Sexual and Reproductive Health” Kit Includes

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Introduction and Instructions

The “Sexual and Reproductive Health” kit includes:

Binder  Introduction and Instructions for entire Sexual and Reproductive Health kit  “Pregnancy and Birth Control” presentation  “STI and Safer Sex” presentation  Sexual Health Supplies - description of each Sexual Health Supply (8x10 laminated picture where actual supplies are not available)

Complementary Resources  SERC Consent Game  Birth Control Matching Game  Condom Line Up Game  True or Not True Game  Sexual Health Supplies - for demonstration and discussion purposes − Actual supplies − Description of each Sexual Health Supply (in binder)

Handouts  SERC : What You Should Know About Fact Sheets - STI Prevention, External Condoms, IUD/IUCs, Internal Condom, Emergency Contraceptive Pill (ECP) https://www.serc.mb.ca/search/node/what%20you%20should%20know  CATIE Safer Sex Guide http://www.catie.ca/en/practical-guides/safer-sex-guide

How to use the kit  Provide participants with evidence based/best practice information about sexual and reproductive health: − consent and decision making − pregnancy prevention and planning − birth control and options (6 most common) − STIs and prevention  Provide opportunities to discuss options with participants so that they can make informed choices related to engaging in sexual activity, pregnancy prevention/planning and protecting themselves from STIs.  n preparing for delivery of the presentations or games, you may want to review the content and order/copy some of the handouts.  Due to the number of items in the kit, it is unlikely that you would be able to cover all components in one session. Each presentation could be a session in itself with the addition of games. Or a game could be done as a mini topic or “nugget”.  Demonstrating the sexual health supplies, can provide participants with knowledge about correct use and aid in the prevention of getting STIs or becoming pregnant.  The sexual health supplies included in the kit are: − External condoms (10) − Internal Condoms (3) − IUD (laminated picture) − Birth Control Pills (laminated picture) − Birth Control Shot (laminated picture) − Sex Dams (3) − Gloves (3) − Lube (5)

If you have questions regarding information contained in this kit, please contact: SERC (Sexuality Education Resource Centre) phone: 204- 982-7800  Email: [email protected]  Website: www.serc.mb.ca  For any question about pregnancy or birth control you can email: [email protected]

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Sexual Health Supplies

 A number of safer sex and birth control supply samples are included within the kit to be used as part of a demonstration or discussion.

 Providing participants with visual information along with a demonstration (ex. putting a condom on a woody) can help participants prepare and learn how to use the item correctly.

 Allowing participants to view and handle items can also add to their understanding and may even help them feel more confident in asking questions.

 Adding some humour and asking for participant involvement can make this a fun activity.

NOTE: These items can also be put on a table for display with the notes so participants can look at the information at their own discretion. External Condoms

• Are the most common form of birth control and STI prevention, due to their affordability and availability. External condoms can be found in most pharmacies for about $2 each, or often at no cost at community health centres.

• External condoms fit around a penis, creating a pocket which contains the ejaculate. This prevents the ejaculate from being transferred to or touched by the other person’s body. By keeping fluids separate, the chances of STI transmission is reduced, and chances of pregnancy is reduced in cases of penis-vagina sexual activity.

• External condoms can also be used on sex toys; in case the sex toy is being shared between people, a new condom should be used each time so that body fluids are not shared between the people involved.

• When worn on a penis, it is important to follow the steps of usage exactly, or else the condom may tear or slip. The steps are outlined in the Condom Line Up Game activity.

• A three-fingered pinch is essential when putting on a condom because the ejaculate from the penis needs space once it exits the penis. If this pinch is not done or is not big enough, there is a chance of tearing.

• Be sure to reiterate that the base of the condom must be held in place during sex, or else slippage may occur.

• The more water-based lubricant that can be used during sex the better, as this lessons the chance of breakage or tearing of tissue.

Note: Proper condom care is essential. Condoms should be kept somewhere warm but not too hot, and kept away from anything sharp. They should also not be squished. So leaving a condom in your wallet or hot car will break down the condom; keeping it in a room temperature environment away from sharp objects will keep it intact.

Important: Most external condoms are made with latex. When passing around condoms to the group make sure first that nobody is allergic to latex; if they are allergic then skip this part and use the pictures in the condom race game to demonstrate condom usage. If nobody is allergic, then the woody which is included in your kit can be used to demonstrate proper procedure for putting a condom on a penis or sex toy. Internal Condoms

• Internal condoms, sometimes called female condoms, can be used for both STI and pregnancy prevention.

• The internal condom can be inserted into the vagina up to 4 hours before internal sexual play. The condom creates a barrier between fluids, which reduces the risk of STI transmission as well as the risk of sperm entering into the uterus.

• The internal condom has 2 flexible rings. When inserted, the smaller ring fits inside the vagina and covers the cervix. The larger ring rests outside the vagina and part of it rests on the vulva.

Important: Most internal condoms are made with latex. When passing around to the group, make sure first that nobody is allergic to latex; if they are allergic then skip this part and simply use the slideshow picture to explain.

IUD

• An IUD can be inserted into the uterus, providing birth control protection for 3-5 years. There are two types of IUDs – hormonal or copper – each with its own side effects.

– Hormonal IUDs (technically called IUS’ – Intra-Uterine System) releases progestin into the lining of the uterus, making the cervical mucous thicker and making it harder for sperm to enter the uterus. It also thins the lining of the uterus, making it harder for a fertilized egg to stick.

– These work for 3-5 years, depending on the type. Side effects may include depression, pain when inserted, and irregular bleeding for the first three to 6 months. Serious side effects are rare, but may include ectopic pregnancy and pelvic inflammatory disease.

– Copper-based IUDs (Intra-Uterine Devices) changes the conditions inside the uterus so that sperm cannot live. Side effects may include pain when inserted, and heavier and more painful periods. Serious side effects are rare, but may include ectopic pregnancy and pelvic inflammatory disease.

– IUDs need to be inserted by a health care practitioner, and often cost between $200 and $400 dollars. Some may be covered by health insurance. Often community health centres will offer these at low or no-cost to those who cannot afford this charge.

• IUDs are 99% effective.

• IUDs do not protect against sexually transmitted infections.

Emergency Contraceptive Pill -ECP

• An emergency contraception medication used to prevent pregnancy after sex when a birth control method wasn’t used, or you suspect the birth control method failed.

• ECP can be obtained without a prescription at many pharmacies and community health centres, and costs around $30-$50.

• ECP consists of 1 pill. ECP is very safe but can feel hard on the body, so if possible it’s a good idea to rest that day and the next.

• If taken within 24 hours of penis-vagina sex, ECP reduces the changes of pregnancy by about 95%. If within 48 hours, it reduces the chance by about 85%. If within 72 hours, it reduces the chances by about 58%. The sooner you take ECP after sex the better, up to 5 days after.

• Side effects may include bleeding or spotting, nausea and vomiting, abdominal pain or headache. If vomiting occurs you should contact your pharmacist ASAP to see if you need another dose.

• ECPs do not protect against sexually transmitted infections. Birth Control Pills

• The birth control pill is to be taken orally. It comes in packages of 21 or 28 pills which contain progestin. The pill tricks your body into thinking you are pregnant, so your ovaries do not release any egg cells. It also makes the lining of the uterus thinner, so it is harder for a fertilized egg to stick to the uterus.

• Birth control pills must be taken at the same time every day for maximum effectiveness.

• Throwing up or having diarrhea one to four hours after you take your pill may flush the pill from your body; if this happens be sure to use another method of birth control for the rest of your pill package.

• Some drugs counteract birth control pills. Be sure to discuss your other prescription drugs with your health care provider or pharmacist.

• When used correctly, birth control pills protect against pregnancy 97-99% of the time.

• Side effects may include depression, nausea, sore breasts, bleeding between periods, headaches, weight change, less interest in sex, acne and increased hair growth. More serious side effects should be discussed right away with your health care practitioner; these include stomach pain, chest pain, severe headache or dizziness, weakness or numbness in your body, eye problems, speech problems, severe leg pain, or yellow skin.

• The birth control pill does not protect against sexually transmitted infections. The Birth Control Shot

• The birth control shot is a hormone given by injection (a needle into the hip). It is important that the person stay on schedule and get an injection every 3 months. Injections can only be given by health care practitioners.

• The birth control shot contains the hormone progestin. This hormone tricks the body into thinking that you are pregnant, so it stops releasing egg cells. It also changes the lining of the uterus so it is harder for a fertilized egg to stick to the uterus.

• The birth control shot prevents pregnancy about 98% of the time.

• The birth control shot does not protect from sexually transmitted infections

Sex Dams

• Sex dams, also called dental dams, can be used to protect against sexually transmitted infections during oral sex. It is usually used on the vulva, but can also be used on the anus. If very careful it can be used on a penis, though the risk of slipping is higher.

• The dam can be placed against the body part of one person, while the other person licks the other side of it. This way the person licking does not come in direct contact with the other person’s body fluids.

• One thing to remember is to keep the licking side and the genital side clear so they are not switched around; otherwise the person might mistakenly lick the side which contains bodily fluids, increasing the risk of STI transmission.

Gloves

• It is possible that some sexually transmitted infections may be transmitted through cuts in skin, or through touching.

• To protect against the spread of STIs, gloves can be used on your hand when touching vaginal, anal or penile fluids.

• Be sure the gloves are made of a material through which STIs cannot penetrate, such as latex, there are no holes or tears, and that the fluid on the glove does not touch any exposed skin or body part. Discard used gloves in the garbage.

Lube

• “Lube" is a shorter, more casual way of saying "lubricant" or "lubrication." In general, lube gives individuals greater glide during sex, making sex more comfortable and pleasurable. Lubes come in three basic types – water-based, oil-based, and silicone-based – all of which have different properties:

– Water-based lubes are generally considered most user-friendly and all-purpose of the three types. They don't deteriorate latex, so they're safe to use with condoms, dams, diaphragms, and other latex safer-sex products. For most people, water-based lubes are non-irritating, user-friendly, and easy to clean up. They can also dry out relatively quickly, but adding a little more lube, water, or saliva will get you sliding smoothly again. – Oil-based lubes like Vaseline or lotion are not recommended for safer sex because they break down latex. They can also leave a coating on the vagina or rectum that can lead to infections. Males masturbating alone, though, can use oil-based lubes as a way to avoid chafing or to simply try something new. – Silicone-based lubes are the newest on the market. Like water-based lubes, they're safe to use with condoms and other latex products, but they last longer. Silicone lubes can also be used in the water without being washed off. However, this means they're harder to clean up after: you'll have to use soap and water. If you're using silicone lube with sex toys, you may want to use caution, since it can damage sex-toys made of silicone.

• You can find more specific kinds of lube, such as flavored lubes for oral sex. If you have sensitive skin, you may want to do a spot-test on your inner arm or thigh to make sure you don't have an unwanted allergic reaction.

• Lubes are a great way to enhance pleasure during sex. There are hundreds of different varieties available, so with a little experimenting, just about everybody can find a lube that makes their sex life both more slippery and satisfying.