Columbia University Health Services

Safer Sex is having oral, anal or vaginal sex, orgasms, or any other sexual activity without sharing blood, semen, or vaginal fluids. The purpose is to reduce the risk of transmitting sexually transmitted infections (STIs), including HIV. It also reduces the risk of unwanted pregnancy. 

Some safer sex techniques include: using a male or female condom correctly and consistently for anal or vaginal sex; using a latex barrier (i.e. condom or dental dam) for oral sex; kissing, touching and other activities where no blood, semen, or vaginal fluids are exchanged; and masturbation.  

Condoms help to prevent pregnancy and STIs when used consistently and correctly. Follow these 12 steps for proper condom use: 

• Consent and foreplay precede action
• Check expiration date on condom
• Pillow test—does air stay in the package?
• Tear open carefully—not with your teeth
• Add a drop of lube inside condom for added pleasure
• Pinch tip to leave room for ejaculate
• Roll condom to base of penis or object
• Gently guide air bubbles out of condom
• Add lube—friction can break a condom
• Enjoy the action
• Hold base of condom while pulling out
• Remove and throw in trash, do not flush 

The Female Condom (FC) can be used during vaginal or anal intercourse. A woman can insert the condom into her vagina before sex, creating a barrier similar to a male condom. For protection during anal sex, remove the inner ring from the FC and place the condom over the finger/dildo/penis before penetration. Do not use a FC together with a male condom. When used consistently and correctly, the FC prevents pregnancy and protects against STIs, including HIV. Made of soft polyurethane (a type of plastic), the FC transmits body heat better than latex and may be a good choice for those who have a latex sensitivity or allergy. 

Follow these 12 steps for proper female condom use:  

• Consent and foreplay precede action
• Check expiration date on condom
• Pinch inner ring of FC
• Gently insert closed end into vagina
• Use index finger to push inner ring up to cervix (similar to how a tampon would be inserted)
• Leave outer ring outside the vagina
• Check that FC is not twisted
• Add water-based or silicone-based lube on penis or penetrating object to increase comfort and decrease noise—can also be done before insertion
• Enjoy the action
• Twist outer ring and gently remove FC
• Remove and throw in trash, do not flush

The FC Female Condom® is available over-the-counter at drug and grocery stores in the same area as male condoms. 

Free condoms on campus are available at: John Jay Hall, 3rd & 4th floors; Lerner Hall, 3rd & 7th floors; and Residential halls.  

Store all condoms in a cool, dry place, away from direct sunlight. Use a new condom for each sexual act. Do not use a condom if it is damaged, discolored, deflated or brittle.  

Dental Dams (or oral) dams are thin pieces of latex that prevent possible transmission of STIs, including HIV, when placed over the clitoris, vulva, or anus for oral sex. Dams act as a barrier between the mouth and the vulva or anus. Dab a little water or silicone-based lube on the side of the dam that will cover the clitoris, vulva, or anus. Place the dam evenly over the area while holding the edges of the dam apart with your hands. Use lips, tongue, and kisses to pleasure your partner. Do not reuse or flip over a dental dam after use. Make your own dam by folding a piece of non-microwaveable plastic wrap in half. Or take a non-lubed condom, snip off the elastic ring, cut along one side using scissors and flatten it into a rectangle.  

Lube is a water- or silicone-based, non-greasy liquid or gel that helps make sex safer and more pleasurable. Lube increases the body’s own natural lubrication. It is great for vaginal or anal sex, first times, sex after a dry spell, or when things feel too tight or dry. Lube increases a condom’s effectiveness and reduces discomfort and friction by adding moisture. Dab a bit of lube on the inside of an unrolled condom, on the outside after putting it on and on the vagina or anus before putting it in. Do NOT use oil-based lubes, such as Vaseline, salad oil, or hand lotion, since they cause latex to break down.  

Masturbation is self-stimulation for sexual pleasure and is an effective method of safer sex. Masturbation prevents pregnancy and STI transmission and helps women and men increase their genital sensations and physical pleasures, improving the quality of their orgasms. People can explore their bodies and discover what feels good to them. Many men and women masturbate regularly as a healthy part of their lives. Learning what feels good is an important step toward feeling pleasure more regularly, with or without a partner. Masturbating can help make sleeping easier and more restful, or it can start the day with an energized calm. Hands are handy, and you can use them in many different ways: applying differing amounts of pressure, using your less dominant hand, moving at different speeds or changing the rhythm, and using lotion or lube. Trim nails and keep toys clean (soap and water will do the trick) before any type of self-pleasure. 

Emergency Contraception You can use emergency contraception (EC) after unprotected sex to help avoid unwanted pregnancy. You may need EC if: Sex was unplanned, unintended, or unwanted; Contraceptives were not used or did not work (condom broke or slipped off); Diaphragm or cervical cap slipped out of place.  

Plan B (levonorgestrel), an emergency contraceptive pill, is now available without a prescription to people 18 years of age or older. Bring an ID with proof of your age when you go to the pharmacist’s counter to buy Plan B.  

If you are under 18, you still need a prescription for Plan B. Columbia University students who are under 18 may obtain a prescription by contacting Primary Care Medical Services at 212 854 7426. For after-hours medical care call 212 854 9797.  

To obtain EC off-campus, call the Emergency Contraception Hotline at 888 668 2528 or go to www.not-2-late.com.  

STI Testing Safer sex may include getting tested for STIs, including HIV. You deserve to know your STI status, and the status of your partner(s). Columbia students can visit Primary Care Medical Services for routine STI screening or to discuss any concerns. The Gay Health Advocacy Project (GHAP) also provides free and confidential HIV testing, counseling and treatment to all Columbia students. You do not need to identify as a member of the LGBTQ community to access GHAP’s services.

Go Ask Alice! is the health question and answer Internet service produced by the Alice! Health Promotion Program. If it's on your mind, it's probably on Go Ask Alice!

Questions

Alice ! Health Promotion Program offers a workshop on Sexual Health Workshop where students can: 

• Discuss STI symptoms, transmission, and treatment
• Identify ways to reduce the risk of STI transmission and unplanned pregnancy
• Develop skills to talk with partner(s) about prevention strategies
• Identify appropriate on- and off-campus resources for safer sex

Primary Care Medical Services (PCMS) provides comprehensive care for routine, urgent, and chronic medical needs for students. Primary Care also provides sexual health, reproductive, and gynecological services, LGBTQ health care, immunizations, and referrals. For more information go to Making Appointments. 

Gay Health Advocacy Project (GHAP)promotes the health of the lesbian, gay, bisexual, transgender, and queer community by providing information, advocacy, referrals, confidential HIV testing, counseling, treatment, and support to the entire University community. For more information go to Gay Health Advocacy Project.

Special Services for Women
Women’s health is an important service provided by PCMS. High quality, individualized women’s care is provided by our staff of excellent primary care providers, all of whom are experienced in Women’s Health and considerate of the sensitive nature of the visit. Our providers are attuned to the sexual, psychosocial, gynecologic, and body image issues that are part of providing comprehensive women’s health care. 

Some of the specific services provided are: 

• well-woman annual examinations
• birth control
• emergency contraception
• pregnancy evaluations
• pregnancy options counseling
• referral for prenatal care
• referral for elective termination (abortion)
• testing and treatment for STIs
• management of gynecologic problems
  

For urgent concerns, you may ask to speak with one of the PCMS Registered Nurses on the Clinical Symptom Line. For more information go to Making Appointments.