Safer Sex

Unless you are 100% sure that you and your sexual partner are HIV and STI free – you should practice safe sex techniques to reduce the chance that you might become infected with, or transmit HIV, Hepatitis C, and other STIs.

HIV can be found in the blood, semen, and vaginal fluid of an infected person. Infection can occur if such HIV-infected fluids enter the bloodstream of another person – either through an open sore or wound, during sexual activity, or through the sharing of needles for drug injection, piercing, or tattoos. For more information about HIV transmission click here.

While the only sure way to prevent sexual transmission of HIV is through abstinence or sexual activity that doesn’t involve any direct contact between penis, mouth, vagina, or rectum (such as kissing, erotic massage, masturbation, or mutual masturbation), there are proven ways to reduce the risk of transmitting or contracting the HIV virus and other STIs. If you are engaging in other sexual practices, it is important to know the risks, and practice safer sex techniques to reduce those risks.

RISKS OF SEXUAL ACTIVITY

Unprotected sexual intercourse (either vaginal or anal) with someone who has HIV, is risky. Having sex with someone whose HIV status you do not know is also risky. HIV can enter the vagina or anus through any sores or small tears in mucous membranes (either already existing, or caused by the activity of sex. Inflammation or infection in the vagina, such as that from an STI, increases the risk of contracting HIV.

In both vaginal and anal sex, the receptive partner is more likely to become infected: Receptive anal intercourse carries the highest risk of HIV infection, because the lining of the rectum is very thin and easily damaged; and women are at greater risk of contracting HIV infection than men from vaginal sex.

Oral Sex Though the transmission rate of HIV through oral sex is much less than with vaginal or anal intercourse, oral-genital contact does pose a risk of HIV infection, particularly when ejaculation occurs in the mouth. This risk goes up when either partner has cuts or sores, such as those caused by sexually transmitted infections (STIs), bleeding gums, or canker sores, which can allow the virus to enter the bloodstream.

Rough, Prolonged, or Repeated Sex that injures the skin or mucous membranes can increase the risk of HIV and STI transmission.

Having Another STI Increases the Risk of Transmitting or Becoming Infected With HIV. Many people who are infected with other STIs – including Chlamydia, Human Papillomavirus, and Hepatitis – are not aware of it. For example, sores that occur with other STIs may be painless, or in a place that isn’t visible, or symptoms may not yet have developed – yet infection is still a risk. Also, if you have an STI, your immune system may be weakened, increasing the chance that you will become infected if you are exposed to HIV.

Engaging in Sex With Someone Whose Drug History You Do Not Know is Risky. People who inject drugs and do not use a clean, sterile syringe every time are at extremely high risk for HIV and Hepatitis B and C.

Even if Both You and Your Partner are HIV Positive, You Should Practice Safe Sex to prevent becoming infected with other STIs, or becoming re-infected with a more aggressive or drug-resistant strain of HIV.

Using Drugs and/or Alcohol Greatly Increases the Chances that You Will Engage in Risky Sex. Using drugs or alcohol can affect your judgement and compromise your decision-making capabilities, not only increasing the chance that you will have sex, but that if you do, you may engage in risky sexual practices, such as failing to use condoms, having sex with people you don’t know, having sex with multiple partners, or engaging in sexual practices that are dangerous, or unfamiliar to you.

Using Drugs and/or Alcohol Increases Your Chance of Being Date-Raped or Sexually Victimised. Using drugs or alcohol may impair your judgement, consciousness or mobility, all of which pose a risk of sexual victimisation, even if you are partying with people you know. You can also become a victim of date rape drugs if you are drinking with strangers. To learn more about sexual assault –  please visit our partners at SafeVibe.

HOW TO PROTECT YOURSELF: SAFER SEX TECHNIQUES

Use Condoms, Especially With Causal Partners. Condoms reduce the risk that HIV and other STIs will enter your body through blood or sexual fluids by using a latex condom every time you have sex. Female condoms can be used to protect the vagina or rectum. Using lambskin condoms do not prevent the spread of HIV. If you are allergic to latex, use polyurethane condoms.

Use Only Water-Based Lubricants With Condoms. Oil-based lubricants – including baby oil, Vaseline and cold cream – break down latex and will make latex condoms fall apart. Don’t use expired condoms. Don’t re-use condoms. Put on condoms before any direct genital contact. The fluid that comes out of the penis before orgasm (pre-cum) can carry HIV. Gay men and MSM can find free condom dispensers at gay bars and venues in the Davie Village.

Use Lubricant. Using lube reduces the chance that condoms or other barriers will break. It also reduces the chance of injuring skin or mucous membranes during sex.

Consider Using A Latex Barrier For Oral Sex. Use unlubricated condoms, squares of latex (“dental dams”) or plastic wrap during oral-genital and oral-anal sex.

Learn Your Partner’s Sexual & Drug History. Anyone who has engaged in risky sexual behaviour, or who has injected drugs or had sex with a needle-sharing partner – even once – is at risk for being infected with HIV. Even people who have tested negative might be infected, if they have had risky sex since the test, or if they got tested too soon after being exposed to HIV.

Be Prepared. Have a plan for reducing your risk. Talk to sexual partners about risks, HIV status, and sexual history. Know your limits and stick to them. If you engage in sexual practices that are unfamiliar to you, or are unsure of the risk of a sexual behaviour, practice safe sex techniques.

Be In Charge Of Managing Your Own Protection. If there is any chance at all that you will have sex (planned or unplanned), have condoms and lube and keep them easily accessible. Don’t rely on a partner to provide protection.

Are You An IDU? Always use clean needles. If you don’t, practice safe sex techniques to prevent infecting your sexual partner(s), and get tested for HIV and Hepatitis regularly.

Is Your Partner An IDU? Sharing needles to inject drugs carries the highest risk of HIV infection. It is important to know a sexual partner’s injection history. Hepatitis risk is also high for those who share needles.

STIS & HEPATITIS

The Human Papilloma Virus (HPV)

HPV is a widespread viral infection. In Canada, we estimate that between 20 and 40% of the sexually active population carries HPV. Among gay men and MSM that number is closer to 70%. There are different types of HPV. The most frequent is warts—highly contagious genital warts that are transmitted through direct contact. Warts can also be transmitted by other body parts (fingers, mouth, etc.), or by sex toys that have been in contact with warts. Transmission can also take place through infected genital secretions (pre-ejaculatory liquid, sperm, vaginal secretions), even without penetration.

The shape, size, and colour of warts can vary: they can resemble little cauliflower, a rooster’s comb, small pimples, or flat lesions, with a head ranging from the size of a hairpin or a nut. They can be pink, red, or the same colour as the skin. Warts can be found at the head of the penis, the shaft of the penis, the testicles, on the inside or the outside of the vagina or anus, in the pubic area, or more rarely in the mouth and on the lips. They can cause an irritating sensation, itching or pain.

If you have symptoms similar to the ones listed here, it is essential that you see a doctor.

Herpes

There are two different types of herpes that affect the mouth and the lips (cold sores); and the penis, the vagina, and the anus (genital herpes). Herpes creates lesions, small ulcers or sensitive wounds that are painful to the touch. The herpes virus is sexually transmitted through direct contact with a lesion through oral, vaginal, or anal sex. For example, during oral sex, a cold sore on the mouth can transmit the herpes virus to the penis. The reverse is also true: herpes on the penis can transmit to the lips of a person who is giving fellatio.

Herpes can also be transmitted if your fingers or hands have been in touch with a lesion and they then touch your partner’s genitals, anus, or mouth. Even if there are no lesions, the risk still exists, because the herpes virus remains in the body for life. There are medications to reduce the intensity and time duration of symptoms of herpes, but they do not eliminate the virus in the body.

It is essential to see a doctor if you have any of the herpes symptoms mentioned above.

Hepatitis A and B

Hepatitis is a disease of the liver. Symptoms include yellow-coloured eyes and skin, diarrhoea and dark urine, stomach aches, appetite loss, and headaches.

  • Hepatitis A can be found in feces and can be transmitted through sex that involves licking the anus, penis, or a toy that has been in contact with the anus.
  • Hepatitis B is transmitted through sperm, vaginal secretions, and saliva. Sexual activities that are most likely to transmit Hepatitis B are the same as the ones that transmit HIV: vaginal or anal penetration without a condom and sharing dildos or sex toys. Hepatitis B is also transmitted through blood and saliva by sharing syringes, razors, toothbrushes, non-sterilised needles for tattooing and body piercing, etc.

Hepatitis A and B Vaccinations

  • Hepatitis A: 2 vaccines, 6 months apart will make you immune. STI clinics offer this free for men who have sex with men, otherwise you can buy it at a travel clinic.
  • Hepatitis B: 3 vaccines at 0, 1 month, 6 months. People born after 1980 probably got this in Grade 6 or as babies. Other people can get it at STI clinics or a travel clinic.

Hepatitis C Virus (HCV)

HCV is a virus that attacks the liver, causing inflammation of the liver. Because the liver performs many important body functions, this can have a large effect on health and quality of life. HCV is passed by blood-to-blood contact, like sharing needles, tattoo equipment, razors or toothbrushes.

HCV is quite a hardy virus and can live outside the body (on a needle, razor, etc.) for days. HCV is very common in injection drug users. There has been some sexual transmission of HCV, especially if sex involves blood (sex during menstrual period, rough sex, fisting).

People with HCV should use condoms. There has recently been a rise in HIV positive men who have sex with men getting HCV from rough sex or group sex.

Twenty-five percent of people who get HCV get rid of the virus on their own. There is a test to find out if this is what happened to your HCV. People with HCV should avoid alcohol, eat a balanced diet, and have regular monitoring with a doctor.

Syphilis

This infection is transmitted through oral, vaginal and anal sex. Transmission of syphilis through oral sex is much more common than with HIV. Syphilis has various symptoms throughout its stages of development. These symptoms can easily go unnoticed. In the first stage, syphilis causes a painless ulcer that, for men, can be found on the head of the penis, on the shaft of the penis, the base of the penis, or the pubic area. Indeed, it can be found anywhere on the body of a man or a woman: anus, rectum, lips, vulva, vagina, tongue, tonsils or throat.

The symptoms go away on their own after a few weeks, even without treatment, but the infection continues to progress and the individual is still contagious. Undiagnosed and untreated, syphilis continues to evolve and can create severe complications that can result in infertility, dementia, and cardiac problems. Only a blood test can determine the presence of syphilis. Speak with your doctor. Syphilis is easily treated with antibiotics.

Gonorrhoea and Chlamydia

These STIs have the same method of transmission and present the same symptoms. Gonorrhoea and chlamydia can be transmitted through oral sex or during vaginal and anal penetration. Gonorrhoea is frequently transmitted through oral sex. Chlamydia does not have symptoms in 70% of infected people (7 out of 10 infected people).

Gonorrhoea shows more symptoms in people (9 out of 10 infected people), but often it does not show symptoms if it is in the throat or the anus. When they do appear, the major symptoms are:

  • green or yellowish discharge from the penis, usually accompanied by pain;
  • burning sensation while urinating;
  • pain around the testicles or swelling of the testicles.

Because a lot of people don’t show symptoms and do not know that they are infected, it is recommended that you take regular tests for gonorrhoea and chlamydia. To take a test, consult your doctor. Do not forget to ask for a test in your throat and anus. These tests (specifically the tests in the urethra, the path from which both men urinate and ejaculate, and an anus test) can be unpleasant and uncomfortable. Most labs offer urine tests for both of these STIs. Left untreated, these infections can cause a lot of complications and infertility. Once discovered, they are easily treatable with antibiotics.

Risks During Oral Sex and Deep French-kissing

Oral Sex: Syphilis, herpes, gonorrhoea, low but possible risk for HIV (especially if you have sores in the mouth, recent tooth-brushing or flossing.)

Deep French-kissing: Herpes, possible risk for syphilis.

Risks of Analingus and/or Anal Sex

Persons performing analingus can get Hepatitis A, or pick up bacteria that cause gastrointestinal problems. Herpes and syphilis can also be transmitted to either partner this way. Use a barrier and wash well.

Anal sex is a risk for HIV, Herpes, Syphilis, Chlamydia, Gonorrhoea, HPV, and Hepatitis B. The person receiving (the bottom) in anal sex is at more risk for HIV. Use condoms.

Infections and How They’re Spread

Genital Skin-to-Skin Contact: Herpes, HPV (the virus that can cause genital warts, or lead to cervical cancer), syphilis, gonorrhoea, chlamydia.

Any Body Part Skin-to-Skin: Staph, crabs, scabies.

Saliva: Not many STI’s are spread by saliva. There is a very low risk of passing Hep B through saliva. It is a good idea for all sex workers to get vaccinated for Hep B. It also is possible that Herpes may be transmitted by saliva. Meningitis and Mono can be passed this way, as well as the common cold, flu, and strep-throat.

Semen and Vaginal Fluid: HIV, Hep B.

Blood: HIV, Hepatitis B and C.

Airborne: Tuberculosis, colds and flu.


A special thank you to the Trade Secrets Group for their contributions to this section


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