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Guide to Safer SexIntroductionThis guide focuses on the basics of safer sex, and on how to make whatever precautions you choose feel as pleasurable as possible. Safer sex precautions are obviously not necessary when neither you nor your partner(s) have anything you could transmit to each other (and will be completely safe in your interactions with anyone else during the course of your relationship, and when birth control is not an issue, etc.), but in all other cases your health and peace of mind can be enhanced by playing safely.IntercourseThe single most effective thing you can do to stay healthy while being sexually active is to use latex condoms for intercourse (whether vaginal or anal). All condoms are not made alike; men should experiment with different brands until they find the one they like best (many men prefer Kimono MicroThins, which also taste fine for fellatio if you get them without Nonoxynol-9). When you put on a condom, pinch its tip as you unroll it (all the way down!) to prevent an air bubble from forming in the reservoir tip. For intercourse, you should then put some water-based lube (such as I-D, ForPlay, Wet, Probe, or Astroglide) on the outside of the condom for comfort, mutual pleasure, and to keep the condom from tearing during sex (some men find that more sensation is transmitted to them if they put a small amount of water-based or silicone-based lube INSIDE the tip of their condom before putting it on). It's very important for men to hold onto the base of their condom as they withdraw (i.e. after becoming soft) so it doesn't slip off.For a while, health experts were recommending that people choose safer sex products with Nonoxynol-9 to protect against HIV transmission; current evidence suggests that Nonoxynol-9 isn't nearly as effective at HIV prevention as it is at contraception, and if you have a sensitivity or allergy to this substance (as many people do) regular exposure to it might actually decrease your level of protection against HIV by irritating delicate vaginal or (especially) anal tissues. If a condom fails during vaginal or anal intercourse, the receptive partner shouldn't douche; if any Nonoxynol-9 contraceptive foam is handy it might help for him or her to insert it and leave it in for about 15 minutes, and it would certainly help to immediately remove the condom from inside the vagina or anus if it was left there. Men can give themselves a little extra protection after potentially being exposed to an STD by immediately visiting the restroom, urinating, and then possibly washing their genitals with an anti-bacterial soap. If unwanted pregnancy is a possible outcome of the condom failure, you should call 1-888-NOT-2-LATE to find out about emergency contraception in your area. It should be obvious that a new condom needs to be used for each new partner, and that condoms should not be reused. Also, if you're going to switch from anal intercourse to vaginal intercourse, you should put on a new condom to avoid causing vaginal infections. Oral SexOpinions differ on the use of safer-sex barriers for oral sex. It's clear that herpes can be transmitted from genitals to mouth or mouth to genitals during unprotected oral sex, but some people feel the risk is acceptably low outside of the most infectious period (which starts with the tingling "prodrome" sensations that precede an outbreak, and continues to two weeks after the herpes sores go away). You can on rare occassion pick up a bacterial infection by going down on someone who currently has a bacterial STD (typically Gonorrhea, more rarely Syphillis or Cancroid), but these can generally be cured with antibiotics once they're identified.It is clear that the risk of transmitting HIV is much, MUCH lower for unprotected oral sex than for unprotected anal or vaginal intercourse, and that the risk is MUCH lower for the person being sucked or licked than for the person doing the sucking or licking. For the person doing the sucking or licking, the risk of transmission is lower if your gums (and lips/mouth/throat) are healthy, if you don't let men come in your mouth, and if you don't perform cunnilingus on a woman while she is menstruating. Some sex educators recommend NOT flossing or brushing your teeth for two hours before giving unprotected oral sex (use Cool Mint Listerine or some other anti-bacterial mouthwash if you're concerned about bad breath or just want to freshen up), and others recommend quickly looking over the genitals you're about to go down on for signs of contagious STDs (including genital warts, which can on rare occassion be transmitted from genitals to mouth). If your policy for performing unprotected fellatio is to not let your partner come in your mouth and he does so anyway, it's better to immediately spit than to either wait or swallow, and it may help (especially for bacterial STDs) to then go use an anti-bacterial or peroxide mouthwash. Pre-cum can contain HIV, and although not letting men come in your mouth SIGNIFICANTLY reduces your already low risk to even lower levels, if you are concerned about becoming infected via pre-cum while performing fellatio you have two risk-reduction options: not taking the head of his penis in your mouth or using barriers for oral sex. If you decide that your personal safety standards include barriers for oral sex, then you'll need to use latex condoms (without Nonoxynol-9) for fellatio, and either saran wrap or one of those "Glyde" dams for cunnilingus (for cunnilingus, put a little water-based lube on your partner's side of the barrier to increase the sensation transmitted to her). The same barrier techniques used for cunnilingus can also be used for analingus (rimming), where they should be considered essential if the person doing the licking isn't immunized against hepatitis A or if the person being licked may have a bacterial infection. Your HandsIf you've had your fingers in someone's vagina, or had someone come on your hands, then it's a good idea to wash your hands with hot water and anti-bacterial soap before touching your eyes or anyone else's genitals. If your skin is compromised in any way, if you want to avoid needing to leave the scene to wash your hands, if you're going to be engaging in anal fisting or exposing yourself to any blood, or if you just want to be extra-safe, then try using latex "examination" gloves - they're available at most drug stores.If you've just had your ungloved fingers in somebody's ass, then you'll want to be sure to clean your hands particularly thoroughly (especially under your fingernails!) before putting your them in or near your mouth. Safer Sex KitsIt's helpful to get a little hip pack for your safer-sex supplies, your smaller bottle of water-based lube, and anything else you commonly use. You might also want to pack a portable toothbrush and a travel-sized toothpaste tube in case you end up staying overnight somewhere.VaccinationsThere are two STDs for which permanent vaccines are available: hepatitis B and hepatitis A. Hepatitis B can be spread easily through intercourse and (less easily) through oral sex or rimming, and hepatitis A is easily spread through rimming. Getting these two vaccinations (which you can do at the same time) would be an excellent idea if you don't always use barriers for these activities.Birth ControlIf you're going to be engaging in intercourse with someone of the opposite sex, birth control may be an issue. If the birth control that latex condoms offer is good enough for you, then you're set. If you want more protection than this, call Planned Parenthood (1-800-230-PLAN) and discuss the options. Special doses of particular birth control pills can reduce the chance of pregnancy by 75% if taken within 72 hours of contraceptive failure; the Emergency Contraception Hotline at 1-888-NOT-2-LATE can tell you where to go to get them.Treatment, Testing, Supplies, and Additional InformationIf you have additional questions about STDs or HIV, call the National STD Hotline at 1-800-227-8922 or visit http://www.thebody.com/. Information about STD clinics in your area can be found by calling this National STD Hotline or by visiting http://www.unspeakable.com/locator/nph-locator.cgi. As the bacterial STDs are almost always curable with antibiotics and the incurable viral STDs (such as HIV, herpes, hepatitis, and HPV) are now more easily managed than ever, it's in your best interest to get tested if you think you might have been exposed to anything.If you require more detailed information on STD/HIV treatments, the best online document is the CDC's Guidelines for Treatment of Sexually Transmitted Disease at http://www.cdc.gov/nchstp/dstd/1998_STD_Guidlines/1998_guidelines_for_the_treatment.htm. The only element lacking in this document is good pictures of herpes sores (and symptoms caused by other STDs) for those who want to be able to identify them by sight; for pictures, visit http://www.thebody.com/sowadsky/symptoms/symptoms.html For more information on making safer sex fun and erotic, read The New Good Vibrations Guide to Sex by Cathy Winks and Anne Semans or watch the videotape Safe is Desire (call 1-800-BUY-VIBE). Finally, you might want to read a longer guide to safer sex which is also available at this site. All of the safer sex products we've mentioned so far may be purchased from online shops such as Condom Sense and The Rubber Tree. Copyright © 1999 Society for Human Sexuality. All rights reserved. |
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