Safer Sex Basics

There are a number of ways to practice safer sex. Safer sex is a form of harm reduction, meaning that even when you take precautions you can end up with an outcome you weren’t intending (pregnancy, STIs, etc.). There are a number of tools and ways of practicing safer sex, which will be discussed below.

External condoms

Condoms are small, thin pouches made of latex (rubber), plastic (polyurethane, nitrile, or polyisoprene) or lambskin, that cover a penis during sex and collect semen, or cover a sex toy (Note: Lambskin condoms do not protect against STIs. Only latex and plastic condoms do.) Condoms exchange of vaginal and anal fluids with semen, and thus prevent pregnancy and STIs that are transmitted via exchange of fluids. Condoms can also be used as a barrier method for oral sex on a penis.

When using a condom on a penis, make sure your penis is erect before rolling on the condom. The condom should be put on before it touches a partner’s genital area or their mouth. It should also be worn for the whole duration of having sex. This is the only way to help protect against pregnancy and STIs (including ones caused by pre-ejaculation).

Note: avoid use of oil-based lubricants with latex condoms, as it can wear down the condom and lead to breakage.

Lube

A good lubricant (lube) is one of the most important tools for having safer (and more pleasurable) sex. Lube reduces friction which can cause tiny tears in the skin, which make it more likely for the person to get an STI if their partner has one. It also reduces the likelihood that a condom will break. Lube can also make sex feel better, during penetrative sex, masturbating, oral sex, or using sex toys.

Lube is for everyone! Although vaginas are self-lubricating, there are many factors that can cause them to create less lubrication than usual, such as medication, energy level, monthly hormonal changes, and other physical and psychological variations. The anus does not self-lubricate, so lube should absolutely be used for anal sex every time to prevent tearing of the very fragile anal tissue--and spit is not an adequate lube!

Water-based lubes are perhaps the most widely available (the packets that HFC provides at our table are water-based). They are easy to clean-up and don’t stain fabrics, but the slipperiness may not last as long as other types.

Silicone-based lubes last the longest out of any lubricant. They don’t need to be reapplied as often as water-based lubricants. They will also hold-up under water, so they’re useful for shower sex. On the other hand, silicone-based lubes can stain sheets more easily. Silicone-based lubes also shouldn’t be used with silicone sex toys, as it can break down the material of the toy over time.

Natural oil-based lubes, like coconut and avocado oils, are also long-lasting, and are great for massage and safe for vaginal-use and safe to ingest. Synthetic oils, such as petroleum jelly, are not recommended for sex. All oils and oil-based lubes should not be used with latex condoms, as they will wear down the latex and can lead to breakage.

The following common lube ingredients should be avoided, so make sure to check your label:

-propylene glycol--can cause allergic reactions

-nonoxynol-g--can cause allergic reactions

-glycerin--can cause yeast infections and micro-tears

-chlorohexidine glyconate--can cause allergic reactions

Dental dams

A dental dam is a thin, flexible piece of latex that protects against direct mouth-to-genital or mouth-to-anus contact during oral sex. This reduces your risk for STIs or gastrointestinal infections while still allowing for clitoral or anal stimulation.

In a pinch, non-microwavable Saran (plastic) wrap can also be used as a dental dam for safer sex on a vagina or anus.

Gloves

Rubber or nitrile gloves are useful for preventing transmission of STIs when multiple partners are involved (so a penetrating partner can move from one person to another without having to wash their whole hands--simply putting on a new glove between each new partner). Gloves (or finger cots) are also useful for preventing scratches on the inside of a vagina or anus caused by long nails. For a penetrating partner with significantly long nails, a little piece of cotton can be placed between the nail and the fingertip inside the glove to help prevent discomfort in the receiving partner.

Internal condoms

Internal condoms (sometimes known as female condoms) are a barrier-type of contraceptive that is inserted into the vagina or anus prior to having sex. An internal condom can be inserted up to eight hours before sex, so it allows the user to put in place ahead of time if they know or think they will be having sex later on. It also means that there’s less interruption of sexual interaction in the moment. Internal condoms also do not require an erection before use, unlike external condoms.

Internal condoms are often made of polyurethane or nitrile, which is safe to use for people who are allergic to latex. Another benefit to polyurethane or nitrile internal condoms is that they can be used with all types of lubricants (including oil-based lubricants)

The internal condoms’ rings might also provide extra pleasure. The outer ring of the internal condom may provide additional stimulation to the clitoris for some people, and some people may feel additional stimulation from the internal ring during deep penetration. Some people using internal condoms also report that they feel more pleasurable for insertive partners as well.

Internal condoms are also great for period sex or anal sex, as any blood or fecal matter won’t be visible outside the anus or vagina.

One of the biggest drawbacks is that they require practice to properly insert, but this gets easier with frequent use. Here’s a great guide on how to insert an internal condom. Internal condoms also should NOT be used in conjunction with external condoms.

PrEP and PEP

PrEP: Short for “pre-exposure prophylaxis,” PrEP is an HIV prevention strategy in which HIV-negative people take an oral pill once a day before coming into contact with HIV to reduce their risk of HIV infection. PrEP must be taken for at least 7 days to reach optimal levels of protection against HIV.

PEP: Short for “post-exposure prophylaxis,” PEP is an HIV prevention strategy in which HIV-negative people take anti-HIV medications after coming into contact with HIV to reduce their risk of HIV infection. PEP must be started within 72 hours after HIV exposure.

Only people who are HIV negative should use PrEP or PEP.

You must be tested for HIV and have a documented negative test result before starting PrEP.

PrEP and PEP are available by prescription from a medical provider, such as a physician, nurse practitioner, or physician assistant. You can also get PEP at your local emergency room or urgent care clinic, although these locations may provide just the first two or three days’ doses to get you started (for example, until your medical provider’s office reopens on a weekday). You will need to talk with your provider to see if PrEP or PEP is right for you.

The CDC recommends PrEP for those at high risk of HIV, including:

-Those in a relationship with an HIV-positive partner.

-Men who don’t use condoms when having sex with men.

-Men who have been diagnosed with a sexually transmitted infection (STI) in the past six months and who are not in a mutually monogamous relationship with an HIV-negative partner.

-Heterosexuals who don’t always use condoms for sex with partners who are themselves at high risk for HIV.

-Anyone who, in the past six months, has shared equipment when injecting illicit drugs or who has been in an injection drug treatment program.

However, whether or not PrEP is right for you does not necessarily depend on you falling into one of the above categories.

PrEP can be expensive, but there are options for both insured and uninsured people to help cover the cost. The PrEP Navigator at Whitman Walker can help with figuring out what your options are if you’re interested in getting on PrEP or just want to learn more. You can contact them at prepnavigator@whitman-walker.org or 202.745.6145. You can also go to https://www.prepfordc.com/ to learn more.

Sex toys

Sex toys (such as dildos, vibrators, and penis rings) can be used in conjunction with or in lieu of or as implements of penetrative sex. However, hygiene and barrier methods are still important tools for safer sex when using toys.

First, the material a toy is made of matters. When purchasing or using sex toys, it is best to avoid porous sex toys of any kind. This usually includes soft and squishy toys, such as those made out of a jelly material. They can trap dirt and bacteria that can never be removed. What that means is that porous sex toys, if used without a condom, can re-infect you with a previous bacterial or yeast infection, cause an outbreak in a pre-existing STI and - if shared without a condom or other barrier - can even spread STIs, bacterial infections and yeast infections between partners. Toys with phthalates should also be avoided. Phthalates are a chemical agent used in plastics to bind them together and make them flexible. They are also known to be endocrine disruptors, and may even cause cancer.

Stick with silicone, hard (ABS) plastic, glass, or metal sex toys.

When using toys, keeping them clean is also essential. Invest in a cleaning spray made especially for sex toys--any sex shop or website will sell them for between $5 and $15. While you technically can use soap to clean sex toys, it’s not recommended, as soap residue can remain on the toys and get into the body. Some sex toys can be put in the dishwasher or boiled for sterilization--check the care instructions or ask a staff member at a sex shop about your particular toy.

When using toys with multiple partners at a time, it’s important to use a new condom for each partner or to clean the toys between use with each partner. Also, always make sure to use a new condom or thoroughly sterilize a toy between anal and vaginal or oral use to prevent transfer of bacteria to the vagina or mouth and cause infections.

Non-penetrative sex

Despite what our cisnormative/heteronormative society tells us, non-penetrative sex is just as valid and can be just as pleasurable as penetrative sex. Non-penetrative sex can also be used as a method of safer sex. This can include sensual massage, mutual masturbation, handjobs (think handjobs are always bleh? You’re probably not using LUBE), etc. There’s a world of pleasure and possibility out there--figure out what works for you (and your partners)!