A guide for safer sex
Introduction
This 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 peace of
mind can be enhanced by making your own choices about safer sex ahead of time
and sticking to them.
Please note that safer sex is about dramatic risk reduction
against the most serious sexually-transmitted ailments, not complete risk
elimination for every possible condition (for example: the virii for cold sores
and warts can be spread through unbarriered contact with any infected area,
including health-looking skin that a condom would not cover).
Intercourse
The 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. 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 on the outside of the condom for comfort, mutual pleasure, and
to keep the condom from tearing during sex. Note that some men find that more
sensation is transmitted to them if they put a drop or two of water-based lube
INSIDE the tip of their condom before putting it on. Also, 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:
scientific evidence resulted in this advice being formally retracted by public
health officials in the year 2000, and unless you are using Nonoxynol-9 as a
contraceptive rather than for HIV prevention it may be wise to cease using it
entirely.
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. Some sex educators have
suggested that men might be able to give themselves a little extra
protection after a condom failure by immediately visiting the restroom and
urinating, though other experts have questioned this advice.
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 Sex
Opinions 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 choose to consider their
personal risk to be acceptably low outside of the most infectious period
(which starts with the tingling "prodrome" sensations that precede an
outbreak, and continues until several weeks after the sores go away). It is
also very possible to pick up a bacterial infection of the mouth or throat by
going down on someone who currently has a bacterial STD (typically Gonorrhea,
Syphillis, or Chlamydia), but these can usually be cured with antibiotics once
they're identified.
At the time of this guide's writing, the available evidence
strongly suggested that the risk of transmitting HIV was much, MUCH lower for
unprotected oral sex than for unprotected anal or vaginal intercourse, and
conventional wisdom amongst sex educators was 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, it seemed physically
plausible that: the risk of transmission could be 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 an hour 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 obvious signs of contagious STDs (including
genital warts, which can potentially 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 probably 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 after getting all the current facts 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 regular 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 Hands
If 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
(individually-packaged anti-bacterial towlettes might be useful if you're
outdoors). 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
and/or extra-tidy, then try using disposable latex "examination"
gloves (available at most drug stores).
If you're not going to use gloves, then just as a hygiene matter
washing your hands before putting them in someone is a good idea.
Of course, 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 anyone's mouth.
Safer Sex Kits
It'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.
Vaccinations
Permanent vaccines are available for 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. By
contrast, there is currently NO vaccine against Hepatitis C (though Hep C is
spread primarily through direct contact with human blood, e.g. through sharing
needles, and only rarely through sexual contact
More recently, in June 2006 a vaccine against several specific
types of human papillomavirus (HPV) was approved for use by girls/women.
Although this vaccine does not protect against every type of
HPV, the types it protects against cause the majority of cervical cancers and
the overwhelming majority of genital warts. Ideally, if one is to get the full
benefit of this vaccine, the vaccination series should be complete before one
becomes sexually active: at this time it's recommended for 11-12 year old
girls, and can be given to girls as young as nine.
Birth Control
If 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. Special doses of
particular birth control pills can reduce the chance of pregnancy by 75% if
taken within 72 hours of contraceptive failure, but can still be effective
within five days.
Treatment, Testing, and Additional Information
bacterial STDs are almost always curable with appropriate
antibiotics and the incurable viral STDs (such as HIV, herpes, hepatitis, and
HPV) are now more easily managed than ever, it's definitely in your best
interest to get tested if you think you might have been exposed to anything.
Please keep in mind that, for standard HIV testing, a minimum of
three months needs to go by since your last potential exposure for the test to
be reliable: in other words, if you and your partner would like to drop safer
sex precautions with each other and are primarily concerned about HIV, you'll
need to go through a period of time where you're completely safe with each
other and everyone else before you'll be able to get a meaningful test result
(you'll also be advised on this matter when you go in for testing).
Still many questions remain which need answers.
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