Safe Sex
When thinking about "safe" sex, it is important to realize that risk from various sexual practices often falls along a continuum, rather than having a clear safe vs. not safe boundary. Throughout this discussion, we will refer to "safer" sex, with the thought that by placing more or fewer "boundaries" around a particular sexual act, it can be made more safe or less safe.
Any sexual practice can be made safe or unsafe. For instance, mutual masturbation can become unsafe if people touch their own genitals after getting a partner's infected semen, blood or vaginal fluids on their hands. We hope to help you develop criteria to use to decide whether previous experiences you've had were safe or not, and how to stay safe in the future.
It is helpful to think about safer sex using a wide definition of sex. Many people think about sex fairly narrowly. For instance, thinking that sex only starts when penetration takes place may limit people's ability to protect themselves and to enhance their sexual lives through safer sex. We consider sex to include any practices that a person finds erotic and sexually exciting.
Why Practice Safer Sex?
Most people are inclined to think that people who practice safer sex are only those who are concerned about getting HIV from their partners because they don't know their sexual partner(s)' HIV status or they know if their sexual partner(s) is/are HIV-positive.
In fact, there are other reasons why some people decide to practice safer sex. Some examples:
- HIV-negative people who always practice safer sex so they don't lose the habit of protection. Also, if a person agrees, with ease, to practice safer sex, this is an indicator that the person has practiced safer sex with previous partners.
- HIV-negative people in a sexual relationship who want to avoid dealing with issues of trust between them. By practicing safer sex, there is no need to discuss whether they are being monogamous.
- HIV-negative people who agree to practice safer sex with each other for three months before they are tested again for antibodies to ensure they are both uninfected. After this time, they may decide to engage in unprotected sex with each other, though HIV infection could occur if either partner is having unsafe sex outside of the relationship.
- HIV-negative and HIV-positive people who want to avoid getting sexually transmitted diseases other than HIV.
- HIV-positive people who want to avoid getting reinfected with HIV. It is possible for someone with a drug-resistant strain of HIV to give it to another HIV-infected person, which could potentially limit their treatment options.
Of course, sexual partners who are HIV-negative, and wait three to six months after their last risky activities before taking an HIV-antibody test, and trust that neither one of them is or will engage in sexual or needle sharing activities that could put them at risk, may practice sex without protection. Obviously, trust and communication are essential.
Safer Sex Guidelines
Any sexual practice that does not let someone else's semen, blood, or vaginal fluids get into someone else's body is generally considered "safer" sex. The parts of the body where HIV could enter the bloodstream are the anus and rectum, the vagina, the penis, the mouth, and the eyes. These body parts must be protected from contact with HIV-infected fluids. HIV cannot go through the skin unless there are open sores or bleeding cuts.
We hope to give you the tools with which you can make your own decisions about where you want to fit in on the continuum from safer sex to riskier sex. Each time you engage in a sexual activity, you choose (whether consciously or unconsciously) the level of risk you are comfortable with for that moment.
Safer sex often involves use of latex condoms, latex dental dams, plastic wrap, latex gloves and finger cots as barriers between the infectious fluids and mucous membranes or open cuts.
Why Latex?
Latex has been proven effective in preventing the transmission of HIV. Latex is a very resilient and strong material that does not allow HIV to pass through it. When used properly, latex products offer the best possible barrier against HIV and other sexually transmitted diseases.
Lubricant
Use of lubricants can make sexual penetration more comfortable and may also help reduce the risk of condom breakage during sex. With latex condoms, however, be sure to use a water-based lubricant. Do not use baby oil or other oil-based lubricants. These may cause the condom to be ineffective.
Condoms and Other Safer Sex Devices
“Male” Condoms |
A condom is a sleeve, closed at one end, which fits over the penis. There are three types of condoms; latex, polyurethane and lambskin. The lambskin condoms may allow passage of HIV and therefore are not recommended. Latex or polyurethane condoms are recommended because they do consistently prevent passage of HIV |
“Female” Condoms |
An approved alternative to the male condom, the 'female' condom, is a disposable vaginal pouch made out of polyurethane. It is soft and thin and has a latex ring at each end. The ring at the closed end goes into the vagina and over the cervix (the opening of the uterus). The other end stays outside the vagina and covers the labia (vaginal lips). The polyurethane covers the cervix and the vaginal canal. The vaginal condom is currently marketed under the name "Reality." This condom is sometimes used by either men or women for anal sex. |
Latex Dental Dams |
Dental dams are squares made out of latex that dentists use to isolate the tooth on which they are working. AIDS educators have advocated their use for oral sex, either mouth-vagina or mouth-anus. Because they were not originally designed for sex, they tend to be thicker than condoms. |
Plastic Wrap |
Plastic wrap is a common product in people's kitchens. It has been shown to prevent passage of HIV and it is recommended as a barrier for oral sex, either mouth-vagina or mouth-anus. Although dental dams can also be used for these activities, plastic wrap has the advantage of being transparent, thinner, cheaper, and easier to get. |
Latex Gloves |
Latex gloves are easy to find in drugstores and medical supply stores. They may be used to cover the hand when inserting the fingers or fist in the vagina or rectum. They may also be used by people who have open cuts in the hands or chronic skin problems such as eczema. Some people simply enjoy the feel of latex on their skin. |
Finger Cot |
Finger cots are made out of latex and cover only one finger. They can be found in medical supply stores. |
Types of Condoms
There are a wide variety of condoms on the market. They can be lubricated or non-lubricated. They come in different colors, shapes, sizes, textures and thickness. There are condoms that are flavored and those that glow in the dark. There is practically no limit to the selection.
Some men complain that condoms make them lose sensitivity in the penis during sex. We encourage these men to try out different brands and types of condoms and select the ones with which they are more comfortable (they can masturbate with them to get used to them and feel more comfortable during sex with their partners). Some people find that although they may lose their sensitivity at first, after using condoms for a while they can regain it. And, of course, they feel more relaxed about sex since they know they are protected.
There are no rules about what condom to use. Some men feel better with a thicker condom while others prefer a thinner one. Some people get excited about colors and flavors while others find these features boring or irrelevant. Some men claim that their penis is too big for a condom. We encourage them to try different brands (which fit different people in different ways; there are no "better" brands). There are also brands of condoms designed explicitly for men who have a large penis. Interestingly, few if any men say that their penises are too small for a condom.
Using "Male" Condoms
- Pick up the condom by grabbing the "nose" (the reservoir tip) between your thumb and forefinger (to ensure that no air bubble gets trapped in the tip, which may cause breakage during intercourse).
- With both hands place the condom on the head of a fully erect penis (remember, you are holding the "nose" in one hand; you roll the condom down onto the penis with the other hand).
- Unroll the condom completely, all the way down to the base of the penis. Having used both hands and held onto the reservoir tip, you have just ensured that no air is trapped inside the condom. Not only does this prevent air bubbles popping the condom during the friction of intercourse, but it also creates a vacuum, which helps to keep the condom in place.
- Use plenty of water-based lubricant (some people use a single drop inside the tip to keep the air out).
- When pulling out, the man or his partner should hold the condom between the fingers so that it does not slip off and spill any semen inside the body.
Preventing Condom Breakage
The main reason for condom breakage is user failure. Although condoms are very resilient, they may become weaker when affected by several factors
: Heat |
Condoms should never be left in places where they will be exposed to heat, such as glove compartments, under direct sunlight or in pockets of pants. |
Old Age |
Condoms should be fresh when used. We recommend not keeping condoms longer than a year. If there is any uncertainty about how old a condom is, it should be thrown out. Most condoms will have expiration dates on the package. |
Insufficient Lubrication |
It is important to use a lubricant (such as saliva or a commercial lubricant like KY jelly or another product) to reduce friction on the outside of the condom during sexual intercourse. When in doubt, more lubrication should be added. |
Use of Oil-based Lubrication |
Oil-based lubricants affect the latex and make it break. Lubricants that should never be used include: Vaseline, baby oil, Crisco, hand lotion, massage oil, face cream, etc. Just look on the label for ingredients: water should be the first ingredient. |
Air Bubbles |
The main reason condoms break during sex is because air bubbles get trapped inside them, which make them break due to the motions of intercourse. The air must be pinched out of the condom's tip before putting it on. |
Using Condoms during Oral Sex
If you wish to perform safer oral sex on a man, you have the option of using non-lubricated condoms and also polyurethane condoms. Lubricated condoms do not taste good to most people and some people don't like the white powder that covers non-lubricated condoms. That white powder is cornstarch and can be easily wiped off with a wet washcloth.
Using Dental Dams and Plastic Wrap for Oral Sex
The dam or plastic wrap can be placed between the mouth and the vagina or anus during oral sex to reduce risk of sexually transmitted diseases. It is very important that you use a different dam or piece of plastic wrap every time that you perform oral sex. It is not a good idea to set the barrier aside and use it again because it's too easy to flip it over and forget what side touched the vagina or anus.
Using Dildoes and Other Sex Toys
Part of practicing safe sex is being creative. Sex toys can add to the pleasure and creativity of sex. However, some precautions are necessary when they are being used by more than one person.
It is best to have one's own personal sex toys and never share them. However, dildoes and other toys may be washed with soap and water and then used by another person. Condoms may be placed on dildoes and vibrators to avoid needing to wash them before a second person uses them. It is important to change the condom every time that the toy passes from one person to another.
