Whether you are gay, bi, or just have sex with other men, it is important to learn what safer sex is all
about. Safer sex is not about eliminating passion and excitement
from your sex life. It just means reducing your risk of acquiring
HIV infection and other sexually transmitted diseases (STDs) while
showing respect and concern for yourself and your partner.
Remember, if you do not have anal, oral or vaginal
sex, and if you have never shared injection equipment, you have
almost no risk of HIV infection. If you are in a mutually monogamous
relationship where you are both certain you are HIV-free and have
never shared injection equipment, you also at minimal risk for HIV
infection. Even with these precautions, however, there can still
be a risk of contracting some viral STDs such as genital warts and
herpes because just skin to skin contact, without any penetration,
may pass these infections between partners.
The good news is that you can usually avoid getting
most STDs and you can minimize your risk of getting HIV.
How can I practice safer sex?
HIV is found in high enough concentrations to cause
infection in the following bodily fluids of infected individuals:
blood, semen, pre-ejaculate, vaginal fluids and breast milk. To
keep from contracting the virus, you will need to keep these fluids
outside of your body.
Safer sex is about making choices. Here are several
sexual activities on a risk continuum. Based on this information,
you can choose what to incorporate into your sex life.
Risk Continuum:
No risk
- abstinence
- fantasy
- masturbating self
- massage
- casual kissing
- masturbating each other
- Moderate risk
- intimate kissing
- oral-anal contact
- rubbing penises together
- oral sex on a man without ejaculation
High risk
- oral sex on a man with ejaculation
- vaginal sex
- insertive anal sex
- receptive anal sex
- sharing injection drug equipment
These guidelines are the same for those with or without HIV. If
you are HIV positive, safer sex can protect you from re-exposure
and from getting other STDs. You can still be sexual, be loved and
love others!
Outercourse
Being physically intimate can take many forms.
One way to describe sexual activity that doesn't include intercourse
is the term outercourse. There are a lot of other things besides
intercourse that you can do that are safe and exciting: warm oil
massage, phone sex, body rubbing, erotica, fantasy, sex talk, role
plays, lots of touching, hugging and cuddlinguse your imagination!
Masturbation
Masturbation alone, with a friend, or in a group
is also very safe as long as the ejaculate or pre-ejaculate doesn't
go into another person's mouth, anus, vagina or on broken skin.
Using Sex Toys
Using sex toys is a fun and creative way to practice
safer sex. Just make sure that you don't share toys or if you do,
use a fresh condom on the toy in between partners.
How safe is oral sex?
While there is much debate on this topic there
have been a few, but significant, number of case reports documenting
HIV infection through oral sex. So, while some men have misconceptions
about how infection can be prevented-such as thinking that "acid
in the stomach will kill any HIV"- or that "saliva always
kills HIV"- the bottom line is that unprotected oral sex can
put you at risk for infection.
Having oral sex while using a latex condom is considered safe behavior.
If you choose not to use a condom while having oral sex you can
reduce the risk of contracting HIV by minimizing contact with pre-ejaculate
or ejaculate (for example, by licking just the shaft of the penis
and not the head and by avoiding ejaculation into the mouth). Remember,
this is all on a continuum and any time pre-ejaculate or ejaculate
comes into contact with a mucous membrane (mouth, anus or broken
skin), there is a risk of contracting HIV.
What about anal sex?
Unprotected anal sex is extremely risky. If you
have anal sex, use a latex condom and lots of lubrication. Don't
use oil-based lubricants (Vaseline, baby oil, hand lotion) because
they can weaken latex. Instead, use water-based lubricants, like
Astroglide or H-R lubricating jelly. Avoid natural skin or lambskin
condoms as they have been shown to be porous and allow transmission
of viruses.
The Debate About Spermicides
Both clinical and laboratory studies used to show
that nonoxynol-9 (N-9), the active ingredient in most spermicides,
can kill or greatly inhibit several pathogens that cause STDs. However,
recent new studies have concluded that N-9 may be the culprit that
puts one at greater risk, so don't use it!
If a person using a spermicide experiences any
itching, burning or allergic reaction then he or she should stop
using spermicides. This is because irritated tissue may allow for
HIV to enter the body more easily. If spermicides are used without
skin reactions then the recommended amount is one teaspoon for every
act of intercourse, an amount about the diameter of a quarter.
For men who have sex with women
If you choose to have sex with a women, the same
guidelines apply. Treat vaginal fluids in the same way you would
treat semen and be safe by keeping her vaginal or menstrual fluids
outside of your body, including your mouth.
What about other activities?
Rimming
Rimming (oral-anal stimulation) is lower risk for
HIV transmission as compared to anal or vaginal sex, but higher
risk for the transmission of hepatitis A and parasites. Rimming
can be made safer by using a latex barrier between the mouth and
the anus. This can include a cut up condom, a latex square, or even
plastic food wrap.
Making a latex barrier from a condom:
You can construct a latex barrier using a condom
in three easy steps. Hint: an unlubricated mint-scented condom works
great!
- remove the condom from the package
- use scissors to snip it up the middle
- unroll it
- Fisting
For fisting, use latex surgical gloves and make
sure that you don't insert your fist past the length of the glove.
Keep fingernails trimmed and smooth so they won't rip the glove.
Using lots of water-based lubricant will also help prevent the latex
from breaking and minimize damage to tissue.
What about alcohol, other drugs and sexual decision-making?
It is important to limit your intake of alcohol
and other drugs, as they impair one's sexual decision making ability
and weaken the immune system. Staying sober and not getting high
is part of safer sex; only when you are sober and not using drugs
do you have the ability to make good judgments!!!
This information produced by:
Health Promotion and Community Relations Department
University Health Services (a Div. Of the Office of Student Affairs)
207 Fletcher Street, Ann Arbor, MI 48109-1050
Copyright © 1996 by the University of Michigan; revised 5-98
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