In the United States, the state of sex education is dismal. In many states and school districts, abstinence education is all that can be taught. Even fewer schools allow sexual education that encompasses the wide variety of sexual experience, including LGBTQ safe sex. This is largely due to a provision written into an unrelated law all the way back in 1992, known as the Helms Amendment. In ’92, then-senator Jesse Helms added the amendment out of a homophobic views of HIV and in attempt to stymie education around prevention of the disease. Since so few of my peers received a comprehensive safer sex education, I will share my insights on the subject.
Safer Sex Tools
Condoms: Oh, condoms. Everyone knows them, very few like them, but they are the tried and true method of preventing the spread of sexually transmitted diseases (STDs) and pregnancy. When used correctly, condoms are 99% effective. When used correctly. I know, it seems pretty difficult to screw up using a condom. In practice, however, this seems only to apply to penetrative sex. To comply with best practices and to gain the most protection, condoms should be used for all sexual encounters, penetrative or not. HIV and other STDs can be spread through things like oral sex and even touching if micro-abrasions (think the broken skin one has after biting nails), wounds, or bleeding is present. That is a very uncommon way of spreading STDs, but it is possible. Also, folk wisdom rings true, don’t keep condoms in a wallet or anywhere they’re subjected to lots of heat and friction, as it increases the risk of breakage.
Female Condoms: Female condoms are, if you’re not familiar—I know I was never taught about female condoms in school, sort of an inverse of a traditional male condom. These condoms are much larger and are meant to be inserted and wrapped around the genital area to protect against STDs. These condoms are more difficult to use, and are less effective because of that. These condoms are most effective with penetrative sex, but can also be used for oral sex.
Dental Dams: Full disclosure, I’ve never used a dental dam before. Dental dams are used for performing oral sex on someone with a vagina. Cover the area and go to town. It is very important to remember that vaginal fluids can carry STDs and to protect yourself if engaging in casual sex. For some reason, there is a misconception that exists that vaginas don’t spread disease the same way that penises do.
Finger Condoms: Finger condoms are, as the name suggests, condoms for the fingers. These are useful for fingering. They slide right on the fingers just as you would expect. They’re not very comfortable, but they get the job done if necessary.
Lube: Lube! Lube is so important. The only thing I can say about lube is use it. Just be careful with silicone-based lubricants in vaginas, as they can affect the natural pH balance, which can lead to yeast and other vaginal infections.
Sex Toy Care: If you’re sharing sex toys, make sure to clean them thoroughly before and after each person uses them. Also, make sure to clean sex toys after engaging in anal play.
Treatment as Prevention
PEP: It’s hard out there for somebody trying to have safer sex. Alcohol and drugs lower inhibitions, one thing often does lead to another, and sometimes bad choices are made. Shit happens. Maybe you were at a party, you slept with someone. You’re not sure of the person’s HIV status. This happens. You’re not relegated to waiting to see if you seroconvert (become HIV+).
If in this situation, get thee to a hospital as soon as you can. Ask for Post-Exposure Prophylaxis or PEP. PEP is a short term, high intensity treatment cycle of Antiretroviral drugs that, if administered within thirty-six hours and taken for roughly six weeks, can prevent seroconversion with roughly 70% effectiveness.
PrEP: PrEP: PrEP stands for Pre-Exposure Prophylaxis. PrEP is a pill, marketed under the brand name of Truvada, taken every day that can prevent the contraction of HIV with 92% effectiveness. PrEP is best suited for people who frequently engage in high risk behavior and those in monogamous sero-diverse relationships (one partner is positive and one isn’t).
PrEP has created quite the firestorm of controversy in the past few years, with many in the gay community opposed to it. Those opposed to PrEP say that this pill protects against HIV, but does not protect against other STDs–which is true–and will lead to more high risk behavior than condoms alone. Supporters like myself believe that PrEP can be an integral part to comprehensive safer sex precautions.
Birth Control: Birth control has far more uses than mainstream culture is comfortable with. Lawmakers are comfortable restricting female-bodied individuals access to birth control as a means of “protecting the children.” They refuse to acknowledge that birth control has several other uses. Birth control can be used to treat Pre-Menstrual Dysphoric Disorder (PMDD), Polycystic Ovarian Syndrome (PCOS), endometriosis, pre-menstrual syndrome (PMS), amenorrhea, and regulating hormone levels. Birth control can also, of course, prevent pregnancy.
Birth control can be delivered many different ways: implants, patches, pills, shots, sponges, vaginal rings, cervical caps, and intra-uterine devices (IUDs). For emergency pregnancy prevention, the morning-after pill is (mostly) available over the counter and effective up to five days after unprotected sex.
Vaccinations: Ah, yes, vaccinations. Those little needles that once made you scream or refuse to go to the doctor’s office may now protect you from STDs. In the United States, the vaccines for hepatitis was added to the regular vaccination timeline back in the 80s. If you know you haven’t been vaccinated for the heps, it is a very good idea to do that, considering that Hepatitis B is still very damaging and very much incurable. A cure exists for Hepatitis C, but it costs roughly $36,000.
Human Papillomavirus (HPV) is the most common sexually transmitted virus in the world. There are something like one hundred different strains of this virus, and they all do very different things. Some can be infected with HPV their entire lives and never present any symptoms. Other strains can cause cancers of the anus, penis, throat, vagina, uterus, cervix, or ovaries. Still other strains cause very unsightly genital warts. Luckily, a vaccine exists for the damaging strains. The vaccine is called Gardisil, is given in three separate injections, and is a really great way to gain peace of mind.
Getting Tested: Getting tested is essential. Best practices would suggest seeing your general practitioner or attending a sexual health clinic every three months while you’re sexually active. For example, if you’ve been celibate for three years, there’s really no reason to continue getting tested, but that’s just common sense. One quick note of advice: If faced with question marks regarding your HIV status, do not purchase and use an over-the-counter OraSure test. They are much less effective than traditional tests, and it is never a good idea to get bad news while you’re home alone.
Consent: It is, hopefully, pretty much common sense that to gain consent for sexual acts is essential for a healthy sexual relationship. There are several models of consent that have varying pros and cons in practice.
No Means No: The standard model used by law enforcement and in general in the United States is a no means no model. This model suggests that violation of an overt no, stop, or don’t is rape/unwanted sexual action. An absence of no is consent by omission. The problems with this model are many. Situations in which an individual is unable to give an informed or clear ‘no’ (intoxicated, unconscious, disabled, unaware, etc.) are legion. The existence of the freeze response to trauma is entirely ignored, in which someone being raped cannot verbalize ‘no’ due to extreme fear.
Yes Means Yes: California is currently the only US state that has a yes means yes law in terms of sexual consent. A yes means yes model requires a verbal affirmation for each new sex act. Many would say that this is too difficult or awkward or whatever. Others say that it is the ultimate safeguard in terms of sexual violence and the law.
Where is Your Line Model: The Line model of consent is my personal favorite. The Line also requires very open and honest discussion about sexual behavior, likes/dislikes, things both partners want, and what they don’t want. The Line model allows for both partners in a sexual relationship to know and understand what’s okay and what’s off-limits during a sexual encounter. An affirmative “yes” is unnecessary for each new act, but those that would elicit a “no” are discussed and avoided ahead of time.
I’m a little bit late again with posting this, but here it is. If there’s anything I didn’t cover that you think I should, drop a comment. Any questions, comments, or concerns, drop me a line.