options are endless and with this limitless choice of everything from religion to careers to lifestyles comes an equally large number of problems.

The consequences of our actions are the price we pay for having free will and individual freedom.

Our choice of moral standards and our patterns of social and sexual interaction are not exceptions to this fact of life. It is therefore essential that each individual make a well-informed and conscious decision in these very intimate areas as the consequences of thoughtless behaviour can be far-reaching and devastating for the individual and the society.

In this day of lethal "social diseases'' we are no longer able to be carefree or ignorant but must take on the adult responsibility of being accountable to ourselves and to each other for our actions.

The choice of whether or not to be sexually active is one each individual must eventually make, consciously or unconsciously. The hope of this author is that each individual reading this article will decide to make a well-thought out choice on this matter and will then behave responsibly as they abide by this choice in daily life.

It can be safely assumed that in this society healthy behaviour patterns are preferred over unhealthy ones and that moderation in all areas of one's life is the ideal toward which we should aspire. If we accept this line of thinking then it logically follows that healthy sexual practices are preferred over unhealthy ones and that excessive or promiscuous sexual behaviour is to be avoided.

Even if one accepts this there are still as many interpretations of the words "excessive'' and "promiscuous'' as there are people in the world. Each individual must ultimately set his or her own limits.

Whatever your personal limits are, the fact remains that in 1992 sex outside of a mutually monogamous, committed relationship is dangerous.

The following are reasons why it is often safer to just say no to sex outside of such a relationship. Hopefully, each of these factors will be considered carefully and will make it easier for you as an individual to set your limits.

THE MORAL FACTOR: All of the world's major religions discourage or prohibit sexual activity outside of marriage, the ideal version of a mutually monogamous, committed relationship. If you practise any religion, chances are it is in contradiction to the ideals of your faith to have sex outside of marriage. Perhaps for moral or spiritual reasons you should say no to sex.

THE PREGNANCY FACTOR: While contraception is readily available today the perfect birth control device has yet to be invented. There are numerous options ranging from barrier methods like condoms, spermicides and the diaphragm to hormonal methods like the birth control pill or injection. The intrauterine device (IUD) is an option for many women and permanent sterilisation for men or women is yet another option available. In spite of all these options, no method of contraception is 100 percent effective and 100 percent safe, except saying no to sex.

THE DISEASE FACTOR: The present epidemic of Sexually Transmitted Diseases (STDs) is arguably entirely the result of the "Sexual Revolution'' of the 1960s and '70s. Most STDs have been present for centuries or longer. The crisis we see today is the end result of promiscuous sexual behaviour which has escalated the rate of spread of these diseases. Syphilis, Gonorrhea, Chlamydia, genital warts (Human Papilloma Virus), Herpes, Hepatitis B and AIDS are not new problems, and they will continue to plague society for a long time to come. While condoms are extremely helpful in preventing the spread of these diseases, they do not provide 100 percent protection from STDs. Self-control and saying no to sex can protect you even better.

If this is old news, you may be interested to learn that cancer of many parts of the reproductive tract, including cervical cancer, vaginal cancer and penile cancer are associated with genital warts. Furthermore, cervical cancer in women is linked to early first sexual contact (before age 18) and multiple sexual partners (more than two in a lifetime). This makes saying no to sex a more attractive option.

THE EMOTIONAL FACTOR: Self-esteem is a fragile but essential personal quality.

It must be nurtured and encouraged to blossom. In our fast-paced, competitive world one does not automatically learn to feel good about oneself, to value oneself and to love oneself. It takes effort. Part of this effort involves protecting yourself from emotional harm. If your social behaviour is careless and thoughtless, if you allow yourself to be emotionally or physically intimate with people who do not have your best interest in mind, you are contributing to your own destruction. Perhaps saying no to these relationships is the best way to preserve your self-esteem and promote your emotional well-being.

C. Peek-Ball, MD Maternal Health/Family Planning Clinic Department of Health.