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SAFE SEX

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Defining Safe Sex

Safe sex is sexual activity engaged in by people who have taken precautions to protect themselves against sexually transmitted infections (STIs) or sexually transmitted diseases (STDs) such as HIV. It is also referred to as safer sex or protected sex, while unsafe or unprotected sex is sexual activity engaged in without precautions, especially forgoing condom use. Some sources prefer the term safer sex to more precisely reflect the fact that these practices reduce, but do not always completely eliminate, the risk of disease transmission.

Safe sex practices became more prominent in the late 1980s as a result of the AIDS epidemic. Promoting safe sex is now one of the aims of sex education. Safe sex is regarded as a harm reduction strategy aimed at reducing risks. The risk reduction of safe sex is not absolute; for example, the reduced risk to the receptive partner of acquiring HIV from HIV-seropositive partners not wearing condoms compared to when they wear them is estimated to be about a four to fivefold.

Although some safe sex practices can be used as birth control (contraception), most forms of contraception do not protect against STIs (or STDs).  Likewise, some safe sex practices, like partner selection and low-risk sex behavior, are not effective forms of contraception but should be considered before engaging in any form of intercourse to reduce risk.

WebMD: Preventing STDs with Safe Sex

HIV Equal: 7 Different Ways to Have Safe Sex

Info: Health and Medical Concerns

Better Health: Safe Sex

Info: Sexual Activity

Tips for Dating When You’re HIV Positive

Naked Truth: Sex Can Be Infectious

WebMD Slideshow: Cleaning Up After Sex

Highest STI Rates in the US

These 50 cities have the highest STI rates in the US

A new analysis of data from the CDC has produced a list of the 50 metropolitan areas with the highest STI rates in the US.  As we’ve reported before, STI rates have continued to increase over the last decade. While HIV transmission has eased somewhat, rates of chlamydia, gonorrhea and syphilis have rocketed. Gay men are disproportionately impacted.  In 2022, across the US, around 1 in 130 people were diagnosed with an STI. However, that’s the average. In some locations, the number was far greater.

The worst place for STIs, perhaps surprisingly is Philadelphia. One in 65 residents were diagnosed with an infection in 2022 in the city of brotherly love. This was followed by Memphis (TN), Jackson (MI) and New Orleans, LA. St. Louis (MO), rounded off the top five.  In terms of gay hotspots, San Francisco (CA) came in eighth place.

If you want to move somewhere with low STD rates, placing 100th in the ranking is Provo, Utah. The city has a high Mormon population, and only 300 out of every 100,000 residents were diagnosed with an STD (well below the 751 average or the 1,504 per 100k in Philadelphia).

Oraquick: The Musical

Queer Artists Changing Our View of Sexual Health

Fabulous Approach to Promoting LGBTQ Health

Planned Parenthood: Safer Sex

Condoms and Birth Control

Tips for Dating When You’re HIV Positive

WebMD Slideshow: Cleaning Up After Sex

Condoms and Birth Control

The top 50 cities (with case numbers per 100,000 residents) is as follows...

The southern states are disproportionately represented. Seventeen of the top 25 cities are in the south. This trend has previously been noted in regard to HIV transmission.

Baltimore is missing from the list. The previous year, it ranked no. 4 on this list. Data was not available for Baltimore for this recent study.

STI rates dipped in 2020 because of the Covid pandemic. However, the 2022 figures showed a return to pre-Covid levels. There were 710,000 new cases of gonorrhea, and 1.6 million of chlamydia, while syphilis rates have risen by 28.6 percent in just a year.

Gay men are advised to have a sexual health check-up at least once a year, regardless of whether they have any symptoms. If you have multiple partners, get tested once every three months.
 

[Source: Centers for Disease Control & Prevention, May 2024]

WebMD: Preventing STDs with Safe Sex

Info: Health and Medical Concerns

HIV Equal: 7 Different Ways to Have Safe Sex

Info: AIDS/HIV

Better Health: Safe Sex

Info: Sexual Activity

Naked Truth: Sex Can Be Infectious

Questions About HIV You've Been Afraid to Ask

CDC Report: Top Three STDs

Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, according to preliminary data released by the Centers for Disease Control & Prevention (CDC) at the National STD Prevention Conference in Washington, DC. 
 

Chlamydia, gonorrhea, and syphilis are curable with antibiotics, yet most cases go undiagnosed and untreated — which can lead to severe adverse health effects that include infertility, ectopic pregnancy, stillbirth in infants, and increased HIV risk. Prior studies suggest a range of factors may contribute to STD increases, including socioeconomic factors like poverty, stigma, and discrimination; and drug use.

[Source: Centers for Disease Control & Prevention, September 2018]

CDC Press Release: Steep Increase in STDs

CDC Help: What To Do If You Test Positive for Gonorrhea or Chlamydia

CDC Info: What Are STDs?

Safe Sex Information

Safe sex is all about protecting yourself and your partners from sexually transmitted infections. Safe sex helps you stay healthy and can even make sex better.

STDs are infections that are passed from one person to another during sexual activity. Anybody who has oral, anal, or vaginal sex, or genital skin-to-skin contact with another person can get STDs. Safe sex means taking steps to protect yourself and your partner from STDs when you have sex.

Oraquick: The Musical

Queer Artists Changing Our View of Sexual Health

Fabulous Approach to Promoting LGBTQ Health

Planned Parenthood: Safer Sex

Condoms and Birth Control

Tips for Dating When You’re HIV Positive

WebMD Slideshow: Cleaning Up After Sex

Condoms and Birth Control

There are lots of ways you can make sex safer. One of the best ways is by using a barrier (like condoms, female condoms, dental dams) every single time you have oral, anal, or vaginal sex. Barriers cover parts of your genitals, protecting you and your partner from body fluids and some skin-to-skin contact, which can both spread STDs. 

Getting tested for STDs regularly is also part of safe sex, even if you always use condoms and feel totally fine. Most people with STDs don’t have symptoms or know they’re infected, and they can easily pass the infection to their partners. So testing is the only way to know for sure whether or not someone has an STD.

Getting tested protects you by letting you know if you DO have an STD, so you can get the right treatment to stay healthy and avoid giving it to other people.

Sticking to sexual activities that don’t spread STDs (like outercourse or mutual masturbation) is a great way to safely get sexual pleasure and be intimate with another person. But if you’re taking off underwear and touching each other or having any kind of sex, using barriers is the safer way to go.

Another way to make sex safer is to avoid drinking too much alcohol or doing other drugs. Getting wasted can make you forget how important safer sex is, and you may accidentally make decisions that increase your chances of getting STDs. It’s also harder to use condoms correctly and remember other safer sex basics when you’re drunk or high.

The only way to be totally sure you won’t get an STD is to never have any kind of sexual contact with another person. But that doesn’t work for the vast majority of people. Most of us are sexually intimate with other people at some point in our lives. So if you’re going to have sex, making it safe sex is the best way to help you avoid getting or passing an STD.

[Source: Planned Parenthood]

Planned Parenthood: Safer Sex

Info: AIDS/HIV

WebMD Slideshow: Cleaning Up After Sex

Condoms and Birth Control

Tips for Dating When You’re HIV Positive

Top STIs and How to Treat and Avoid Them

Wikipedia: Safe Sex Defined

Info: Sexual Activity

WebMD: Understanding STD Prevention

FDA Approves First Condom Specifically for Anal Sex

How Do You Get STDs?

STDs are usually passed from one person to another during oral, anal, or vaginal sex. There are lots of different STDs. Some are carried in body fluids like semen, vaginal fluids, and blood. Others can be passed just from skin-to-skin touching with an infected body area. Using barriers like condoms and dams helps you avoid contact with fluids and some types of skin-to-skin contact during sex. So when you don’t use condoms, your chance of getting an STD goes up.

All STDs can infect your genitals. Vaginal or anal sex without a condom has a high risk for passing:

Some STDs can also infect your lips, mouth, and throat. Oral sex without a condom or dam has a high risk for passing: herpes, syphilis, gonorrhea, HPV, hepatitis B.

Some STDs can be passed even if there’s only some skin on skin action with no fluids passed. Genital skin-to-skin contact can spread: herpes, HPV, pubic lice, scabies.

[Source: Planned Parenthood]

WebMD: Preventing STDs with Safe Sex

Info: Health and Medical Concerns

HIV Equal: 7 Different Ways to Have Safe Sex

Info: AIDS/HIV

Better Health: Safe Sex

Info: Sexual Activity

Naked Truth: Sex Can Be Infectious

Questions About HIV You've Been Afraid to Ask

Types of Safe Sex Activity

Are some kinds of sex safer than others? Yes. There are even a few totally risk-free ways to get sexual pleasure and be intimate with another person, like masturbating, and dry humping (grinding) with clothes on.

Low risk activities include kissing, touching your partner’s genitals with your hands, using sex toys with a partner, dry humping (grinding) without clothes, and oral sex. But it’s still possible to get certain STDs from these things, so using condoms and dams to avoid contact with skin and fluids whenever you can helps you stay healthy.

Wikipedia: Safe Sex Defined

WebMD: Preventing STDs with Safe Sex

HIV Equal: 7 Different Ways to Have Safe Sex

Better Health: Safe Sex

HIV Equal: 7 Different Ways to Have Safe Sex

Top STIs and How to Treat and Avoid Them

FDA Approves First Condom Specifically for Anal Sex
US Dept of Health & Human Services: Reducing Risk With PrEP
Naked Truth: Sex Can Be Infectious

Questions About HIV You've Been Afraid to Ask

Having vaginal or anal sex without a condom is super risky. You can get any and all STDs from unprotected vaginal or anal sex. The best way to protect yourself if you’re going to have vaginal or anal sex is use a condom every single time. Using lube with that condom also makes sex safer, especially anal sex.

When it comes to HIV, oral sex is much safer sex than vaginal or anal sex. But other infections, like herpes, syphilis, hepatitis B, gonorrhea, and HPV, can be passed during oral sex. So no matter what kind of sex you have, use condoms or dams to make it safer.

If I have an STD, how can I have safe sex?  If you find out that you have an STD, it’s important to know how to have safe sex and avoid passing it on. Luckily, many STDs can be easily cured with medication, so once you finish treatment, you don’t have to worry about giving your STD to anyone.

Planned Parenthood: Safer Sex

WebMD Slideshow: Cleaning Up After Sex

Condoms and Birth Control

Wikipedia: Safe Sex Defined

Info: Sexual Activity

WebMD: Understanding STD Prevention

FDA Approves First Condom Specifically for Anal Sex

And even though some STDs can’t be cured, there are ways to treat your symptoms and help avoid giving your STD to people you have sex with. Depending on what STD you have, there are things you can do to protect your partners. Here’s a handy checklist:

--Always use condoms and dental dams during oral, anal, and vaginal sex — whether or not you have an STD.

--Don’t have sex at all if you have any STD symptoms (like sores or warts around your genitals, weird discharge from your penis, vagina or anus, or itching, pain, irritation and/or swelling in your penis, vagina, vulva, or anus).

--Go see a doctor or nurse so they can start treating your STD as soon as possible.

--If you have a curable STD (like gonorrhea, chlamydia, or syphilis), take all of your medication the way your doctor tells you to, even if your symptoms go away sooner. The infection stays in your body until you totally finish the treatment. Your partner(s) should also be treated at the same time. Don’t have sex at all until you both finish your treatment, and your doctor or nurse says it’s OK.

--If you have an STD that can’t be cured (like HIV or herpes), talk with your doctor about medicines that can help lower your chances of spreading it to a partner. Depending on what STD you have and where it is, you may need to use condoms/dams every time you have oral, anal, and/or vaginal sex.

--Always tell your sexual partners that you have an STD before you have sex, so you can work together to make a safe sex plan and help prevent it from spreading. It’s not the easiest conversation, but it’s an important one.

[Source: Planned Parenthood]

Planned Parenthood: Safer Sex

Info: AIDS/HIV

Condoms and Birth Control

Tips for Dating When You’re HIV Positive

Wikipedia: Safe Sex Defined

Top STIs and How to Treat and Avoid Them

WebMD: Preventing STDs with Safe Sex

HIV Equal: 7 Different Ways to Have Safe Sex

Better Health: Safe Sex

Outercourse vs. Intercourse

Outercourse is other sexual activities besides vaginal sex. Sexual abstinence and outercourse can mean different things to different people.

Non-penetrative sex or outercourse is sexual activity that usually does not include sexual penetration. It generally excludes the penetrative aspects of vaginal, anal, or oral sexual activity, but includes various forms of sexual and non-sexual activity, such as frottage, mutual masturbation, kissing, or cuddling. Some forms of non-penetrative sex, particularly when termed outercourse, include penetrative aspects, such as penetration that may result from forms of fingering or oral sex.

People engage in non-penetrative sex for a variety of reasons, including as a form of foreplay or as a primary or preferred sexual act. Heterosexual couples may engage in non-penetrative sex as an alternative to penile-vaginal penetration, to preserve virginity, or as a type of birth control. Same-sex couples may also engage in non-penetrative sex to preserve virginity, with gay males using it as an alternative to anal penetration.

Although sexually transmitted infections (STIs/STDs) such as herpes, HPV, and pubic lice can be transmitted through non-penetrative genital-genital or genital-body sexual activity, non-penetrative sex may be used as a form of safer sex because it is less likely that body fluids (the main source of STI/STD transmission) will be exchanged during the activities, especially with regard to aspects that are exclusively non-penetrative.
 

Abstinence and Outercourse

Overview of Outercourse Sexual Activity

Outercourse Techniques

Questions About Outercourse

Outercourse: Non-Penetrative Sex

Pre-Exposure Prophylaxis

Pre-exposure prophylaxis, or PrEP, is a way for people who do not have HIV but who are at substantial risk of getting it to prevent HIV infection by taking a pill every day. The pill (brand name Truvada or Descovy)) contains two medicines (tenofovir and emtricitabine) that are used in combination with other medicines to treat HIV. When someone is exposed to HIV through sex or injection drug use, these medicines can work to keep the virus from establishing a permanent infection.

When taken consistently, PrEP has been shown to reduce the risk of HIV infection in people who are at high risk by up to 92%. PrEP is much less effective if it is not taken consistently. PrEP is a powerful HIV prevention tool and can be combined with condoms and other prevention methods to provide even greater protection than when used alone. But people who use PrEP must commit to taking the drug every day and seeing their health care provider for follow-up every 3 months.  Truvada and Descovy are manufactured by Gilead Sciences.

Descovy for PrEP

CDC: Pre-Exposure Prophylaxis

Facts and Info: What is PrEP?

US Dept of Health & Human Services: Reducing Risk With PrEP

Dental Dams

Dental dams are for use during cunnilingus and anilingus, especially for women who have sex with women. After lubrication with a water-based lubricant, an unpunctured dental dam may be held over the vulva or anus, allowing oral stimulation of these areas without transmission of bodily fluids and direct physical contact. Condoms can be turned into dental dams if they are properly cut.

A dental dam, like a condom, is a barrier method. It is a thin, square piece of rubber which is placed over the labia or anus during oral-vaginal or oral-anal intercourse.

Dental dams are most often made of thin latex or silicone. Although specially-made rubber dental dams are sold in stores, clear plastic wrap from your kitchen can serve as an effective dental dam as well. A dental dam can help reduce the risk of STD transmission, including herpes, genital warts (HPV), and HIV.

Queer Girls, Dental Dams, and STIs

CDC: How to Use a Dental Dam

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