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Don’t Wait: Vaccines, STI Testing and Emergency Contraception
Teens (including me) are often thinking about the timing of things. Usually, it’s a good idea to take our time when making decisions and be sure about them before diving in headfirst. When it comes to sexuality and relationships, this is especially the case. Should you ask them out? Are you ready to get sexually involved with your partner? Many will answer, “I need more time to think about it.”
But when it comes to making decisions about our sexual health, there are times when it’s a better to be proactive and not wait. Whether it’s getting vaccinated against sexually transmitted diseases (STIs), getting tested for STIs or getting emergency contraception, it usually doesn’t make sense to wait.
I spoke about these more time-sensitive topics with an expert, Justine Wu, M.D., M.P.H., Assistant Professor of Family Medicine at the University of Michigan and Immediate Past Chair and a current Executive Board Member of the Association of Reproductive Health Professionals. Dr. Wu helped clue me in on when not to wait.
Vaccines—the Earlier, the Better
Let’s start by talking about decisions that are best to think about before becoming sexually active. For instance, getting vaccinated to prevent an STI. “There are two vaccines that can prevent infections that you can get from sex with another person,” says Dr. Wu. She’s referring to Gardasil 9, which prevents HPV, and the hepatitis B vaccine.
Gardasil 9 protects against human papillomavirus (HPV), which is the most common STI. Often, HPV goes away on its own, but some strains can cause genital warts or develop into different types of cancer, including cancer of the cervix (most commonly), vulva, penis or mouth. Luckily, the HPV vaccine can prevent the strains that cause most of these cancers. If you make the decision to get Gardasil 9, you’d get two sets of shots six months apart if you’re under 15 and three doses if you’re 15 or older. “The best time to get the HPV vaccine is before you ever become sexually active,” says Dr. Wu. “If you get it earlier, it gives your body more time to develop immunity against the virus.” Good to know! She also notes that even if you’ve already been sexually active, “you will still get some protection from the vaccine, but not as much as if you had gotten it earlier.”
You might be hesitant, but getting tested is easier than you may think!
There is also a vaccine to protect against hepatitis B, a viral infection that can damage your liver. Though this vaccine is routinely given to infants, teens who haven’t received the vaccine can still get it. “If you have not gotten the hepatitis B vaccine as a child, you can still get it as a teenager, and it will be effective,” says Dr. Wu.
Testing Time
Another example of when not to wait? Getting tested for STIs. You should get tested if you are experiencing any symptoms, like pain during urination or genital sores. But the main thing to remember with STIs is that more times than not, there aren’t any signs or symptoms. “You may have an STI and feel absolutely fine,” says Dr. Wu. “You may have nothing you can see on your body, your genitals or your skin that would indicate that you have one.” So when should you go ahead and get tested? “Anyone who is sexually active should get tested for gonorrhea, chlamydia and HIV at a minimum prior to having sex with a new partner,” says Dr. Wu. “Ideally, you should talk to your partner about both of you getting tested prior to having sex together. That way, you both know that you are not putting each other at risk for getting an infection.”
You might be hesitant, but getting tested is easier than you may think! “Testing for STIs is fast and painless,” says Dr. Wu. “You can get tested for gonorrhea and chlamydia by peeing into a cup… For HIV testing, some places offer rapid testing that only involves swabbing the inside of your mouth. Other clinics may only offer a blood test (for HIV testing).”
While testing is pretty easy and is often free or low-cost at health centers, Dr. Wu mentions another good point: “Sometimes, people don’t want to get tested for STIs because the idea of having an STI is scary.” Dr. Wu goes on to say that many STIs are easily treated with antibiotics. Even with HIV, which can’t be cured with antibiotics, she says there is help out there. “People can live healthy, long lives as long as they know about an HIV-positive diagnosis early enough and get the right medications, just as someone with diabetes needs to be on medication to control their sugar,” she says.
Time to get tested for STIs? Use Sex, Etc.’s clinic finder to find a clinic near you.
Any type of [emergency contraception] must be used within five days after the unprotected sex in order to have an effect.
Emergency Contraception
Still another decision you shouldn’t wait too long to make is whether or not to get emergency contraception (EC) when you need it. EC is “an important option to have to prevent pregnancy after sex has already occurred and no other birth control was used,” explains Dr. Wu. So when should you seek it out?
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- You were having penile-vaginal sex and the condom either broke or fell off.
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- You got caught up in the moment while having sex where pregnancy is a risk and did not use birth control or something went wrong with your regular birth control, like maybe you or your partner skipped a pill.
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- You were sexually assaulted and forced to have unprotected penile-vaginal sex.
Dr. Wu explains that “in all these situations, you should still seek testing for STIs because emergency contraception cannot protect you from a sexually transmitted infection.”
It is also important to know that there are different types of EC. “There are pill brands that are available at a pharmacy and do not need a prescription from a doctor,” says Dr. Wu. These contain a hormone called progestin. They are safe to use, and teens can purchase them over the counter. The quicker you use these after sex, the more effective they are. There is also a “pill called ‘ella’,” says Dr. Wu. “The advantage of ella is it works slightly better than the progestin-only pills, especially if 72 hours (three days) have passed since sex. The disadvantage is you need a prescription.” Finally, says Dr. Wu, “the most effective form of EC is a copper IUD.” This also requires a prescription and needs to be inserted into the uterus by a health care provider. Any type of EC must be used within five days after the unprotected sex in order to have an effect; as mentioned above, ella and a copper IUD will continue to work after three days have passed while the progestin-only pills become less effective as time goes on.
One last thing to keep in mind is the importance of finding a health care provider you can go to should any of the above situations arise. Dr. Wu points out that “during your teen years, it’s good to check in with a health care provider you trust at least once a year.” It’s important to find a health care provider that you feel you can talk to and ask any sexual health questions you have. If you don’t already have a health care provider you trust, it may be time to find one; there really is no time like the present!
