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 (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.
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 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
occasion pick up a throat infection by going down on someone who currently
has a bacterial STD (typically, gonorrhea), but these infections 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 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 even 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 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 occasion 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 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.
Vaccinations
There 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 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. 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 Information
If you have additional questions about STDs or HIV, call the National
STD Hotline at 1-800-227-8922. Information about STD clinics in your
area can be found by calling this National STD Hotline 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 any sort of STD.
Copyright © 1999 Society
for Human Sexuality. All rights reserved.
Last Modified: June 11, 1999
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