SAFER SEX

Why Have Safer Sex?

Types of Sex

Maintaining a healthy, active and fun sex life is important to many people
and can have many positive benefits for your overall health and wellness.
But it’s hard to enjoy sex when you’re stressed out, particularly if you’reconcerned about the spread of HIV and other sexually transmitted infections(STIs). While there will always be some level of risk involved with having
sex, this guide is designed to help you minimize those risks and ease youranxiety by providing practical information about safer sex.

Now that you’ve learned about the importance of having safer sex, it’s time
to explore some different types of sex, the risks associated with each, andthe variety of ways you can protect yourself. By following these easy tips,
you can lead a healthy and active sex life while also reducing your risk ofgetting or transmitting HIV and other STIs.

Specifically, this guide will:► Provide a brief overview of the importanceof having safer sex► Outline the risks associated with particular
types of sex, and► Offer practical suggestions on how to protect
yourself and your partner(s) from the spreadof HIV and other STIs.
Let’s Talk About Sex!

The first step you can take toward having safer, moreenjoyable sex is to talk about it. Many of us are told froman early age that sex isn’t something you discuss. However,people who make a point of regularly speaking with theirpartner(s) about sex often find it becomes much easier tohave these discussions. Talking to your partner(s) about thetypes of sex you like to have—and the steps you can taketo protect yourself—is an opportunity to build trust andalleviate concerns.
Talking to your partner(s) about sex also gives you thechance to establish consent, which is the important, mutual
agreement between two or more people to engage in sexual
activity. Sex can be a particularly vulnerable experiencefor some people. Asking your partner(s) for consent isimperative and will go a long way toward helping everyone
feel safe and sexy.
1

Sex with Fingers & Hands

Fingers and hands are often used during sex to stimulate
certain areas of a partner’s body, including the penis, vagina
or anus (i.e., “fingering,” “fisting,” “giving a handjob”).
Safer Sex Tips:► Trim and file your nails before engaging in sexual activity.
Also, take off any jewelry that may get in the way.
► Use gloves! Latex or vinyl gloves can reduce your risk ofinfection.
► Use lots of lube to prevent micro-tears and increase
partner satisfaction. (Read further for a discussion on thebest types of lube to use).
► Use a different hand or glove than the one used on yourself
to touch or penetrate your partner.

Sex with Toys

Some people enjoy using toys such as dildos, vibrators andbutt plugs when having sex. To make sex with toys safer,try to avoid sharing toys that have been exposed to bloodor other bodily fluids such as semen or vaginal fluids, as
doing so can increase the risk of transmitting an STI. If you
do share a sex toy with your partner(s), be sure to clean it
thoroughly in-between uses with a mixture of bleach andwater. However, it’s important to note that leather sex toys
cannot be cleaned with bleach and water. In those cases, you
should follow the manufacturer’s instructions.
Safer Sex Tips:► Wash non-leather sex toys with a mixture of bleach andwater in-between uses.
► Consider placing a condom on sex toys used for penetrative
types of sex.

2

Oral Sex on a Vagina or an Anus

Some people enjoy using their mouth to stimulate a partner’s
vagina, vulva or clitoris (i.e., “cunnilingus”), or a partner’s
anus (i.e., “rimming,” “analingus”). To make performing
oral sex on a vagina/anus safer, avoid engaging in this typeof sexual activity if someone has bumps, sores or is bleedingfrom their vagina/anus, as doing so can put you and yourpartner at increased risk for contracting an STI. You should
also avoid receiving oral sex from someone who has bumps,
sores or is bleeding from their mouth.
Safer Sex Tips:► Place a latex dam (i.e., “dental dams”), plastic food wrap,
or a cut-open condom over the vulva/anus. Drop the barrier?
Get a new one.
► Place non-flavored lube on the inside of the dam and flavoredlube on the outside for increased safety and pleasure.

Oral Sex on a Penis

Some people enjoy using their mouth to stimulate a partner’spenis (i.e., “fellatio,” “giving a blowjob”). To makeperforming oral sex on a penis safer, avoid engaging in thistype of sexual activity if someone has bumps, sores, or isbleeding from their penis, as doing so can put you and yourpartner at increased risk for contracting an STI. You should
also avoid receiving oral sex from someone who has bumps,sores or is bleeding from their mouth. It's also important tonote that swallowing the penis (i.e., “deep throating”) canirritate the lining of the throat, making it easier to get ortransmit an STI.
Safer Sex Tips:► Place a condom over the penis.
► Try using flavored condoms for increased pleasure.

Sex with Vaginal or Anal Penetration

Some people enjoy engaging in vaginal or anal penetration(i.e., “intercourse”). To make sex with vaginal or anal
penetration safer, avoid engaging in this type of sexual
activity if someone has bumps, sores, or is bleeding fromtheir genitals—including cuts, scrapes and menstrual
blood, as doing so can make it easier to spread an STI.
Additionally, it’s important to keep in mind that thereceptive partner in vaginal or anal sex (e.g., “the bottom”)
is generally at higher risk for contracting STIs than theinsertive partner (e.g., “the top”). Therefore, open and honest
communication—and consent—is critical to having safer
vaginal or anal sex.
Safer Sex Tips:► Use a condom. Be sure to check the expiration date on thecondom wrapper, as expired condoms are more likely tobreak during sex.
► Never use more than one condom on a penis at one time.
Wearing one condom over another increases friction, whichmakes it more likely for both condoms to break during sex.
► Use lube. Lube reduces friction, which makes it easier forthe condom to stay intact during sex. (Read further for adiscussion on the best types of lube to use.)► Make sure to put the condom on correctly. The tip of thecondom should be facing upwards as it is rolled onto the penis.
► Pinch the tip of the condom after putting it on. This will
leave space to collect the semen (i.e., “cum”), which will
help prevent the condom from breaking.
► Hold onto the base of the condom while the penis is pulled out.
This way, semen won’t spill onto your partner.
► Use a new condom with each new sex act and each new partner.

Sex without Penetration

Some people enjoy having sex by rubbing their genitals, or
penis and anus, together without any sort of vaginal or anal
penetration (i.e., “rubbing,” “dry humping”).
Safer Sex Tips:► Put a latex dam or long piece of plastic wrap between you andyour partner if rubbing vulvas together.
► Use a condom and lube if rubbing a penis against a vulva, anusor another penis.

34

Safer Sex and STIs

The term “sexually transmitted infection” or “STI” is one that is often casually thrownaround, but rarely understood. STIs are infections that are passed from person to person
through direct or indirect sexual contact and can cause serious health problems if left
ignored. There are many different kinds of STIs, and they are incredibly common. In fact,
110 million Americans are thought to have an STI at any given point in time.
You can get an STI by having sex or other intimate contact with someone who alreadyhas an infection. Many people often do not know they have an STI because so few STIs
produce recognizable symptoms. Fortunately, many STIs are treatable and even curable.
For example, bacterial STIs such as syphilis, gonorrhea and chlamydia can be cured withantibiotics.
Some viral STIs such as HIV, herpes and HPV cannot be cured with antibiotics. But there
are medications you can take to prevent them from seriously damaging your health, which
can reduce the likelihood of passing on an infection. The only viral STI that can currently
be cured with medication is hepatitis C. Ultimately, the only way to know if you have an
STI is to get tested early and often.

See the chart to learn which types of sex can put you
at risk for potentially contracting one or more STIs.
Contracting an STI causes many people to feel embarrassed and ashamed. However, it’s
important to remember that STIs are incredibly common, and most are easily treatable. Ifyou might have contracted an STI from a sexual partner, be sure to see a knowledgeable
healthcare provider right away.
During your visit, you should try to be as forthcoming as possible with your provider about
your reason for concern. This may require you to talk about your sexual history and recent
partners. Rest assured that everything you disclose to your provider is strictly confidential.
Finally, if you do indeed have an STI, consider notifying your recent sexual partners,
including anyone you might be sleeping with now. Several state and local healthdepartments offer anonymous partner notification services if you don’t feel comfortable
sharing the information with them yourself.
Ultimately, the more you talk about the types of sex you like to have—and learn about
the risks associated with them—the safer you’ll be. Honest communication and healthydecision-making can create the best and safest kinds of sex.

5

Type of Sex

Known Risks *Theoretical Risks

Sex with Toys

► N/A

► Chlamydia► Gonorrhea► Hepatitis A► Herpes► HPV

Sex with Fingers /Hands► N/A► Chlamydia► Gonorrhea► Hepatitis A► Herpes

Oral Sex on a Vagina► Herpes► HPV

Oral Sex on an Anus

► Parasites► Hepatitis A► HPVOral Sex on a Penis► Chlamydia► Gonorrhea► Herpes► Hepatitis B
► HIV
► HPV
► Syphilis► Hepatitis A► Hepatitis C

Sex with Vaginal orAnal Penetration► Chlamydia► Gonorrhea► Herpes► Hepatitis B
► HIV
► HPV
► Pubic Lice
► Scabies► Syphilis► Trichomoniasis► Hepatitis C

Sex without Penetration► Herpes► HPV► Pubic Lice
► Syphilis► Yeast Infection► N/A►

Sources: Planned Parenthood, San Francisco City Health Clinic* There are documented cases of STI transmission.

6Tools & Strategies forHaving Safer Sex
There are many tools that are designed to help you have safer sex.
Consider using one or more of the following tools depending on thetypes of sex you like to have and the risks associated with them.

Barriers
Condoms

When used correctly, condoms greatly reduce the risk ofgetting or transmitting many STIs, including HIV. Condoms
are also effective at preventing pregnancy. Condoms comein many shapes and sizes, so be sure to try out different
kinds to see which ones feel best to you.
Some condom packages will say if the condom inside islubricated or contains a spermicide. Avoid spermicides like
Nonoxynol-9, as they can cause irritation of the vagina, anusand penis, which can increase the likelihood of contracting
an STI. Most condoms are made of latex, but people with alatex allergy should use other kinds, such as polyurethane
condoms. Avoid lambskin condoms because they do notprevent the spread of HIV. Also avoid purchasing condoms
that are too large, as they can fall off during sex.
Insertive condoms, often also called female condoms (orFC2), are condoms that can be placed inside of the vagina
or anus before sex. Insertive condoms are effective inpreventing pregnancy and the spread of STIs. When usedcorrectly, insertive condoms collect semen and prevent
bodily fluids from getting inside of the covered vagina oranus. Insertive condoms are also a great alternative forindividuals allergic to latex.

Lube

Lube can be used when putting a penis, fingers or sex toy
inside a vagina or anus to make sex more pleasurable. Lubealso helps keep a condom or latex barrier from breaking.
Only use water-based or silicone-based lubricants. Oilbased lubricants like Vaseline or massage oils can cause thecondom to break.

Latex Barriers & Plastic Wrap

Latex barriers and plastic food wraps can be used for oral
sex on a vagina or anus and may subsequently prevent the
spread of many STIs. Latex barriers are square pieces ofstretchy plastic.

Gloves

Latex or vinyl gloves can be used when putting fingersinside an anus or vagina to reduce the risk of getting ortransmitting STIs through tiny cuts on your hands or fingers.
78Medicines
Pre-Exposure Prophylaxis (PrEP)

Contraception

Post-Exposure Prophylaxis (PEP)

Vaccines stimulate your immune system to produce
antibodies, exactly like it would if you were exposed to adisease. After getting vaccinated, you develop immunity
to that disease, without having to get the disease first. This
is what makes vaccines such powerful medicine. There
are a few vaccinations that can prevent infections that arespread through intimate, sexual contact with an infected
partner. Getting these vaccinations can be a very importantpart of your overall sexual health and wellness. Talk to aknowledgeable healthcare provider to learn whether one, ormore, of the following vaccines is right for you.

PrEP is an HIV prevention strategy that currently involves
taking a once-daily pill to reduce the chance of acquiringHIV. As of this publication, the only pill that is FDAapproved for PrEP is a prescription medication sold underthe brand name Truvada®. When paired with other safer sex
practices, including condoms, and taken as prescribed by aknowledgeable healthcare provider, PrEP is upwards of 90
percent effective at preventing the spread of HIV. However,it’s important to keep in mind that PrEP does not provide
any protection against other STIs. Just like with otherprescription medications, an important part of taking PrEP
is making appointments with your provider to get routine
STI screenings and other tests to make sure the regimen
is still appropriate.

PEP is an HIV prevention strategy that currently involves
taking HIV medications immediately after a single high-risk
event, such as condomless sex with a partner whose status
you do not know. These medications stop HIV from making
copies of itself and spreading throughout your body. PEP
must be started as soon as possible to be effective, but nomore than 72 hours after you may have been exposed toHIV. Two to three drugs are usually prescribed as part ofPEP treatment, and they must be taken for 28 consecutive
days. PEP does not provide protection against any otherSTIs. If you ever need to take PEP, you might also want toconsider talking to your provider about PrEP.

Staying healthy when you have HIV

Research shows people living with HIV who consistently
take their medication can reduce the risk of passing on thevirus by 96 percent. Therefore, having sex with people
living with HIV who consistently take their medicationand have achieved an undetectable viral load is a highly
effective way to prevent the spread of HIV. Seeing a doctor
regularly and having very low levels of HIV in the body(even though the virus is still there) are keys to staying
healthy for people living with HIV.
9While this document specifically deals with how to reduce
the risk of getting or transmitting HIV and other STIs,
contraception, or “birth control,” can be an important part ofsexual health for some individuals and partners. In addition
to condoms, contraception comes in the form of a pill, shot,patch, intrauterine device (i.e., "IUD") and more. Speak withyour provider about what types of contraception may beright for you.

Vaccinations (Sexual Health)► HPV (Human Papillomavirus) Vaccination
This vaccine protects against many strains of HPV, themost common STI in the U.S. HPV can cause cancer
and/or genital warts if left untreated.
► Hepatitis A Vaccination
This vaccine protects against hepatitis A, a virus that cancause serious illness if left untreated. Hepatitis A
is easily spread through oral-to-anal sexual contact(i.e., “rimming”).
► Hepatitis B Vaccination
This vaccine protects against hepatitis B, another virusthat can cause serious illness if left untreated. Hepatitis
B is spread through contact with blood and bodily fluids
just like HIV, but is much easier to transmit.

10WHITMAN-WALKER HEALTH
Established in 1978, Whitman-Walker Health is a nonprofit, community health center serving the Washington,
DC, metropolitan area. Through four sites in the District ofColumbia, Whitman-Walker Health offers primary medicaland dental care; mental health and addictions counselingand treatment; HIV education, prevention, and testing;legal services; medical adherence case management; andmore. Whitman-Walker Health is committed to meeting thehealth needs of the gay, lesbian, bisexual and transgendercommunity and people living with HIV/AIDS.

HUMAN RIGHTSCAMPAIGN FOUNDATIONThe Human Rights Campaign Foundation improves thelives of lesbian, gay, bisexual, and transgender (LGBT)
people by working to increase understanding and encourage
the adoption of LGBT-inclusive policies and practices. We
build support for LGBT people among families and friends,
co-workers and employers, pastors and parishioners, doctors
and teachers, neighbors, and the general public. Throughvarious programs and projects, we are enhancing the lived
experiences of LGBT people and their families as we change
hearts and minds across America and around the globe.