1. Alternate Sexual Behaviors STI Risks

2. Definitions sexual behavior: bodily contact meant to give or derive sexual gratification. alternate sexual behavior: a sexual behavior other than vaginal intercourse (penis in the vagina)

3. Reasons Teens and Young Adults use Alternate Sexual Behaviors • To avoid pregnancy • To maintain virginity

4. 1. To Avoid Pregnancy • Vaginal sex is the way most females become pregnant • Pregnancy does not occur with oral sex • Sexual behavior that deposits semen/sperm near the vagina, does carry some risk for pregnancy. Therefore, some types of mutual masturbation and anal sex carry some risk for pregnancy.

5. 2. To Maintain Virginity How Teens Define Virginity Mutual Masturbation: 83.5% say you are still a virgin Oral sex: 70.6% say you are still a virgin Anal sex: 16.1% say you are still a virgin Vaginal sex: 5.8% say you are still a virgin Bersamin M.M, Fisher D.A.,Grub J.W., “Defining Virginity and Abstinence: Adolescents’ interpretations of sexual behaviors.”

6. Anal Sex Penetration by a sexual partner of the anus/rectum with the penis, tongue, hand, or an inanimate object Oral Sex Contact of one person’s mouth (active) with the genitals of another person (receptive) Mutual Masturbation Stimulation by a sexual partner of the genitalia with the hand or inanimate object Risky Alternate Sexual Behaviors

7. Is Anal Sex Safe?

8. Rectal Condylomata (HPV)

9. Is Oral Sex Safe?

10. Syphilitic Chancre, Mouth

11. HPV of the Lip

12. Is Mutual Masturbation Safe?

13. Syphilitic Chancre, Abdomen

14. Herpetic Whitlow of the Finger

15. Men who have sex with men (MSM) • No risk of pregnancy • High risk for STIs • 63% of all new HIV infections were in MSM in 2010.1 • 2/3 of the cases of primary and secondary syphilis diagnoses in U.S. are MSM cases2 • 2015 Treatment Guidelines include screening at least yearly for gonorrhea and chlamydia2

16. Women who have sex with Women (WSW) • No risk of pregnancy • Risk of STD dependent upon sexual activity • CDC 2015 Guidelines: WSW should not be presumed to be at low or no risk for STDs based on sexual orientation.1 • WSW at risk for acquiring bacterial, viral, and protozoal STDs from current and prior partners1 • Risk from sex toys2 • Risk of HIV transmission2

17. ToiletSeats For nonsexual transmission of an STI to occur through a fomite (such as a toilet seat/rim) the following sequence of events would need to occur. • Infectious skin or organs touch the toilet seat • The organism could survive on a hard dry surface • Susceptible skin/organs contacts the surface before the organism dies • An “infectious dose” is reached Conclusion: Nonsexual transmission of STIs is extraordinarily unlikely

18. Centers for Disease Control and Prevention Abstinence from vaginal, anal, and oral intercourse is the only 100% effective way to prevent HIV, other STDs, and pregnancy.1 Risk Avoidance