All About Birth Control,
You must have heard it time and time again, but we’re going to let you know one more time: abstinence, or not having sexual intercourse, is the only 100% sure method of avoiding getting pregnant or contracting sexually transmitted diseases (STDs), including HIV, the virus that causes AIDS. But if you do decide to have sex, protect yourself and your body by knowing how to get and use condoms.
Nearly half of all new STD infections in the U.S. are caught by 15-24-year-olds. And teenage girls who are sexually active with guys—even some of the time—and don't use a condom every time have a 90% chance of getting pregnant within a year of first having intercourse. (To learn more about STDs, click here.)
By using birth control and condoms together, you reduce two risks at once: the chance that you’ll get an STD and the chance you’ll have an unwanted pregnancy.
In this section, we’ve provided information about both the male and female condom. We’ve also explained how various female contraceptives work, such as the pill, the patch, and the diaphragm. We’re hoping that these facts will help you make informed decisions about your sex life.
But the tough news is that when it comes to preventing pregnancy, even the combination of birth control and condoms won’t give you 100% protection. The only surefire way to not get pregnant is to avoid penis to vagina contact.
Because you are putting your body on the line for someone else, consider talking to your partner about birth control and condoms before you start messing around. Get familiar with each another’s sexual history. Share your feelings and concerns about sexual activity. You want to make sure that you are making a decision that you won’t regret later.
If you become sexually active, you’re exposing yourself to a whole new range of possible medical conditions. It’s more important than ever to maintain your health. If you’re a woman, get regular gynecological (GYN) examinations and STD tests. If you’re a man, get tested regularly for STDs.
Planned Parenthood offers confidential services to teens regardless of age or income, including GYN exams, all kinds of contraceptives, family planning counseling, emergency birth control, pregnancy testing, prenatal care, abortions, and STD and HIV testing. For the Planned Parenthood nearest to you, call 1-800-230-PLAN or check www.plannedparenthood.org.
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Description: A cover that fits over the penis and catches semen (cum) before, during and after a man ejaculates (cums), preventing sperm from entering his partner’s body.
The condom is the only form of birth control that men can use to prevent pregnancy. The condom and the female condom are the only birth control methods that protect against STDs.
Condoms are usually made of latex. Some condoms, called “lambskin condoms,” are made from animal tissue. Lambskin condoms don’t protect you from HIV and other STDs. Make sure the package says “latex condom.”
Effectiveness: Of 100 women whose male partners use condoms when they have sex, about 15 will become pregnant during the first year of typical use. Typical use rates take into account that most people won’t use condoms correctly every time. Using condoms correctly includes putting one on before you start rubbing up against each other naked (because semen can leak out of the penis before a man cums). It also means being careful about how you put the condom on and take it off (see this diagram for a demonstration).
Being careful is worth it: Only 2 in every 100 women will become pregnant if condoms are used perfectly.
Because condoms help protect against HIV and other infections as well as against pregnancy, anyone who is having vaginal (penis in vagina) or anal (penis in anus) sex should use them. To protect against STDs, you should also use a condom for oral (penis in mouth) sex. If you’re performing oral sex on a woman (mouth to vagina) use a dental dam, a square piece of latex that lies over the vagina. You can also use a condom that has been cut open so it can lay flat.
Because it can break or slip off if not used correctly, the condom is more effective as birth control when used with a spermicide, which is a sperm-killing foam, film, cream, insert or jelly.
Pros: Condoms help prevent the spread of HIV and other STDs. They are inexpensive and easy to get. You can buy them at any drugstore without a prescription, and many clinics and some high schools make them available for free.
Since condoms are small and lightweight, it’s easy to carry them with you at all times. They make it possible for men to take responsibility for birth control. They may also help a man stay erect longer.
Cons: You have to use one every time you have intercourse. Putting the condom on may feel awkward or uncomfortable at first, since it must be used right at the time of intercourse. It may also dull sensation for either partner. It may tear or come off during intercourse, especially if it’s not put on correctly (see directions below).
Possible Side Effects: There are none, except for people who are allergic to latex. (They can use plastic condoms, which are just as effective as latex.)
Cost: You can pick up free condoms at a number of clinics and at organizations around the city. Click here to find locations distributing free condoms near you. From the "Select Services" menu on the left, choose NYC Condoms and then NYC Condoms.) Otherwise, condoms cost $7-$12 per dozen.
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The Female Condom
Description: A plastic pouch that has flexible rings on each end. One ring is inserted deep into the vagina and the other ring stays open outside the vagina. The rings help to hold the condom in place.
The female condom collects semen before, during and after ejaculation, keeping sperm from entering the vagina and protecting against pregnancy. Female condoms should not be used at the same time as male condoms.
Effectiveness: With typical use, 21 out of every 100 women using female condoms will get pregnant in a year. With perfect use, 5 out of 100 will get pregnant. Spermicide increases effectiveness.
Pros: The female condom helps prevent many STDs (including HIV and AIDS), and can be used for both anal and vaginal sex. The female condom can be purchased at a drugstore without a prescription. It allows women to take responsibility for STD prevention without having to rely on their partner. And it can be used by people who are allergic to latex.
Cons: Female condoms can be tricky to use. They are generally more expensive than male condoms.
Possible Side Effects: May cause irritation.
Price: You can pick up free female condoms at some clinics and other organizations. Click here to find locations distributing free female condoms near you. (From the "Select Services" menu on the left, choose NYC Condoms and then Female Condoms.) At a drug store female condoms start at about $3.50 each.
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More Ways to Prevent Pregnancy (But Not STDs)
Like condoms, the diaphragm and the cervical cap help prevent pregnancy by blocking sperm from entering the uterus. They should also be used with spermicide.
Click here for more details on these types of birth control.
The Pill, the Patch, the Ring, Depo-Provera and Implanon are all forms of birth control that work by releasing hormones that prevent your body from producing eggs. When used correctly, they are very effective at preventing pregnancy.
However, none of these methods protect against HIV and other STDs. To protect yourself from infection, you must also use a condom.
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Plan B/The Morning After Pill
If a condom breaks or you have unprotected sex, it’s still possible to avoid pregnancy by taking the “morning after pill,” also known as emergency contraception (EC) or Plan B. EC does not protect you from STDs.
You can use emergency contraception up to five days after having unprotected sex. However, it is most effective if taken within 72 hours (three days) after having unprotected sex. The sooner you take these pills, the more likely they are to prevent pregnancy. Emergency contraception pills work in a few ways. They can stop an egg and sperm from meeting, or stop the fertilized egg from attaching to the uterus where a pregnancy would begin.
Short term side effects may include nausea, fatigue and breast tenderness. Your menstrual period may be temporarily irregular after taking EC.
Emergency contraception should not be used in place of birth control because it’s not healthy to take it often and it’s not as effective as many other kinds of birth control. Even if taken within three days, 1 or 2 women out of 100 will still get pregnant after using EC.
Because EC is not 100% effective, see your doctor if you don't get your next expected period after taking it.
If you’re over 18, you can get EC at your local pharmacy or health clinic. If you’re under 18, you must get a prescription for EC. To find a health care provider near you who can prescribe EC, and for more information, click here or call 1-888-NOT-2-LATE.
The cost of emergency contraception varies a great deal, depending on where you go and what services you need. Plan B may cost anywhere from $10 to $45.
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Explore your options
Finding out that you are pregnant can be very emotional and confusing. Whether the pregnancy was planned or not, it’s common to feel a range of emotions, such as fear, anger, happiness, guilt, confusion, excitement and sadness. Once you find out you’re pregnant, you have some big decisions to make. The three options you have when you are pregnant are:
- Continue the pregnancy and raise the child once it is born
- Continue the pregnancy and put the child up for adoption when it is born
- End the pregnancy (have an abortion)
It’s important to weigh all of your options, examine your values about each option and talk to people you trust. Even if you got pregnant on purpose, maybe you have changed your mind about raising a child, or you have
questions about your options.
For the facts about adoption, click here.
For the facts about abortion, click here.
For the facts about pregnancy and raising a child, click here.
Whatever you decide, we hope this info will help you find the support you need.
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Crisis Pregnancy Centers are anti-abortion centers staffed by people who try to persuade pregnant women to keep their babies. They often look like sexual health clinics and advertise free pregnancy tests. But unlike a licensed clinic like Planned Parenthood, most do not provide medical services. Some may provide false information about abortion.
At a CPC, you might be shown a graphic video of abortion or be handed religious information. If you are looking for a medical clinic, make sure that it is licensed by the NYC health department before you go.
The ‘A’ Word: The rundown on abortion
Choosing to End a Pregnancy
All pregnant women, including teenagers, have the right to choose what is best for them, including ending the pregnancy with a surgical or medical abortion.
Abortion is not a substitute for birth control. To prevent another unintended pregnancy, it is important to choose an effective, ongoing birth control method and to begin using it immediately after an abortion.
A surgical abortion is an operation that ends pregnancy. Surgical abortion is very safe for women. The procedure is performed in a specialized clinic or doctor’s office, and you can go home the same day.
In New York State, it is legal to perform a surgical abortion up to the 24th week of pregnancy. The earlier in pregnancy an abortion is performed, the safer it is. Fewer than 1% of women have complications from abortions done in the first trimester of pregnancy (the first 14 weeks).
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Until the 14th week of pregnancy, most surgical abortions are performed using a method called “vacuum aspiration.” Here’s what happens:
- A doctor does a pelvic examination.
- A shot of anesthesia (pain killer) is applied, which numbs the pelvic area. Some women choose general anesthesia, which basically means being put to sleep during the abortion. If you are interested in this option, talk to the clinic staff.
- Once the anesthesia (pain medicine) begins working, the cervix is “dilated” or widened and a soft, flexible tube is inserted into the uterus.
- The tube removes the contents of the uterus. The entire procedure takes 5-15 minutes.
After the 14th until the 24th week of pregnancy, surgical abortions are preformed using a similar method called “Dilation and Evacuation” (D&E)
Other things to know:
- The longer you wait to have the procedure, the more expensive it will be. Abortions under 12 weeks can range from $350-$450. However, many clinics offer sliding fee scales, charging only what you can afford to pay. And in most cases in New York State, Medicaid should cover the cost.
- You may want to take someone with you to the clinic for support and so you don’t have to travel home by yourself after the procedure.
- A woman can usually return to normal activities on the same day she has the abortion. She should wait at least a week before using tampons, douching, or having sexual intercourse.
- Serious problems from an abortion are rare, but a woman should get medical care right away if she has heavy bleeding, severe cramping, pain, fever, or unusual vaginal discharge.
- It is important to see your provider for a check-up two or three weeks after a surgical abortion.
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A medical abortion is one in which medication (not surgery) is used to end pregnancy.
To get the medication, you need a prescription from a doctor or a family planning clinic.
Some women choose medical abortion instead of surgical abortion because it seems more natural (like a miscarriage). However, medical abortion is only an option early on in your pregnancy. It must be less than 8 weeks since your last period.
When done within this time period, medical abortion is 95% to 98% effective in ending pregnancy. If a medical abortion is not effective, a surgical abortion is necessary. Medical abortion is very safe for women.
- The doctor will give you a medication that causes the lining of the uterus to start to break down.
- A few days later, the doctor will give you another medication, which causes the uterus to contract and empty. You will feel cramping and will bleed (like during your menstrual period, but heavier).
- About two weeks later, you return to the doctor’s office for a check-up. At this visit the doctor will make sure the abortion is complete and there are no complications.
Other things to know:
- It usually it takes from three days to one week to end the pregnancy, but for some women it may take up to four weeks.
- Side effects include mild-to-severe cramping, abdominal pain, nausea and vaginal bleeding.
- Remember to call your health care provider if you have any problems or concerns during this process.
All women, including teenagers under 18, have the right to confidential abortion information and services. You do not need permission from a parent or caretaker, the consent of the baby’s father, nor proof of citizenship to have an abortion in New York State. Free or low-cost services are available.
To find an abortion provider in your area, call The National Abortion Federation Hotline, at 1-800-772-9100. You can also call Planned Parenthood (1-800-230-PLAN) or contact one of their New York clinics:
Want more information?
The National Abortion Federation offers information on abortion and listings of abortion providers by state.
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Putting your child up for adoption is another alternative for pregnant teens who feel that they aren’t ready to be parents. Choosing adoption is not the same as placing your child in foster care. If you choose adoption, ACS will not have custody of the child and he or she will not be put into the system. Adoption of infants is handled by private adoption agencies, not ACS. Adopted infants go to people who want to raise a child of their own, but either cannot or choose not to have a child biologically.
There are three types of adoption:
Open adoption is when the birth parent(s) are allowed contact with the child and adoptive parents before and after placement. Because the child is adopted, the birth parent's (or parents') rights are legally terminated. The adoptive parents can control when visitation or any kind of contact between the birth parent and the child occurs. However, the goal in open adoption is that the child have some contact with birth parent(s).
In semi-open adoption, birth parent(s) are involved with the adoption agency in choosing a placement for the child. The birth parent(s) are also allowed to exchange letters and photos of themselves with the child. Semi-open adoption has to be arranged between the birth parent(s), adoption agency and adopting parents before placement of the child.
In closed adoption there is no contact between the child and birth parent(s). During the matching process only basic information, such as medical records and anonymous background information about the birth parent(s), is exchanged. This information is disclosed to the adoptive parents to give them an idea of the child’s background.
If you are considering adoption, you should talk to a licensed adoption agency or adoption attorney to learn more about your options. Here’s a directory of private adoption agencies in NYC.
Questions you might want to ask the adoption agency:
• Will I get counseling during my pregnancy, after I sign the papers allowing my child to be adopted, and after my baby goes to live with his or her new family?
• Can my baby’s father and other people important to me join me in the counseling, if they want to?
• What kind of financial, legal, and medical help will I receive? Can I get help with medical and legal expenses?
• Can I choose my baby's adoptive parents? Can I meet them?
• Will I get to know about my baby after the adoption?
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Becoming a Parent
Many teens in care end up having kids before they’re ready. I was 14 when I gave birth to my daughter, and I had to change a lot. I had to learn to be patient and responsible. Some days I was so tired and she would cry and cry. But when I didn’t feel like giving her all my attention, I’d think about how bad I felt as a kid when I was not getting any attention from my dad. The last thing I want to do is make my baby feel like she can’t depend on me.
If you’re thinking about having a baby, ask yourself the questions I wish I’d asked myself: Am I working and living in my own apartment? Am I in love with my child’s father? Have we been together for a long time? Does he have a job? Are we both well-educated? Are we independent? Can we depend on each other? If not, are there other supportive adults in my life who will help me raise this child?
If you can’t answer “yes” to these questions, you might want to think twice about becoming a parent right now.
If you’re already caring for a child and trying to do the best you can, here’s my advice: Keep your head up. Listen to the older generation—someone who you think treats their children well. Try to pay your child a lot of attention. And most of all, if you need help, ask for it.
Prenatal Care and Pregnancy Basics
When you're pregnant, it’s extra important to get the right medical care (this is called “prenatal care”). Your doctor will help make sure you stay healthy so that your baby is delivered healthy. He or she will also teach you about what to eat, what not to eat, and anything that could harm your baby, like alcohol, cigarettes and many drugs, both illegal and over-the- counter. You should also know what to expect when you give birth and how to care for your baby once it’s born.
What To Expect at the Doctor’s Office
During your first prenatal visit, the doctor will ask you lots of questions, including the date of your last period. This helps the doctor estimate how long you have been pregnant and your due date.
The length of your pregnancy is measured in weeks. Most babies are born between 37 and 40 weeks after conception (when the sperm fertilizes the egg). Only a small percentage of women actually deliver exactly on their due dates.
Pregnancy is divided into three phases, called trimesters. The first trimester is from conception to the end of week 13. The second trimester is from week 14 to the end of week 26. The third trimester is from week 27 to the end of the pregnancy.
The doctor will explain the types of physical and emotional changes you can expect during pregnancy. He or she will also teach you to how to recognize the signs of possible problems during pregnancy (called complications). This is especially important because teens are more at risk for certain complications. Typical complications include anemia (usually caused by an iron deficiency), high blood pressure, and delivering a baby earlier than usual (called premature delivery).
During visits, your doctor will check your weight, blood pressure, and urine, and will measure your abdomen to keep track of the baby’s growth. Once the baby’s heartbeat can be heard with a special device (at about 10-12 weeks), the doctor will listen for it at each visit. Your doctor will probably also send you for some other tests during the pregnancy, such as an ultrasound, to make sure that everything is OK with your baby.
It can be difficult to talk to the doctor about your body. But remember that your doctor is there to help you stay healthy during pregnancy and have a healthy baby. There is nothing he or she hasn’t heard from expectant mothers! So ask those questions, even if they seem embarrassing.
Pregnancy Dos and Don'ts
DO: Eat healthy
Pregnancy is not the time to try to lose weight or diet; it can harm the baby. Even if you are suffering from morning sickness, try to eat regularly, and stay away from junk food. Talk to your doctor about how much weight you should gain and what kinds of healthy foods to eat.
DO: Stay active
Avoid strenuous activity (like playing basketball) but stay active by walking or swimming. Being active during pregnancy will help you with the delivery of the baby, and some studies now show that getting moderate exercise during pregnancy can improve your baby's brain function after he or she is born.
DO: Get educated about giving birth and caring for your baby
There are classes you can take at most hospitals that can help prepare you for the birth and taking care of your baby. Or check out the resources below.
DO: Take a prenatal vitamin every day
Taking a vitamin with folic acid and other nutrients is very important and will help make your baby healthier. Ask your doctor about the best vitamin to take.
DON’T: Drink alcohol, smoke, or take drugs
Drinking, smoking cigarettes, or using drugs while pregnant all put your baby at risk for birth defects, mental problems, prematurity (when babies are born earlier than 37 weeks), miscarriage, and other medical problems. If you’re using drugs, babies can also be born addicted. Withdrawal is physically painful for your baby. And being born with an addiction can have a life-long impact.
If you are having a hard time not drinking, smoking or using, call 311 for help. There are free programs that can help you (and your baby).
DON’T: Have unprotected sex. You (and now your baby) are still at risk for STDs.
Talk to your doctor about sex during pregnancy. If your doctor says it’s OK to have sex while you’re pregnant, you must use condoms (including during oral sex) to prevent getting an STD.
Some STDs can cause blindness, pneumonia, or meningitis in newborns. By avoiding unprotected sex, you’re protecting your baby as well as yourself.
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Places to Get Help
If you’re still in foster care, your agency is required to help you find prenatal care. But if you are not getting all the help you need, check out these resources:
The Women’s Health Line
Call 311 and ask for the Women's Health Line
This New York City hotline provides information about the many government programs that can help you and your baby stay healthy both during pregnancy and after delivery.
Prenatal Care Assistance Program/Medicaid Obstetrical and
Maternal Services PCAP/MOMS
1-800-522-5006 (New York State Growing Up Healthy Hotline)
This free New York State program offers women a range of services, including medical care for mothers during pregnancy and for two months following delivery; HIV counseling; help in applying for benefits; and health care for babies for one year after birth. Eligibility is based on income.
Visiting Nurse Services
If you’re a first-time mom-to-be, you may be able to receive free, in-home care and support from a nurse or health worker. These services start before your baby is born. The nurse or health worker will help you prepare for the birth and show you how to care for your baby after it’s born. She will help make sure you and your baby stay healthy and teach you how to get the resources you need.
Here are three programs that offer these services:
1) Healthy Families of New York City Home Visiting Program
This program offers free home visits by a Family Support Worker once a week while the mother is pregnant and for the first six months after the baby is born.
Mothers may participate in the program until their children turn 5 or are enrolled in Head Start. The Family Support Worker will help mothers become more comfortable with good early childhood practices, such as understanding the baby’s needs and using play to teach the baby about the world. The worker also provides support to the mother in finding good health care and reaching job and educational goals. Click here to find a Healthy Families location near you.
2) Nurse-Family Partnership
The Nurse-Family Partnership helps teach first-time moms how to care for their babies and advocate for themselves. Each participant is assigned a nurse, who visits the mother while she’s pregnant and keeps working with her until the baby is 2 years old. You must sign up by the 28th week of your pregnancy. There are NFP locations in every borough. To find the one nearest you, call the Targeted Citywide Initiative at 646-672-2865, or ask your foster care agency to refer you.
3) Community Health Worker Program
Community health workers visit pregnant women in their homes at least once a month from pregnancy through the baby’s first year. They provide basic health education and help families connect to the resources they need.
Urban Health Plan
Morris Heights Health Care
Hospital & Medical Center
Northern Manhattan Perinatal
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Emotional Support and Parenting Help
Becoming a parent will change your life in many ways. It’s important to think about how you’ll accomplish your own goals, like completing your education or finding a job. It’s also important to have emotional support, because parenting is tough. Even if you don’t have many supportive people in your life, you don’t have to face these things alone. The following resources can help.
555 Broome Street
212-941-9090, ext. 3203 or ext. 3207
The Door offers several programs for young moms: a Prenatal and Mothers’ Support Group; the LYFE Program; and the Early Head Start Program.
The Prenatal and Mother’s Support Group gives pregnant and parenting young women both emotional support and concrete instruction on issues like nutrition and children’s health.
LYFE is a NYC Department of Education program that allows young mothers to continue their high school education or GED program. Daycare is provided. Space is limited and women must enroll or be enrolled in a Department of Education program to be eligible. Call 212-941-9090 ext. 3317 for more info.
The Early Head Start Program helps young parents develop their parenting skills, understand their children’s development, and connect with other young parents through parent/child playgroups.
Young Mothers Mentoring Program
Big Brothers Big Sisters
223 East 30th Street
This program matches pregnant and parenting young women with mentors who can identify community services, parenting classes, and fun activities, and help prepare for childbirth.
240 East 123rd Street (2nd & 3rd Aves.), 3rd Floor
The STRIVE Fatherhood program targets fathers who need help with parenting skills and navigating the child support system. Fathers participate in Strive’s Core Employment Training while taking part in weekly peer support groups on topics like relationship building and communication skills.
New York Foundling Crisis Nursery
590 Avenue of the Americas (W. 17th St.)
24-Hour Parent Hotline: 1-888-435-7553
Provides emergency childcare for stressed out parents for up to 72 hours without ACS involvement.
NYC Early Intervention Program
Call 311 and ask about Early Intervention programs
Each baby develops differently. However, if you are concerned about the development of your baby, speak with your doctor. If you continue to have concerns about your baby’s development, the Early Intervention Program can assess your child’s development and provide services when needed.
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Sexually Transmitted Diseases: Protect Yourself and Your Partner
The last thing you want to do when you’re having sex is get a disease, or give one to your partner. Sexually transmitted diseases (STDs) are very serious, but you can take steps to protect yourself and your partner. Here’s what you need to know:
Who gets STDs?
Teens and young adults are most likely to be infected. There are about 19 million new STD infections each year, almost half of them among people ages 15 to 24. A recent study estimated that 1 in every 4 teen girls has been infected with at least one of the four most common STDs (chlamydia, genital herpes, HPV and trichomoniasis).
How do you get an STD?
STDs are primarily spread through sexual contact such as vaginal sex (penis to vagina), anal sex (penis to anus) or oral sex (penis, vagina, or anus to mouth). If you are having sex, you are at risk of getting an STD, regardless of whether you are having sex with women, men, or both.
How can you prevent STDs?
The only completely sure way is to practice abstinence (don’t have sex). If you are sexually active, using a barrier method like a condom every time you have sex--including oral sex--will reduce your risk.
How do you treat an STD?
Trichomoniasis, chlamydia, gonorrhea and syphilis can be cured with antibiotics. Be careful—after being cured, you can still get re-infected.
Herpes and HIV (the virus that causes AIDS) have no cure—they stay in your body for life. But medication can help reduce the symptoms.
There is no treatment for HPV, but it can be prevented with a new vaccine. This vaccine is especially important to get, because it protects you against the strain of HPV that causes cervical cancer in women and girls. It’s best if you get the vaccine before becoming sexually active.
Who should get tested?
If you’ve ever had sex, you should get tested for HIV and other STDs. Even if you've had protected sex, you should still get tested, since no method is 100% effective. You can get tested for free, and you don’t need a parent or guardian’s permission. They don't have to know about the tests or the results. For more information, including what to expect and a list of clinics providing free and confidential tests, click here.
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Common STDs, and Ways to Treat Them
Want more information? Here are the specifics on each STD, including how it affects your body, symptoms and treatment.
WHAT IT IS: HIV stands for human immunodeficiency virus. This is the virus that causes AIDS. HIV attacks the immune system, the system that helps us fight infections. When HIV weakens the immune system to a certain level, then the person has AIDS, a disease in which the body can no longer fight off infections. Ultimately, the disease causes death.
About 1 million people in the United States are living with HIV or AIDS. About a quarter don’t know that they are infected. Not knowing puts them and others at risk. Each year more than 56,000 people get infected with HIV.
SYMPTOMS: The only way to know whether you are infected is to get tested regularly for HIV. Someone can look and feel healthy but can still be infected; it can take years for symptoms to show up.
HOW YOU CATCH HIV: HIV lives in the blood, semen (cum) or vaginal fluid of an infected person. HIV is transmitted in two main ways: (1) Having anal, vaginal, or oral sex with someone infected with HIV; (2) sharing needles and syringes with someone infected with HIV. (Infected mothers can pass the virus on to their children during pregnancy or through breast feeding. People can also get HIV through blood transfusions, though that’s very rare now.)
HOW TO PREVENT HIV: Always use a latex condom for vaginal, anal and oral sex. Get tested and talk to your sex partner about getting tested. If you are infected, tell your current and former partners. And if you are taking intravenous drugs (shooting up), never share needles.
HOW TO TREAT HIV: There is no cure. But there are now drugs that let many HIV-positive people live longer, healthier lives. These drugs help control the outbreak of the virus, but they have a lot of side effects that can impact your quality of life, such as causing chronic diarrhea.
WHAT IT IS: Genital herpes is caused by the herpes simplex virus (HSV). There are two kinds: Type 1 (oral herpes, cold sores on the mouth) or Type 2 (genital herpes).
Nationwide, at least 45 million people ages 12 and older, or one out of five people, have had genital HSV infection.
SYMPTOMS: Blisters on or near the genitals (penis or vagina) or rectum. These sores may take two to four weeks to heal the first time they occur. You may also have flu-like symptoms, including fever and swollen glands. Another “outbreak” of sores can appear weeks or months after the first. These outbreaks are usually shorter and less painful. A person can have about four to five outbreaks a year.
However, many people have no symptoms, and they still can infect others. Usually people are only contagious while they’re having an outbreak, but an outbreak can begin before you notice it.
HOW YOU CATCH HERPES: Most genital herpes is caused by HSV-2, which spreads through contact with the infected area—usually vaginal or anal sex. HSV-1 can be transmitted to the genitals through oral sex.
HOW TO PREVENT HERPES: Use latex condoms for genital, anal and oral sex. Get tested and if you are infected, tell your current and former sex partners. Do not have sex during an outbreak.
Genital HSV can lead to deadly infections in babies. It is especially important for women to get tested for herpes when they know they're pregnant, and to avoid unprotected sex during pregnancy. If you know you have herpes and are pregnant, make sure to tell your doctor immediately.
HOW TO TREAT HERPES: There is no cure; you have herpes for life. Doctors are working on a herpes vaccine, and there are antiviral drugs to reduce the number and intensity of outbreaks.
WHAT IT IS: Genital human papillomavirus (HPV) infects the skin and mucous membranes. There are more than 40 HPV types that can infect the genital areas, including the penis, vulva (area outside the vagina), and anus, and the linings of the vagina, cervix and rectum.
HPV is the most common sexually transmitted infection. At least half of sexually active men and women get a genital HPV infection at some point in their lives.
SYMPTOMS: Most people with HPV don’t get symptoms or health problems. But certain types of HPV can cause genital warts in men and women one to six months after they catch it. Other HPV types can cause cervical cancer and other less common cancers, such as cancers of the vulva, vagina, anus and penis. The types of HPV that cause genital warts are not the same as the types that can cause cancer.
Genital warts usually appear as small bumps, usually in the genital area. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. Warts may appear within weeks or months after sexual contact with an infected person—or they may not appear at all.
HOW YOU CATCH HPV: Skin-to-skin contact with warts—but those warts could be hidden inside the urethra (urine canal) or vaginal walls.
HOW TO PREVENT HPV: A new vaccine can now protect females from the four types of HPV that cause most cervical cancers and genital warts. It is given in three doses, which should be started before girls become sexually active. The vaccine will not protect you if you’ve already been infected with HPV.
Using a condom will also reduce the risk of infection.
HOW TO TREAT HPV: HPV often goes away on its own, without causing health problems. But there’s no guarantee. Most people who become infected with HPV do not even know they have it. You should get tested for disease that HPV can cause, especially cervical cancer.
WHAT IT IS: Trichomoniasis is caused by a tiny parasite. The vagina is where women are usually infected. The urethra (urine canal) is the most common site of infection in men.
Trichomoniasis is the most common curable STD in young, sexually active women.
SYMPTOMS: Symptoms are more common in women and usually appear within five to 28 days of exposure. Symptoms include yellowish green vaginal discharge with a strong odor; itching; pain during urination and/or intercourse; and urinary tract infections. Most men with trichomoniasis do not have signs or symptoms; however, some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation.
HOW YOU CATCH TRICHOMONIASIS: The parasite is spread through penis-to-vagina intercourse or vulva-to-vulva contact with an infected partner. Women can catch the disease from infected men or women, but men usually contract it only from infected women.
HOW TO PREVENT TRICHOMONIASIS: Condoms and dental dams can help prevent it. Stop having sex if you have any of the above symptoms—and get tested.
HOW TO TREAT TRICHOMONIASIS: Antibiotics, usually taken in one dose, will get rid of it. Your sexual partner/s should get treated at the same time so they don’t re-infect you.
WHAT IT IS: Chlamydia is a bacterial infection that can lead to serious reproductive problems for women.
Chlamydia is the most common infectious disease in the U.S.: over one million cases are reported a year. Many more cases go undiagnosed—as many as 2.8 million new cases each year.
SYMPTOMS: Most women never have symptoms, so you should get tested every year. Women who do get symptoms may have abnormal vaginal discharge, painful urination, fever, nausea, or pain during sex. Men may have discharge from the penis, burning or itching in the urethra, or pain or swelling in the testicles.
HOW YOU CATCH CHLAMYDIA: Genital-to-genital and genital-to-anal contact.
HOW TO PREVENT CHLAMYDIA: Sex with a condom can help prevent chlamydia.
HOW TO TREAT CHLAMYDIA: It can easily be cured with antibiotics, which can clear up the infection in about 7-10 days. If you find out you have it, your partner should get tested and treated as well, so you don’t get re-infected.
If left untreated, chlamydia can cause severe health consequences for women, including pelvic inflammatory disease (PID). PID is an infection of the uterus, fallopian tubes and/or ovaries that can lead to ectopic pregnancy and infertility. Up to 40 percent of females with untreated chlamydia infections develop PID, and 20 percent of those may become infertile.
WHAT IT IS: A bacterial infection that enters the body through mucous membranes in the vagina, urethra, cervix, anus, and mouth.
Gonorrhea is the second most commonly reported infectious disease in the U.S.
SYMPTOMS: Most people don’t have symptoms. Those who do may have abnormal discharge from vagina or penis and pain during urination.
HOW YOU CATCH GONORRHEA: Genital, oral, or anal sex.
HOW TO PREVENT GONORRHEA: Using a condom during sex helps reduce the risk, but again, it is not 100% effective.
HOW TO TREAT GONORRHEA: Antibiotics can get rid of it, but a growing number of gonorrhea cases are resistant to the antibiotic that has been used to treat it.
You should get tested for gonorrhea and chlamydia at the same time, since they often occur together, and neither shows symptoms. If left untreated, gonorrhea in men can cause epididymitis, a painful infection in the tissue around the testicles that can lead to infertility. Like chlamydia, untreated gonorrhea in women can lead to Pelvic Inflammatory Disease, which can cause infertility or make it difficult to get pregnant.
WHAT IT IS: Syphilis is a disease caused by a bacteria that enters the body through the mucous membranes or cuts in the skin.
Six times more men than women have syphilis, partly due to its prevalence among men who have sex with men.
SYMPTOMS: If untreated, syphilis develops in four stages.
First Stage: Painless, red-rimmed sores on genitals, anus or mouth. These can last for about three to six weeks.
Second Stage: This happens six weeks to six months later. Symptoms include a rash all over the body or on the palms and bottoms of feet, and bad flu-like symptoms like fever and nausea as well as joint swelling and hair loss. This lasts one to eight weeks.
Third Stage: If syphilis is not treated in the first two stages, it can “hide” for years. You won’t have any symptoms, but the disease is still in your body.
Fourth Stage: This happens 10-20 years later. At this point, the infection has spread throughout your body and can cause brain damage, heart disease, paralysis, and even death.
HOW YOU CATCH SYPHILIS: Syphilis is spread by contact with the sores or through genital-to-genital, genital-to-oral, or genital-to-anal contact. Like many other STDs, it can help spread HIV, because the HIV virus can easily enter the sores during unprotected sex.
HOW TO PREVENT SYPHILIS: Using a condom can help. It’s especially important for pregnant women not to have or get syphilis: It can cause stillbirth, infant death, or physical deformity and brain and nervous system complications in children.
HOW TO TREAT SYPHILIS: Antibiotics can cure syphilis in its early stages. However, the longer the infection remains in your system, the more treatment is required. It’s important to get tested and treated as soon as possible.
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It can be scary to acknowledge that you might have an STD. But if you’ve had unprotected sex, you need to get tested. Many STDs can be easily cured. And the ones that can’t, like herpes and HIV, can be controlled. For you own health—and that of your partner—you need to know if you have anything.
For information on STD testing, including what to expect and a list of clinics providing free and confidential tests, click here.
“Sexual abuse is a hard thing to live through. It may be even harder to talk about. The shame, the powerlessness, the fear and the hurt can seem to saturate every part of your being. It takes great strength to get through sexual abuse without your soul and compassion and hope for the world completely dying. If survivors can do that, we can do anything—even talk about it and heal.”
Sexual abuse is when someone forces or manipulates you into sexual behavior for their own gratification. Sexual abuse can include kissing, touching sexual parts of the body, or oral, vaginal, or anal sex. It also includes non-physical violations like being shown pornography or having someone expose their genitals to you.
Sexual abuse does not have to include physical violence. If someone who is older or more powerful than you gets you to engage in sexual activity, it is abuse, even if you don’t say no and even if it feels good. It is not your fault. No matter what you did or how you felt, you are not responsible for the abuse you experienced.
If you’ve been sexually abused, tell someone you trust. A foster parent, therapist, friend, teacher, or other adult can give you emotional support and make sure you receive the medical and psychological care you need. If the first person you tell doesn’t believe you, find someone else to talk to. You deserve support and there are people who will believe and help you.
How Can We Recover?
Advice from Mary Boncher, a therapist at New York Foundling’s Child Sexual Abuse Treatment Services
Q: Who is most likely to be a victim of sexual abuse?
A: Sexual abuse can happen to anyone. But it often happens to people who are more vulnerable. A child who is less protected is more likely to be abused. If a parent is not able to be around, is working a lot, or has emotional problems, the child is more vulnerable and is more likely to be abused.
Sexual abuse is more likely to occur if there is drug or alcohol abuse or mental illness in the family. Also, if it happened in previous generations and there wasn’t intervention, like if the mom was sexually abused and never had an opportunity to deal with it, she’s likely to close out signals that her child sends about abuse.
Q: Why do some people not speak up about sexual abuse?
A: Often a child doesn’t believe that he or she would be believed. The perpetrator [the one doing the abuse] might have told him that no one will believe him. Or that child might’ve been tempted to tell someone—but her discomfort might make her tell someone in a way that isn’t direct or clear.
And sometimes kids feel like sexual abuse is their fault—they might be told it’s their fault by the perpetrator, who might say, "I’m doing this because you want it." The child might believe that.
The child may love the perpetrator. A perpetrator may give the child more nurturing than anyone else. And then they’re supposed to tell about the abuse on top of that? That’s hard. It takes a lot of courage.
Q: What are some of the effects of sexual abuse?
A: Children who have caregivers who believe them will have less negative impact from abuse than children who have caregivers who don’t believe them. In either case, sexual abuse can be very traumatizing. It is a violation of trust, of body and of a relationship.
Post Traumatic Stress Syndrome can occur, including flashbacks to the abuse, hyper vigilance [often expecting something bad to happen], nervousness, anxiety. Some kids have blocked the abuse out of their memory. [That’s called "dissociation."] If someone uses dissociation too much, they’ll have a hard time focusing in school and won’t be in touch with their emotions, which can make it hard for them to know when they’re in dangerous situations.
Adolescents who have been abused might be suicidal or use alcohol and drugs to numb their feelings. Some kids become hypersexual. They may engage in a lot of sexual activity to gain a mastery of the abuse. Other kids try to be neutral sexually. They don’t want to be sexual at all. They might wear layers and layers of clothing, trying to protect their body and not let people see it. For others, it doesn’t affect their sexuality.
Relationships can be pretty difficult. Because of the trust violation, the child starts wondering whom he can trust. If you don’t trust, it’s hard to know how to react and what are normal boundaries to have. Some children who’ve been abused are blindly trusting, which can make them vulnerable to more abuse. Others don’t trust anybody. Some children bring you in too close. Others keep you too distant.
And there are often issues of control and power, because abuse is about an adult taking inappropriate power over the child.
Surprisingly, some kids don’t seem to have any effects at all. Studies have shown that usually those kids have someone in their life who they really think is there for them. Usually they have some sense of power over the situation, and usually their day-to-day lives haven’t changed too much after the abuse.
Q: Can therapy help?
A: Yes, but remember that’s coming from a therapist. I think that all children should have the opportunity to talk about what happened to them in a supportive environment. It can help the child resolve feelings from the abuse, or connect to feelings he may have blocked out.
I believe that sexual abuse not only impacts a child psychologically, but also spiritually—it impacts their ability to believe in the goodness in the universe.
Therapists walk journeys with the client in which the client is the expert on what happened to them, and the therapist is the expert on healing.
Group therapy is very powerful for teenagers, because peer relationships are so important to teenagers. And kids who have been sexually abused feel different, feel stigmatized. It’s powerful for them to hear others talk about it. It helps them feel less alone.
Therapy is not all easy, and sometimes the person may feel worse for a while before they feel better. But the long-term effect is positive. In therapy we try to help people become the human beings they have the potential to be—powerful human beings.
Q: What advice would you give someone who hasn’t spoken up?
A: Find someone you trust to tell. If they don’t believe you, find someone else. And even if you don’t believe this, the abuse is not your fault.
If you have been a victim of sexual abuse or know someone who has, there are lots of places you can go for help. Here are a few:
Safe Horizon Rape, Sexual Assault, and Incest Hotline
Rape, Abuse and Incest National Network (RAINN)
NYPD Sex Crimes Report Hotline (to report sexual abuse to the police)
Girls Education & Mentoring Services
GEMS provides preventive and transitional services to young women, ages 12-21 years, who are at risk for or involved in sexual exploitation and violence.
New York City Alliance Against Sexual Assault
Their resource page offers listings of free or low-cost services for sexual abuse victims as well as sexual offenders, plus information on state law and reporting or not reporting sexual abuse to the police.
If you are worried about your sexual behavior toward others:
Click here for a list of sex offender treatment programs in New York City.
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Domestic Violence & Relationship Abuse
What is the difference between a healthy relationship and an unhealthy one?
A good relationship feels empowering. It makes you feel confident to pursue goals that are important to you. Good relationships make you feel healthy and happy at school, work, and home. If this describes your relationship, you should hang on to it.
Unhealthy relationships are almost the opposite. An unhealthy relationship undermines the way you feel in other parts of your life. If you begin to feel isolated, afraid to talk about the relationship, disconnected from friends, or pressured to be a certain way that just doesn’t feel right, you should think seriously about ending that relationship. Often, unhealthy relationships get worse, to the point where you may not be safe.
Even though you may love the person who is treating you badly, remember that a healthy relationship makes you feel bigger, not smaller; happier, not sadder; safer, not less safe; more yourself, not a stranger to yourself. In a healthy relationship you are supported to be your best, not put down and made to feel weak. You deserve to be in a healthy relationship.
What is Relationship Abuse?
Relationship abuse (also called domestic violence, dating abuse, or dating violence) is when one partner uses a pattern of damaging behavior to control the other partner.
The damage can be physical (one partner hits the other). But it can also be emotional, like when one partner is manipulative, makes threats, or constantly puts the other down and makes him or her feel worthless.
Although most victims of relationship abuse are women, it can happen to anyone, male or female, gay or straight, married or unmarried.
A lot of kids in foster care have witnessed domestic violence. If you’ve come from a violent home you’re also more likely to get into a violent relationship yourself. If you’ve never processed what happened to you by talking to a therapist, you may repeat the same abusive patterns in the relationships you develop as you get older. Therapy can help you break the pattern.
If you recognize abusive behaviors in yourself, see this page by Love Is Respect for advice on how to change.
If you are being abused, it's not your fault. You deserve to be treated with respect.
If you think you or someone you know is being abused, these resources can help.
Where to Get Help
NYC Domestic Violence 24-Hour Hotline
The National Dating Abuse Helpline
Center Against Domestic Violence
Offers education and prevention programs and helps people to become economically independent; has a resource page just for teens.
New York City LGBTQ Anti-Violence Project
Provides counseling and advocacy services, offers support groups, assists in obtaining orders of protection, and helps locate shelters and emergency housing options for LGBTQ people dealing with domestic violence.
Women’s Therapy Centre Institute
562 West End Avenue, Suite 1C
New York, NY 10024
Their domestic violence program, Connect and Change, provides free weekly therapy to women who have experienced domestic violence, for “as long as it takes.”
Provides education and support services aimed at ending dating abuse and domestic violence; also gives legal assistance to young people ages 12-24 who are in abusive relationships.
24-hour hotline will direct you to domestic violence shelters in New York City: 800-621-HOPE (4673)
How Therapy Can Help
Linda Arkin, a clinical social worker at the Women’s Therapy Centre Institute, explains:
In therapy, people have a consistent, trustworthy person to talk to about their feelings.
Therapists can help people sort out their feelings as they try to deal with the issues of their lives. Especially if you have children, it’s very difficult to get childcare, jobs, apartments, and legal issues taken care of. Victims often have a lot of medical issues and a lot of running around to do. Therapists can help break down tasks so life feels more manageable.
Therapists can especially help to evaluate new partners. If they haven’t taken the time to really understand what happened to them, they can go on to date someone else who will also be violent. It’s not that they’re looking for an abusive partner, but that their thinking is still off. They’re still feeling bad about themselves and unable to make decisions about their own safety. They may downplay safety risks because they feel alone and want the relationship to work.
When people are really conscious of their needs and wants, and understand the cycle of violence, they’re likely to spot someone who might be abusive sooner. It’s a very conscious effort. You have to become very conscious of yourself and of who you’re going out with, so you notice if there’s the slightest thing wrong and react to it. If the therapist is hearing about a new guy, and this new partner sounds controlling, the therapist can help with “reality testing.”
With trauma, it usually takes a long time to deal with the deeper issues. There are many different ways that therapists work, and many different ways that patients want to work. If a woman is having flashbacks, she may share what they’re about or she may not. But at least she’ll work with the therapist to understand why she’s having flashbacks and how to take care of herself when they happen.
Or if a woman feels that she’s not doing OK, that she’s depressed, or maybe just finding herself irritated or upset with her kids a lot, the therapist can help her figure out what’s going on and learn practical ways to cope better.”
The Mayor's Office to Combat Domestic Violence has an online tool directing you to domestic violence counseling programs and shelters citywide, including services specifically for teens.
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