Dr Caitlin: A Guide To Safer Sex

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Dr Caitlin O’Connor of Tralee Medical Centre in St Brendan’s Park on practising safer sex and avoiding STIs…

“Safer sex” usually refers to having sex in a way which reduces your risks of catching a sexually transmitted infection.

Although sex should be an enjoyable activity, it can put you at risk in several ways. Because it involves being very close (intimate) with another person, it may allow infections to pass from one person to another. Other risks to think about include pregnancy, emotional consequences and legal issues.

“Safe sex” guidelines often are called “safer sex” guidelines because sex can never be completely without any risk at all. However, taking a few sensible precautions can reduce the risks greatly.

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Reducing your risk of sexually transmitted infection (STI)

Listed below are various important ways in which you can reduce your risk of catching an STI.

Barrier methods

The most commonly used barrier method is the  male condom. Other options are female condoms and dental dams. A dental dam is a sheet of latex (or similar material) used during oral sex to help stop STIs being spread.

Condoms have been shown to reduce the risk of passing on most STIs including:

• HIV and AIDS

• Chlamydia

• Gonorrhoea

• Syphilis

• Genital herpes

They are not completely guaranteed to prevent any risk but they do greatly reduce the risk. Latex condoms are the most effective but for those who are sensitive to latex, condoms made of polyurethane also help to reduce the risk.

Female condoms have also been shown to be effective in reducing the risk of catching an STI.

In the UK, condoms are available free of charge from family planning clinics. They are also available in some genitourinary medicine (GUM) clinics and some GP surgeries. They can also be bought from pharmacies. Consider always having a condom with you “just in case”.

Tips to make condoms more effective:

• Ideally, use a condom every time you have vaginal, anal or oral sex. Even using a condom as often as possible is safer than not using one at all. If you forget to use a condom on one occasion, it is still worth using one on future occasions.

• Practise using a condom so you can reliably put one on even if it is dark or you are in a hurry.

• You can pass on an STI even if you don’t come (ejaculate) so use a condom for all penetrative sex.

• Put the condom on before having sex.

• Remove all air from the condom before rolling it on.

• Do not unroll the condom before putting it on.

• Hold the condom on after having sex as you withdraw your penis.

Number of partners

It makes sense that the fewer sexual partners you have, the less chance you have of catching an STI.

People who think of sex as something to enjoy in a committed relationship are less at risk of infections than people who think of it as a more casual activity.

Even people who have never been aware of having an STI may be carrying an infection. For example, you can pass on herpes without ever having any symptoms.

Or you can pass it on many years after you had symptoms of an infection. This is why even in a regular committed relationship, it can be worth considering using a condom.

Sexual practices

Some kinds of sexual practices are higher-risk than others. If you are in no contact with another person whatsoever (for example, phone sex, self-masturbation) you are not at risk of catching an infection.

Sex involving penetration (with a penis, sex toy, tongue, finger, fist, etc) involves more risk than sex without penetration.

However, it is possible to catch some infections without penetration. For example, by rubbing genitals you can catch genital warts or genital herpes. You can catch genital herpes from having oral sex with somebody who has a cold sore.

Other STIs which can be passed on during oral sex include HIV, gonorrhoea, syphilis,  human papillomavirus (HPV),  hepatitis B and hepatitis C.

Anal sex is particularly high-risk because the lining of the anus and rectum are very thin. This makes it easier for germs to enter the body. HIV and hepatitis B in particular are more likely to be passed on through anal sex.

STIs can be caught from infected sex toys. Therefore, to have safer sex, always wash and clean sex toys or use them with a barrier such as a condom.

Alcohol and recreational drugs

Alcohol and recreational drugs can loosen inhibitions. Therefore, they may make you more likely to have higher-risk sex (for example, with a stranger, without a condom, anal sex) than you might normally do.

Consider this risk in advance of a situation where alcohol or drugs might be involved. You may then be able to make plans to reduce your risk.

Summary: tips for safer sex

• Do not have lots of sexual partners. Get to know a person before having sex with them. Only have sex with somebody who is happy to practise safer sex and listen to your wishes.

• Make sure each partner consents and is happy with the consequences of having sex. Do not start a sexual relationship until both partners are ready for it.

• Always use a condom for all types of penetrative sex. Consider a barrier method for oral sex.

• Beware of having sex under the influence of alcohol or drugs. Make plans in advance to protect yourself.

• Think about getting yourself and your partner tested for STIs before you start having a sexual relationship. Always go to your GP or GUM clinic as soon as possible if you have any symptoms of an STI, such as soreness of, or discharge from, your vagina or penis. Don’t have unprotected sex until you have been checked out.

• Consider contraception if needed.

If you take steps to keep yourself safe, sex should be a pleasure and not a risk.

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