Sex

• Q. What is sexual intercourse?
  • Sexual intercourse is when a male's hard penis goes inside a female's vagina or anus or a male’s anus. Oral sex is when you lick or suck another person's penis or vagina.
• Q. When can you start having sex?
  • There is no absolute right age to start having sex. What matters is whether it is the right time for you. If you have never had sex, you should wait until you are ready. It also depends on what you mean by 'having sex'. There are many ways in which you can give and receive sexual pleasure without having sexual intercourse. Giving each other massages, kissing and hugging can be very passionate. It's a way of sharing and showing love. If you are sexually active, you should always use a condom.

Sex and Pregnancy

• Q. Is there a "safe time" to have sexual intercourse?
  • There is no safe time to have unprotected sex if you wish to avoid pregnancy and sexually transmitted infections (STIs). STIs can be transmitted whenever your sexual organs come in contact with the sexual organs of an infected person.
    
    There is not a safe time to avoid getting pregnant, even during a girl's menstrual period. Although women are generally only fertile for a few days every month (usually around the middle of the menstrual cycle) most women have no definite way of knowing when this is. A girl cannot get pregnant from giving oral sex to a boy, even if she swallows his sperm. Likewise a girl cannot get pregnant from receiving oral sex.

Condoms

• Q. Why should I use a condom?
  • Condoms prevent unwanted pregnancy and transmission of sexually transmitted infections, including HIV. Use a condom every time you have sex. Even one unprotected sexual encounter (without a condom) with a person whose sexual health status you are not certain of will put you at risk of STIs, including HIV.
    
    Condoms can be purchased at most chemists, paan wallahs or health centres. You should not feel embarrassed about buying condoms. It shows you are smart, responsible and care about your well being and your sexual partner’s health.
    
    Many people believe that using condoms reduces pleasure. Condoms can actually increase pleasure as they reduce the worry of contracting sexually transmitted infections or causing unwanted pregnancy.
• Q. What is the correct way to use a condom?
  • Use a NEW condom every time you have sex. Condoms cannot be washed or reused. Always check the expiry date before using the condom. If the condom has passed the expiry date, it is possible that it may not be effective. Remember to store condoms in a cool place, as heat damages them.
    
    Check the condom for any damage after you have taken it out of the packet. With the lubricated side on the outside, place the condom on the erect penis, pinching the tip to ensure that air is not trapped inside. You want to prevent an air pocket in the condom, as this can cause the condom to burst or tear. Roll the condom all of the way down the erect penis. After you have ejaculated your semen, hold the base of the condom while you remove your penis from your partner.
    
    If the condom does not unroll on the penis, it probably means that you are trying to put the condom on upside down. Flip the condom over and try again. You may need to use a new condom.
• Q. Are two condoms more effective than one?
  • No! Do not use two condoms at the same time. In fact, using two condoms could increase the chances of the condom getting damaged because the latex rubbing against each other may cause the latex to tear.
• Q. What is a female condom?
  • The female condom is a sheath or pouch about 17 cm (6.5 inches) in length. It is worn by a woman during sex. It entirely lines the vagina and it helps to prevent pregnancy and sexually transmitted infections, including HIV.

Sexually transmitted infections

• Q. What are Sexually Transmitted Infections?
  • Infections of the sexual organs of men and women are known as sexually transmitted infections (STIs). STIs can be spread by having unprotected sexual intercourse with someone who has an infection. HIV is one of many sexually transmitted infections. Many people do not realise they have an infection of the sexual organs. Some STIs do not show any symptoms, so you can be infected and not know it. You may unknowingly transmit your infection to your sexual partner. Using condoms during sex is the best way to prevent sexual transmission of infections, including HIV.
• Q. What are the common symptoms of STIs?
  • Symptoms vary from person to person but could include:
    Unusual fluid or discharge from the penis or vagina. Women normally have some fluid discharge from the vagina, which is normal. Men, apart from discharging semen, also discharge pre-ejaculatory fluid. Both these are natural and normal. When some of the following changes take place in the discharge, these may signal the presence of a STI: change in colour, unpleasant smell, a curd-like appearance
    
    Swelling or excessive itching of the sexual organs
    
    Pain while having sexual intercourse
    
• Q. What do I do if I have symptoms?
  • See a doctor immediately if you have pain, a burning sensation or sores relating to the sexual/reproductive organs. STIs can be diagnosed and treated only by a qualified doctor. Home remedies cannot cure STIs completely. Even after your treatment, please visit your doctor periodically in order to ensure that you have fully recovered. Your partner should also see a doctor and be treated if necessary.
    
    If you do not get proper treatment for your STIs, it can lead to impotency, infertility, permanent urinary tract infections, death or injury to the unborn child and increased risk of getting HIV.
    
• Q. Is there a connection between HIV and other sexually transmitted infections?
  • The presence of sexually transmitted infections in an HIV-infected person can increase the risk of HIV transmission. This increase in risk is due to the STI causing breaks in the skin, which enables HIV to enter the body more easily. If an HIV negative person has an STI, he or she is at increased risk of being infected with HIV if he or she has unprotected sexual relations with someone who has HIV.

HIV and AIDS

• Q. What are HIV and AIDS?
  • HIV or Human Immunodeficiency Virus is a virus that enters the human body and slowly weakens the immune system. The virus is detected in a person’s blood. A person can look very healthy, but still have HIV. HIV is the virus that causes AIDS.
    
    AIDS or Acquired Immune Deficiency Syndrome is not a disease on its own but a stage at which the body cannot fight diseases due to HIV. Since HIV weakens the body’s ability to fight disease, people with HIV become ill more easily and minor infections can lead to serious life-threatening conditions. If you have HIV and suffer from another illness such as tuberculosis, pneumonia or cancer, your condition is considered to have progressed to AIDS. People can live with HIV for many years before the virus progresses to AIDS.
• Q. How is HIV transmitted?
  • There are four ways that HIV can be transmitted from one person to another, through:
    
    Unprotected sex (i.e. without a condom) with someone who has HIV
    
    Using/sharing needles that have been used by someone who has HIV
    
    Transfusion of HIV-infected blood
    
    An HIV-infected woman to her baby during pregnancy, child birth or breastfeeding
    
• Q. How is HIV not transmitted?
  • HIV is NOT transmitted by touching, working, playing or sharing eating utensils, toilet seats or public phones with an HIV-infected person, mosquito bites or masturbation.
• Q. What precautions do I need to take?
  • You can prevent HIV by abstaining from sex. If you have never had sex, you should wait until you are ready. HIV can be prevented if both uninfected partners remain faithful to each other. If you are sexually active, you should reduce the number of sexual partners you have, or always use a condom.
    
    In health care centres, always ask for new, single use injection equipment (i.e. needles and syringes), to be opened in front of you. Sharing needles during injecting drug use puts you at risk of HIV. Ensure that the needle is disinfected (by boiling for 20 minutes) or use a new, unused needle.
    
    If you are in need of a blood transfusion, you should use only tested blood. This is available from a government or licensed blood bank that ensures that the blood provided has been tested for HIV, among other diseases.
    
    Pregnant women should be tested for HIV. Medicine is available at most district hospitals that can help prevent mother to child transmission during delivery.
• Q. Can I get HIV through deep kissing?
  • The risk of HIV transmission is very low for deep or open-mouthed kissing. HIV is present in saliva in very tiny amounts, which is insufficient to cause infection through kissing alone. However, if you (or your partner) have open sores in your mouth, you should avoid kissing until these are healed fully.
• Q. Can I get HIV through oral sex?
  • Although it is possible to become infected with HIV through oral sex, the risk of becoming infected in this way is very low compared to the risk of infection via unprotected sexual intercourse with a man or woman.
    
    When giving oral sex to a man (sucking or licking a man's penis) HIV infection can take place if infected semen enters any cuts, sores or receding gums a person might have in their mouth. Using condoms for oral sex can minimize the risk of infection. Giving oral sex to a woman (licking a woman's clitoris or vagina) is also considered relatively low risk. Transmission of the virus could take place if infected sexual fluids from a woman got into the mouth of her partner. The likelihood of infection occurring might be increased if there is menstrual blood involved or the woman is infected with another sexually transmitted infection.
• Q. Is there a higher risk of HIV infection through unprotected anal intercourse?
  • AUnprotected anal intercourse does carry a higher risk of HIV infection than most other forms of sexual activities. The lining of the rectum has fewer cells than that of the vagina, and therefore can be damaged and cause bleeding during intercourse. This can then create a route into the bloodstream for HIV-infected sexual fluids or blood. Both partners could be at risk.
• Q. How do I know if I have HIV/AIDS?
  • Having HIV is also known as being HIV positive (HIV+). You cannot tell just by looking at a man or woman if he or she has HIV-infected blood. People can live with HIV for years without knowing it. It is very important to know your HIV status. Someone with HIV may unknowingly infect others through unprotected sex. Blood tests are the only way to know your HIV status. If you have the slightest doubt that you may have HIV, please visit a doctor and get tested. This test can be done at most government-run health centres or private laboratories. Integrated Counselling and Testing (ICT) centres are health centres that test for HIV. They provide confidential counselling as well as testing.
• Q. If after the blood test I am HIV+ then what should I do?
  • Because your body’s ability to fight disease is weakened by HIV, it is important that you remain healthy and avoid common diseases and infections. Have a healthy diet. Always use condoms while having sexual intercourse and avoid multiple sexual partners. Do not share needles with others. Consult the doctor if you are planning to conceive a child, as the child could get HIV during pregnancy, childbirth and breast feeding.
    
    Having the HIV virus does not mean that you are certainly going to die soon. There are many support groups and organisations that can help you live a healthy, happy and fulfilling life. Remember that your HIV status does not make you inferior. People living with HIV can live a very purposeful and healthy life. Contact your local State AIDS Control Society to find out where you can get support.
• Q. Is there any treatment for HIV/AIDS?
  • There is currently NO CURE for HIV/AIDS. Medicines called anti-retrovirals (ARVs) taken by people who have HIV can delay the onset of AIDS. ARVs are available free at government hospitals. Once started, ARVs have to be taken for the rest of your life.
    
    Some of the questions and answers have been taken from, “Frequently Asked Questions in Sexual and Reproductive Health for the National Call Centre Counselors, Janasankhya Sthirata Kosh, June 2007.”