1. R. I feel too embarrassed to buy condoms.
2. R. I fear getting HIV/AIDS or a sexually transmitted disease.
3. It is my responsibility to use a condom with my sexual partner(s).
4. I would use condoms if my partner asked me.
5. R. Condoms are embarrassing to use.
6. R. I want information on feeling better about my sexuality.
7. R. I have had anal or vaginal sexual intercourse without a condom in the last 30 days.
8. FOR MEN I gave myself a testicular exam in the last 30 days. FOR WOMEN I gave myself a breast exam in the last 30 days.
9. R. I feel I am at high risk for getting HIV/AIDS or a sexually transmitted disease.
10. R. I worry that I might be infected with a sexually transmitted disease.
11. R. I want information on sexually transmitted diseases.
12. R. I feel ashamed when seeking medical care for sexually transmitted diseases.
13. I feel comfortable when I touch my genitals.
14. R. Condoms make sex less pleasurable.
15. R. I have noticed physical changes on my genitalia in the last 30 days that concern me.
16. My partner would use condoms if I asked him/her.
17. R. I want information on how to practice safer sex.
18. R. I worry that I might be infected with HIV.
[ ] check here if you know you are HIV Positive.
19. R. I want information on HIV/AIDS.
20. I know how to correctly use a condom.
21. R. I engaged in unsafe sexual behavior in the last 30 days.
Scoring:
Score 1 point for each YES for the following: 1-2, 5-7. 9-12, 14-15, 17-19, 21.
Score 1 point for each NO for the following: 3, 4, 8, 13, 16, 20
The higher the score, the increased risk to your overall sexual health and HIV/STD.
The purpose of this topic is to review HIV and Sexually Transmitted Illnesses (STIs) as they relate to your sexual behavior and possibly to the acting out cycle. This topic does not focused on prevention, (see http://www.mnaidsproject.org/ or http://www.cdc.gov/hiv/default.htm) or treatment issues (see http://www.thebody.com/). Together, these three websites cover a range of topics from prevention techniques, resources and responses to commonly asked questions regarding HIV/AIDS. And while prevention and treatment issues are important and are related to sexual health, the goal of this topic is to help you understand how this information shapes your sexual behavior. My experience highlights how the relationship between your identity, thoughts and sexual behavior is multi-directional. To maintain and create sexual health, it is important to understand the thoughts you have about HIV, STIs and sexual behavior.
Multidirectional Relationship between Sexual Health and Safer Sex
The relationship between sexual health and safer sex behaviors can be multidirectional. This position reflects that your mood can shape your sexual behavior, and your reaction to that behavior may set you up for the next round of the cycle. “I’m so ashamed of my behavior that my feelings of hopelessness and worthlessness have increased.” The positive part of this reality is that intervening anywhere in the process is a start toward improving sexual health.
Reasons for Unsafe Sex Research.
The field of HIV prevention has done significant research in why people engage in unsafe sexual behavior. The research has generally suggested a number of themes relevant to sexual health which include Sexual Compulsivity, Mood, Alcohol and Drug Use. In terms of your sexual behavior, reflect on the times you have engaged in unsafe behaviors. What reasons appear to be more relevant for you? These issues need to be addressed in your prevention planning.
Unsafe Sexual Behaviors and Mood.
One of the saddest things in my experience is when I sit across from a person who is negative or a person who is positive when they report that their self-hatred, shame, guilt, depression and/or hopelessness is contributing to their unsafe sexual behaviors. I’ve heard too many times “I wanted to kill myself by getting HIV.” This is a classic example of why sexual health has so many components and highlights the difficulty in moving toward sexual health. In these situations, sexual health requires addressing the underlying mood. In the topics on depression and anxiety, the connection between mood and sexual compulsivity were briefly reviewed. Much of that material applies to safer sex issues: If I believe I’m worthless, and I can only get affirmation through sex, I may do whatever my sexual partner wants to have them stay including the possibility of not following my ground rules for safer-sex. The problem lies in where do you start in the intervention process. This dilemma highlights how treatment for sexual health is so difficult.
Anxiety about HIV and Safer Sex.
Where as a depressed mood can contribute to safer sex, some people experience so much anxiety around HIV that they have simply shut down their sexual expression. The anxiety has led to a paralysis and fear that becomes the focus of the problem. In some of these cases, the anxiety is transformed to ritual masturbation or pornography use that is the manifestation of the acting out cycle. In this example, however, it is the thoughts that create the anxiety about the HIV that precedes the acting out cycle. Another example of the role of anxiety highlights when people are so anxious about HIV that they use alcohol and drugs to self-medicate and reduce the level of anxiety. And while under the influence, they begin to engage in unsafe sexual behavior which creates feelings of shame and guilt ultimately continuing the acting out cycle.
Assignment.
Review your unsafe sexual behavior. Highlight the 4-5 reasons for unsafe sexual behavior that are relevant to you.
Examine the questions above. For each question you scored a point, reflect on the underlying issues and identify plans to address the needs regarding why you scored the point.
Examine your safer safer sex behaviors through the lens of the values you want to shape your life. How consistent are the behaviors and values? If, for example, you value respect, how is self-respect impaired or damaged when you engage in unsafe sex behaviors? How is respect for others diminished when you engage in unsafe sexual behaviors?
What are your plans to address safer sex issues?
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