Att 4_English Sexual Health Guide

Attachment 4

TAKE CHARGE OF YOUR
SEXUAL HEALTH
What you need to know about preventive services

NATIONAL COALITION FOR

SEXUAL HEALTH

NATIONAL COALITION FOR

SEXUAL HEALTH
TAKE CHARGE OF YOUR SEXUAL HEALTH
What you need to know about preventive services
This guide was developed with the assistance of the Health Care Action Group of the National Coalition for
Sexual Health. To learn more about the coalition, visit http://www.nationalcoalitionforsexualhealth.org.

Suggested citation
Altarum Institute. Take Charge of Your Sexual Health: What you need to know about preventive services.
Washington, DC: Altarum Institute; 2014.
Take Charge of Your Sexual Health: What you need to know about preventive services was supported by cooperative
agreement number 5H25PS003610-03 from the Centers for Disease Control and Prevention (CDC). Its contents are
solely the responsibility of Altarum Institute and do not necessarily represent the official views of CDC.

Altarum Institute
2000 M Street, NW Suite 400
Washington, DC 20036

2015

What’s in this Guide?
• Action steps for achieving good sexual health
• Information on recommended sexual health services for men and women
• Tips on how to talk with a health care provider
• Resources on sexual health topics
This guide informs men and women of all ages, including teens and older adults, about sexual
health. It focuses on the preventive services (screenings, vaccines, and counseling) that can help
protect and improve your sexual health. The guide explains these recommended services and
helps you find and talk with a health care provider.

CONTENTS
SEXUAL HEALTH AND HOW TO ACHIEVE IT 2
WHAT ARE PREVENTIVE SEXUAL HEALTH SERVICES?

3

WHAT SEXUAL HEALTH SERVICES DO WOMEN NEED?

4

WHAT SEXUAL HEALTH SERVICES DO MEN NEED?

9

WHAT TYPES OF HEALTH CARE PROVIDERS ADDRESS SEXUAL HEALTH?

13

TALKING WITH YOUR HEALTH CARE PROVIDER ABOUT SEXUAL HEALTH

14

WHAT TO LOOK FOR IN A SEXUAL HEALTH CARE PROVIDER

16

WHERE TO LEARN MORE 18

What is Sexual Health and
How Do I Achieve it?
A healthier body. A satisfying sex life. Valuing and feeling good about yourself. Having peace of mind. Positive and
satisfying relationships. Avoiding sexually transmitted infections (STIs) and unplanned pregnancies. These are just
a few of the important benefits of good sexual health. Being sexually healthy means being able to enjoy a healthier
body, a satisfying sexual life, positive relationships, and peace of mind. It also means enjoying your sexuality and
taking care of yourself and your partners throughout your life. Being free to talk about sexual health with your
partner and health care provider is key to your health.
pregnancies. Condoms can prevent both STIs and unplanned

ACTION STEPS TO GOOD
SEXUAL HEALTH

pregnancies, while other contraceptives only prevent

There are five key steps you can take to help
you achieve good sexual health. These steps
apply regardless of your age or the relationships
you choose to have:

Treat your partners well and expect them to treat you

• Value who you are and decide what’s
right for you
• Get smart about your body and protect it
• Treat your partners well and expect them to
treat you well
• Build positive relationships

• Make sexual health part of your health care
routine

pregnancy. For extra protection, some people choose to use
condoms, along with another contraceptive method.

well. Be with someone who makes you feel good about
yourself, comfortable and safe. Partners should respect
your boundaries, and should not pressure or force you to do
something you don’t want to. Likewise, respect your partner
and don’t force them to do anything they don’t want to.
Build positive relationships by having open and honest
conversations about your relationship, desires, and sexual
health. Respect each other and make decisions together.
If health problems come up, discuss them openly and seek
medical care. If your partner is violent, or pressures or tries to
control you, seek help from your health care provider or an
organization that addresses partner violence.
Make sexual health part of your health care routine,
which will help protect your sexual health and well-being.

Value who you are and decide what’s right for you. Sex is
a natural part of life; it can bring you pleasure, intimacy, and
joy. But it is up to you to decide if and when you choose to
have sex. First, think about what you want, and define your
personal values, desires, and boundaries. These might change
depending on your stage in life.
Get smart about your body and protect it. Learn
about your body and how it works, and explore ways to
express yourself sexually. Practice safer sex to protect
yourself and your partners from many STIs and unplanned

2 TAKE CHARGE OF YOUR SEXUAL HEALTH

Find a health care provider who makes you feel comfortable
and respects you. You have a right to good medical care. Have
open conversations with your provider about how to stay
healthy and any other issues that affect your sexual health.
Wellness check-ups are a good time to get recommended
services, ask questions, or share any concerns about your
sexual health, including sexual performance and functioning.
It’s time to give sexual health the attention it deserves.
To learn more go to www.NCSHguide.org

What are Preventive Sexual
Health Services?
A range of preventive sexual health services is available
to help you stay healthy and detect and treat any
problems early. These services are recommended by
many leading medical organizations.*
Most of these services are now available at no cost
under the new health reform law, but check with your
insurer to make sure your health plan covers them.
Low-cost or free services might also be available at
community health centers and family planning clinics.
See the Where to Learn More chapter to help you find a
provider or nearby clinic.

Preventive services include:
• Screenings that test for sexually transmitted infections
or diseases, whether or not you have symptoms
• Vaccines, such as the human papillomavirus (HPV)
vaccine, which decreases your risk of getting the virus
that causes genital warts, cervical cancer and some
other cancers (anal, oral, and penile)
• Counseling to help you make healthy decisions.
For example, you can learn about the best ways to
protect yourself and your partner from getting sexually
transmitted infections

A NOTE ABOUT
CONFIDENTIALITY
If you are covered by your parent’s or partner’s
health insurance, keep in mind that a list of the
health care services you receive might appear on
their routine insurance statements. Ask your health
care provider if the sexual health care services you
are getting will be reported, and make sure you are
comfortable with their policy.

* The Centers for Disease Control and Prevention (CDC), the U.S. Preventive Services Task Force, and other national organizations recommend these services

A GUIDE TO PREVENTIVE SERVICES

3

What Sexual Health Services
do Women Need?
The following preventive services are recommended for most women. Your provider will help you decide which
ones you need. Even if you don’t have symptoms, screenings can detect many sexually transmitted infections
(STIs). If you do have an STI, the sooner you get treated, the better. Early treatment can often prevent serious
problems from developing. Vaccines are also available that can protect you from getting certain STIs. You can
receive many of these services during a regular wellness exam or a Well Woman visit.

SCREENINGS
Sexually Transmitted Infections (STIs)
All sexually active women aged 24 and younger should be
screened annually for chlamydia and gonorrhea. Women
aged 25 and older who have risk factors for STIs, such as
having unprotected sex (sex without a condom), a new
partner, or multiple partners, should also be screened for
both chlamydia and gonorrhea.
Talk to your provider about being screened for syphilis. You
may need to be screened if you have multiple partners, have
HIV, have exchanged sex for money or drugs, or been in
prison.
All pregnant women should be screened for chlamydia,
syphilis, HIV, and hepatitis B during their first prenatal visit
or within the first trimester. Pregnant women aged 24 and
younger, as well as older women with risk factors for STIs,
should also be screened for gonorrhea. Those who are at
continued risk for STIs should be retested for chlamydia,
gonorrhea, syphilis, and HIV in their third trimester.

HIV Testing
You should be tested for HIV at least once as part of your
routine health care, even if you think your partner only has
sex with you. You should also be tested if you aren’t currently
having sex, but you have had sex in the past.
You should be tested at least once a year if you have
unprotected sex, have had an STI or have a partner who
has, have multiple partners, share drug injection equipment
(including needles or syringes), or have a partner who
engages in any of these behaviors.

Cervical Cancer Screening
Most women aged 21-65 should have a Pap test every three
years. You may need to be screened more often if you’ve had
an abnormal result. If so, talk with your provider. The Pap
test looks for cells on a woman’s cervix that could become
cancer. A Pap test alone does not test for STIs, nor does it
test for other cancers of the reproductive system.
Some women over age 30 can safely go up to five years
between cervical cancer screenings. To do so, ask your
provider to also test you for HPV (human papillomavirus).
The cells collected for the Pap test will also be tested for
HPV. If it shows that you don’t have HPV and you have a
history of normal Pap tests, you can go five years between
screenings.
Even though you may not need annual screening, you should
still see your provider regularly for checkups. For more
information, visit www.cdc.gov/cancer/cervical/basic_info/
screening.htm

4 TAKE CHARGE OF YOUR SEXUAL HEALTH

WOMEN WHO HAVE SEX
WITH WOMEN
If you are a woman who has sex with women, you
still need many of these preventive services. You
can get chlamydia, gonorrhea, HPV, and other
sexually transmitted infections from your female
partners. You also need to be tested for HIV,
especially if you or your partners had sex with
men in the past or still do. The HPV vaccine will
help protect you from getting cervical cancer,
which is caused by the human papillomavirus.
Hepatitis B Screening
You should be screened for hepatitis B if you are pregnant,
have a partner who has hepatitis B, have multiple partners,
have had an STI, share drug injection equipment (including
needles or syringes), or live with a person who is infected
with the hepatitis B virus. You should also be screened if
you were born in a country where hepatitis B infection is
common (Asia, Africa, the Pacific Islands, parts of South
America) or were born in the United States to parents from
one of those countries.
Hepatitis B is a virus that attacks the liver. It is spread
through infected body fluids, including blood and semen.
Infection can either be acute (short-term) or chronic (longterm). People with hepatitis B may not look or feel sick, but
can still infect others. Chronic hepatitis B infection can often
be treated, but not cured. To learn more, visit www.cdc.gov/
hepatitis/B.

periodically for hepatitis C. You should also be screened if
you’ve been in prison, have HIV, or have ever injected illegal
drugs.
The risk of getting hepatitis C from having unprotected sex is
low, but it is possible. You are at higher risk if you have HIV or
another STI, have multiple partners, or engage in rough sex.
Hepatitis C is a virus that attacks the liver. It can cause severe
illness and permanent liver damage. However, it can often
be cured, especially if the infection is detected early. To learn
more, visit www.cdc.gov/hepatitis/hcv/index.htm.

Intimate Partner Violence
If your partner is sexually, verbally, or physically abusing you,
or forcing you to do things against your will (such as get
pregnant, not use birth control, or engage in unsafe sex),
speak up and let your provider know. They can refer you to a
program or mental health professional who can help you.

Hepatitis C Screening
All women born between 1945 and 1965 should be screened
once for hepatitis C. Many “baby boomers” have hepatitis C
and don’t know it. They may have engaged in risky behaviors
or received a blood transfusion or organ transplant before
national screening for the virus was in place. Most people
become infected with hepatitis C by sharing drug injection
equipment. If you inject illegal drugs, you should be screened

A GUIDE TO PREVENTIVE SERVICES

5

VACCINES
Human Papillomavirus (HPV) Vaccine
This series of three shots is recommended for girls aged
11-12 before they’ve been exposed to HPV, but may be
given up to age 26. Some women over age 26 may also
benefit from being vaccinated. Talk to your provider to
see if you’re eligible.
HPV is extremely common. Although most infections go
away on their own, some types of HPV cause cancer (mainly
cervical, but also anal, vaginal, vulvar, and oral) and other
types cause genital warts.
Two different vaccines (Cervarix and Gardasil) are available
that can protect girls and women from the types of HPV that
cause cancer. However, only Gardasil protects against both
cancer and genital warts. For more information, visit www.
cdc.gov/hpv/vaccine.html.

most likely vaccinated as an infant. Before 1991, the vaccine
was only given to high-risk adults.

Hepatitis A Vaccine
This two-shot series is recommended for all unvaccinated
teens. Teens who are missing the last dose should complete
the series in order to be fully protected against hepatitis
A. Women should get this vaccine series if their partner or
someone they live with has hepatitis A, or if they use illicit
drugs.
The hepatitis A virus attacks the liver. There is no treatment
for hepatitis A. While most people recover without
permanent liver damage, they will probably feel very sick
for a while. Not sure if you’ve been vaccinated? Routine
vaccination began in 1999 so older teens and most adults
have not been vaccinated. For more information, visit www.
cdc.gov/hepatitis/hav/aFAQ.htm.

Hepatitis B Vaccine
This three-shot series is recommended for all unvaccinated
teens. Teens who have started, but not finished, the series
should get the remaining doses in order to be fully protected
against the hepatitis B virus. Unvaccinated women should
get this vaccine series if they have multiple partners, a
partner who has hepatitis B, have been diagnosed with
HIV or another STI, have unprotected sex with a partner
whose health status they don’t know, share drug injection
equipment (including needles or syringes), or have a partner
who injects drugs.
If you were born in a country where hepatitis B is common
(Asia, Africa, the Pacific Islands, parts of South America) or
were born in the United States to parents from one of those
countries, talk to your provider about being vaccinated. You
may be given the first dose and tested for the virus at the
same time.
Hepatitis B is a virus that attacks the liver. It is spread
through infected body fluids, including blood and semen.
Infection can either be acute (short-term) or chronic (longterm). People with hepatitis B may not look or feel sick, but
can still infect others. Vaccination is the best protection
against hepatitis B. Not sure if you’ve been vaccinated? If
you were born in the United States in 1991 or later, you were
6 TAKE CHARGE OF YOUR SEXUAL HEALTH

How Do I Know if I’m at Risk?
Your sexual health is at risk if you answer “yes”
to any of the following questions::
• Have you had unprotected vaginal, anal, or oral
sex (sex without a condom)?
• Do you have multiple partners?
• Do you have an STI, including HIV?
• Have you shared injection drug equipment,
including needles or syringes?
• Do you exchange sex for drugs or money?
• Do you have a partner who answers “yes” to any
of these questions or whose health status you
don’t know?

COUNSELING
Contraception
Talk with your provider about your plans for having, or not
having, children. He or she can then provide information
on the best contraceptive methods for you. Long-acting
reversible contraceptives - the intrauterine device (IUD)
and the implant - are among the easiest and most reliable
methods for all women who want to prevent pregnancy.
Other available methods include injections, birth control
pills, the vaginal ring, the patch, diaphragm, sponge, cervical
cap, and male and female condoms. Condoms are the
only contraceptive method that prevent both pregnancy
and STIs. If you’re done having children or know you don’t
want any, permanent contraception (e.g., tubal ligation)
may be right for you. Natural family planning methods and
abstinence (not having sex) are other options.

STI Prevention
Using a male or female condom every time you have sex
is one of the best ways to reduce the risk of getting many
STIs, including HIV. Other effective ways to protect yourself
include abstinence (not having sex) or only having one
partner who you know does not have an STI. If you have
sex without a condom, have an STI or recently had one, or
have a new partner and are unsure of their health status,
talk to your provider or a health educator. They can counsel
you on ways to protect yourself and your partner from STIs,
including whether medicines to prevent HIV infection are
right for you. People who do not have HIV but are at high risk
of becoming infected can stay healthy by taking PrEP (preexposure prophylaxis). PEP (post-exposure prophylaxis)
might be prescribed if you think you’ve been exposed to HIV.
Also, consult the resources at the end of this guide for more
information about preventing STIs.

Your provider can also tell you about emergency
contraception (EC), or the “morning after pill.” EC can
prevent pregnancy if taken within a few days of having
unprotected sex. EC is available to anyone without a
prescription at family planning clinics and pharmacies.

IT’S YOUR BODY!
You know your body better than anyone.
Always tell your health care provider
about any changes in your health. Speak
to them about any concerns you may
have about conditions, diseases, or
issues related to sexual functioning or
performance.

A GUIDE TO PREVENTIVE SERVICES

7

RECOMMENDED PREVENTIVE SEXUAL HEALTH SERVICES FOR WOMEN
Sexual Health Service

Adolescent (13-18 years)

Cervical cancer screening

Not recommended

Chlamydia screening

Those who are sexually active (screen annually)
or pregnant

Adult (19+)
Those aged 21-29 every 3 years
Those aged 30-65 every 3-5 years
Those aged 24 and under (screen annually)
Those over age 24 who are at risk
Those who are pregnant

Contraceptive counseling

Those who are sexually active

Those who are sexually active and/or
of childbearing age

Counseling to prevent
sexually transmitted
infections

Those who are sexually active

Those who are at risk

Gonorrhea screening

Those who are sexually active or pregnant

Hepatitis A vaccine

Those not vaccinated as children

Those aged 24 and under (screen annually),
including those who are pregnant
Those over age 24 who are at risk, including
those who are pregnant
Those who are at risk and are unvaccinated
Those who are at risk and are unvaccinated

Hepatitis B vaccine

Hepatitis B screening

Hepatitis C screening

HIV testing

Those not vaccinated as children

Those born in a country where the hepatitis B
virus is common

Those who are pregnant

Those who are pregnant

Those who are at risk and are unvaccinated

Those who are at risk and are unvaccinated

Those born in a country where the hepatitis B
virus is common

Those born in a country where the hepatitis B
virus is common

Not recommended

Those who are or have been sexually active
(test at least once)
Those who are pregnant

Those born between 1945 and 1965
Injection drug users
Those who are or have been
sexually active (test at least once)
Those who are at risk (test at least annually)
Those who are pregnant

HPV vaccine

Those not vaccinated at age 11 or 12

May be given through age 26
(and to eligible adults over age 26)

Syphilis screening

Those who are pregnant or at risk

Those who are pregnant or at risk

You’re at risk if you have had unprotected vaginal, anal, or oral sex (sex without a condom), have multiple partners, have an STI (including HIV), share injection drug
equipment (including needles or syringes), exchange sex for drugs or money, or have a partner who answers “yes” to any of these questions or whose health status you
don’t know.

8 TAKE CHARGE OF YOUR SEXUAL HEALTH

What Sexual Health Services do Men Need?
The following preventive services are recommended for most men. Your provider will help you decide which ones
you need. Even if you don’t have symptoms, screenings can detect many sexually transmitted infections (STIs).
If you do have an STI, the sooner you get treated, the better. Early treatment can often prevent serious problems
from developing. Vaccines are also available that can protect you from getting certain STIs.

SCREENINGS
Sexually Transmitted Infections (STIs)

Hepatitis B Screening

Men who have sex only with women: You might consider
being screened for chlamydia, gonorrhea, and syphilis if you
have unprotected sex, have multiple partners, or have a new
partner and do not know her health status, even if you do not
have any symptoms.

Regular screening for hepatitis B is recommended for men
who have sex with men and those who share drug injection

Men who have sex with men: If you are sexually active,
you should be screened at least once a year for chlamydia,
gonorrhea, and syphilis. Men who have sex with men often
have chlamydia and gonorrhea infections in their rectums
and throats but don’t know it. Depending on the kinds of sex
you have, you may need additional screening to find these
infections. You should be screened every 3-6 months if you
have unprotected sex, have had an STI or have a partner who
has, have multiple partners, use illicit drugs, or have a partner
who engages in any of these behaviors.

HIV Testing
Men who have sex only with women: You should be
tested for HIV at least once as part of your routine health
care, even if you think your partner only has sex with you.
You should also be tested if you aren’t currently having sex,
but you have had sex in the past. You should be tested at
least once a year if you have unprotected sex, have had an
STI or have a partner who has, have multiple partners, share
drug injection equipment (including needles or syringes), or
have a partner who engages in any of these behaviors.
Men who have sex with men: You should be tested for HIV
at least once a year. You should be tested every 3-6 months
if you have unprotected sex, have multiple partners, use illicit
drugs, share drug injection equipment (including needles
or syringes), or have a partner who engages in any of these
behaviors.

equipment (including needles or syringes), especially if they
have not been vaccinated. If you have a partner or family
member who has hepatitis B, have multiple partners, or
have had an STI, you should be screened as well. Others
who should be screened include those who were born in a
country where hepatitis B infection is common (Asia, Africa,
the Pacific Islands, parts of South America) or were born in
the United States to parents from one of those countries.
Hepatitis B is a virus that attacks the liver. It is spread
through infected body fluids, including blood and semen.
Infection can either be acute (short-term) or chronic (longterm). People with hepatitis B may not look or feel sick, but
can still infect others. Chronic hepatitis B infection can often
be treated, but not cured. To learn more, visit www.cdc.gov/
hepatitis/hbv/index.htm.

Hepatitis C Screening
All men born between 1945 and 1965 should be screened
once for hepatitis C. Many “baby boomers” have hepatitis C
and don’t know it. They may have engaged in risky behaviors
or received a blood transfusion or organ transplant before
national screening for the virus was in place. Most people
become infected with hepatitis C by sharing drug injection
equipment, including needles or syringes. If you inject illegal
drugs, you should be screened periodically for hepatitis C.
You should also be screened if you’ve been in prison, have
HIV, or have ever injected illegal drugs.
The risk of getting hepatitis C from having unprotected sex
is low, but it is still possible. Men who have sex with men and
have multiple partners and/or engage in unprotected rough
A GUIDE TO PREVENTIVE SERVICES

9

sex (specifically sex that can result in bleeding) are at
higher risk.
Hepatitis C is a virus that attacks the liver. It can cause severe
illness and permanent liver damage. However, it can often
be cured, especially if the infection is detected early. To learn
more, visit www.cdc.gov/hepatitis/hcv/index.htm.

Intimate Partner Violence
If your partner frequently threatens you, constantly accuses
you of doing something you didn’t, tries to control what
you do or where you go, refuses to have safe sex, or hits,
slaps or kicks you, talk to a health professional. Although
your provider will probably not ask you about abuse in your
relationships, if you let them know they can refer you to
programs that can help you.

If you were born in a country where hepatitis B is common
(Asia, Africa, the Pacific Islands, parts of South America)
or were born in the United States to parents from a high
prevalence country, talk to your provider about being
vaccinated. You may be given the first dose and tested for
the virus at the same time.
Hepatitis B is a virus that attacks the liver. It is spread
through infected body fluids, including blood and semen.
Infection can either be acute or chronic. People with
hepatitis B may not look or feel sick, but can still infect
others. Vaccination is the best protection against hepatitis B.
Not sure if you’ve been vaccinated? If you were born in the
United States in 1991 or later, you were most likely vaccinated
as an infant. Before 1991, the vaccine was only given to highrisk adults.

Hepatitis A Vaccine

VACCINES
Human Papillomavirus (HPV) Vaccine
This series of three shots is recommended for boys aged
11 or 12, before they have been exposed to HPV. If not
vaccinated as a teen, all males through age 21 should get the
HPV vaccine. All men who have sex with men and those with
compromised immune systems (including HIV) should be
vaccinated and can do so up to age 26. If you are between
the ages of 22 and 26, talk to your provider about being
vaccinated. Gardasil (the HPV vaccine for boys and young
men) protects against the most common types of HPV that
cause genital warts and some cancers of the anus and throat.
For more information, visit www.cdc.gov/hpv/vaccine.html.

Hepatitis B Vaccine
This three-shot series is recommended for all unvaccinated
teens. Teens who have started, but not finished, the series
should get the remaining doses in order to be fully protected
against the hepatitis B virus. All unvaccinated men should
get this vaccine series if they have sex with men, have
multiple partners, have a partner who has hepatitis B, have
been diagnosed with HIV or another STI, have unprotected
sex with a partner whose health status they don’t know, share
drug injection equipment (including needles or syringes), or
have a partner who injects drugs.

10 TAKE CHARGE OF YOUR SEXUAL HEALTH

This two-shot series is recommended for all unvaccinated
teens. Teens who are missing the last dose should complete
the series in order to be fully protected against hepatitis A.
Unvaccinated men should get this vaccine series if they have
sex with men, have a partner or live with someone who has
hepatitis A, or if they use illicit drugs.
The hepatitis A virus attacks the liver. There is no treatment
for hepatitis A. While most people recover without
permanent liver damage, they will probably feel very sick
for a while. Not sure if you’ve been vaccinated? Routine
vaccination began in 1999 so older teens and most adults
have not been vaccinated. For more information, visit www.
cdc.gov/hepatitis/hav/afaq.htm.

Even if you don’t have
symptoms, screenings
can detect many
sexually transmitted
infections (STIs).

COUNSELING

STI Prevention

Contraception
If you and your partner want to avoid pregnancy, learn
about birth control methods both of you can use. The most
effective options for men are using condoms correctly and
consistently, abstinence (not having sex), and vasectomy
(permanent contraception). Your female partner has
many more options to choose from. By learning about her
preferred method, you can support her choice.
Also learn about emergency contraception (EC), or the
“morning after pill,” that she can use to prevent pregnancy if
you had unprotected sex. EC can prevent pregnancy if taken
within a few days of having unprotected sex. It is available to
anyone without a prescription at family planning clinics and
pharmacies.

Using a male or female condom every time you have sex
is one of the best ways to reduce the risk of getting many
STIs, including HIV. Other effective ways to protect yourself
include abstinence (not having sex) or only having one
partner who you know does not have an STI. If you have
sex without a condom, have an STI or recently had one, or
have a new partner and are unsure of their health status,
talk to your provider or a health educator. They can counsel
you on ways to protect yourself and your partner from STIs,
including whether medicines to prevent HIV infection are
right for you. People who do not have HIV but are at high risk
of becoming infected can stay healthy by taking PrEP (preexposure prophylaxis). PEP (post-exposure prophylaxis)
might be prescribed if you think you’ve been exposed to HIV.
Also, consult the resources at the end of this guide for more
information about preventing STIs.

IT’S YOUR BODY!
You know your body better than anyone.
Always tell your health care provider about any
changes in your health. Speak to them about
any concerns you may have about conditions,
diseases, or issues related to sexual functioning
or performance.

A GUIDE TO PREVENTIVE SERVICES

11

RECOMMENDED PREVENTIVE SEXUAL HEALTH SERVICES FOR MEN
Sexual Health Service

Adolescent (13-18 years)

Adult (19+)

Chlamydia screening

Those who are at risk

Those who are at risk

Counseling to prevent
sexually transmitted
infections

Those who are sexually active

Those who are at risk

Gonorrhea screening

Those who are at risk

Those who are at risk

Hepatitis A vaccine

Those not vaccinated as children

Men who have sex with men
Those who are at risk and are unvaccinated

Hepatitis B vaccine

Hepatitis B screening

Those not vaccinated as children

Those born in a country where the hepatitis B
virus is common

Those who are at risk (including men who have
sex with men) and are unvaccinated

Those who are at risk (including men who have
sex with men) and are unvaccinated

Those born in a country where the hepatitis B
virus is common

Those born in a country where the hepatitis B
virus is common
Those born between 1945 and 1965

Hepatitis C screening

Not recommended

HIV testing

Those who are or have been sexually active
(test at least once)

Injection drug users
Those who are or have been sexually active
(test at least once)
Those who are at risk (test at least annually)

HPV vaccine

Those not vaccinated at age 11 or 12

May be given through age 26

Syphilis screening

Those who are at risk

Those who are at risk

How Do I Know if I’m at Risk?
Your sexual health is at risk if you answer “yes” to any of the following questions:
• Have you had unprotected vaginal, anal, or oral sex
(sex without a condom)?

• Have you shared injection drug equipment, including
needles or syringes?

• Do you have multiple partners?

• Do you exchange sex for drugs or money?

• Do you have an STI, including HIV?

• Do you have a partner who answers “yes” to any of
these questions or whose health status you don’t know?

12 TAKE CHARGE OF YOUR SEXUAL HEALTH

What Types of Health Care Providers
Address Sexual Health?
Described below are the types of health care professionals who can provide sexual health care services and advice,
along with where you can find them. For specific information about how to locate a provider near you, please
consult the resources at the end of this guide.
Primary care providers, such as internists, family
doctors, general medicine doctors, nurse practitioners,
physician assistants, and nurse-midwives, are trained
in general medicine and care for the whole body. They
work in private doctors’ offices, clinics, community health
centers, family planning clinics, STI clinics, and college health
systems. Even if they do not specialize in sexual health, they
can be a good starting point and refer you to a specialist, if
needed.
Specialists, such as obstetricians and gynecologists
(OB/GYNs), urologists, and women’s health nurse
practitioners, focus on women’s and men’s reproductive
health. They work in private doctors’ offices, community
health centers, and family planning clinics.

Health educators work in clinics, community-based
programs, schools, and colleges. They might offer sexual
health counseling and educational materials to inform and
equip people to make healthy decisions.
Pharmacists, working in pharmacies, clinics, and community
health centers, are experts about prescription and over-thecounter medications and can dispense birth control.
Mental health professionals, such as therapists,
counselors, psychologists, social workers, sex therapists,
and psychiatrists, can address the emotional and mental
health issues related to sexual problems. You will find them
at college campuses, private practices, clinics, community
health centers, and social service agencies.

A GUIDE TO PREVENTIVE SERVICES

13

How Can I Talk with My Health Care
Provider about Sexual Health?
How do I bring up the topic?

What kinds of questions should I ask?

Talking about your sexual health might make you feel
uncomfortable or embarrassed. However, if you talk openly
and honestly with your provider about your body and
concerns, he or she can give you better care and advice.
You have the right to get full and accurate information
about sexual health. And, remember, it is your provider’s
job to help you take care of your whole body.

The questions you might ask can cover a range of topics,
including: the best forms of contraception, STI screening
and treatment, preventing STIs, protecting your fertility, and
issues related to sexual functioning or performance.

Ways you could start the conversation are:
“I just saw an article about high rates of sexually
transmitted infections. What can I do to protect
myself?”
“I know I’m here to get a check-up, but can we talk
about my sexual health for a few minutes? I have
some questions.”
“I’m in a new relationship, and I’m not sure about
the best ways to protect myself from infections and
getting pregnant.”

Sample questions you might ask during your visit:

Screening and Testing
• What tests are you giving me?
• How are they done?
• When and how will I get my results?

Sexually Transmitted Infections
• Based on my history, should I be tested for STIs,
including HIV? Which ones?
• How often should I be tested for STIs?
• Should my partner get tested, too?
• Are there any vaccines I should get to protect myself
from STIs?
• How can I protect myself from getting STIs?

IF YOU ARE
TRANSGENDER
Many of the preventive services in this guide will
help you stay healthy. Although finding a provider
who can address your unique healthcare needs
may be challenging, it is important to get tested
regularly for HIV and other STIs, and vaccinated
against hepatitis A, hepatitis B, and HPV (if you’re
eligible). Use condoms and practice safer sex to
protect you and your partners. For more in-depth
guidance, see the resources listed at the end of
this guide.

14 TAKE CHARGE OF YOUR SEXUAL HEALTH

• If I have an STI, can it be treated?

Contraceptives
• What are the most effective forms of birth control?
• What are the best options for me?
• What are the side effects of different contraceptives?
• How and where can I get affordable contraceptives?

Partner Issues
• I want my partner and I to get tested for STIs before we
have sex for the first time. How should I bring up the
topic?
• How do I tell my partner if I test positive for an STI?
• What if my partner doesn’t want to use a condom?
• I’m married and I assume my spouse is only having sex
with me. Should I still be tested for STIs?
• My partner cheated on me and I’m worried I might have
an STI. Which STIs should I be tested for?

Sexual Functioning or Performance

What questions might my health care
provider ask me?
Your provider might ask you questions that seem personal,
but don’t take it personally. They generally ask all of their
patients the same questions. Answering these questions will
give your health care provider information to help keep you
healthy and safe.

Health care professionals might ask you the following
questions about your sexual history and current
behaviors:
• Are you sexually active? If no, have you ever been?

• I no longer find sex (or masturbation) pleasurable.
Why?

• Do you have sex with men only, women only, or both?

• My sex drive is lower than normal. What’s the deal?

• How many people have you ever had sex with? In the
past six months? In the past 12 months?

• Having sex hurts. What’s the problem?
• I’m being treated for another illness or disease, and I’m
wondering how that will affect my sex life?
• I’m having trouble getting an erection/reaching climax.
What’s going on?
• I was told my prostate is enlarged. Will this affect my
sex life?

• Do you have anal, oral and/or vaginal sex?

• What are you doing to protect yourself from STIs?
• Have you been tested for STIs, including HIV? Would
you like to be tested?
• Have you or your partner ever tested positive for an
STI? If so, which one(s), and where was the infection
found?
• Were you and/or your partner treated?
• Are you or your partner trying to get pregnant?
• Are you concerned about getting pregnant or getting
your partner pregnant?
• Are you or your partner using contraception? Do you
need any information about types of contraceptives?
• Are you happy with your sex life? Do you have any
concerns or questions about your sexual functioning?
• Have you ever been coerced or pressured to have sex
or do something you didn’t want to do?
• Do you or your partner use alcohol or illicit drugs when
you have sex?

A GUIDE TO PREVENTIVE SERVICES

15

What to Look For in a Sexual Health
Care Provider
Remember, a health care provider
who takes good care of your sexual
health should:
• Have a friendly and welcoming staff
• Speak clearly and use words you understand
• Put you at ease and listen to any sexual and
reproductive health issues that are important to you
• Answer your questions and address your concerns in a
helpful, respectful way
• Ask permission before performing any tests
• Explain what they’re doing and the reason why
• Keep your conversations confidential
• Support your right to make decisions about your sexual
health care, based on your own values and what you
believe is best for yourself

A health care provider should NOT:
• Assume to know your sexual behaviors or preferences
without asking
• Be judgmental in response to your questions or
concerns
• Be disrespectful of your sexual orientation or
preferences
• Deny you care or treatment because of your sexual
choices
If you feel uncomfortable with your health care provider for
any reason, listen to your feelings. Ask your friends or family
to recommend someone you can trust, research providers
through an online rating site, or ask your health plan for a list
of top-rated doctors in your area.

16 TAKE CHARGE OF YOUR SEXUAL HEALTH

TAKE CHARGE
You can do many things to take charge
of your sexual health. Make visiting
a health care provider a priority. But,
when you go for a visit, don’t just rely
on your provider. It’s up to you to
know which services you need and
to make sure that you get them.
Schedule an appointment and get
the services and advice you need to
take care of your entire body, and to
help you enjoy good sexual health for
a lifetime.

Where to Learn More
TO FIND A PROVIDER OR CLINIC
Get Tested

Planned Parenthood Federation of America

http://gettested.cdc.gov

http://www.plannedparenthood.org

Use this site to find fast, free, and confidential testing

Find a local Planned Parenthood clinic by using the

locations near you. You can also learn which tests and

“Find a Health Center” search box on the home page.

vaccines you may need. Enter your zip code or city and

This site provides a range of sexual and reproductive

state in the search box. It has a list of FAQs about HIV, viral

health information for men and women (including teens),

hepatitis, and other STIs.

plus resources for parents and educators.

Health Resources and Services Administration
http://findahealthcenter.hrsa.gov

American Association of Sexuality
Educators, Counselors, and Therapists

Use the search box to find a federally-funded health center

http://www.aasect.org

near you. These centers provide care even if you don’t have

To find a sexuality educator, counselor, or therapist in your

health insurance. You pay what you can afford, based on

area, go to the “Locate a Professional” section on the home

your income.

page.

National Association of Free
& Charitable Clinics

American College of Nurse-Midwives
http://ourmomentoftruth.midwife.org

http://www.nafcclinics.org

Nurse-midwives provide primary care to women of all ages,

Search for a free clinic near you using the search box on the

as well as maternity care to pregnant women. Click “Find

home page. Free clinics typically provide primary care to

a Midwife” in the upper right corner on the home page to

those who are uninsured and low-income. Some may also

search for a midwifery practice near you.

provide specialty care and run pharmacies where you can get
free medicine.

National Family Planning &
Reproductive Health Association
http://www.nationalfamilyplanning.org

American Congress of Obstetricians
and Gynecologists
http://www.acog.org
Click “Find an Ob-Gyn” on the right side of the home page,
then search by state, provider name, or zip code to find a

To find a federally-funded family planning clinic near you,

physician. This site also provides information about women’s

enter your address or zip code in the search box on the

sexual and reproductive health.

home page.

A GUIDE TO PREVENTIVE SERVICES

17

Where to Learn More
HIV, STIs, AND VIRAL HEPATITIS

CONTRACEPTIVES

American Sexual Health Association

Association of Reproductive
Health Professionals

http://www.ashasexualhealth.org
Go here to learn about various STIs and screening tests,

http://www.arhp.org

as well as tips for having safe sex. This site also contains the

Use their Method Match (http://www.arhp.org/MethodMatch)

HPV Resource Center and the Herpes Resource Center.

to compare up to four types of contraception to find the best

Resources are available for parents, teachers, and health

method for you. You can also get information on a range of

care providers.

sexual health topics, including men’s reproductive health.

The Complete HIV/AIDS Resource

Bedsider Birth Control Support Network

http://www.thebody.com

http://www.bedsider.org

Learn everything you need to know about HIV and AIDS.

Explore different birth control methods and find one that’s
right for you. You can also search for nearby places to get

Centers for Disease Control and Prevention
http://www.cdc.gov/std
http://www.cdc.gov/hepatitis/PublicInfo.htm#whatIsHep
Visit the CDC’s web site for information about STIs and viral

birth control.

Condomology
http://www.factsaboutcondoms.com

hepatitis, as well as ways to prevent them.

Everything you need to know about condoms. Watch a

INTIMATE PARTNER VIOLENCE

condoms prevent different STIs, as well as pregnancy.

Rape, Abuse & Incest National Network

The Emergency Contraception Website

http://www.rainn.org

video on how to put one on correctly and understand how

http://ec.princeton.edu

This site can help survivors of sexual violence get the

Learn about the types of emergency contraception and find

assistance they need. The National Sexual Assault Hotline

a location where you can get it.

(1-800-656-HOPE) is open 24/7.

National Domestic Violence Hotline
http://www.thehotline.org
Visit this site to learn about ways to safely leave an abusive
relationship or to help someone who is in one. The National
Domestic Violence Hotline (1-800-799-SAFE or 1-800-7873324 (for TTY)) is open 24/7.

18 TAKE CHARGE OF YOUR SEXUAL HEALTH

Where to Learn More
TEENS & YOUNG ADULTS
Advocates for Youth

Scarleteen

http://www.advocatesforyouth.org

http://www.scarleteen.com

Parents, educators, health care providers, and others will find

This site provides sex education for teens and young

information and resources to help teens and young adults

adults. Read up on sex and sexuality, relationships, gender,

make healthy sexual decisions.

and more.

Coalition for Positive Sexuality

Sex, Etc.

http://www.positive.org

http://sexetc.org

Provides information to young people about safe sex,

Sexual health information for teens, by teens.

contraception, STIs, parental consent laws, and more.

It’s Your (Sex) Life
http://www.itsyoursexlife.com
Go here to get information about relationships, learn about
various sexual health topics, and view a list of hotlines and
resources.

I Wanna Know!
http://www.iwannaknow.org
This site provides guidance to help young people protect
their sexual health, explains the changes that occur during
puberty, and addresses misinformation about sex and STIs.

Kinsey Confidential
http://kinseyconfidential.org
This site provides college-age adults with information on a
variety of sexual health topics. This information is available
through articles, blogs, podcasts, and Q&As.

A GUIDE TO PREVENTIVE SERVICES

19

Where to Learn More
GAY, LESBIAN, BISEXUAL
& TRANSGENDER
Centers for Disease Control and Prevention

TransGenderCare

http://www.cdc.gov/lgbthealth

http://www.transgendercare.com

Go here to learn about health issues that affect LGBT

Find information about transition-related treatments and

people, as well as the sexual health services they

therapies for transgender individuals.

should get.

Gay and Lesbian Medical Association

World Professional Association
for Transgender Health

http://www.glma.org

http://www.wpath.org

This site can help LGBT individuals find a health care

The Standards of Care (SOC) inform health care providers
and consumers about strategies to help transgender
individuals achieve optimal health. Access the SOC by
clicking “Publications” on the navigation bar.

provider they can trust and understand the important health
topics they should discuss with their provider.

The Gay, Lesbian & Straight
Education Network
http://www.glsen.org
Learn how to help schools become safer and more respectful
for all, regardless of sexual orientation, gender identity, or
gender expression.

GLBT National Help Center
http://www.glnh.org
Gay, lesbian, bisexual and transgender people of all ages can
call the national hotline (1-888-843-4564) to access peer
counseling, information, and local resources. A youth hotline
is also available (1-888-246-7743).

20 TAKE CHARGE OF YOUR SEXUAL HEALTH

YouthResource
http://www.youthresource.com
LGBTQ young people can go here for information and
support on sexual and reproductive health issues.

Where to Learn More
OLDER ADULTS
Safer Sex for Seniors
http://safersex4seniors.org
Go here for information for older adults about sex and
sexuality. Learn how to talk to your partner or health care
provider, understand how desire changes as we age, and
educate yourself about safe sex practices.

ACRIA
http://www.ageisnotacondom.org
Get tips on overcoming issues that can reduce sexual desire
among older adults, and learn important facts about HIV and
people over age 50.

AARP
http://www.aarp.org/home-family/sex-intimacy
Learn about keeping the passion alive while also staying
healthy in the Sex & Intimacy section of AARP’s web site.

Administration on Aging
http://www.aoa.acl.gov/AoA_Programs/HPW/HIV_AIDS
Educate yourself about HIV/AIDS among older adults and
find a testing location near you. This site also has links to
other resources about HIV/AIDS among people over 50.

A GUIDE TO PREVENTIVE SERVICES

21

It’s time to give sexual health
the attention it deserves.

NATIONAL COALITION FOR

SEXUAL HEALTH