, in the cases of vaginal birth. You may have heard people talk about episiotomies; routine episiotomies are no longer recommended, although they may be medically necessary in some cases.

RC: After the (last) baby moves through the vaginal canal, which is often called delivery, the last stage of the birth process begins: the delivery of the placenta.  In some cultures, people eat some of their placenta, other folks may choose to get it encapsulated in pill form, others may choose to bury it under a beloved plant, and still others may dispose of it.   

AG: At this point the delivery is complete! It’s often really helpful to ensure that the baby and the delivering parent have enough support to navigate a new phase of life. It’s also important to note that both parents (in a two parent dynamic) may experience a range of emotions and likely both will benefit from screening for depression and anxiety during this time.

RC:  While we have outlined a lot of technical information in a linear manner, it’s really important to note that everyone’s experiences of labor and delivery are different and may include a number of factors, people, babies, etc. that aren’t explicitly named in this post.  I also want to make sure that, as the IRL writer, I note that each labor and delivery involves risk and may not go as intended.  That was certainly true for me; there are risk factors for different populations that are really important to note and consider as one goes through this process.  It’s especially important to call out in this space the health disparities that women of color face when growing and delivering babies in America.  Serena Williams’s experience is a high-profile example of exactly that.  

My partner and I just found out that we are pregnant. We both want to be parents, but I read somewhere that pregnancy can add stress to relationships.  What are some things we should look out for?

AG: Thanks for the question! Pregnancy can be a big change for an individual, a relationship, and/or a family system. It’s important to first remember that every person may experience this differently. For some, pregnancy can be a source of intimacy and excitement. For others, it can add stress and uncertainty. For many, it can be some combination of all of these feelings and many others! In this blog post we will address some common themes. We want to note, though, that these may not apply to everybody and that this is far from comprehensive.

RC:  As a person who has now gone through this process twice, my observation of my own experiences is that each pregnancy felt different.  Something that folks often talk about, regardless of how familiar this process is to them, is an experience of navigating a future in which there is less certainty than before.  This is sometimes accompanied by an increase in anxiety or feelings of (in some ways) lacking control.  I want to note, this is partly due to changes in neurobiology; when pregnant and/or parenting, our brains actually redirect resources to increase our ability to respond quickly and effectively to primal threats.  While this was a crucial adaptive strategy, it can make things feel hard or overwhelming in the modern world.  Often people express feeling better able to manage this when in open dialogue with their supportive people.

AG: In part because of these changes, patterns of communication may be impacted. People may feel that they are experiencing parts of the pregnancy and parts of the relationship differently, and that they may not be on the same page. Also, it isn’t uncommon for people to feel that the relationship is no longer the main priority as it might have previously been. People who choose to be parents may be redirecting emotional energy toward the growing baby that was once focused on the relationship and adapting to this shift can be confusing. Naming these feelings to your people can be helpful, if that feels like an option.   

RC:  It’s important to flag that, especially in partnered relationships that are characterized by imbalanced dynamics of power and control, increases in interpersonal violence have been documented.  This often, but certainly not always, correlates with a “mistimed” or unplanned pregnancy.  In relationships with a history of physical violence, pregnancy often correlates to an increase in homicide.  There is little accessible data that speaks to interpersonal violence within broader family systems.  

Often a relatively accessible place for folks to raise concerns during pregnancy is during prenatal visits with a medical professional.  In the US, medical providers are required to screen for interpersonal violence during the course of a prenatal relationship and should ask those questions without any partner(s) present.  If you have any concerns about your well-being, please know that local and federal resources are available.  The National Domestic Violence Hotline or a local Interpersonal Violence agency may be a good place to begin.  OSAPR (Harvard), Transition House (Cambridge), Casa Myrna (Boston), Reach Beyond Domestic Violence (Waltham), The Network/ La Red (Boston), Fenway Health (Boston) or Respond (Somerville) are some of the resources available locally.

AG: Thanks Ramsey for noting all of that. And while it’s certainly true that pregnancy can add stresses on relationships, it can also be a really big source of excitement!  For people that are choosing to carry the pregnancy to term and/or to parent, the thought of bringing a new human into the world can bring up many emotions, experiences, and reactions and some may feel that it gives them a different perspective on things.  Whatever your experience, we hope that you feel equipped to navigate the process in a way that feels right for you.  Please know you are always welcome to reach out with any more questions!  Our email is: harvard.sexual.literacy@gmail.com.

Ramsey Champagne,

OSAPR Community Advocate

AG

Student

 

I’ve just entered into a sexual relationship, and I don’t want to get pregnant. What are some birth control options I can try?

AA: Thanks so much for writing in to ask this question. This is a very common question as there are many birth control options out there to choose from and it can be hard to navigate which is which. What works for one person may not be the best option for another; different types of contraceptives may have different risks and/or levels of efficacy when interacting with different bodies.  It is important to understand yourself, your body, and the different options available to you, and to consult a medical professional.  

LM: We’ll talk about several options for birth control here, starting off with some of the more widely-known ones. 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 before sex. Both types of condoms are available for free at many places around Harvard’s campus. This map shows all the locations with external condoms, and internal condoms are available from the Health Promotion Office, the Women’s Center, and at SHARC office hours!

AA: Another method you may have heard of is the pill. This is a hormonal birth control method that is taken orally at the same time every day. It is important to remember that if you miss one pill you should use a backup birth control method like condoms for one week after the missed dose. The pill requires a prescription from a doctor. You can schedule an appointment with one of the doctors at HUHS through your patient portal.

LM: If the idea of having to remember to take a pill every day isn’t appealing to you, there are also various other hormonal contraceptive methods. One is the patch, which is like a Band-Aid. You have to change your patch every week. Another option is the NuvaRing, a small, flexible ring that is inserted into the vagina and left there for three weeks. Each of these methods allow you to have a period during an “off-week.”

AA: A longer term hormonal option is the Depo-Provera shot which you receive at your doctor’s office every 12 weeks. This is a good option if you are wanting a very private form of birth control, although studies do show that long-term usage of Depo-Provera may lead to bone mineral density loss. Another great option that can give you up to four years of pregnancy prevention is the implant, which is inserted under the skin of your upper arm and secretes hormones. It is effective for up to four years and the insertion is a quick procedure.

LM: The last birth control method we want to talk about is the IUD (intrauterine device), which has been getting more and more popular. An IUD is a small T-shaped device that is inserted into the uterus, and they last for several years. There are several different types of IUD; many are hormonal and last between 3-6 years, and one is made of copper (ParaGard). ParaGard can last up to 12 years, and is a great option if you’re looking for a non-hormonal contraceptive option, but it can also make periods heavier.

AA: If you’re interested in an IUD, you can talk to a clinician about the different options. The procedure to get an IUD is outpatient and can cause minor cramping. Your doctor will go over all the details with you when you are deciding if an IUD is the best option for you.

LM: To wrap things up: If you want a non-hormonal method go with condoms (either external/male or internal/female) or the ParaGard IUD. If you’re okay with taking a pill every day try out one of the many different kinds of birth control pills. If you’re interested in a hormonal method that you don’t need to remember every day, consider the patch, the ring, the shot, or the implant. It’s also important to remember that condoms are the only one of these methods which prevent STIs, so you can also use condoms in tandem with any of these other methods for an extra layer of protection.  

AA: Most of the options we’ve discussed here are covered by most insurance providers. Make sure to check out Bedsider to get a much more in depth description and to help you understand which method might be best for you.

Amanda Ayers, Health Educator

LM, Student

 

What are some situations in which a person can get pregnant? For example, I’ve heard you can get pregnant from pre-cum, is that really true?

AA: Thanks so much for asking about different situations in which pregnancy can occur. Speaking really broadly, pregnancy can occur entirely accidentally or through a more intentional process.

LM: At its most basic, pregnancy happens when a sperm fertilizes an egg and the fertilized egg implants in the uterus. There is a window of a few days during the menstrual cycle when an egg is receptive to fertilization, so if a sperm reaches the egg in this timeframe, pregnancy is likely to occur. However, sperm can also hang around in the uterus and fallopian tubes for up to 6 days, so there is a fairly broad window in which fertilization can physically occur.

AA: Regarding the example that you mentioned in your question, generally pre-cum does not contain sperm but there have been some rarer cases of pre-cum containing some sperm. Because of this, if you are trying to avoid pregnancy, the withdrawal method should not be used as a form of contraception. There are many more effective strategies, which we will go into detail about next week.

LM: For those who are trying to get pregnant, the process may range from tracking ovulation to looking for a sperm or egg donor to using in-vitro fertilization. Surrogacy is also an option, although there have been a number of conversations in the public discourse about the ways in which this process, when not done carefully, can offload labor and potential physical complications onto already marginalized or at-risk female-bodied people.

AA: While historically our understandings of pregnancy through the medical model have characterized the egg as passive and the sperm as active, there is new research that indicates that the egg may play a much more active role in the process of fertilization and implantation.

Over the next few weeks, we’ll be discussing a series of questions surrounding various facets of pregnancy, so stay tuned!

Amanda Ayers, Health Educator

LM, Student

I feel like I should get STI tested but I’m really nervous about the process and about my parents finding out. How does it work and how do I keep my parents from finding out?

AA: Thank you so much for sending in your question. Wanting to keep anonymity is a really common concern when people think about getting STI (Sexually Transmitted Infections) tested at HUHS. There are many ways to ensure that no one finds out that you’ve received STI testing at school.

AG: Yes definitely! STI testing is safe, easy and important and the CDC generally recommends that if you are engaging in sexual activity (especially with new partners) that you get tested between every three months and a year depending on your sexual practices. The most common symptom of STIs is actually no symptoms at all (I know, yikes) so it’s definitely worth getting testing even if you don’t think anything is abnormal. So good on you for thinking about it and trying to learn more about getting tested here at Harvard!

AA: I want to make sure that all Harvard students know that they can receive free STI testing at HUHS. As AG mentioned getting STI testing at HUHS is very easy. You can schedule a STI test online via the HUHS patient portal, you don’t even need to call. First head the HUHS website and log into your patient portal. Once you are logged in fully, click on “appointments” and then “schedule an appointment”. When the next choices appear you’ll need to select Primary Care and choose the location option that corresponds to your PCP's name and then type in STI testing and complete the rest of the form. Appointment time options will pop up and you will be able to choose the time that is best for you.

AG: 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 directly 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.

AA: If the clinician orders a test that requires a blood sample they will most likely send you to Quest Diagnostics which is in the basement of HUHS. Since Quest is a separate company, who does their own billing, it is important for you to remind them to bill HUHS for this blood sample. HUHS pays for all student STI testing, including the any tests done through a blood draw. Sometimes, but rarely, there is a small margin of error as billing is done by humans. If a bill is sent to your insurance it will generally just say “lab test” and not the specific type of test. If this is still of concern to you we recommend that students call their insurance company's (most phone numbers can be found on the back of your insurance card) and ask that their Explanation of Benefits (EOBs) get sent to their address on campus.

AG: 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. I just want to end by affirming that there are outside providers that may be more accessible for some individuals. Some outside options 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.

Amanda Ayers MPH

Office of Health Promotion and Education

AG

Student