Safe sex
From Wikipedia, the free encyclopedia
Safe sex (also called safer sex or protected sex) is a set of practices that are designed to reduce the risk of infection during sexual intercourse to avoid developing sexually transmitted diseases (STDs). Conversely, unsafe sex refers to engaging in sexual intercourse without the use of any barrier contraception or other preventive measures against STDs.
Safe sex practices became prominent in the late 1980s as a result of the AIDS epidemic. From the viewpoint of society, safer sex can be regarded as a harm reduction strategy. Safe sex is about risk reduction, not complete risk elimination.
Although safe sex practices can be used as a form of family planning, the term refers to efforts made to prevent infection rather than conception. Many effective forms of contraception do not offer protection against STIs.
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[edit] Terminology
Recently, and mostly within Canada and the United States, the use of the term safer sex rather than safe sex has gained greater use by health workers, with the realization the grounds that risk of transmission of sexually transmitted infections in various sexual activities is a continuum rather than a simple dichotomy between risky and safe. However, in most other countries, including the United Kingdom and Australia, the term safe sex is still mainly used by sex educators. Because these terms are virtually synonymous with each other, they will be used interchangeably throughout this article.
[edit] Focus on HIV/AIDS
Much attention has focused on controlling HIV, the virus that causes AIDS, through the use of condoms, but each STI presents a different predicament. However, sex educators recommend that some form of barrier protection as a harm reduction measure should be used for all sexual activities which might potentially result in the exchange of body fluids.
[edit] Safe sex precautions
[edit] Abstinence
One way to avoid the risks associated with sexual contact is to abstain from sexual activity entirely, which nearly eliminates the chances of contracting STIs (the only alternative methods of infection being non-sexual as described below). This approach is advocated by the members of many religions who oppose sex outside marriage, and is sometimes encouraged by the promotion of virginity pledges and sexual abstinence education for teenagers in lieu of providing information on contraceptives. This tends to place some teenagers at higher risk of unintended pregnancy and sexually transmitted disease (STD), because it is estimated that 60% of teenagers who pledge virginity until marriage will break their pledge, and are then one-third less likely than teenagers who have not made such a pledge to use contraceptives once they do become sexually active.[1]
However, so-called sexually transmitted infections may also be transmitted non-sexually, and therefore, abstinence from sexual behavior does not guarantee 100% protection against sexually transmitted infections. For example, HIV may be transmitted through contaminated needles which may be used in tattooing, body piercing, or injections. Health-care workers have acquired HIV through occupational exposure to accidental injuries with needles.[2]
[edit] Masturbation
Solitary masturbation (including "phone sex" and "cybersex") is a safe form of sexual activity, so long as contact is not made with other people's discharged bodily fluids.
[edit] Issues related to anal sex
Anal sex is a high risk activity. Although in the minds of many people it is closely associated with homosexuality and with HIV/AIDS, in fact:
- "Research strongly suggests that anal sex carries a greater risk of HIV transmission than does vaginal sex. Most people automatically assume that anal sex is just a gay male thing, but behavioral research shows otherwise. While heterosexuals are much less likely than gay men to engage in anal sex, there are simple so many more of them that the total amount of heterosexual [anal sex] likely is several-fold that of gays.
- "Even more troubling is the fact that straight couples appear to be much less likely to use condoms when they have anal sex then when they have vaginal sex. That is because they tend to think of condom use in terms of preventing pregnancy rather than preventing disease." [1]
[edit] Caution
Acknowledging that it is usually impossible to have entirely risk-free sex with another person, proponents of safer sex recommend that some of the following methods be used to minimize the risks of STI transmission and unwanted pregnancy.
- Monogamy or polyfidelity, practiced faithfully, is very safe (as far as STIs are concerned) when all partners are non-infected. However, many monogamous people have been infected with sexually transmitted diseases by partners who are sexually unfaithful, have used injection drugs, or were infected by previous sexual partners; the same risks apply to polyfidelitous people, who face slightly higher risks depending on how many people are in the polyfidelitous group.
- Communication with one's sexual partner(s) makes for greater safety. Before initiating sexual activities, partners may discuss what activities they will and will not engage in, and what precautions they will take. This can reduce the chance of risky decisions being made "in the heat of passion".
- For those who are not monogamous, reducing the number of one's sexual partners, particularly anonymous sexual partners, may also reduce one's potential exposure to STIs. Similarly, one may restrict one's sexual contact to a community of trusted individuals - this is the approach taken by some pornographic actors and other non-monogamous people.
- Refraining from the use of recreational drugs, including alcohol, before and during sexual activity can protect against associated risks such as lowered inhibitions, impaired judgement, and loss of consciousness.
[edit] Fluid exchange
Various devices are used to avoid contact with blood, vaginal fluid, and semen during sexual activity:
- Condoms cover the penis during sexual activity. They are most frequently made of latex, but can also be made out of polyurethane. Polyurethane is thought to be a safe material for use in condoms, since it is nonporous and viruses cannot pass through it. However, there is less research on its effectiveness than there is on latex.
- Female condoms are inserted into the vagina prior to intercourse. They may also be used for anal sex, although they are less effective.
- A dental dam (originally used in dentistry) is a sheet of latex used for protection when engaging in oral sex. It is typically used as a barrier between the mouth and the vagina during cunnilingus or between the mouth and the anus during anilingus. A piece of plastic wrap may be used as a dental dam; Plastic wrap has been tested by the Food and Drug Administration and CDC and found effective in preventing the transmission of virus-sized particles, although "microwave-safe" wrap may be ineffective [citation needed]. Latex condoms can also be cut to form an improvised dental dam.
- Medical gloves made out of latex, vinyl, nitrile, or polyurethane may be used as an ersatz dental dam during oral sex, or to protect the hands during mutual masturbation. Hands may have invisible cuts on them that may admit pathogens that are found in the semen or the vaginal fluids of STD infectees. Although the risk of infection in this manner is thought to be low [citation needed], gloves can be used as an extra precaution.
- Another way to avoid contact with blood and semen is outercourse (non-penetrative sex), or forms of penetration that do not involve a penis, such as the use of dildos (when cleaned or covered with condoms).
Fluid bonding is the practice of those who intentionally expose themselves to their partner's bodily fluids, to increase their physical intimacy. This practice can only be safe in conjunction with strict monogamy or polyamory.
[edit] Ineffective methods
Note that most methods of contraception other than the barrier methods mentioned above are not effective at preventing the spread of STIs.
The spermicide Nonoxynol-9 has been claimed to reduce the likelihood of STI transmission. However a recent study by the World Health Organization [2] has shown that Nonoxynol-9 is an irritant and can produce tiny tears in mucous membranes, which may increase the risk of transmission by offering pathogens more easy points of entry into the system. As a result condoms with a Nonoxynol-9 lubricant are not to be promoted.
Coitus interruptus (or "pulling out"), in which the penis is removed from the vagina, anus, or mouth before ejaculation, is not safe sex and can result in STI transmission. This is because of the formation of pre-ejaculate, a fluid that oozes from the urethra before actual ejaculation. In opposition to conventional wisdom, some recent studies awaiting confirmation suggest that pre-ejaculate may not contain sperm; it does, however, contain pathogens such as HIV.[3][4] In addition, open sores on either partner can permit transmission, as can microscopic breaks in the skin which arise due to friction, or other irregularities in the skin of either partners genitalia or other body parts. This does reduce the chance of STI transmission, however, and is sometimes recommended as a harm reduction strategy for those habitually engaging in unsafe intercourse.
[edit] Controversy
Some conservatives object to safe sex programs because they believe that providing education about condom use and other protective measures promotes non-procreative and promiscuous sex. As an alternative, they endorse abstinence before marriage and monogamy during marriage, arguing that this is the only reliable way to stop STIs. Many safe sex advocates believe that harm reduction is more practical than merely exhorting people to avoid having sex outside of marital relationships.
Some governments and organisations have been criticised heavily for promoting their beliefs in their HIV/AIDS programmes. UNFPA's request for $28 million to offer birth control to Tsunami survivors is just one example. [3]
[edit] References
- ^ Recent Findings from The 'Add Health' Survey: Teens and Sexual Activity
- ^ Do AN, Ciesielski CA, Metler RP, Hammett TA, Li J, Fleming PL (2003). "Occupationally acquired human immunodeficiency virus (HIV) infection: national case surveillance data during 20 years of the HIV epidemic in the United States". Infect Control Hosp Epidemiol 24 (2): 86-96. PMID 12602690.
- ^ Researchers find no sperm in pre-ejaculate fluid. Contraceptive Technology Update. Volume 14, Number 10, October 1993, pp.154-6.
- ^ Zukerman, Z. et. al. Short Communication: Does Preejaculatory Penile Secretion Originating from Cowper's Gland Contain Sperm? Journal of Assisted Reproduction and Genetics. Volume 20, Number 4, April 2003, pp. 157-159(3).
[edit] See also
[edit] External links
- Sex: Safer and Satisfying from Planned Parenthood
- "Guide to Safer Sex" from the Society for Human Sexuality's sexuality.org site. Very explicit information on making various sexual practices safer:
- Tiny Nibbles Safer Sex Chart - Presents risk levels of a variety of sexual activities and most major STIs.
- Information and resources on safer sex
- Condoms4Life
- (French) Condom use — with many pictures.
