Safe sex

Safe sex (also called safer sex) is a term describing practices designed to reduce the risk of catching sexually transmitted diseases (STIs). Sexual abstinence obviously virtually eliminates the risk of STIs, but also the possibility of natural reproduction and the pleasure of sex.

Most attention has focused on controlling HIV, which causes AIDS, but each STI presents a different situation.

Recommended practices

• Solitary masturbation (including so-called "phone sex" and cybersex) is completely safe.
• Monogamy. However, be aware that many monogamous people have been infected with sexually transmitted diseases by non-monogamous partners.
• Knowing your partner, especially their STI status.
• Communicating with your partner. Being assertive in saying what you want and don't want. This includes discussing beforehand what is acceptable and what is not to avoid "heat of passion" decisions.
• For those who are not monogamous, reducing your number of sexual partners, particularly anonymous sexual partners, will also reduce your potential exposure to STIs.
• Not using recreational drugs, including alcohol, in a way that increases the likelihood you will "forget" other safer sex guidelines.
• Avoiding any contact with blood, vaginal fluid, and semen of the partner:
  • Using condoms. Condoms are used to cover the penis during sexual activity. They are most frequently made of latex, but can also be made out of polyurethane for those who have a latex allergy, or they can be made out of animal intestine. Polyurethane is thought to be a safe material for use in condoms, since it is nonporous and viruses cannot pass through it. However, there is less research on its effectiveness than there is on latex. Any condoms made out of animal skin or intestine, such as Trojan NaturaLamb, are not thought to be safe because they are porous and viruses such as HIV can pass through them. Do not handle condoms with sharp fingernails, do not use latex condoms together with oil-based lubricants, never reuse condoms, and ensure that the condom is not past its expiration date. Never keep a latex condom in a wallet! Moreover, never "double up" latex condoms by using two at the same time. The friction of latex against latex may cause the condoms to tear.
  • Female condom. This condom is inserted into the vagina prior to intercourse. It is also sometimes used for anal sex.
  • Dental dam. A sheet of latex (originally used for dentistry) for protection when engaging in oral sex. It is typically used as a barrier between the mouth and the vagina during cunnilingus or between the mouth and the anus during anilingus. A piece of plastic wrap (such as Saran™ wrap) may also be used as a dental dam, but regular plastic wrap is too porous. Dental dams may also be made by cutting up condoms or vinyl or latex gloves.
  • Medical gloves. Gloves made out of latex, vinyl, nitrile, or polyurethane may be used as dental dams during oral sex, or to protect the hands during mutual masturbation. Hands may have invisible cuts on them that may admit pathogens that are found in semen or vaginal fluids. Although the risk of infection in this manner is thought to be low, many people use gloves as an extra precaution. Gloves also make mutual masturbation more comfortable by preventing sharp fingernails from accidentally scratching the genitalia.
  • Another way to avoid contact with blood and semen is outercourse, which is sexual activity not involving penetration. Despite that the method is effective it is only sometimes mentioned by safer-sex educators.

Note that most methods of contraception (birth control) other than the barrier methods mentioned above are not effective at preventing the spread of STIs.

The spermicide Nonoxynol-9 has been claimed to reduce the likelihood of STI transmission. However a recent study by the World Health Organisation [[1]] has shown that Nonoxynol-9 is an irritant and can produce tiny tears in mucous membranes, which some may increase the transmission by offering pathogens more easy points of entry into the system. As a result condoms with a Nonoxynol-9 lubricant are not to be promoted. However it is better to use a condom with Nonoxynol-9 than no condom at all

"Pulling out," in which the penis is removed from the vagina, anus, or mouth before ejaculation, is not safe sex and can result in STI transmission. This is because of the formation of pre-ejaculate, a fluid (which may contain sperm) that oozes from the urethra before actual ejaculation. In addition, open sores on either partner can permit transmission.

Change in terminology

With the realization that risk of transmission of sexually transmitted diseases in various sexual activities is a continuum rather than a simple dichotomy of risky/safe, US health workers began to talk of "safer sex" rather than "safe sex." However, in most other countries, including the United Kingdom and Australia, the term "safe sex" is still mainly used by sex educators, perhaps in the recognition that with the strict adherence to these techniques the risks of catching the more dangerous STIs are quite low.

Controversy

Some conservatives object to the "safer sex" movement on the grounds that it promotes what they hold to be immoral and high-risk behavior, namely promiscuous sex outside of marriage. This, they argue, increases rather than decreases the risk of contracting STIs. They believe that the best way to avoid sexual disease is abstinence before marriage followed by lifelong mutual fidelity thereafter. By way of contrast, proponents of the safer sex movement contend that it is often difficult to compel adolescents to refrain from sexual activity. They conclude that it is better to offer comprehensive sexual education involving "safer sex" techniques as a practical measure rather than risk infection or pregnancy to uphold a moral ideal.

In the US, some have claimed that condoms are ineffective against HIV transmission, particularly during anal sex. These claims have been disputed by many medical researchers, who view correctly used condoms as effective protection. Some studies have shown that, even with the best of intentions, condom users can often use condoms improperly, so that the transmission rate remains disturbingly high. Advocates of safe sex education point out that it has to start at an early age to be effective, a notion which arouses even heavier opposition from conservatives given the taboo of child sexuality.

External links

• "Guide to Safer Sex" from the Society for Human Sexuality's sexuality.org site. Very explicit information on making various sexual practices safer:
  • Concise version (20k)
  • Long version (97k)
• "Safe Sex" by Roedy Green. Introduction (with personal comments) by a HIV-positive gay man.