Safer Sex

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Overview

Practicing safer sex is important for anyone who is sexually active—women who have sex with men, men who have sex with men, and women who have sex with women. "Safer sex" means learning and practicing behaviors that decrease the chance of contracting or transmitting sexually transmitted diseases (STDs).

An STD is a short-term or long-term disease that is transmitted through contact with blood, semen, and body fluid. STDs cause painful, impairing, chronic conditions that may require lifelong medical treatment. Safer sex is possible when STDs and how they are spread is understood.

Some of these illnesses, such as human immunodeficiency virus (HIV) infection, which causes acquired immunodeficiency syndrome (AIDS), can be life threatening. In the United States, more than 600,000 cases of AIDS have been reported since 1981, and it is estimated that there may be as many as 900,000 Americans infected with HIV.

According to the NIH, HIV infections are increasing more rapidly among women, who contract the virus primarily through unprotected sex with an infected male partner. In the United States, AIDS is the fourth leading cause of death in women between the ages of 25 and 44. AIDS cases among women increased threefold from 1985 to 1996.

In July 2003, the Centers for Disease Control and Prevention (CDC) reported that the incidence of HIV and AIDS in gay and bisexual men had increased by almost 18% since the lowest point in 1999.

According to the National Institutes of Health (NIH), practicing safer sex may involve the following:

• Using latex barrier protection (condom) for both vaginal and anal intercourse
• Withdrawing the penis prior to climax and ejaculating outside the partner
• Avoiding all low- and high-risk sexual activity, even with protection

Regardless of sexual preference, participation in high-risk sexual behaviors (e.g., intercourse without a condom) and contact between mucous membranes and broken skin (e.g., cut, scrape) increase the risk for contracting or transmitting STDs.

STD History

Abstinence (i.e., not having sex) is the only sure way to prevent STDs. The safest sex is between two uninfected people who have never had another sex partner.

Partners should ask about each other's STD history before having sex and should be careful not to let alcohol or drug use, passion, or embarrassment interfere with their judgment. It is important to stay informed and make smart choices concerning sexual activity. Some STDs produce lesions or discharge that is noticeable on the body and some do not. Before intercourse, partners should examine one another for lesions, growths, or torn skin and each should ask about the other's health history.

Asking a partner if they have a history of genital warts, sores, or discharge before having sex is a good practice. It is important to remember that people are not always honest about their sexual history. Partners may choose to explore sexual activities that do not involve intercourse.

Barrier Protection

Using a latex condom with a water-based lubricant (e.g., KY Jelly®) that does not contain nonoxonyl-9 (N9) significantly reduces the risk for acquiring or transmitting STDs, but does not eliminate it. Petroleum-based lubricants (e.g., Vaseline®, baby oil) should not be used because they degrade latex.

Condoms should be kept on hand if the chance exists for spontaneous or unplanned sex, and should be stored properly to prevent them from degrading. The condom should be put on prior to sexual activity and if it tears during sex, the penis should be withdrawn and the condom replaced. A new condom should be used for each sexual act. Although sex is safer with a condom, either partner should be comfortable abstaining from sex when there are signs of STDs.

Some people believe that it is safe to have sex without a condom if they are taking antibiotics for an STD. This is not true. The risk for transmission exists until the course or treatment is completed.

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