Safer sex practices

Barriers

These are one of the easiest and most effective ways to prevent fluid exchange during sex because they keep each person’s fluids on a different side of the barrier. Different types of barriers used for safer sex:

Condoms

• Be careful to select condoms approved by the FDA  to prevent both pregnancy and STIs (some novelty flavored or glow in the dark condoms are not).

• Both external and internal versions exist:

  • There is only one FDA approved internal condom in the US: FC2 Internal Condom.

  • Internal condoms are more expensive but have the advantage of being able to be inserted in the vagina or anus up to 8 hours before sex.

• Latex and latex-free condoms exist for those with allergies.

• Lambskin also exists but it does not prevent STIs (only pregnancy).

• Can be pre-lubricated or not.

• DO NOT use oil-based lubricant like baby oil or coconut oil because they will degrade the latex decrease its effectiveness.

• Some contain spermicide. Don’t use these. The amount of spermicide is not enough to make a difference in pregnancy risk but can cause irritation, making STI transmission more likely.

• Custom made condoms exist!

Dental Dams

• A flat sheet of latex (or polyurethane) to be placed on the genitals or anus for oral sex. 

• Can be purchased online but are cheaper and easy to make one by unrolling a condom, cutting the top and bottom off and then cutting it lengthwise to make a square sheet of rubber.

Gloves

• Generally speaking, you cannot get STIs through your hands unless you have some kind of abrasion or skin irritation.

  • Cover cuts, hangnails, fresh tattoos,  eczema, dermatitis, or other skin irritations.

• If you touch multiple people’s genitals with gloves or touch your eyes or mouth with them you are negating the protection they offer.

• Generally gloves are recommended for any sex that may involve contact with blood, such as sex during a period or any kind of fisting.

Medical

• HPV Vaccine (see previous episode):

  • Update: There is no age limit for HPV vaccine. Talk to your doctor about it.

  • Get the vaccine even if you have HPV. It protects against around 9 strains and it’s very unlikely that you have more than one or two strains. It also helps prevent reinfection and can decrease outbreaks.

• HIV Prophylaxis (see previous episode):

  • Two kinds, PEP and PrEP.

  • PrEP stands for pre-exposure and is taken daily to decrease the risk of developing an HIV infection if you are exposed. 

  • PEP is taken within 72 hours after you are potentially exposed.

Others

Sex toys

• Be sure to wash your toys before and after use, as there are infections that are not considered STIs that can still be transmitted if toys aren’t clean.

• As a rule of thumb, non-porous materials like glass or metal can be used with multiple people as long as you clean and sanitize them. Porous toys should not be shared without a condom, and to improve safety levels further, it’s an option to use a condom on any toy you’re using with multiple people. Here is a guide on cleaning sex toys, and here is a good article on how to pick body-safe materials for your toys.

Lubricant

• Lube is part of safer sex. Friction causes irritation, and that increases STI transmission risk.

• Be sure it is high quality lubricant, and avoid spermicidal ones for STI prevention.

• If you are prone to vaginitis (yeast or bacterial infections) avoid warming, numbing, or flavored lubes.

• If you have an allergic reaction, consider using silicone instead of water-based lube (just be careful with silicone toys, as those can interact badly with silicone lube, especially for cheaper toys).

Activity choices

The types of sexual activities that you engage in with others have different safety levels as well. For instance, abstinence is very effective but even that isn’t 100% perfect since some STIs can be transmitted through sharing food, drinks, towels, or other non-sexual contact. Routine testing is still worthwhile in these situations.

Additionally, while lifelong monogamy between two people is theoretically a safer choice, a 2015 study shows that monogamy as it is actually practiced in real life is not effective at preventing STIs. In fact, they suggest people who practice serial monogamy are significantly less likely to get tested and practice safer sex than people who are ethically non-monogamous. 

• There are lot of different kinds of sex and different types of contact have different levels of risk for various STIs. For example:

  • Kissing can transmit HSV, CMV, and possibly some others but it is generally unlikely.

  • Manual sex and mutual masturbation are incredibly unlikely to transmit any STIs.

  • Using toys is unlikely to transmit any STIs as long as they are cleaned and condoms are used on them if shared.

  • Oral sex can transmit most STIs if done without a barrier, but has almost zero risk for HIV transmission.

  • Vaginal or anal sex can transmit any STI, including HIV. If no barriers are used, anal sex sometimes has a higher rate of transmission because the anal tissue is more delicate than vaginal tissue and more likely to tear. Remember to use lots of lube for preventing this!

  • With oral and vaginal/anal sex, barriers significantly reduce the risks of STI transmission.

When do we talk about sex?

In many situations, earlier is better!

• Have the conversation about sexual health before any relevant sexual contact. This can vary depending on your STI status. If you get cold sores, for example, you should mention that before you kiss and make sure everyone understands what that means.

• Having a sex conversation too early could feel a bit forward, but in general it’s better to have it as early, as sober, and as clothed as you can.

• It’s easy to make decisions that we later regret when our brain chemicals are all excited about an experience with someone, so talking beforehand and coming prepared with whatever equipment you need is key.

• Having the STI conversation over text is totally fair game!

  • In fact, if your meetup is specifically to hook up then having that conversation ahead of time via text is not only ok, it’s actually advised!

How to talk about sex

When talking about sex with a partner or potential partner, there are two main parts:

• Disclosing your testing status and learning theirs.

• Deciding on the safer sex practices you will use if you have sex together.

Testing, STI status, and disclosure

For disclosing, there are three key pieces of information:

• When you were tested.

• What you were tested for specifically.

• What the results of those tests were (positive or negative).

From an article by Gabrielle Kassel, called “We Put Together Text Templates for That STI Convo” they got some expert advice on some template phrases you can use to start the STI conversation:

Here’s a basic one to start with:

“My last STI screening was [insert date], and I am [positive/negative] for [insert STIs]. How about you?”

If you are positive for an STI some examples could be: 

• “A doctor found that I carry the HPV virus during a routine gynecological exam. But HPV transmits through direct contact, so if we use a condom or other barrier method during sexual intercourse, the risk of transmission is a lot lower. I haven’t had an infection for [x months/years], and I don’t have an infection now.”

• “I have been exposed to HSV in the past, but I do not have any active lesions, so there is no risk of transmission. To make sure it can’t transmit between us, I take antiviral medication to prevent future outbreaks. As long as we use a condom or dental dam, the chance of you acquiring the HSV virus is unlikely. The virus has not been transmitted between me and any of my sexual partners in the past, but I wanted to share this information with you so you are not misled.”

• “I have herpes, and I know you might need time to think about what that means. Here are some resources that helped me with my diagnosis and might be helpful to you, too. Please feel free to ask me any questions.”

• If you have a treatable STI like gonorrhea or chlamydia, you may want to share what medicine you’re on, when you’re undergoing testing again, and where you are in your treatment plan. 

After sharing, give them space and offer resources, ideally giving them some resources that include some advocacy and humanizing information about people with your particular STI status. And then no matter what, do your best not to take their response personally.

“If the other person isn’t willing to talk about it matter-of-factly or gets defensive or tries to tell you some shit about energy healing preventing STIs, DO NOT HAVE SEX WITH THIS PERSON.”

If they don’t believe in germs or are unwilling to educate themselves then they are not a safe person to entrust with your health.

If the other person is uncomfortable, admits to not having been tested, or is scared: Be cautious and decide how much you are willing to guide them: 

• You could offer to send them some resources (like these episodes).

• You could offer to go with them to get tested.

• Be willing to wait until they have educated themself and gotten their results.

• BE CAUTIOUS, though. From our experience, even if someone is willing to learn, there can be a lot of residual baggage and fear which can make a person more likely to gloss over or leave out important details, or to avoid this conversation with other partners.

If you have multiple sexual partners, it can get more complicated to disclose your level of exposure to different STIs:

In order for others to give consent they need to be informed, but at the same time, STIs do carry a lot of social stigma and a partner may not be comfortable with you sharing their status with people they don’t know. 

There isn’t a one-size-fits-all solution to this scenario, but the best case is that everyone is consenting to have enough information shared that others can make informed decisions:

• If they aren’t, you may end up in a situation where there just isn’t an ethical way to proceed, in which case, you may need to limit the types of sexual activity you do.

• Depending on your situation, you may find a way to disclose that you do occasionally sleep with someone with a certain STI and explain what precautions would be taken in that situation without being specific about who it is. In certain situations this may not feel possible or ethical.

• It’s important to start this process early because if you’re trying to rush this conversation an hour before you’re going to have sex with someone and you haven’t had time to check with other partners about their comfort with you disclosing their status then you may be tempted to omit or to expose someone’s private information without their permission.

Options on proceeding

Any sex conversation will be best if the option of not having sex, or at least not having it yet, is a real option on the table, without anyone storming out of the room or whining and guilt-tripping the other person about it.

It is entirely possible to have an amazing relationship that doesn’t ever involve sex. Just keep that option open because it makes the other options even better if you decide on them.

• To start out, realize that there is not a right or wrong answer but that it comes down to each individual’s risk tolerance.

  • Every time we get in a car, have a drink, take drugs, smoke, walk down the street at night, go to a public gathering, or do basically anything, there is some kind of risk involved.

  • In any situation there are things you can do to mitigate that risk and it all comes down to how to evaluate that level of risk and how comfortable you are with those risks.

  • When it comes to sexual health, those risks can also affect other people you care about.

Whoever has the lowest risk tolerance gets their way, no questions asked. They are the one who can change their own mind if and when they decide. Do not try to change it for them.

• If one partner is only comfortable with mutual masturbation then your option is to do that or just decide you don’t want to be sexual with them at all. 

• If their decision is based on a lack of information, you can share that and give them resources to learn more but ultimately they have to take the responsibility for it. You don’t want to be the one who convinced them to take a risk they didn’t want to and then the worst happens.

• Always remember that not having sex is a perfectly valid option, too! Sometimes we forget that.

We asked our listeners how they handle safer sex practices with their partners to see the range of ways people can answer this question:

• A common answer was condoms with everyone except NP:

  • Though also, some examples of using condoms with NP because they don’t with other partners.

  • Some also brought up how being fluid bonded in the past had caused some weird possessiveness and controlling behavior so they don’t do it anymore.

  • Switching between using barriers or not based on partners’ other sexual experiences (i.e. deciding to stop using barriers with another partner, going from COVID-based polyfidelity to dating again, etc.).

• Sharing STI results and requesting them from partners (clarifying that important info will be shared with others in the polycule).

• Frequency of testing may change based on behavior and number of people in their sexual network.

• Some share even more health information like vaccination status, mental health diagnoses and medications, STIs, etc.

• Some also just have some basic policies in place like using condoms (external or internal) for penetration but don’t have a specific requirement for sexual health talk or testing (and don’t expect their partners to either).

• Generally people who take more risks are also getting tested more often (every 3-4 months).

These last two episodes had a LOT of information to take in, but it’s all vital to being healthy and informed when it comes to sexual wellness.