Would you say you had unprotected sex if... ? Sexual health language in emails to a reproductive health website

The words and metaphors that people use to describe sexuality and reproductive health reflect experiences with peers, sexual partners, health service providers and public health campaigns. In this paper we analyse 1134 emails sent to an emergency contraception website in the USA over the course of one year. Through an examination of the terminology used by authors to describe contraceptive methods, sexual intercourse and other sexual acts, we analyse what those terms signify within their textual context. We find that the kinds of risk concerns used in assessing sexual activity -whether evaluating pregnancy risk, disease transmission risk or moral risk - influence the definitions people give to terms that are multiply defined or whose definitions are culturally contested. This finding emerged clearly in the meanings given to terms for 'sex' and 'unprotected sex', which varied widely. We conclude with a discussion of the implications of this finding for research, clinical care and health education activities.