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Sexuality. Choices in Sexual Behavior. Sexuality: The Five Circles. Sexual Identity. Biological Genetic instructions X & Y chromosomes Gender identity Gender roles Masculine or feminine/stereotypes Transgendered Transsexual Androgynous Metrosexual Cultural influences
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Sexuality Choices in Sexual Behavior
Sexual Identity • Biological • Genetic instructions • X & Y chromosomes • Gender identity • Gender roles • Masculine or feminine/stereotypes • Transgendered • Transsexual • Androgynous • Metrosexual • Cultural influences • Sexual orientation
Sexual Orientation • Heterosexual • Homosexual • Gay • Lesbian • Bisexual • Transsexual • Homophobia
The Human Sexual Response • Stage One: • Excitement/arousal (foreplay) • Stage Two: • Plateau • Stage Three: • Orgasm • Stage Four: • Resolution
Traditional Sexual Behavior: Western Standards • Two-person, heterosexual • Coital standard • Orgasmic • Romantic • Safe
Options For Sexual Expression • Celibacy/abstinence • Autoerotic behaviors • Sexual fantasies • Masturbation • Kissing and erotic touching: erogenous zones • Manual stimulation • Oral-genital stimulation • Cunnilingus • Fellatio • Anal intercourse
Variant Sexual Behavior • Group sex • Transvestism • Fetishism • Exhibitionism • Voyeurism • Sadomasochism • Pedophilia • Autoerotic asphyxiation • Alcohol/Drug Use • Rohypnol (roofies); GHB (liquid X); Ketamine (special K)
Sexual Function: Difficulties • Sexual desire disorders • Sexual arousal disorders • Orgasm disorders • Sexual performance disorders • Sexual pain disorders
Responsible Choices Preventing contraception & sexually transmitted infections
Fertility Management Choosing when to facilitate conception
Contraception: Barrier Methods • Condom • Male • Female • Spermicides • Diaphragm
Condoms: Some Tips • Use approved lubricants • Do not use products with mineral oils • Store in a cool, dry place • Inspect for small tears • Carry a spare • Check the expiration or manufacture date • Breakage
Excuses & Answers • It doesn’t feel as good with a condom • I'll feel more relaxed. If I am more relaxed, I can make it feel better for you. • I don't stay hard when I put on a condom • I'll help you put it on. That will help. • I am afraid to ask him to use a condom. He'll think I don't trust him. • If you can't ask him, you probably don't trust him. • It's up to him. It's his decision • It's your health. It’s your decision too! • Putting it on interrupts everything • Not if I help put it on • I don't have a condom with me • I do
Contraception: Hormonal Methods • Oral • 21/7 • 12/1 • Patch • Ring • Depo-Provera
Advantages Spontaneity Research Lighter menstrual flow Less menstrual side affects Sexual enjoyment Disadvantages Daily Drug interactions Delayed return to fertility No STI protection Side effects Research The Pill
Contraception: Other Methods • Sterilization • Vasectomy • Tubal ligation; hysterectomy • Intrauterine devices • Withdrawal • Fertility awareness/rhythm • Emergency contraceptive pills • Outercourse • Abstinence
Abortion • Roe v. Wade • Termination of unplanned pregnancies accounts for 50% • U.S. rate higher than any other industrialized nation • Challenges to law • Violence
Sexually Transmitted Infections Preventable public health dangers
Modes of Transmission • Sexual intercourse • Oral-genital contact • Hand-genital contact • Anal intercourse
Herpes: Family of Infections • Herpes simplex virus (HSV) • Skin sores, eruptions • Vagina, penis, anus, buttocks, thighs, mouth • No cure • Symptomatic relief • Reactivation • Stress, inadequate diet & sleep, overworked immune system
Genital Warts • Human Papillomavirus (HPV) • 5.5 million Americans/yr • 30% progress to precancerous cells • Treatable – podophyllin, cryosurgery, simple excision, laser surgery, creams containing 5-fluorouracil, interferon injections • Preventable: vaccine
Chlamydia • Most commonly reported STI • Males • Painful urination • Watery, puslike penil discharge • Injury to glands, damage to blood vessels & heart, symptoms of arthritis • Females • Most often asymptomatic until progression • Vaginal discharge, spotting • Damage to cervix, tubes & inner pelvic structure, sterility; high risk for miscarriage/stillbirth • Treatable with antibiotics
Gonorrhea • 700,000 cases/year • Primarily infects the linings of the urethra, genital tract, pharynx, and rectum • High risk • Males aged 20 to 24 • Females 15-19 • Treatable with antibiotics • If left untreated, can cause sterility
Syphilis • Progresses in stages • Primary – chancre that disappears in 3-6 weeks • Secondary – 1-12 months after chancre disappears, rash or white patches on skin lasting a few weeks or months • Latent – infectious lesions • Late – heart damage, central nervous system damage, blindness, paralysis, dementia • Treatable with antibiotics
Human Immunodeficiency Virus (HIV) The virus that progressively destroys the body’s ability to fight infections and certain cancers
Acquired Immunodeficiency Syndrome (AIDS) 26 clinical conditions that affect people with advanced HIV disease
HIV/AIDS: Global Crisis • Sub-Saharan Africa • <1 in 5 worldwide have access to basic prevention • 1,800 children/day become infected worldwide • Only 20% affected receive treatment
HIV/AIDS: Women • > 60% U.S. AIDS cases • Leading cause of death in African American women aged 25 to 44 • Underrepresented in clinical trials • Economic disadvantages, cultural norms, rape, sexual abuse, caregiving burdens, less education, passive role in negotiating safe sex
High Risk Behaviors • Exchange of body fluids • Blood, semen & vaginal secretions • Vaginal, anal & oral sex • Sharing needles • Blood transfusion prior to 1985 • Mother-to-infant (prenatal) transmission
HIV: Transmission • HIV enters the host from an infected host • Mucous membranes of the genitals and anus are easiest route of entry • Once inside the host, the virus begins to multiply • Virus begins to destroy helper T-lymphocytes • Virus changes the genetic structure of the cells it attacks • The body begins to produce antibodies • ELISA • Western blot
New Hope & Treatments • New drugs have slowed the progression from HIV to AIDS • Protease inhibitors block the HIV protease enzyme from cutting protein chains to form new viruses • Protease inhibitors are difficult to manufacture • There is, at this time, no cure
Avoid casual sex Avoid unprotected sex Always use latex condoms Never share needles Never share razors & tattoo or piercing instruments Always use dental dams during oral sex Always be a self-advocate with medical professionals Assertively discuss protection with partners Healthy Behaviors
You Can Prevent HIV Infection Make responsible choices: avoid high risk behaviors