It can be hard for parents to accept that their son or daughter may be involved in a sexual relationship. If parents cannot acknowledge that their child is in a sexual relationship, they likely will not talk about sexuality with them.
Talking to youth about sexuality is important because it can increase their ability to make healthy decisions, including whether or not to have sex.
SARAH & JOSH’S STORY…
Sarah and Josh met two years ago volunteering at Stampede. What started as friends turned into a dating relationship that they both had fun with. Recently Sarah’s group home coordinator Vic had a call from Josh’s parents asking if he could talk to the couple about safer sex. Josh told his parents that he loves Sarah and is ready to take the relationship to the next level. His parents are really happy that he had shared this with them and although they are worried, they know that at age 23 Josh wants to make his own choices. Vic feels comfortable talking about the topic with the couple, but where can he get the most up to date information and advice about birth control and STIs?
- The consequences of sexual activity including pregnancy and sexually transmitted infections (STIs).
- How to give and get consent to take part in sexual activity.
- How to talk about safer sex with a partner including negotiating use of condoms.
- Where to go for information about birth control and STIs.
- To help all Canadians obtain positive outcomes (e.g., rewarding relationships, self-esteem, informed reproductive choices, non-exploitive sexual relations); and
- To help all Canadians avoid negative outcomes (e.g., unintended pregnancy, STIs, sexual coercion).
This means not taking part in any sexual activity that involves exchanging body fluids, genital to genital contact, or skin to genital contact. If abstinence is not possible, then birth control and condoms should be used consistently and correctly.
To learn more about pregnancy and pregnancy options, click here.
- Natural family planning – includes abstinence, fertility awareness and withdrawal (“pulling out”). These methods require planning and are not considered very effective since many people have a hard time using these methods correctly.
- Hormonal – includes the pill, patch, vaginal ring, “the shot” (Depo-Provera injections), and hormonal IUD. These methods are very effective, but a visit to a health care provider is needed. The emergency contraception pill is a hormonal method that can be purchased at many pharmacies without a prescription.
- Barrier – includes diaphragms and male and female condoms. A prescription is needed for the diaphragm and it needs to be fitted by a healthcare provider. Male and female condoms can be purchased at pharmacies or supermarkets. Some youth clinics have them available for free. If used consistently and correctly, male and female condoms can be effective at preventing both pregnancy and STIs.
- Spermicidal – includes foams, jellies, film and sponge. These methods are less effective and usually need to be used with another method of birth control.
- Other – includes copper IUD and surgical methods (e.g., tubal ligation and vasectomy). Surgery is considered permanent and the IUD can be removed at any time. All are very effective but require a visit to a health care provider.
To learn more about methods of birth control, click here.
There are three methods of EC: two types of emergency contraceptive pills (ECP); and Copper IUD. The ECP works best if taken within first 24 hours but can be used up to 5 days. Levonorgestrel ECPs can be bought at a pharmacy without a prescription, or found at many family doctors, walk in clinics or Alberta Health Services Sexual and Reproductive Health Clinics. A newer type of ECP, ulipristal acetate is also available by prescription. The Copper IUD needs to be inserted into the uterus by a trained health care professional.
- Latex allergies and sensitivities are particularly common in people diagnosed with spina bifida. Even though condoms are commonly made from latex, there are non-latex condoms widely available and should be used if there is a latex allergy.
- Using condoms can be difficult for anyone with reduced dexterity.
- Hormonal methods, such as the pill (taken daily), may not be the best option for youth with learning disabilities who may have a hard time remembering to take it.
- Seizure medication reduces the effectiveness of the birth control pill.
The good news is that there are lots of different methods to choose from and there is something that will work for everyone, no matter the disability.
- Are you truly ready to be sexually active? Do you trust the other person? Do you both give each other consent to have sex?
- Do you need a birth control method that gives protection from STIs? If both people are free of STIs, meaning this is their first sexual relationship or they have been tested for STIs, they may choose not to use condoms. Dual protection (e.g., using a hormonal contraception plus a condom) greatly lowers the risk of unintended pregnancy and STI.
- Do we need to visit the doctor to talk about which method is best? What are the side effects? Where can we go to get birth control? This may take planning as some types of birth control will not work right away.
- What will you do if you do not like the type of birth control you choose? If someone has unpleasant side-effects or does not like using the chosen method, it is important to talk with a health care provider. Quitting a method suddenly can lead to unintended pregnancy.
- MYTH: Only people who have lots of different partners are at risk.
FACT: Anyone who is sexually active can come into contact with STIs and it is possible to contract an STI during the first sexual experience. Do not assume that youth who are dating for the first time are not at risk.
- MYTH: It is easy to tell if someone has an STI just by looking at them.
FACT: Having an STI is not like having the chicken pox. Many people show no symptoms and if there are any, they may not be visible. Testing is the only way to know for sure if someone has an STI and partners can only really know if they ask each other. Anyone can get tested at a sexual and reproductive health clinic, STI clinic, or doctors’ office. Testing and treatment is free.
- MYTH: STIs are only spread through sexual intercourse.
FACT: STIs can be passed on through skin-to-skin contact, with no body fluids involved. Oral sex is a high risk activity for STIs along with vaginal and anal sex without protection.
- Bacterial (e.g., chlamydia, gonorrhea, syphilis),
- Viral (e.g., HPV, genital herpes), and
- Parasite (e.g., public lice, scabies).
If detected early, bacterial and parasite STIs are generally easy to treat. Viral STIs can be treated, but are more difficult to cure. Some viral STIs are not curable at this time. Untreated STIs can lead to damage to the reproductive system, which may cause problems with fertility later in life.
Some types of BBPs are human immunodeficiency virus (HIV) and hepatitis B. HIV is a virus that attacks the immune system and makes it hard for the body to fight diseases and infection. There is no cure for HIV. However, with early diagnosis and treatment people can live long, healthy lives. HIV can lead to a condition called AIDS (PHAC, 2015). Hepatitis b is a liver infection caused by the hepatitis B virus and is more infectious than HIV.
For more information on STIs and BBPs, click here.
- HPV Gardasil vaccinations are routinely given to grade 5 boys and girls in Alberta. Gardasil protects against four common strains of HPV.
- Hepatitis B vaccinations are routinely given to grade 5 boys and girls in Alberta. The vaccine may be given during the first year of life, if parents were born in an endemic area or if they are carriers of the disease.
Condoms can prevent pregnancy and STIs and the best time to talk about using them is before a youth starts to have sex. It is important to help them get familiar with what condoms look like and how to use them correctly but it is equally important to help them talk about and negotiate condom use with a partner.
- Choose a time without distractions and prepare for some embarrassment and maybe giggles.
- Not everyone can use latex condoms dues to allergies. Latex free condoms are available along with female condoms that do not contain any latex.
- Be sure to show condoms inside packages and talk about where condoms can be bought and also picked up for free (e.g., sexual health clinics).
- Explain that condoms, like medicines, have an expiry date and that it is best not to use the condom if that date has passed.
- People with hand mobility challenges may find it difficult to use condoms as they require some fine motor skills. A partner can be encouraged to help and this makes condom use something that couples can talk about together.
- Discuss setting limits about sex and condoms – no condom means no sex! Talk about what might happen if a couple wants to have sex but they don’t have a condom. What if one person does not like using condoms? For more tips about talking to a partner about condoms see STI high risk portal.
To see the teaching booklet Know About… Condoms from the BC Coalition for People with Disabilities, click here.
Youth can go to an Alberta Health Services Sexual and Reproductive Health Clinic.
Youth can go to an Alberta Health Services Sexual and Reproductive Health Clinic or STI Clinic.
- Walk-in clinics,
- A family doctor, and
- Urgent care facilities.
Public Health Agency of Canada (PHAC). (2013). Questions & Answers: Sexual health education for youth with physical disabilities. Retrieved from http://librarypdf.catie.ca/pdf/ATI-20000s/26289_B_ENG.pdf
Public Health Agency of Canada (PHAC). (2015). Canadian guidelines on sexually transmitted infections. Retrieved from http://www.phac-aspc.gc.ca/std-mts/sti-its/cgsti-ldcits/index-eng.php