Let's Talk About Sexual Health

September 2022
Pregnancy Prevention

I won’t discuss Roe v. Wade here, I’ll leave that to the legal and political pundits. Let’s talk about pregnancy prevention. Did you know there are many ways for people to avoid becoming pregnant?

Females are the ones carrying the highest pregnancy burden, both physically and socially. Men can help prevent unwanted pregnancies, too. Females can have one pregnancy each year, whereas males can impregnate hundreds of females in a calendar year. Let’s look at ways we can avoid unplanned and unwanted pregnancies.

Abstinence. A sure way to avoid an unexpected pregnancy is to not have sex. People abstain from sex for a variety of personal reasons. Some want a sexual sabbatical, others for work, sports, beliefs, commitments. This is 100% effective.

The pullout method, also known as preejaculation withdrawal, has an estimated 73% success rate. Who knew it was that high? Still not 100%. The pullout game is never solid.

Natural family planning, or the rhythm method, takes some work. It involves the female tracking her monthly cycle, from period to ovulation. This can help determine when they are most fertile and least likely to become pregnant. If the pen and pad are too much, today you can buy an ovulation tracker, which measures estrogen, luteinizing hormone and progesterone to know when’s the best time to become or avoid becoming pregnant. Some products even claim the ability to assist those with irregular cycles and polycystic ovarian syndrome in becoming pregnant. Some manufacturers claim they are 99% effective; the science says the tracking method can be effective 76% of the time.

Spermicides. There are foams, films and suppositories that can prevent pregnancy 82% of the time. Placed inside the vagina before sex, these chemicals block the cervix to prevent the sperm from connecting with an egg.

Emergency contraceptives. People ask us whether the morning-after pill constitutes an abortion. It does not. This pill prevents the egg from becoming fertilized by the sperm. The name is a little misleading because some such drugs can prevent pregnancy when taken up to five days after sex. Now you can even go online and take a quiz to see whether you’re a good candidate for these services, which can be 98% effective.

Barrier protection in the form of condoms, male and female, if used properly,  can prevent pregnancy 95-98% of the time. They’re affordable and easily accessible, especially at Northland Cares, where we give out over 18,000 per year in Yavapai County, free. Use them correctly, check the date, squeeze the sealed packaging to make certain there is air inside that you can feel. Dry condoms don’t work!

Vaginal rings, diaphragms and pessaries. This group of pregnancy-preventers have been around for centuries. In cultures around the world people have used honey, plant leaves, wool covered in oil, acacia gum, fennel, and other methods to block sperm in the vagina. Thankfully today we have diaphragms and vaginal rings to replace the pessaries of yore. Diaphragms are 94% effective, they are small, flexible, often silicone or latex cups that go inside the vagina to block the sperm. Vaginal rings can be used as contraceptives as well, small, flexible rings that females can insert into the vagina. These deliver hormones to the vagina to prevent fertilization, and are about 91% effective in preventing pregnancy.

Permanent birth control. Tubal ligation, having fallopian tubes tied or blocked, is typically done in a healthcare center or hospital and is 99% effective in preventing pregnancy. Males can elect to have a vasectomy, also known as male sterilization, where the small sperm tubes in the scrotum (seminiferous tubules) are cut or blocked off to prevent the sperm from leaving the body. This form of birth control is extremely effective in preventing pregnancy, almost 100%.

Intrauterine devices (IUDs) are small, usually T-shaped devices that fit inside the uterus. These are 99% effective and can last inside the uterus for three to ten years. They come in plastic and copper, and require a medical professional to insert.

Implants are little hormone-filled rods that can be implanted in the upper arm to slowly release the hormone progestin, which will stop the ovaries from releasing eggs. These are nice — no daily pill reminders and fewer side-effects than pills, and they can be removed. They also thicken the mucosa in the cervix, which prevents sperm from entering. For the uninsured, most county health departments provide this service to community members at little or no cost. Implants are 99% effective.

Shots. For those who struggle with pill compliance, this is a great alternative. These inject progestin into an arm or hip, and are 99% effective for three months.

Patches. Hormone patches furnish progestin through the skin (transdermally) and are 99% effective in keeping the ovaries from releasing eggs. Like the implants and shots, the patches also thicken the cervical mucosa.

The Pill. Birth-control pills are 99% effective when taken as prescribed, meaning at the same time each day, to keep the ovaries from releasing eggs.

These prevention methods do not protect against communicable pathogens — no, not even condoms can be 100% effective at that. I want to encourage you to take charge of pregnancy avoidance and be proactive. If you don’t have insurance, go to your local county health department, which has Title X funding and can offset the costs of these prevention methods. Sex does not have to equate with pregnancy.

This is Hedda Fay reminding you that you oversee your body. Be bold, stand up, dust off and take control of your personal reproduction. There are many options, and I’ve listed a few to get you started.

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

August 2022
Types of STIs and How They Function
Part 2: Parasites, Fungi and Prevention

Sexually transmitted infections come in different categories, which makes them act differently, so we treat them differently. STIs can have a profound effect on the health of individuals and communities. Some are curable, others are treatable. In Part 1 (July) I covered bacteria and viruses. Now I'll get to the plant and animal world.

Parasites

Parasitic STIs are caused by protozoans, nematodes and arthropods.

The most common is trichomoniasis vaginalis, a protozoan parasite. This is typically treated with metronidazole.

You can spot the egg, nymph and adult stages of pediculosis pubis, the crab louse or pubic louse, which is easily treated with the same medications you would use on head lice. We also have an itch mite called sarcoptes scabiei, aka scabies. These parasites reproduce by laying eggs in the pubic-hair region that take six days to hatch. Females can lay three to five eggs daily, and they live up to a month. Crabs feed excessively on blood, sipping four or five times each day.

Two other parasitic STIs are amebiasis, caused by entamoeba histolytica, and giardiasis, by giardia lamblia. These parasites are usually diagnosed with an examination of a stool specimen. Giardia is often found in people who engage in anal sex. Both are easily curable conditions.

Fungi

Fungal overgrowths are the most commonly occurring STIs, which makes it great that they’re so easily cured. Fungal infections love the warm, wet, moist human body and its mucosa, ideal habitat for them to grow in.

Tinea cruris, aka jock itch, is a fungal infection more common in males than females. It likes warm, damp areas like the groin, including the skin between thighs and groin.

Vulvo-vaginal candidiasis (VVC), aka the yeast infection, is candida, a kind of yeast that occurs naturally in small amounts throughout the body, and there are over 1,000 species. At times an imbalance can cause the yeast to multiply, and we experience an overgrowth. This is easily cured with a topical cream or an anti-fungal pill. The vulva/vagina environment encourages candida growth and proliferation, with its dark, warm, moist mucosa. It is its own life form, part yeast, part fungus, parts vegetable, bacterium and animal. It can adapt and change form and shape, making it difficult to treat. It creates a biofilm made of proteins, plant cellulose, DNA, RNA and fats. It can reproduce sexually on its own, because each nucleus carries two copies of the chromosomes to create two separate cells that meet and fuse to create a new cell.

Yeast is either anerobic or aerobic. Lacking oxygen it produces energy by converting sugars to CO2 and ethanol, which is why some with systemic candida report feeling brain fog — it’s the alcohol!

Prevention

To prevent these STIs you can use a condom correctly, and lubricant with the condom. If you don’t like that we recommend a full-panel STI test every three months, so when you do pick up something, you can get it cured in a timely manner and avoid long-term health problems from it.

I’m Hedda Fay reminding you that there are sexually communicable viruses, bacteria, fungi and parasites everywhere, and if you have enough unprotected oral, vaginal or rectal sex, you will meet one or more of them. Be responsible and get checked today to avoid problems later. Suit up, lube up, and be safe out there, it’s a microbial jungle!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

July 2022
Types of STIs and How They Function
Part 1: Bacteria and Viruses

Sexually transmitted infections come in different categories, which makes them act differently, so we treat them differently. STIs can have a profound effect on the health of individuals and communities. Some are curable, others are treatable, and I’ll be breaking all that down here.

First let’s talk bacteria.

Bacteria are unicellular microorganisms, single-cell organisms that lack nuclei. Bacteria have no nuclear membrane, no mitochondria, and reproduce asexually. In contrast with viruses, they do not have to take over a cell to infect you.

When bacteria conjugate, they simply transfer DNA between two cells. No flowers, fancy dinner or dancing going on here. Bacteria can survive on the most inhospitable of surfaces. They can form groups and communities where they encase themselves in a slimy polymer matrix, called a biofilm.

Bacteria are found everywhere, thriving even in the harshest environments, from hydrothermal undersea vents to frozen Antarctic tundra. They can certainly survive inside the wet, warm, mucous-laden, 98-degree petri dish you call your body.

As our primary bacterial antagonists we have chlamydia, gonorrhea and syphilis.

Chlamydia is the most common STI in the US, infecting over 1.5 million of us annually. It’s curable, with a but. Researchers at the Arkansas Children’s Research Institute discovered that antibiotics can cure it genitally, but it can survive inside the GI tract, waiting to reinfect. So if you find you chlamydia has come back, wait before accusing your partner of stepping out again.

While antbiotics have been the standard cure for bacterial infections, we’re now seeing a strain f medication-resistant gonorrhea. We’re hoping this won’t be the next superbug. Gonorrhea forever does not sound fun.

Viruses

Viruses cannot do anything alone — talk about codependent! They can’t reproduce on their own. They have to get into our body and take over a cell. The virus comes armed with its own genetic material in the form of viral DNA or RNA.

Viruses enter our bodies through our eyes, nose, mouth, vagina, penis or rectum. There are many types of viruses, and these infect every type of life form on earth. A virus that infects your dog is not likely to make you sick. Viruses can adapt, change or mutate to be able to infect another host. Usually it’s one virus and one host. A virus is usually made of genetic material (DNA or RNA), a protective protein shell and a fatty envelope (like a cell barrier).

Once a virus gets into a cell, it uploads its DNA or RNA and tells the cell to follow its directions and make the parts necessary for the virus to survive. Then the new viruses escape the cell, killing it, and they seek out new cells to infect. It’s a hostile takeover of your body’s cells.

Viruses are much smaller than bacteria. They can travel in bodily fluids, breast milk, sputum, blood, semen, vaginal fluids, rectal fluids, preseminal fluids, spit and even snot. Yes, that greenish-yellowish paste that we sometimes find in our noses can carry certain viruses, though not the STIs we’re discussing. Think Covid, the other ‘C’ word.

Our bodies react to viruses protectively. Once the body discovers a viral infection it raises its temperature to destroy the virus, and makes your eyes and nose run to flush out trapped viral particles.

Viral STIs are different, first in that antibiotics can’t touch them. Some have been known to go away on their own, like human papilloma virus (HPV), but that’s not the rule.

HSV, HPV, Hep B and C

There are vaccines for HPV and Hepatitis B, meaning they can be prevented — well, Hep B anyway. The HPV vaccine protects a person from developing cancer later in life if they have been exposed.

There is now a solid cure for Hepatitis C, an eight- to twelve-week course of medication that works well, without the side-effects of the former “cure,” interferon.

We have treatment options for herpes simplex virus (HSV) I and II, antiretroviral medications that can help suppress the viruses in the body.

In Part 2 next month: Parasites,Fungi and Prevention

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

July 2022
Types of STIs and How They Function

Part 1: Bacteria and Viruses

Sexually transmitted infections come in different categories, which makes them act differently, so we treat them differently. STIs can have a profound effect on the health of individuals and communities. Some are curable, others are treatable, and I’ll be breaking all that down here.

First let’s talk bacteria.

Bacteria are unicellular microorganisms, single-cell organisms that lack nuclei. Bacteria have no nuclear membrane, no mitochondria, and reproduce asexually. In contrast with viruses, they do not have to take over a cell to infect you.

When bacteria conjugate, they simply transfer DNA between two cells. No flowers, fancy dinner or dancing going on here. Bacteria can survive on the most inhospitable of surfaces. They can form groups and communities where they encase themselves in a slimy polymer matrix, called a biofilm.

Bacteria are found everywhere, thriving even in the harshest environments, from hydrothermal undersea vents to frozen Antarctic tundra. They can certainly survive inside the wet, warm, mucous-laden, 98-degree petri dish you call your body.

As our primary bacterial antagonists we have chlamydia, gonorrhea and syphilis.

Chlamydia is the most common STI in the US, infecting over 1.5 million of us annually. It’s curable, with a but. Researchers at the Arkansas Children’s Research Institute discovered that antibiotics can cure it genitally, but it can survive inside the GI tract, waiting to reinfect. So if you find you chlamydia has come back, wait before accusing your partner of stepping out again.

While antbiotics have been the standard cure for bacterial infections, we’re now seeing a strain f medication-resistant gonorrhea. We’re hoping this won’t be the next superbug. Gonorrhea forever does not sound fun.

Viruses

Viruses cannot do anything alone — talk about codependent! They can’t reproduce on their own. They have to get into our body and take over a cell. The virus comes armed with its own genetic material in the form of viral DNA or RNA.

Viruses enter our bodies through our eyes, nose, mouth, vagina, penis or rectum. There are many types of viruses, and these infect every type of life form on earth. A virus that infects your dog is not likely to make you sick. Viruses can adapt, change or mutate to be able to infect another host. Usually it’s one virus and one host. A virus is usually made of genetic material (DNA or RNA), a protective protein shell and a fatty envelope (like a cell barrier).

Once a virus gets into a cell, it uploads its DNA or RNA and tells the cell to follow its directions and make the parts necessary for the virus to survive. Then the new viruses escape the cell, killing it, and they seek out new cells to infect. It’s a hostile takeover of your body’s cells.

Viruses are much smaller than bacteria. They can travel in bodily fluids, breast milk, sputum, blood, semen, vaginal fluids, rectal fluids, preseminal fluids, spit and even snot. Yes, that greenish-yellowish paste that we sometimes find in our noses can carry certain viruses, though not the STIs we’re discussing. Think Covid, the other ‘C’ word.

Our bodies react to viruses protectively. Once the body discovers a viral infection it raises its temperature to destroy the virus, and makes your eyes and nose run to flush out trapped viral particles.

Viral STIs are different, first in that antibiotics can’t touch them. Some have been known to go away on their own, like human papilloma virus (HPV), but that’s not the rule.

HSV, HPV, Hep B and C

There are vaccines for HPV and Hepatitis B, meaning they can be prevented — well, Hep B anyway. The HPV vaccine protects a person from developing cancer later in life if they have been exposed.

There is now a solid cure for Hepatitis C, an eight- to twelve-week course of medication that works well, without the side-effects of the former “cure,” interferon.

We have treatment options for herpes simplex virus (HSV) I and II, antiretroviral medications that can help suppress the viruses in the body.

In Part 2 next month: Parasites,Fungi and Prevention

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

May 2022
How to Talk with Your Partner About Sex
You deserve to hear each other

That headline’s not as appealing as “Let’s Talk About Sex,” is it? How do we communicate about sex and sexual health? How did you learn about sex and sexual health? Was it the often awkward birds-and-bees discussion with your parents or guardians? How thorough was this conversation? Did you explore risks beyond pregnancy? Was there a discussion about STIs, how they’re transmitted and shared? Did you hear the chatter of older siblings or adults, with no clue what they referenced with their sexual slang?

Priscilla Du Preez

How do you express yourself or your needs to your partner today? Do you know what you like? Have you explored yourself? Yes, I’m asking whether you have given yourself a successful orgasm — you know, masturbation. This is truly how we learn what feels good, what’s stimulating to us, by touching ourselves. For some, how to say no to a partner is the most difficult issue, due to potential embarrassment on one or both sides.

When we begin a new relationship, it’s steamy, hot and exciting. The butterflies, being tongue-tied, nervousness, the gentle hand-touching and the first kiss. Before the first kiss, do you ever discuss the kiss? No, right? It’s the gazing into one another’s eyes and getting closer before the lips meet. The kiss may be awkward, mushy, wet, and so on; was it amazing? Of course, because it was what we’d been thinking, daydreaming and fantasizing about. Of course it was perfect.

A few months pass and the sex is still going well, two to four times a week. But is there something missing from the physical connections? Is there something you like sexually that concerns or embarrasses you, thinking that your newfound partner may not like or have experienced it? How do you mention your sexual fantasy, desire or kink? Is there something about the sex you’re having that, due to an earlier lived experience, makes you uncomfortable?

Talk about it. It’s important that we can mutually enjoy our sex life with a partner.

There may be something for you both to try and share with one another that neither of you has experienced. Let’s be honest, if you don’t like something, you need not have to do it right. How do you say no to something that your partner wants to try, but that you’re not comfortable with?

Let’s take anal sex as an example. Women routinely ask me how to address this sexual albatross with a partner. Men or people with penises especially can derive satisfaction from receptive anal sex, because the prostate is there, and when manipulated or stimulated it can cause arousal and orgasm. (Some men only learn this after turning fifty, during their very first prostate exam. But I digress.)

Anal sex may not be pleasant for females or people with vaginas who lack a prostate gland. How then do you say “no” to a special-occasion backdoor rendezvous with an anally excited partner? You can say, “I don’t like anal sex.” You can give specifics if you choose: simply saying that it’s not something you like is okay too. Let your partner know your position on whatever it is that you dislike.

How do you have the talk? When do you talk? My recommendation: name your need, write it down on paper, look at it, reflect, and practice articulating it. If you don’t know how to express your sexual health needs, practice! Practice saying it alone in the car while driving and rocking out to your favorite tune.

Practice in front of a mirror, with your pet. If your need or request elicits an emotional response in yourself, I want to stress the need for practice before that discussion. Take some of the power out of the action, kink or desire by literally practicing saying it. The more you say it, the easier it will be when having the discussion with your partner.

Then, having practiced what you are to say, when you do sit with your partner to have the talk, it will be easier, and you might be surprised how easily the conversation goes. I hope you surprise yourself.

Now that you know what you need to say, you’ll want to find a time that works for you both, where you can sit comfortably and have an uninterrupted conversation. Express yourself. Try and use “I” statements when discussing your needs. It’s also important as a partner to show appreciation to our partner. Do not forget that discussing your intimate needs and desires is also a suitable time to ask your partner whether there is anything that they like or enjoy that you haven’t tried.

If you’re someone who has unresolved sexual-health trauma from your lived experience, get some support to work through that. It is possible. If you have physical damage, there are therapists and exercises you can do to strengthen and rebuild your pelvic wall.

You may not have had any control over how you learned about sex, but you are 100% in charge of how you do it moving forward.

This is Hedda Fay encouraging you to express yourself to yourself and your partner. If you can’t speak to what you need, it may never be fulfilled! Remember, when out exploring the sexual landscape, take protection.

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

April 2022
More Than Twigs and Berries
Let’s talk about the male reproductive system

In males, genitals are both internal and external. The obvious external parts are penis, scrotum, and testes. For every slang term for female genitalia there are probably three or four for the male equivalent.

What is a penis? The penis is made from three cylindrical pieces of erectile tissue and a large cover, (sometimes removed). The two corpora cavernosa are side-by-side, and as the name suggests, these are spaces that fill with blood when the male is aroused and make the penis erect. The third cylindrical part is the corpus spongiosum, and this covers the urethra. The foreskin, if not removed, covers the large end or tip of the penis, which is called glans penis. If you have had an erection, you can thank the corpora cavernosa and corpus spongiosum for that!

The scrotum, sometimes referred to as the ballsack, is a thick sac of skin that protects the testes and regulates their temperature, so they can hug the person’s undercarriage when it’s cold or hang lower and looser when warm. The testes have to be a few degrees cooler than the rest of the body for optimal sperm production and nourishment.

Testes is the term for two testis. A common nickname for these is the family jewels, because they are precious and important to reproduction. The testes have two primary functions: producing sperm, also known as spermatogenesis, which carries the person’s DNA, and testosterone, the male sex hormone.

The seminiferous tubule, located within the testes, is where sperm are produced in a process called meiosis, where stem cells divide to create four daughter cells with half the chromosomes of the parent.

Sperm is the male gamete or reproductive cell, created when the spermatogonia or male germ cells undergo spermatogenesis to produce sperm. Sertoli cells nourish the male germ cells so they can become sperm.

Leydig cells are interstitial cells found outside the seminiferous tubes that secrete testosterone and androgens.

Accessory ductwork

The rete testis carries sperm from the seminiferous tubules to the efferent ducts. It is a space for fluid reabsorption.

The vasa efferentia are 12-20 ductules connecting the rete testis with the vas deferens, and forming the compact head of the epididymis, making the pathway for sperm cells from the testis. This is important for both system function and sexual pleasure.

The epididymis is a coiled part of the spermatic ducts that provides the spermatozoa a place to mature and learn to swim. It is responsible for transport and maturation.

The vas deferens or ductus deferens is a pair of thick, muscular tubes 18-45cm long and part of the spermatic cord, transporting sperm from the epididymis to the ampulla, the reservoir for sperm prior to ejaculation.

The ejaculatory duct is a muscular canal connecting the vas deferens and seminal vesicles. It passes through the prostate and delivers the sperm in time for ejaculation.

The urethra is a tube that travels through the penis and connects the bladder to the urinary meatus. In men the urethra carries urine and semen, so it’s a challenge for men with erections.

The urinary meatus, as in women, is the opening for the urethra, where urine and sperm exit during urination and ejaculation. See, simple!

Men have two urethral sphincters, internal and external. The internal sphincter regulates involuntary control of the flow of urine from the bladder to the urethra, and the external provides voluntary control of that flow. The internal sphincter also acts as a guard against semen going into the bladder during ejaculation, which would be a bad thing.

Accessory glands

The two seminal vesicles are tightly coiled sacs on the back of the bladder extending from the base of the prostate, 2- 4cm long and 1-2mm in diameter. They produce fluid to feed the sperm cells, proteins, sugar, enzymes, and mucus.

The prostate gland sits in the lower pelvis, in front of the rectum and beneath the bladder. When you’re young it’s the size of a walnut; when you turn 40 it can be the size of an apricot, and when you reach 60 it can be as large as a lemon. It produces the fluid that mixes with sperm to create semen.

Men have two pea-sized bulbourethral glands or Cowper’s glands, which are responsible for producing the pre-ejaculation fluid secreted during sexual arousal. Urine in the urethra can be acidic enough to kill sperm cells, and this fluid is important to keep them alive.

Whatever you choose to call these parts, it’s important to know what they are and how they function.

More than franks and beans, twigs and berries or cock and balls, there’s a whole lot going on inside and out. Did you learn anything about your anatomy or your partner? I hope so!

I’m Hedda Fay reminding you that your parts are parts of you, take good care of them, get them tested and wear protection when navigating the seas of sex and sensuality. Have a wonderful orgasm!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

March 2022
PEP Right Up!

Happy March everyone! Did you know that this July Northland Cares will celebrate 20 years of serving the residents of Yavapai County? And have we changed these past two decades!

We have one outreach office and clinics in both Prescott and Cottonwood, where our clients and patients can see one of our providers, their medical case manager, and a  therapist if that is part of their treatment plan. Our offices are one-stop shops for HIV+ clients and our PEP and PrEP clients.

Did you know we have the medical technology to stop HIV worldwide right now? We do! The advancements in HIV treatment and prevention have come a long way.

HIV Treatment: This has come a long way, baby! We have single-pill regimens with few side-effects (upset stomach), and now have monthly injectables, so patients do not have to remember to take a daily pill. This is outstanding news. The new medications work fast fighting the virus in your system. Today no one in Arizona and specifically Yavapai County need develop AIDS. It’s true! Even if we find someone who technically has AIDS, it is easily reversed with the medications we have today.

AIDS: Acquired Immunodeficiency Syndrome, a side-effect of untreated HIV, is technically when a person’s CD4 (T-cell) count falls below 200. We have seen them much lower when finding people living with the virus who did not know they had it. Once medications are introduced to the patient’s system, we will see the viral load go down and the CD4 go back up to a nice robust, healthy number within a month. That’s fantastic!

PrEP: Pre-exposure prophylaxis is an excellent prevention tool that anyone who has unprotected sex, shares injection equipment (including steroids), or has multiple partners without using protection can benefit from. Think of it like putting your seat belt on. You won’t have an accident every day you drive, but the potential is always there. It’s the same with unprotected sex or sharing equipment. Taking this pill daily will prevent you from getting HIV. It won’t protect you from any other STI or pregnancy, but if you get a different STI as our patient, we can treat you in-house for those.

PEP: Post-exposure prophylaxis is another excellent prevention tool that we make available to the public on weekends and holidays. Now with PEP we only have a short window of time — 72 hours, three days — to get the medication into your system. It is more effective the closer to the time of exposure we administer it. Not all local pharmacies keep these medications in stock because they can be cost-prohibitive — $2,000-3000 for one month. Fear not, we keep these medications in stock and have PrEP Navigators available to assist with getting you the rest of the medications within that 72-hour window.

Who would need PEP, you ask? Anyone who has a condom break, is a victim of sexual assault by someone of unknown status, or gets an accidental needle stick.

• HIV can live in a discarded syringe for up to 42 days.

• 83% of accidental needle sticks go unreported.

• Yavapai County experienced a 275% increase in new HIV diagnoses in 2019.

• 85% of all new HIV+ diagnoses in cisgender heterosexual women are from an unprotected sexual encounter.

• People who are HIV+ and do not know it can have it up to ten years before they getting a secondary illness that would indicate the condition to a provider.

• STIs like HIV are largely asymptomatic, so if the person doesn’t know, how can you?

Northland Cares offers PEP Navigation during weekends and holidays. If we know the risk earlier, we get you the medications and a better outcome for you and your family. We have staff on call who will respond if you need PEP medications. Our on-call number is 928-910-6707, available Fridays beginning in the evening till Sunday evening.

Full-Panel STI Testing: We are now offering full-panel STI testing at our office. We recommend you call first to schedule the test. Soon you will be able to go online and order a kit be sent to your home. We presently test for hepatitis B and C, HIV, chlamydia, gonorrhea and syphilis. If you are sexually active and prefer not to use protection, we recommend that you get these tests done every three months, and we further recommend making an STI test a part of your annual healthcare examination.

• Arizona is #1 in the nation for syphilis.

• We are #5 in the nation for babies born with syphilis.

• Chlamydia and gonorrhea can be asymptomatic in 75% of people with vulvas.

• Chlamydia and gonorrhea can be asymptomatic in 50% of people with penises.

• Syphilis is called the “Great Pretender” because it can cause meningitis, dementia, blindness or loss of peripheral vision.

• Treatment cannot repair brain or optic-nerve damage from syphilis.

I’m Hedda Fay reminding you that there are viruses, parasites and bacteria out there, so use protection and get tested so the only thing your orgasm leaves you with is a pleasant memory. Wishing you a safe, healthy and fun sex life!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

February 2022
Knowing the Parts is a Great Start!

Female reproductive organs enjoy a variety of euphemisms: va-jay-jay, vajeen, lady parts, cooter, cooka, pussy. There are literally hundreds of these terms to describe this body part. Comparatively you will find a mere handful to describe one’s thumb, maybe because the thumb does not have the mystique or notoriety that the vulva and vagina have. Just what is the appropriate term for female reproductive parts, ‘vulva’ or ‘vagina’?

The term ‘vagina’ is widely used and accepted as the appropriate term. The vagina is a 4.8- 6.4cm canal that connects the vulva to the cervix, then the cervix to the uterus. It’s a tubular, muscular, fleshy highway from the opening to the uterus, a path for sperm to travel in hopes of fertilizing an egg. It’s where a penis enters for intercourse between someone with a penis and a vagina. It is also the first canal we all traveled to get here today, unless you were a test-tubular pregnancy or birthed via caesarean section.

The vulva is the external part of the female reproductive organs, the covering to the portal to another dimension, where life comes from. It includes the clitoris, vestibular bulbs, vulval vestibule, labia minora, labia majora, urinary meatus, hymen, pubic mound, external opening of the urethra, and vagina.

These days everyone is talking science — “follow the science,” “believe the science” — while simultaneously using incorrect terms. ‘Vagina’ has reigned supreme as the term to use when describing female reproductive parts for many years. Is it because it’s the portal we all traveled to get here, or is it because it is the place that provides heterosexual males the most pleasure? Whatever the reason, it’s important that we know these parts and use correct terminology when talking about sexual health.

Now for some clitoracy. Ladies/people with female reproductive parts, if you are not orgasming with intercourse, you need more clitoral stimulation. It’s fun and will add to your sex life. As women/people with female reproductive genitalia are getting aroused, we become wet and moist in our vulva and vagina. This is not an orgasm. It’s how these parts naturally lubricate during arousal, heavy petting and foreplay.

Let’s look at the vulva parts, shall we?

The clitoris, human females’ most-erogenous zone, is at the front of the labia minora, above the urethra. In humans its only known function is sexual pleasure.

The labia majora are equivalent to the male scrotum, a pair of rounded adipose tissue and skin that cover and protect the inner, more delicate structures of the vulva.

The labia minora are two smaller flaps of adipose tissue, found below the majora and protecting the clitoris, urinary orifice, and vaginal orifice.

The vestibular bulbs are two elongated muscles on either side of the vaginal orifice. They cause the contractions experienced with orgasm.

The vulval vestibule is the body cavity that creates space in the labia minora, providing an opening into the vagina and by extension the urethra.

The urinary meatus is the external urethral orifice, the opening of the urethra.

The hymen is a thin mucosal tissue covering and surrounding the vaginal opening.

The pubic mound is the front part of the vulva, a mass of fatty tissue that covers the pubic symphysis or the pubic bones. In Latin it’s the mons pubis.

To understand how these parts look anatomically, you can view an anatomy book or search online for these folds and parts.

Now that we have differentiated between the vulva and vagina, what do you think the appropriate term is for female reproductive parts, vulva or vagina? Do you even care? I’m not expecting anyone to correct others when using terms or make it a topic of discussion at happy hour this week. My goal is to help educate and let you to decide what terms you want to use.

Love your parts, whatever parts you have. Protect them, clean them, and get them checked.

This is Hedda Fay reminding you to love yourself, use protection and learn about your parts and what feels good to you. Touch yourself — it’s okay, I haven’t turned into a pillar of salt and blown away yet!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

January 2022
Understanding the Old Chap

The aging penis is our topic this month. People with penises have a lot of penis pressure put upon them. I do not have one and cannot imagine the stress involved with it. Imagine being measured as a human depending on one fleshy appendage! We are not here to talk about the performance or size expectations put on our neighbors with penises, oh no, we are going to talk about what happens as they age.

Yes, as one ages, so does their penis, much differently from the changes people with vaginas go through.

First, penis bearers begin to experience a one-percent annual reduction in testosterone beginning around age 40. For most it is a gradual diminishing, so slight that most don’t notice much difference.

Lower testosterone, also called late-onset hypogonadism, is common among aging people with penises. It can lead to reduced muscle mass, depression, loss of interest in activities including sex, scrotal sagging, and reduction in penis length and girth. It’s estimated that penis bearers with high belly or stomach fat lose half an inch in penis length for every 30 pounds they are overweight. That adds up.

A growing prostate will increase your desire to urinate while restricting the flow. Your semen output can fall as well. Peyronie’s disease is common in people with penises who are 55 years old and older, and you can tell whether you have it from curvature in your penis. As you age the smooth muscle tissue that holds your penis upright is replaced with collagen, which affects size and girth. It’s normal for it to shrink and work differently as you age.

People with penises come under even more pressure to perform as they age.

Erectile dysfunction is common in men 50 and older. Up to half of people with penises in this group experience erectile dysfunction, increasing toas high as 70% in those over 70. If you feel you are experiencing late-onset hypogonadism (age-related lower testosterone), make an appointment with your provider for some bloodwork and a follow up appointment. It is treatable, and there are other medications that get you back to six-to-midnight in no time!

Remember, you are not your penis. Your penis is your penis, and it ages with you. Its needs change as you do. It will hang lower, as will your scrotum. Do your balls hang low, do they wiggle kind of slow? —just kidding, there’s no song. There should be.

People with penises come under even more pressure to perform as they age. They may have their “personhood” judged on how long they can stay erect before ejaculation. I can’t imagine being judged how long Ican hold off an orgasm, and I find that judging metric both unfair and unreasonable.

It’s important to be supportive of our penis-bearers and encourage them to see their providers if they believe they are experiencing low testosterone. A blood test can gauge your testosterone level and whether you may need supplementation. Hormone-replacement therapy can help people suffering from this, and as with any medication it’s important to see a provider before beginning therapy. Hormones can have many side-effects, and your friend from the gym is not the best place to get replacement hormones. Just saying.

The AMA suggests that people with penises get their prostates checked annually to prevent prostate cancer. If you have frequented tanning beds sans bottoms, you are at increased risk for penile skin cancer. Yes, that's a thing as you age, too, so get those moles checked!

If you are going to handle, fondle, caress or insert a penis this holiday season, use protection. Unless that penis with the erection has been checked over with a full medical inspection, do not touch it without protection.

This is Hedda Fay reminding you that to get the most out of your 2022orgasms, make them fun and safe!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

December 2021
Services Expanding at Northland Cares
Sexual Health with Hedda

Northland Cares is becoming much more than a specialty healthcare clinic for people living with HIV, and we are expanding our services to include STI testing and Hepatitis C testing and treatment.

One-Step PEP Program: PEP(post-exposure prophylaxis) is medication for those who have had direct exposure to HIV. We must get the medication to the person within 72 hours of their direct exposure. The closer to the time of the exposure, the better. Taken daily for 28 days, the medication will prevent becoming HIV-positive.

Northland Cares has medication in the office to allow people to begin treatment immediately. Our One-Step PEP Program involves coming to the office, where we provide one week of PEP medications, a new-patient packet, lab orders, a follow up appointment with our provider, and our PrEP/PEP Navigator Teresa will assist in getting the remaining three weeks of medication. Northland Cares keeps PEP in stock because not every pharmacy carries it, and it can range in cost between $2000 and 3000 for one month. We do not have the luxury of time to locate these medications.

Rapid-Start PrEP: PrEP (pre-exposure prophylaxis) is an excellent tool for preventing and reducing the effects of HIV infection. Think of it as you would a preventive vaccine, only it’s a medication that, when taken daily, prevents people from contracting HIV. For receptive anal sex you need to take the medications for seven days to ensure there’s enough in your system to protect against HIV transmission. For receptive vaginal sex or intravenous drug use, you need to take PrEP medications for 21 days for the same protection.

Engaging people immediately with care improves health outcomes and better serves people in our county.

When someone contacts us for PrEP medication, the first step is for them to come into the office, where we provide a new-patient packet, lab order and follow up appointment. We encourage everyone to get their labs done as quickly as possible, soon the first appointment with the provider they will be able to start the medications and leave with a prescription. No insurance (or not enough)? No problem! We’ll get you covered. Undocumented immigration status? Not to worry, we’ll get you covered!

Fast-Track HIV Care: Fast-Track HIV is an international program we have implemented here at Northland Cares. To achieve the goal of stopping the HIV epidemic, we have to stop it as soon as we find it in the community. That means whether you come to our office for a rapid HIV test or you are being tested at one of our events, if you test preliminary positive for HIV, we will start you on medications that same day!

We will provide a new-patient packet, a sample bottle of Biktarvy, a lab order, a follow up appointment, an appointment with a medical case manager, and an appointment with our in-house therapist if you need that support. We have found that engaging people immediately with care improves health outcomes and better serves people in our county.

Self-Collect STI Tests: That’s right folks, imagine being able to do an at-home or in-office self-collect full-panel STI kit! Just visit the Northland Cares website, input the required information and we’ll mail you a kit. It comes with everything you need for a three-site test for chlamydia, gonorrhea, HBV, HCB, HIV and syphilis — right, we’ll test you for everything. Each kit also comes with a self-addressed stamped envelope for return to the labs, and you’ll get your results in three to five days. If you test positive/reactive for any of it, we’ll get you treated, or cured if it’s curable. STIs like HPV, HIV, HBV are treatable, there is no cure; HCV, syphilis, chlamydia and gonorrhea are curable!

World AIDS Day Celebration: Yes, this does have a lot to do with sexual health. We are having the celebration to raise money and awareness about HIV and other STIs affecting our community. Stigma, fear, and shame discourage many from seeking treatment, and this is how it spreads through the community. We work to raise awareness about STIs and stop the stigma. Why is it we can discuss Covid-19 in public, but not syphilis? HIV is still a worldwide pandemic, even though you don’t have to die of it today.

H is for Human: In January 2022 we’re producing a stage play to remind everyone that the first letter in HIV stands for human — you know, us, as a species. I think people sometimes forget that. Our story follows a cisgender heterosexual young man a she goes through life and an HIV diagnosis. His experience is human, and we are hoping to engage the public with this original story!

Cartoons for 2022: The creative minds in the NC Outreach Department have created cartoon characters who will be educating people about themselves through short interactive cartoons. Characters include HIV, Hepatitis C, Abstinence, Masturbation, Syphilis, Gonorrhea, Chlamydia, Medical Case Manager, Doctor, Community Health Worker, Safe Syringe Program Volunteer, PEP and PrEP. We are thrilled to have this in the works, and can’t wait to show it to the world!

I'm Hedda Fay, wishing you healthy and happy orgasms through the winter season!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

November 2021
Aging: Rolling with the Changes

This week a friend sent me a meme that said, “dating after 40 is like trying to find the least damaged thing at a thrift store that doesn’t smell.” I giggled, and then went, “Ouch.”

Asa married woman over 50, I no longer need to “date.” But what about the rest of the implication in the silly meme? Damaged, smelly, none of which is age-applicable — there is still some prejudice about sex as we age.

Sex does change as we age, physically, mentally, and emotionally. For starters, our pheromones and hormones change, affecting everyone. When I experienced menopause I happily donated the myriad vaginal-hygiene products and overpriced cotton items to my friends and neighbors. No more seeing Aunt Flo in my house! What a change! Afterward it was harder for my vagina to self-lubricate, even while aroused. My provider sat my husband and me down and explained that, for my vagina to lubricate, we needed more foreplay. My honey was thrilled with the idea of extra time with my “fun bags” and bits.

My desire for sex diminished slightly, which is normal, while the skin and walls of my vagina thinned and slightly narrowed. As we age our bodies produce less of the hormones that help support our integumentary system. Estrogen helps keep our skin tight and healthy ,and assists with elastin and collagen production. As we age, our skin all over begins to thin with the loss of this hormone, and it takes longer for the vagina to naturally lubricate itself.

As we age we care less about what others think, and learn to appreciate more about ourselves. We are all naked or in a state of undress with ourselves daily. How often do we check ourselves out and take a personal inventory of our naked bodies, front and back? One of my favorite comedians, Mo’Nique, asked the reader in one of her books, “when was the last time you took a personal inventory of yourself naked?” My goodness, I see myself every day! What on earth is she referencing? I thought about it and, aside from makeup applications, I was not really looking at all of me.

Right then and there, in my bathroom I stripped, got my compact out and checked myself out naked in the mirror. This one act has helped me accept and love myself where I am at in my own aging process. Every wrinkle, dimple, scar and bruise I can face and accept as part of myself. Being naked and comfortable with ourselves as we age helps us to be comfortable and confident while naked with a partner, hookup, etc. As we age our skin loosens. Sometimes we develop expression lines and wrinkles in places we are not expecting. My perkier breasts sit lower on my chest, and you know what, it’s okay!

As we age our desire for intimacy of different sorts increases. The need to feel close to people and enhance connections is strong. My knees occasionally snap and pop when moving, and my boudoir acrobatics are not what they once were. But with some adaptations to accommodate my physical changes, they can be every bit as fulfilling. Expressing our sexuality is more than the lowest common denominator. It involves different types of touching and genital stimulation. This can happen with yourself, or you can share it with someone else. Sex and orgasms are good for us. They help relax the central nervous system and our minds, burn calories, and masturbation is a form of self-care.

As women we are often judged by our appearances first and character somewhere after that. We are beautiful as we age. Our lines show we have laughed and experienced joy. Those “crow’s feet” are from smiling a lot, and have more to do with expression than being an “old bird.”

So find joy in your newfound wisdom, and allow yourself to experience and love whatever type of sex life brings you happiness today. Embrace your aging process and sexuality. Protection from sexually transmitted bacteria and viruses is as important at 50+ as it was at19 — hey I don’t make the rules, these infections don’t discriminate.

Remember, the only thing you should get from a great orgasm is a fond memory!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

October 2021
Herpes: Still a Thing

There are those who do not believe they’re still around, but yes, herpes is just as common and contagious today as it ever was.

HSVI and HSVII: The two viruses are not as simplistic as their names suggests. There is a lot of misinformation out there about these two viruses, so let’s explore the facts.

All strains of herpes are extremely contagious, and typically spread through saliva, sores and skin-to-skin contact. These viruses are known to “shed,” releasing trace particles of themselves even when the host is asymptomatic. They lay dormant for years before presenting any symptoms. There is currently no cure for either virus, but they are treatable with antiviral medications.

Herpes simplex I(oral herpes) is very contagious. Most people that have this form of herpes obtained it as children from being kissed by relatives. The cold sores people get around the lips and face are beyond their control, but when they do have them, they should be cautious and not kiss anyone. We also sometimes find oral herpes in a person’s genital region, even though we more typically find HSVII there, usually due to oral sex.

Herpes simplex II (genital herpes) is also very contagious, and generally affects the genital area. Two-thirds of genital herpes cases are a symptomatic. Because much of the genitals remain uncovered with proper condom use, during an outbreak you can still contract genital herpes with a condom, which reduces risk by up to 30%. It is always important to know your status and be engaged with care should you need it. The CDC reports that more than one of every six people aged 14 to 49 has genital herpes, it’s that common. The herpes virus can also be shed from skin without a visible sore.

First outbreak: The first things to look for during the first herpes outbreak are fever, swollen lymph nodes, chills, muscle aches and headache. Outbreaks can cause sores, pain in the genital area, mouth or anus, and shooting pain in legs or buttocks, which can occur hours or days before the eruption of a herpetic lesion.

Each year Americans report two million HSVI diagnoses and three million HSVII diagnoses. Unfortunately, there can be unnecessary shame, stigma and embarrassment with a herpes diagnosis, but since this virus is so communicable, it’s vitally important that you get tested if you believe you have been exposed or have had unprotected or risky sex.

If you are in a relationship with someone who has genital herpes, there are ways of lowering your risk:

  • Talk with your partner and find out whether they are taking anti viral medication. Intimacy is more than physical interactions, it can include personal health information. If your partner does not have access, refer them to the county health clinic, which treats people for HSVII with or without insurance.
  • Avoid engaging in sex, whether vaginal, anal or oral, when your partner has symptoms or feels like a flareup is occurring.
  • Use condoms and lubricant appropriately to further reduce your risk when having sex.
  • Use dental dams for oral sex.
  • Use female condoms for vaginal and receptive anal sex.

Remember to make a full-panel STD test and HIV test a part of your annual healthcare exam. This is Hedda Fay reminding you to send your sexual health questions to me at fay.h@northlandcares.org.I look forward to hearing from you soon!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

September 2021
Your Questions
Sexual Health with Hedda

Dear Hedda: If I am in a monogamous relationship, and I know my partner and I don't have any STIs, is there ever a reason to go get tested? I feel like if I trust my partner not to cheat on meand potentially get an STI from someoneelse, we won't really prioritize getting tested unless we must. Plus, I think I would have a hard time convincing my boyfriend to get off his butt and do so if there isn't a good reason! — Lazy in Love

Dear Lazy in Love: We recommend that everyone who is sexually active make an STI panel test part of their annual healthcare examination. Being in a committed monogamous relationship certainly reduces your chances of encountering an STI, but some are highly contagious and may not appear as such. For example, in the secondary stage of syphilis people develop a rash, the rash appears on the person’s hands, feet and torso. Ask yourself, would you think a rash on a person’s hands, feet or torso is an STI? Probably not, right? The rash may or may not be painful if you touch it, and you can contract syphilis from it. When in doubt, get a test. Your reproductive and overall health may depend on it. Did you know that some agencies offer home STI-testing kits, so you can do the tests in the privacy of your own home? Locally, Northland Cares provides this service — discreet and effective!

Dear Hedda: Do you have any advice on how to talk to someone you are not in a relationship with about using a dental dam while going down on them? I just want to keep us both safe, but they are so uncommon that people get freaked out or offended when I mention it. I have even had someone tell me that wanting to use one was me suggesting they were unclean. Help! — Saran-wrapped Sapphic

Dear Saran-Wrapped Sapphic: Good for you for trying to keep yourself and your partner safe! Dental dams are an excellent prevention tool, they come in a variety of colors and flavors, and using lube can increase the sensation. You may want to talk to your partner and explain that most STIs are a symptomatic, which means a person can have one and not know. Having an STI does not make a person dirty or unclean, it just means a person encountered one while engaging in unprotected sex. These pathogens have been around for centuries and they can have serious consequences if left untreated. Let your partner know that oral STIs can be transmitted between your mouth and genitals and you want to make certain they are protected too. You can also suggest that since you are being intimate together, it may be a good idea for you to both get checked and share your results. This can increase both intimacy and trust.

Dear Hedda: I want to know how I can tell the difference between razor bumps downstairs and bumps that could be something more serious. I feel like I get jaded about seeing bumps down there occasionally when I shave, so I just slap on some lotion and forget about it. I don't want to have to go get tested every time a pimple shows up. Any advice? — Calamine Queen

Dear Calamine Queen: I understand your plight! There are STIs that cause genital sores: syphilis will first appear as a small, slightly raised, painless sore that most people miss. Herpes causes blister-like sores which can appear anywhere on the body and do not resemble pimples. Donovanoisis, aka granuloma inguinale, is rarely seen in the US with about 100 cases per year, and mainly found in India, Guyana, and New Guinea. These sores are painless red lumps on or near your genitals, which will slowly enlarge and then break down to a sore.  Lymphogranuloma venereum is an ulcerative disease caused by chlamydia trachomatis. It starts as a small, barely noticeable blister that will then heal. In the next stage, your groin lymph nodes swell and it can affect your labia. Pubic lice can also cause sores, and these little critters are visible with your eyes, as are their nymphs and eggs. Scabies will itch, present as red papules, and the itching increases at night. If you are up for it, you can search online for good info on these STIs and their respective sores for an afternoon of fun education!

Thank you Lazy in Love, Saran-Wrapped Sapphic and Calamine Queen for writing to me, and for helping ask questions others may be afraid to ask! I’m Hedda Fay reminding you that the best orgasm is one that’s protected!

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.

August 2021
Lets Talk With Hedda Fay
Sexual Health with Hedda

Welcome to Sexual Health with Hedda, Yavapai County! Share your questions about sexual health, STDs and HIV here, and have your questions answered in this amazing publication.

I am a sexual-health educator, HIV/STD tester and a PEP and PrEP Navigator. I want to talk about sex with the community because my eight-to-four is providing prevention services, testing, prophylaxis distribution and education and educating our community about HIV and STDs, with the goal of stopping both the stigma and the spread! 

This is something we can do right now. It starts with making it okay to talk about our sexual health. I am old enough to remember when my grandmother whispered “C-A-N-C-E-R,” because it was not something people felt comfortable speaking about in public spaces. Now there are public campaigns to raise funds and awareness. We don’t have a March against Gonorrhea or a Concert to Raise Awareness About Syphilis, but we need one. We truly do! 

Having an STD is nothing to be ashamed or embarrassed about. Being unable to discuss your own sexual health is the cause for concern. Think about it: it’s you, your body and your parts. Next to your desire to survive, the second-strongest in us mammals is the reproductive urge. It’s hard-wired into our beings. Without my knowledge or consent, my body sends out and receives chemical responses from complete strangers at the store. It’s my own brain doing it without my knowledge.

Pheromones and hormones are our internal and external chemical exchange. They are why we’re sometimes sexually attracted to a person we would never otherwise consider as a partner or even one-night stand. Honestly, have you ever been turned on by someone and wondered why? Pheromones, baby! That’s for another day.

Today’s goal is to bring awareness of STDs and HIV to everyone and have it be part of the conversation in the newspaper. We need to talk and be able to have open dialogue — without making it smutty — about STDs, HIV, prevention and the latest and greatest advancements in the battle against sexually transmitted infections.

Share your questions and I will do my absolute best to provide you with answers and information so you can be more empowered with your sexual health.

Send in your questions today! I look forward to engaging with each of you.

Hedda Fay Community Outreach and Program Manager at Northland Cares

Contact her by email fay.h@northlandcares.org or

call her at (928) 776-4612 ask for Hedda

Hedda Fay is Community Outreach and Program Manager at Northland Cares. Contact Hedda with your questions at 928-776-4612 or fay.h@northlandcares.org.