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close this bookMezzo: For Young People by Young People (IPPF, 1997, 52 p.)
close this folderHEALTH
View the documentPlaying it safe. Use your head (please)
View the documentFOCUS ON: abortion. Mezzo looks at both sides of this controversial subject
View the documentWhich contraceptive? We give you the low-down on the contraceptives around today
View the documentMaking decisions. Do you want to have sex?
View the documentBetter sex guide. We suggest, you decide
View the documentJoin our club. Which team do you support?
View the documentIrish coffee talk. Irish young people discuss some big questions
View the documentHe loves him, she loves her. Get your facts right about sexuality
View the documentSo what about you, sugar? Find out your rating in our sexperts' questionnaire

Playing it safe. Use your head (please)

Safe sex

Young people between 15 and 24 years old are most at risk of contracting a sexually transmitted disease (STD). Every day at least half a million young people are infected with an STD, including the human immuno-deficiency virus (HIV). The most common STDs among young people are gonorrhoea, ahlamydia syphilis, herpes, genital warts and HIV.

What can I do to reduce the risk of getting STDs/HIV?

The only 100 per cent effective method of avoiding STDs/HIV is to practise abstinence. This does not mean that you avoid all physical contact and affection. But for many people, abstinence is not always possible or indeed desirable. You can also show affection and enjoy safer sex by avoiding penetrative sex through touching, massage and mutual masturbation. Many people get aroused by sharing sexual fantasies, dreams and desires with their partners. In many cultures, penetration is seen as the only way to have sex. However, men and women often gain sexual satisfaction penetrative sex. If you are going to have penetrative sex, use a condom correctly every time you have sex. Condoms greatly reduce the risk of getting STDs/HIV, as does mutual fidelity (i.e. you and your partner only have sex with each other). It is also important to seek medical advice immediately if you think you might have acquired or been exposed to an STD or HIV.

I don't like using condoms because they make sex less enjoyable. Why should I use them?

To avoid STDs/HIV it is essential that you use a condom correctly every time you have sex. Some people complain that condoms interrupt foreplay and reduce sexual pleasure. This is not always true. Condoms can be put on as part of foreplay. Using condoms reduces the fear of STDs/HIV, allowing you and your partner to relax. If you are relaxed you are likely to find sex more enjoyable. So in a way, condoms actually increase sexual pleasure.

When you say use condoms every time, do you really mean every time?

Yes, even one unprotected contact with a person infected with an STD or HIV can transmit the disease. People who have used condoms the majority of the time but not all of the time may have already been infected with an STD or HIV.

I didn't have sex until I got married. Why do I need to worry about STDs/HIV?

Being married or waiting until marriage to have sex do not by themselves guarantee protection against HIV or STDs. Many people who believed that they were safe have been infected by their partner. This is especially true for young women who have had only one sexual partner and have been infected by their husbands. Harried people can become infected when they are unfaithful to their partners, but are unlikely to confess to acts of infidelity.

I've never met anyone who has an STD/HIV infection, why am I at risk!

The chances are that you have met someone who has an STD or HIV. One in 20 teenagers gets an STD or HIV infection every year. You cannot tell whether someone is infected just from their physical appearance. Most people with STDs/HIV have no symptoms or have symptoms which are not visible. Furthermore, a person is unlikely to admit to others to having an STD or HIV because of the stigma attached to these diseases (people often think that you have to be homosexual, a drug addict or promiscuous to get an STD or HIV). STDs and HIV are very common in young people and anyone who has unsafe sex can become infected.

Being young is about taking risks. What's wrong with taking a chance with STDs or HIV?

Yes, it's true that you are more likely to take chances when you're young, even on matters relating to your health. What is important though is to know exactly what risk you are taking before you take the risk. Anyone who practises unprotected sex) is at risk of getting an STD or HIV. Many young people who thought that trey could not get an STD or HIV have already been infected. By taking a chance with STDs/HIV you are not only putting yourself at risk but you may also end up infecting someone you love. Is it really worth taking the risk?

Is it true that having an STD increases the likelihood of getting HIV?

Yes, having an STD, particularly one that causes genital ulcers, greatly increases the risk of getting HIV.

If I am menstruating, am I more likely to get infected with STDs/HIV?

Women who have unprotected sex during their periods are more likely to be infected with STDs/HIV or to transmit the infection if they are already infected.

How you don't get STDS or HIV

You cannot get an STD or HIV just from being near someone who has an STD or HIV, through contaminated food or water or from mosquito bites.

How do I know if I have an STD or HIV?

Both sexes may experience soreness or itching on or around the genitals, pain when urinating or lumps, sores, blisters or warts on or around the genitals. Hen may also have clear or white discharge from the penis. Women may have vaginal discharge (which may be frothy, yellow or smell unpleasant) or abdominal pain. If you have any of these symptoms you should not have sex, and seek medical advice immediately. Many people infected with an STD or HIV have no symptoms. If someone you have had sex with tells you that they have an STD or HIV you should visit an STD clinic or see your doctor.

What are the consequences of STDs or HIV?

Sexually transmitted diseases can have devastating consequences if untreated. leading to infertility, chronic ill health. sexual dysfunction and death. HIV in almost all cases leads to AIDS, which is usually fatal.

High risk

Vaginal sex (penis in vagina) without a condom
Anal sex (penis in rectum) without a condom
Semen (or blood) taken into the mouth during oral sex
Any sexual activity that makes you bleed

Low risk

"Protected sex" - sexual Intercourse using a condom consistently and correctly
Oral sex - fellatio (mouth on penis without taking semen into the mouth) cunnitingus (mouth on vagina without taking blood into the mouth) anilingus (mouth on anus)
Deep wet kissing

Safe sex (no risk)

Masturbation
Massage
Rubbing
Touching genitals


Figure

Can STDs or HIV be treated?

Most STDs can either be treated or effectively managed with drugs (usually antibiotics) and creams. There is as yet no cure or vaccine for HIV or AIDS. There are drugs available which can postpone or reduce the symptoms of AIDS. However, these drugs are not only prohibitively expensive, but also have unpleasant side-effects (including vomiting and diarrhoea).

Aren't HIV and AIDS only a problem for homosexuals and drug addicts?

No, anyone can get HIV/AIDS, not just homosexuals or drug addicts who share syringes. In fact, most new infections (70 per cent) are transmitted through unprotected - heterosexual intercourse.

Do you have to have many sexual partners to get Infected with STDs/HIV?

No, if you or your partner have had more than one sexual partner. you can get infected. The risk increases if you have more sexual partners.

FOCUS ON: abortion. Mezzo looks at both sides of this controversial subject

Thinking it trough

Pro-life

· The unborn fetus has a right to life. Therefore abortion is murder.

· Abortion is selfish - the unborn fetus did not ask to be conceived.

· Most religions forbid abortion.

· People must accept the responsibility and consequences of sexual activity.

· Abortion is not a contraceptive.

· The child could be adopted after birth.

· The unborn fetus has a potential contribution to make to society - e.g. could become an influential leader, scientist, etc.

"Truly I would feel very hurt if a friend had an abortion, because her baby did not ask to be born. I think we have to use a lot of contraception to ovoid unwanted pregnancy.
17, F, Mexico

"I'm radical about it, I do not agree with it. Nobody has the right to have an abortion. There's a whole life there. The baby is not guilty."
19, F, Panama

"Everyone has a right to be born to this world and we can't destroy a life for our own convenience."
21, F, Sri Lanka


Figure

Questions to consider

How do I feel about being pregnant?
How do I feel about being a parent?
How do I feel about abortion?
What will the abortion be like?
Haw might this decision affect me in 5 years? 10 years?
Who can I talk to about my decision?
How does my partner feel?

Pro-choice

· It is a woman's choice whether to go through pregnancy and birth since it is her body.

· Pregnancy and childbirth may be harmful to a woman's physical and mental health.

· Many women die (70.000 each year) during illegal, unsafe abortions or are Left severely disabled.

· Unwanted children may be abused or neglected.

· Abortion is a humane practice because it cares for the individual well-being of women.

· No contraceptive is 100 per cent reliable.

· A child born out of wedlock may lead to social rejection of the mother.

· Pregnancy/parenthood can jeopardize educational opportunities.

· If abortion is unlawful, it blames the woman for the unplanned pregnancy even though the man is equally responsible far the conception.

Times today are difficult. Pregnancy when one is still in school means a year or more of setbacks. If one falls pregnant accidentally then they should not, if they do not want to have the child. There are too many expenses."
21, F, South Africa

"It's the woman's choice. I would support her 100 per cent."
16, F, New Zealand

I see now that it should be legalized, for the simple reason that these contraceptives sometimes fait and people cannot afford to have unwanted children or unplanned children."
20, F, Lesotho

No regrets

I was 21 when it happened. I was using contraceptives -the pill - but sometimes I forgot to take them. I didn't really worry too much about it since I wasn't involved with anyone at the time. Then one evening I met a guy and we went out a couple of times. I wasn't in love with him but we had a good time together...

When I missed my period, I panicked. I knew that abortion was an option but I didn't have a due what to do. The hardest part was telling the guy. But he was cool about it. One thing was clear - I didn't want to be pregnant. I was still studying and I didn't love the guy. Yet I felt so ashamed. I felt stupid and guilty.

When I went to the abortion clinic, the best thing that they did was to help me get rid of these feelings. It was easy to make the final decision with them. I was still scared of what would happen. During the abortion, the female doctor kept on talking to me and a nurse held my hand. I still remember it. it was very touching. It felt as if they really cared, I have never regretted my decision, but it's still not easy to talk about it...


Formula 1 drivers wear helmets - every time

Which contraceptive? We give you the low-down on the contraceptives around today

Contraception

So you're about to become sexually active. But before you jump in at the deep end, you need to make sure that you are safe - safe from unwanted pregnancies AND safe from sexually transmitted diseases (STDs) including HIV. With so many different types of contraception available these days, how can you choose which method to use? We review ten of the most common methods available for young people to help you decide which one is best for you.

Contraceptive use-effectiveness: indicates how good the method is in practice for protection against pregnancy.

STD/HIV protection: indicates how good the method is for protection against STDs/HIV infection.

Ticks score from one
(low) to a
maximum of five
(high)

For women: For protection against unwanted pregnancy choose one method from 1-8. For protection against STDs including HIV, it is best if your partner uses a condom. Alternatively you can use a female condom.

For men: For protection against STDs including HIV and to reduce the risk of an unwanted pregnancy - always use a condom. At the same time, your partner may wish to use another method for protection against unwanted pregnancy.

1. Pill: combined oral contraceptives

The combined pill contains low doses of the hormones oestrogen and progestogen. It prevents ovulation.

How is it used?

Usually taken each day for 21 days followed by a break of seven days when no tablets are taken. Alternatively, dummy tablets may be taken during the seven day break so that pill-taking is continuous.

Advantages

No action required at the time of intercourse. May decrease menstrual pain and bleeding. Easily accessible in most countries.

Disadvantages

Must be taken daily.

Hot recommended for

Women who have a history of high blood pressure; women who are

Use-effectiveness

STD/HIV protection

NONE

Verdict

First choice oral contraceptive for most women.


Figure

2. Minipill progestogen only pills

Progestogen only pills thicken the cervical mucus, preventing sperm penetration.

How is it used?

Must be taken at the same time every day with no break.

Advantages

No action required at the time of intercourse. Can be used by breastfeeding women.

Disadvantages

Effectiveness is reduced if a pill is missed or taken late. In this respect progestogen only pills are much less forgiving than combined oral contraceptives. Irregular periods. Not widely available.

Not recommended for

Women who may find the strict pill-taking regime difficult.

Use-effectiveness

STD/HIV protection

NONE

Verdict

A good choice if you can't use combined oral contraceptives.


Figure

3. Norplant®

Norplant® prevents ovulation and in addition, thickens the cervical mucus which prevents sperm penetration.

How is it used?

Matchstick-sized capsules inserted under the skin of a woman's arm. Norplant® releases progestogen into the bloodstream, providing up to five years of effective birth control.

Advantages

Removes the need Co take pills every day. No action required at any time during use.

Disadvantages

Expensive (if not used for the full five year period). Not widely available. Needs to be inserted and removed by a trained health worker. Irregular bleeding.

Not recommended for

Women who wish to use short-term conception.

Use-effectiveness

STD/HIV protection

NONE

Verdict

It is expensive but if you find it difficult to remember to take a pill every day and you want Long-term contraception, Norplant may be good for you.


Figure

4. Injectables

There are two major types of injectable contraceptives - progestogen-only injectables such as Depo-Provera® or Noristerat® and combined injectable contraceptives such as Cyclofem® or Mesigyna®. All prevent ovulation and in addition, progestogen only injectables thicken the cervical mucus which prevents sperm penetration.

How is it used?

Depo-Provera® is injected once every three months, Noristerat® once every two months, Cyclofem® and Mesigyna® once a month,

Advantages

Once injected, no further action is required until the next injection.

Disadvantages

Must be injected by trained health personnel. For Depo-Provera® and Noristerat®, irregular bleeding or absence of bleeding.

Not recommended for

For Depo-Provera® and Noristerat®. girls under the age of 16. For Cyclofem® and Mesigyna®, women who have a history of high blood pressure or women who are breastfeeding.

Use-effectiveness

STD/HIV protection

NONE

Verdict

If you do not wish to take a pill every day, injectables are a safe and reliable choice. However, you will have to visit your service provider for each injection.


Figure

5. Diaphragms

The diaphragm is a latex rubber barrier, shaped like a dome and 5-10 cm across, which tits over the cervix.

How is it used?


Before intercourse, the diaphragm is smeared with spermicide, pushed into position and removed at least six hours after intercourse.

Advantages

No side effects.

Disadvantages

Unreliable both as a contraceptive and as a method for the prevention of STDs and HIV. Needs to be fitted initially by a health worker to ensure that the size is correct. Requires action at the time of intercourse.

Not recommended for


Women who want good protection from unwanted pregnancy or STDs.

Use-effectiveness

STD/HIV protection

Good for

If you are unable to confront an unplanned pregnancy - use a more effective method. However, it may be suitable if you are confident that you can use the diaphragm consistently and correctly. Remember, you will still have to use a condom for protection against STDs and HIV.


Figure

6. Intra-uterine devices (IUDs)

The copper-releasing intra-uterine device (IUD) is a small piece of plastic with copper wire wrapped around it which provides long-term contraceptive protection.

How is it used?

Inserted into the uterus of a woman by trained health personnel.

Advantages

Long-term protection. Less expensive per year than other methods.

Disadvantages

IUDs can sometimes fall out (usually during menstrual bleeding). Can increase the risk of pelvic inflammatory disease in women who are at risk of (or have) a sexually transmitted disease.

Not recommended for

Young women at risk of an STD, such as those with multiple sexual partners (or whose partner has multiple partners) and those who have never had a child.

Use-effectiveness

STD/HIV protection

NONE

Verdict

IUDs are not normally recommended for young people since they increase the risk of pelvic inflammatory disease, which can cause infertility. For that reason the IUD is not suitable for women who have never had a child. However, if you have already had one or more children and wish to have long-term contraceptive protection, lUDs could be a good bet


Figure

7. Male condoms

The male condom is made of thin latex rubber. Condoms are available in a variety of sizes, colours and even flavours. Most condoms are lubricated with spermicide to make them easier and safer to use.

How is it used?

Fits over the erect penis before intercourse.

Advantages

Easily available; inexpensive: protects against STDs/HIV as well as unwanted pregnancy; allows men to be involved in disease and pregnancy prevention.

Disadvantages

Requires action at the time of intercourse. Not highly effective as a contraceptive and therefore needs to be used with another method of contraception; can sometimes break or slip off.

Not suitable for

No one - everyone can and should use male condoms for protection against STDs/HIV.

Use-effectiveness

STD/HIV protection

Verdict

Essential for safer sex. If you're safe, you can relax. If you relax, sex is more enjoyable. It's as simple as that. Look at condoms as being part of foreplay. Be creative!


Figure

8. Female condoms

The female condom is a lubricated plastic tube, closed at one end, which lines the vagina completely.

How is it used?

It is pushed, before intercourse, into the vagina by means of a ring at the closed end.

Advantages

Allows women to take responsibility for safer sex; protects against STDs and HIV as well as against unwanted pregnancy.

Disadvantages

Requires action at the time of intercourse. Not highly effective as a contraceptive therefore may need to be used with another method of contraception. Not widely available.

Not recommended for

No one.

Use-effectiveness

STD/HIV protection

Verdict

Allows women to protect themselves against STDs and HIV without relying on their partner to wear a condom. May be worth a by - some people prefer them to male condoms.


Figure

9. Natural methods

A. PERIODIC ABSTINENCE

How does it work?

A couple has sex at the time during the menstrual period when the woman is unlikely to become pregnant.

Advantages

No physical side effects.

Disadvantages

It is very difficult to predict menstrual cycles, especially for young women whose cycles may be irregular. Highly dependent on the commitment and co-operation of both partners. Requires long initial training.

Not recommended for

Young people who lack high motivation and self-control, or young people who engage in short-term or casual relationships.

Use-effectiveness

STD/HIV protection

NONE

Verdict

Periodic abstinence may be suitable if moral or religious objections to contraception prohibit the use of modern, more effective methods.

B. WITHDRAWAL (coitus interruptus)

Withdrawal (or coitus interruptus) is when the man withdraws his penis from his partner's vagina before he ejaculates. Withdrawal only reduces the risk of pregnancy since sperm may be present in pre-ejaculatory fluid. This method does not protect against STDs including HIV. In addition, many young men find it difficult to control the response of their bodies and both partners may find that withdrawal can be an unsatisfactory and frustrating method of contraception. However, it may be the only method that is always accessible.

MYTHS - the following methods will NOT prevent a pregnancy:

· If you wash immediately after having sex
· If you jump up and down after sex
· If you only have irregular or infrequent intercourse
· If you have genital contact but no penetration (heavy petting)
· If you have sex standing up
· If the girl does not have an orgasm

10. Luck!

How does it work?


Use no method at all.

Advantages

NONE

Disadvantages

No protection from unwanted pregnancy or STDs and HIV. Fear of pregnancy and STD or HIV infection may make sex less enjoyable.

Not recommended for


Anyone who wishes to avoid an unplanned pregnancy or an STD/HIV infection.

Use-effectiveness

NONE

STD/HIV protection

NONE

Verdict

Good for couples who want to start a family. Otherwise, AVOID.

Emergency contraception

If you have had sex without using a contraceptive or if you had an accident with your contraceptive method (e.g. condom broke or slipped off) and you are worried about the risk of pregnancy, you should consult your doctor or visit your family planning service provider as soon as possible. There are two options open to you to prevent pregnancy. One option is to use emergency contraceptive pills. These are sometimes referred to as "morning-after pills" which is misleading because they are effective for up to three days after unprotected intercourse. Emergency contraceptive pills (ECPs) are the same as regular combined oral contraceptive pills. The number of pills taken is dependent on the dose of the pills. Therefore it is very important to check the dose of the pills beforehand. The modern, more commonly available pills are typically low dose (30 mcg) but high dose (50 mcg) pills may also be available.

TAKE THEM AS FOLLOWS:

(i) Low dose pills, 30 mcg take 4 pills within 72 hours of unprotected intercourse and 4 pills 12 hours later.

(ii) High dose pills, 50 mcg take 2 pills within 72 hours of unprotected intercourse and 2 pills 12 hours later.

· ECPs may cause nausea and vomiting.

· ECPs will not protect you from pregnancy for the remainder of the menstrual cycle - if you have sex again during the same cycle, you should use a method of contraception such as a condom.

· If your period is more than a week late, consult your doctor or family planning service provider as soon as possible to eliminate the possibility of a pregnancy.

EMERGENCY CONTRACEPTION IS ONLY FOR EMERGENCIES.

Emergency contraceptive pills will only reduce the chances of pregnancy by 75 percent. Therefore, you cannot rely on emergency contraceptive pills for continuous contraceptive protection.

Alternatively you can have an IUD inserted within five days of unprotected intercourse. This method is usually not recommended for young women (see "intra-uterine devices").

And the winner is...

Well, there is no winner. Choosing a contraceptive is about choosing what's best for you. Before you have sex, you are faced with two important decisions. First, you must decide how you are going to protect yourself from STDs and HIV. There are two choices available to you - you can either abstain from sex (the only 100 per cent safe method) or you can use a condom (male or female). Second, if you want to use contraception, visit your family planning service provider to discuss the options available to you. Not every method listed here is available in every country. Your service provider can advise you as to which method is best for you. At the end of the day, the decision is yours. If you remove the fear of pregnancy and STDs or HIV (and the stress and anxiety that it causes), you and your partner can focus your energy on having a fulfilling and satisfying sexual relationship.

TWO to tango

"I think it affects anyone, you and me. People should be even more careful about contraceptives, now people have to care more and be even more trusting of their partners. You have to be responsible."
19, F, Japan

"Those who use contraceptives become prostitutes."
18, F, Uganda

"If he does not have a condom, the woman should say: 'If you don't have, you can't get'. If he don't have he should not go on."
18, M, Trinidad and Tobago

"Contraceptives should be made available only to married people. They should not be given or even discussed with unmarried young people or teenagers."
22, F, Jordan

Who is responsible?

"It takes two to tango, so two people are responsible for it."

18, F, USA

"Men ore equally responsible since a sperm is needed to create a baby."

19, F, India

"We are all responsible but our minds have culturally been turned to believe that women are the ones to take the responsibility."

20, M, Lesotho,

"It takes two!" If the partners are mature enough for sex, they are mature enough to consider and deal with the consequences together."

17, F, UK

"It's a joint responsibility between the man and the woman. A woman does not have sex on her own."

21, F, Iraq

"It is the man's responsibility. After ail, the man controls the woman."

19, M, Ghana

"Women are responsible because it is them who become pregnant and carry the baby for nine months."

18, M, Zambia


Figure

How would you feel if you couldn't use contraceptives?

"Very bad. It is like wanting to kill me."
19, M, Cameroon,

"Very worried, frightened about a partner
21, M, UK

"I think it's a violation of a human right not to be allowed to use contraceptives."
21, F, Sri Lanka,

"I would not even have sex. I would feel like shit."
16, F, New Zealand

"My mother told me that when she was young she didn't use contraceptives. They were too expensive or she couldn't get them so they practised withdrawal where the boy had to go out before ejaculation: well, I am the result of that."
16, F, Netherlands

"According to the Bible, the use of contraceptives is bad so I will not worry."
19, M, Ghana

"Without contraceptives, I would feel like a fish without water."
18, F, Albania

"I would feel that my right as a sexually active person Co protect myself from STDs and unwanted babies is violated."
24, M, Grenada.

"No contraceptives? No fret. If you have to die by AIDS you die. If you get pregnant you mind the child."
17, M, Trinidad and Tobago

"If I didn't have contraceptives, I wouldn't have sex. I'd feel cheated."
18, F, UK

"I would feet nude. unwanted, deceived, insulted, hated, despised. In short, BAD."
22, F, Cameroon


Figure

Making decisions. Do you want to have sex?


Do you want to have sex

"The age-old fear that teaching young people about sex will encourage them to be sexually precocious, and promiscuous, is without foundation; it is the very opposite of the truth"

Professor R V Short

Better sex guide. We suggest, you decide

Healthy loving

For many people, being a good lover is an essential part of a healthy and loving sexual relationship. But sexual techniques are rarely, if ever, taught in schools or textbooks. So how do you learn ways and means of improving your sex life? Relax, there are others in the same boat as you. A rewarding and satisfying sex life is about trust, communication, experimentation, variety and mutual enjoyment. It does not come overnight, hut comes through experience. There is a misconception that safe sex is boring sex. In fact there are many non-penetrative sexual activities which are not only enjoyable and satisfying but are also safer than intercourse. There are infinite ]possibilities but here are few suggestions.

Massage

There are few better ways to relax and unwind with your partner than a long sensual massage. Rub a few drops of oil (scented oil or coconut oil) into your hands before you begin. There 'is no foolproof method of massage which will suit all people, so experiment - find out what your partner really likes. However, a few Long strokes across your partner's back will soon ease the tension out of those muscles. Keep it slow and keep it smooth. Massage all areas of your partner's body. not just the back. And when you've finished, your partner can return the compliment.

Mutual masturbation

Better sex is not just about penetration. Touching each other can be as erotic and sensual as penetrative sex. Mutual masturbation is totally safe, freeing you from the worry of unwanted pregnancy and STDs. Again there is no correct technique so the best approach is to experiment. Touch and stroke your partner's thighs and stomach and from there move on to his/her genitals (penis or clitoris). If necessary, guide your partner, telling him/her what you like and what you don't like. With practice you may be able to reach orgasms together, through touch alone. Mutual masturbation is an especially attractive option for people who do not want to have penetrative sex.

Bathing

Bathing with your partner is a truly intimate experience. Rubbing soap into your partner's body won't just leave you short of breath, it will also leave you clean. Showers can be steamy too - invigorating and refreshing. The tingling feeling of the water hitting your body can be quite sensual. Stay safe, sexy and clean.

"Sex is not only penetration. It should always consist of foreplay, which is a sexual activity such as caressing the sexual organs and kissing it sex includes good foreplay it need not be regarded as boring.
21, F, Lesotho

Young people should know how to do sexual techniques and petting.
15, F, Albania

Communication

Having an enjoyable and fulfilling sex life is all about knowing what you want and finding out what your partner wants as well. To achieve this you have to communicate frankly and openly with your partner. You may also change your mind about what you like and even find a sexual activity painful or unappealing. It's important to find the courage to discuss this with your partner and to try not to get hurt if your partner no longer wants to do something that you may enjoy.

Orgasms

Orgasms are experienced by both sexes as a series of pleasurable waves that spread throughout the whole body. Men and women don't necessarily reach orgasm in the same way or at the same time. For many women, it is not easy to have an orgasm unless the clitoris is stimulated and this doesn't always happen during Intercourse, Although orgasms are important to many people, you can certainly enjoy sex without them.

Love

Enjoying sex is about giving pleasure as well as receiving pleasure, which is much easier when you're in love. It is possible to have a loving relationship without sex. It is also possible to have sex without love. Sex is not proof of love, but being in love or being infatuated with someone can make your sex life much more exciting and enjoyable.

Fantasies

Sexual fantasies are thoughts and dreams which you find arousing. You can fantasize while you masturbate or indeed at any other time. Sometimes you may fantasize about doing something which you would never do in real life - like having sex in a public place or with a famous person. But the good thing about fantasies is that you can guide them in the direction you want and since they are just fantasies they are always safe. Sharing your fantasies with your partner can add to your sexual enjoyment.

Oral Sex

Oral sex is a highly erogenous act, and can, for many people, be more stimulating than penetrative sex. Oral sex means stimulating your partner by licking, sucking or caressing his/her genitals with your lips and tongue. It is vital to keep your genitals clean, otherwise the experience may be unpleasant for your partner (see bathing). Oral sex can have a risk of STD or HIV transmission (see p. 16-17), so to be extra safe you should use male or female condoms (flavoured if possible). Licking or sucking your partner's penis is called fellatia (or blow job). Licking or kissing your partner's clitoris is called cunnilingus. Many women find it easy to reach an orgasm through oral sex. Some people find oral sex (or even the thought of it) unpleasant. If you don't want to do it, then don't. You shouldn't be forced into doing it just to please your partner.

I am carrying the HIV virus, but I guess I am living with the mistake I made. I feel that the word has to get around that we all have to be extra careful now that this disease is spreading. I really wish I had the proper education about sex and all beforehand.


Figure

Join our club. Which team do you support?

The essential guide to sexual relationships


Abstinence

Playing Style

Abstinence's reputation as defensive masters is wholeheartedly deserved. Like their sister club, Virginity, they have never conceded an STD or a pregnancy and nor do they look likely to. The coach's decision to play without strikers means that despite patient build-up, attacking play in and around the area lacks any real penetration. However, no one can accuse them of being boring. In terms of ability, the players at Abstinence more than match those at the more glamorous clubs but the team elects to play a strategy that revolves around an Impregnable defence. Although Abstinence never score, their approach play can be exciting and adventurous; but always safe. Their players and fans are drawn to the club for a variety of reasons. The club's religious connections are well known, but the club has also attracted new fans and players in recent years, since the advent of AIDS. Players and fans rarely pledge allegiance to the club for life but whilst at the club they are loyal and content.

What the players say

"Realistically, abstinence is rare. I am not for casual sex. I abstain from sex." 20, F, USA "The way things are now, it is better to wait and find the right partner."
22, M, Trinidad and Tobago


Virginity

Playing Style

Virginity are a young team, with a similar defensive reputation to Abstinence. Like Abstinence, Virginity demonstrate that there is more to the game than scoring, although they can be 3 match [or any club when it comes to creating chances. At times. Virginity look as if they could score at will, but hold back, content to entertain the crowd with nice touches at the edge of the area. Every player plays for Virginity at the beginning of their career. Most move on to other clubs with many transferring direct to Monogamy. The club has a reputation as a training ground for young players, giving them the freedom to learn about the game and develop in a safe environment before furthering their careers at other clubs. It is disappointing that many players feel pressured into leaving the club early in their careers rather than waiting until the move is right for them. Virginity are a club built on high principles, laying the foundations for players early in their career so that they can flourish later in life at other clubs.

What the players say

"Virginity. In a word, it means honour." 21, M, Jordan "If you have sex before you get married, somehow it will not be the some on your wedding night, it will not be special. It would be just another night."
20, F, India


Monogamy

Playing Style

Monogamy are a club built on tradition and family values. Monogamy are a high-scoring team, although they are often accused of being a bit predictable, lacking variety and flair. This is not entirely fair, because with a bit of imagination and creativity, Monogamy an be exciting and attractive. In particular, there is a good understanding between the players which allows them to be patient in their approach play. However lapses in concentration at the back mean that, all too often. Monogamy concede needless unwanted pregnancies and STDs. In recent seasons, the coach has been trying to tighten up the defence, but many of the players at Monogamy remain sceptical about the need for this tactical switch. Team spirit, however, is good with relationships at the club often close and rewarding. Monogamy responds well to pressure, and the players are able to maintain their composure in the face of adversity.

What the players say

"Sexual intercourse is the feeling of becoming one and is something very special to two people."
21, F, Sri Lanka
"I think that sex between two people who love each other is always better than meaningless sex."
19, F, UK


Serial Monogamy

Playing Style

Serial Monogamy are often confused with their neighbor, Monogamy. Whilst their style of play can be similar, Serial Monogamy often undergoes dramatic changes in personnel. Players are always looking for new challenges which can lead to frustration and conflicts off the pitch. The defence can become complacent, making Serial Monogamy vulnerable at the back. Over a season, Serial Monogamy can concede as many unwanted pregnancies and STDs as Casual Sex. The situation is very different if Condom plays in goal. However the coach has a tendency to drop Condom just as he looks like establishing himself in the side. The club is also renowned for folding when put under pressure. Despite their shortcomings, the style of Serial Monogamy suits many young players. Its Laid-back approach and emphasis on experimentation allows players to enjoy the game without the demands of Monogamy.

What the players say
"I think if you are responsible there is nothing wrong with it. It's not as if you go steeping around with everyone."
19, F, USA
'There is nothing wrong with it if, and only if, the people are using contraceptives."
21, M, Botswana

"It's a personal choice in life." 21, M, Cameroon
"Everyone can live their lives the way they want to." 18, F, Mexico


Casual Sex

Playing Style

Casual Sex rely more on individual flair than on teamwork. On their day, Casual Sex can be exhilarating and entertaining. The Fans expect Casual Sex to conjure up a goal from nowhere and as a result, the players are more than happy to try their luck with long shots. However, in the drive for a moment of magic, all too often the need for precaution is abandoned. Casual Sex lack consistency, and if they don't score early in a game, they are easily frustrated. Their games are frenetic at times and can lack the sophisticated interplay of Monogamy and Serial Monogamy. Their carefree approach in defence makes them susceptible to conceding unwanted pregnancies and STDs. Players are often accused of being selfish, playing for themselves rather than for the team. Their critics say that Casual Sex lack the commitment required to play the game. However, it is exactly this lack of commitment (and responsibility) which attracts many of the players and fans to the club. In the end, Casual Sex do not always live up to expectations, which can leave the players and fans demoralized and Low on self-esteem.

What the players say

''Casual sex is gooood! I like it, I like it a lot."
19, M, USA
"It's cool as long as both parties know the score."
21, M, UK

DEFINITIONS

ABSTINENCE

Abstinence is when someone (who may have had sex before) chooses not to have sex. A person may decide to abstain for a variety of reasons - there may be a cultural taboo prohibiting sex (e.g. after the birth of a child); it may be for religious reasons; a person may abstain if engaged to be married or after an unpleasant sexual experience (e.g. abuse, rape) or a person simply may not want to have sex.

VIRGINITY

Virginity is when someone has never had penetrative sex. In many societies, virginity is retained until marriage. Indeed, in some cultures, the virginity of the bride must be assured to validate a marriage. Many young people choose to remain virgins until they meet the right partner or the person they intend to marry.

MONOGAMY

A person is monogamous if they have only one sexual partner. Monogamy usually implies, although does not necessarily mean, that a person has a long-term sexual relationship with commitment which may be formalized through marriage. For many people, monogamy is the ideal, indeed only, way to live. Monogamy, if strictly observed, reduces the risk of STDs/HIV.

SERIAL MONOGAMY

Serial monogamy occurs when a person begins a new monogamous relationship when another one ends. Whilst a person has only one sexual partner at any one time. he or she may have several short-term monogamous relationships over a period of a few years. Not everyone chooses serial monogamy, but may end up being a serial monogamist whilst looking for a stable long-term monogamous relationship.

CASUAL SEX

Casual sex describes sexual relationships which occur outside monogamous relationships. It includes one-night stands, commercial sex, illicit affairs and open sexual relationships (i.e. not monogamous). For a number of reasons, people do not always use condoms when they have casual sex. As such, casual sex carries a high risk of STD and HIV transmission as well as unwanted pregnancy.


Figure

"Before the war I was happy I had many friends real friends. You never asked them about their background. It didn't even matter whether you were Bosnian or Croatian or Serb We didn't even know then We are all from mixed backgrounds anyway. But then during the war I lost my friends. All at once I was declared a Muslim And so I lost my friends I find it difficult to make new friends now

WHO CAN I TRUST?

Before the war I used to go out with many boys I didn't have sex until I was married. but I know at a lot of girls who were doing that Now alter the war it is very different - sex has become too easy. Young people don't care any more. People want to forget so they try to have fun and sex is one way of having fun.

It is very difficult for me to talk about sex now you know after what happened to me I would never have believed that things like this could happen to me. I fled from my home leaving my parents I learned of my parents death a little later, but I couldn't believe it in 1994. I returned here Then people around me started dying. My schoolfriends were killed at the frontline - they were standing on the other side. Then they came and raped me I just cannot talk about it. It depresses me and I am plagued by many questions for which I have no answers.

I LOST MY WILL, MY SELF-CONFIDENCE AND MY FAITH IN HUMAN BEINGS.

But being at the shelter helps me a lot. They trust me and I trust them.
This place means a lot to me. It brought me back to reality it gives me strength to start a family.

DINA, 22, BOSNIA HERZEGOVINA

Irish coffee talk. Irish young people discuss some big questions

Extracts from a group discussion in Ireland

Friends

MARIE: When do you consider someone to be a friend?

EMMA: Well, there is no rule - like you did this and this for me - therefore you are my friend.

FEARGAL: No, there are people who you go out with and get drunk with, but you never talk to, and never tell them anything you really care about.

AINE: If you're friends, there shouldn't be any set rules that make you feel you have to act in a certain way around them.

MARIE: It's when you are completely and utterly relaxed and you feel you don't have to prove anything any single day.

EMMA: Isn't that just with your closest friends?

MARIE: But that is a friend. Someone you can rely on. It's not a case of 'if you do something for me I'll do something for you'.

RUARRI: What about your friendships with guys? Are they any different?

EMMA: When I got to college, it was a big shock. It was 'oh my god, there is man!'

MARIE: It wasn't 'oh my god, there are all these guys'. It was more that it was just different to what we were used to.

EMMA: I still found it very hard to adjust to it, because it's okay making friends with a girl. I find it easier to make friends with girls because of my background. All I did for six years was have friends who were girls. Then when I got to college there were guys there. I found I was shy. Initially I found it difficult making friends with guys. But this year it has been easier to make friends.

AINE: People bring different things into a friendship. A friendship between a girl and a boy is so different from a friendship between a girl and a girl or even a boy and a boy.

Talking to adults

FEARGAL: How do you feel about approaching adults in general?

MARIE: It depends on their attitude. There are some people I wouldn't approach.

RUARRI: There are some I wouldn't approach but there are some I would. It depends on your relationship.

AINE: I feel they are on this kind of superiority thing. That's what it feels like.

MARIE: How do you feel in general, are you intimidated easily by adult people?

RUARRI: If I had a problem I would be much happier going to my friends.

AINE: I don't think they want you to grow up. There's a feeling they won't approve of it.

EMMA: I guess my parents were for the more moral Catholic side. Don't have sex before marriage and that kind of thing.

FEARGAL: But you were all told about the birds and the bees...

MARIE: Very vaguely.

AINE: I don't think I was sat down, but I think I was told gradually bit by bit. Every time my question came up it was answered.

EMMA: I don't remember not knowing about it. But I do remember wondering about it.

Marriage

FEARGAL: What do you think of young people getting married while they are still young? Take two people who have been going out for two/three years and they have decided to get married, they are in their 20s and both at college. Is it a mistake for them to get married? Would it be a waste?

EMMA: Maybe they should wait.

MARIE: They have the rest of their lives together to get married.

RUARRI: I can't see the reason, They could move in without having to get married.

MARIE: What do you think of people living together anyway?

FEARGAL: I don't know, as long as it's not straight into it.

RUARRI: Morally I don't think it is right or wrong but individually it might be wrong for the person.

FEARGAL: I think the obvious issue here is they are sleeping together, which is what it boils down to, and they are not only sleeping together some of the time but the potential is there all the time and she get pregnant.

Abortion

AINE: How would you feel if one of your friends had an abortion?

EMMA: It would depend on what the situation was- But if it was just a form of contraception I would be angry with them. Maybe I would try to understand why they did it, as I am sure that no woman really wants to live with that.

RUARRI: I probably wouldn't be angry or anything because it is a very distressing thing to go through.

AINE: You don't need people jumping down your throat with their moral views.

RUARRI: They are going to be in some sort of state afterwards.

MARIE: You know, when there are other options available, it is hard to see abortion as the answer.

RUARRI: If they came for advice that would be different.

AINE: I would listen first.


Ruarri (M), Emma (F), Feargal (M), Aine (F) and Marie (F) are all 19.

Rape

MARIE: Do you think if a woman who got raped, it could ever have been her own fault?

FEARGAL: Ever? No.

MARIE: No matter what she was wearing.

FEARGAL: No.

AINE: Nobody is going to ask somebody to rape them. Whatever you were wearing.

FEARGAL: Okay, the girl... for example, walks around the wrong area of town... on her own, half drunk, do you not think that is very foolish?

RUARRI: Yes, foolish. But she is not asking for it.

FEARGAL: You don't run out in front of a truck. It is not an ideal world and no one is blaming the woman for being raped. No one would wish that on anyone.

RUARRI: If you are walking around in the wrong part of town, half drunk, then you are asking to be mugged. Not asking, but you are foolish still.

MARIE: Is there such a thing as date rape?

FEARGAL: Yes, oh yes there is. And it is wrong.

EMMA: Do you think that a girl is asking for it if she goes on a date with a guy and wears a short skirt and goes back to Ms place for coffee? Is that necessarily asking for it?

FEARGAL: No, if she says no, and he rapes her, then it is rape and should be treated as such.

Sex before marriage, pregnancy & parenthood

RUARRI: Why do you think that people have sex before marriage?

MARIE: It could be a big let down... if you wait till you are married.

RUARRI: That's true. Ifs a part of life. Not necessarily a big part.

FEARGAL: Curiosity. Get it over and done with.

MARIE: It is not like the big unknown.

EMMA: If you got a girl pregnant?

FEARGAL: I would make damn sure I am the father.

EMMA: Would you many her?

FEARGAL: I would wait a while. I wouldn't marry her straight away, but I would consider it...

RUARRI: The only reason for marriage is for love.

AINE: We have a friend and she has a baby and she is now engaged. She had the baby... it is really strange because you wonder if that's the reason they are together. Because a couple of months before she got pregnant we were talking about relationships. Then a couple of months later she says she is having a baby. They are a family now. It is so strange. First friend that's pregnant, While the rest of us are still growing up.

MARIE: I am not doubting the relationship. It must be very difficult as you are expected to be a family unit, and if you have any sort of problems you can't just walk away. She is only 19 or 20. Like she can't walk away, which she should be able to do. Like she is there. Very permanent. No choice. If the relationship breaks down they can't walk away from it as simply as we could.

For Health Professionals

How to treat us young people:

· Be confidential with us
· Provide us with the information and services we need
· Accept us as we are, do not moralize or demoralize us
· Use language or means we understand
· Ask and respect our opinions about the services
· Allow us to decide for ourselves
· Make us feel welcome and comfortable
· Don't judge us
· Provide services at the time and within the time frame we have available

He loves him, she loves her. Get your facts right about sexuality

Personal style

It is not known why someone is heterosexual or homosexual. During puberty and adolescence, it is common for someone to have homosexual feelings. Homosexuality refers to same-sex attraction which extends beyond adolescence and into adulthood.

It can be a confusing time - having homosexual feelings which are arousing and pleasurable, knowing at the same time that society is usually not tolerant of homosexuals.

Homosexuality means sexual attraction to members of the same sex. It is not always expressed through physical sexual activity and may be expressed through sexual fantasies and feelings of love. Homosexual men are called gay and homosexual women are called lesbian. Bisexuality means sexual attraction to members of both sexes.

It is now believed that sexual orientation is a continuous scale from exclusive heterosexuality to exclusive homosexuality, with most people somewhere in between. However, it is not a choice. People do not choose their sexual orientation.

Homosexuality occurs in all societies and cultures, and in every ethnic and racial group. It is poorly understood and often feared. Many consider it to be evil and repulsive. Most societies are intolerant of homosexuality. In many countries, physical homosexual activity is illegal. Even in countries where it is permitted, the age of consent is usually higher than for heterosexual sex. Intolerance of homosexuality is called homophobia. This is an irrational fear of homosexuals based on myths and ignorance. It can lead to harassment and even violence towards homosexuals. Being openly gay can lead to rejection by family and friends and may threaten job opportunities. As a result, many homosexuals choose not to "come out". Indeed some homosexuals marry and have children despite strong sexual feelings for members of the same sex.


He loves him


She loves her

If my friend was gay I would feel weird, but at the same time she's my friend, so I wouldn't feet uncomfortable."

13, F, USA

"I would be happy for a friend if he found out he was gay, since he would have discovered his passion and learnt a lot about himself, which can't be a bad thing."

17, F, UK

"I have friend who is gay. He respects my sexuality and I respect his. I believe that is normal with all gay."

19, M, Mexico

"He will be my friend forever, for everything not related to sex."

21, M, Albania

Homophobia

"To me, homosexuality is sick and abnormal."

16, M, South Africa

"Homosexuals are possessed by Satan."

19, H, Zambia

"I would stay away from such a person (gay, lesbian, bisexual)... these things are not natural. Even animals do not behave in such a way."

21, F, Sri Lanka

Myths

Homosexuals are always easily identifiable from heterosexuals.

Not true. Homosexuals usually differ only in sexual preference.

Homosexuals desire to be one of the opposite sex.

Not true. Homosexuals are usually happy with their gender. They just prefer same-sex sexual relationships.

Homosexuals are sick people.

Not true. Homosexuality is not a mental illness.

Homosexuals seduce and abuse children.

Not true. Homosexuals are no more likely to abuse children than heterosexuals.

Homosexual are always recruiting.

Not true. Homosexuals try and find out if someone is interested in them in the same way that heterosexuals do.

Homosexuality can be cured or changed.

Not true. Homosexuality is not a choice.

So what about you, sugar? Find out your rating in our sexperts' questionnaire

Sex questionnaire

What are you like in a relationship? Are you cool and confident or just a fluffy bunny rabbit? Do you get what you want. or are you too shy to ask? Your mezzo sexperts have romped through the realms of love 'n stuff to produce a quiz that tells it how it is.

1. After months of being single, you spot someone pretty special at a party. Do you

a march over and give him/her a kiss.
b start with some flirty eye contact and gradually get talking.
c turn away - you know you haven't got a hope of catching his/her attention.

2. One way and another, your partner just isn't In the mood for some rough and tumble. Do you

a end the relationship at once - after all, if you're not having sex, what's the point.
b realize that your partner's just tired and feeling a bit low - ifs not a big deal.
c immediately conclude that you must be desperately unattractive.

3. Your partner's wandering hands want more than you can offer; you'd prefer to take things a little bit slower. Do you

a tell your partner he/she's a depraved pervert - and promptly find someone else.
b explain that your views on sex are important to you and you'd like them to be respected.
c go to bed with him/her anyway - it's better to lose your principles than your partner.

4. So ifs your turn to buy the condoms. Do you

a walk straight up to the shop counter with the box of condoms - you don't mind at all.

b linger in the shop, summoning your courage, then finally buy the condoms along with a load of other items you don't really need.

c leave it to your partner - you can't be seen buying condoms, it's far too embarrassing.

5. Your partner feels like a bit of experimentation - you know, dressing up, public places and lots of chocolate sauce. Do you

a go for it and throw in a few ideas of your own.

b make clear to your partner which suggestions you are happy with, and which ones are a step too far.

c try to avoid being alone with him/her, and hope he/she gets the point

6. Your best friend doesn't approve of your new partner. Do you

a stop talking to your best friend - where sex is concerned, no one is going to tell you what to do.

b try and get the two of them to know each other properly - if they both care about you, they should get along.

c break up with your new partner - you just can't stand people being critical about you.

7. Your mother discovers a condom wrapper at the foot of your bed and confronts you with it. Do you

a promptly launch into a heart-to-heart with her about the joys of sex.
b try to explain it away - you wish you'd been less careless.
c break down in tears and vow to celibacy.

If you answered:

Mostly a

You're as spicy as a chilli and as subtle as a steam train. You know what you "really, really want" but perhaps others can't keep up with you?

Mostly b

You're sexy, sassy and sorted. You know it's all about give and take, caring and sharing. You know what, you want, and give loads too.

Mostly c

Docile doormat? You spend too much time doing what others want and too little time telling them how you feel, but with a bit more confidence and willingness to talk, it can only get better.

And remember, keep it sexy, keep it safe!

LOVE & MARRIAGE

"Young people are restless they are bound to make mistakes. They also lack commitment to one another."
20, F, Netherlands

"Getting married when you're young is only good if you know what you are getting into since marriage is a serious commitment"
21, F, Sri Lanka

"Love is most important. Without love nothing is correct. But marriage is important."
18, F, Philippines

"Love is the most essential ingredient without which the relationship would be animal-like and without feelings."
20, F, Lebanon

"I can only give my love, emotions and dedication to the person I am sure will be my future husband."
21, F, Syria

...and if you couldn't choose your own partner

"I believe it's about time our parents left us alone to choose our partners: that person whom you know you can't live without and marry because you love them."
21, F, Lesotho

"I would feel insulted and undermined if I was presented with a partner. It's like one is not man enough to do one's own hunting. Just imagine life without the fun of chasing the game around."
21, M, Botswana

"I don't mind as long as my parents don't spoil my life by choosing me a bad partner."
19, F, India

"It's my life, my body, my choice. I would refuse."
14, F, New Zealand


Figure