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Safer sex

Introduction

 

Once you have decided to have sex with someone you should also be considering how to protect yourself from infection or if you are a woman from an unplanned pregnancy.  Practicing safer sex means protecting yourself and your partner from sexually transmitted infections including amongst others HIV and for women, pregnancy, by taking the necessary precautions during sex and foreplay.

This may require different strategies depending on your circumstances at the time:

  • Casual sex
  • Dating
  • Committed relationship

For example in a casual relationship you need to take responsibility for protecting yourself.  When dating or in a committed long term relationship you may be able to negotiate a different strategy with your partner.

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Protecting yourself

 

This means using a condom or ensuring your partner uses one to protect you from STIs, HIV (and for women pregnancy) and not making any assumptions about your partner.  Without both of you testing for STIs it is not possible to know that either you or your partners are free of infection.

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Avoid having more than one sexual partner at a time

Evidence shows that people that have multiple partners, particularly more than one sexual partner at a time (this is called concurrency), are putting themselves at much higher risk of catching an STI or HIV.

This may be one of the reasons that we have seen such a large increase in STIs amongst young people in the last 20 years.

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Alcohol

Many people drink too much when they go out and wake up with regrets. Alcohol is commonly linked with unsafe sex and for women may put them at risk of sexual assault. Try alternating alcoholic drinks and soft drinks when you are out socialising and decide on your upper limit in advance and stick to it.  Circumstances may also arise where you are at risk of someone tampering with your drink so as to render you vulnerable to a sexual attack.  You should never leave your drink unattended and ideally always buy your own drinks directly from the bar.  Click here for futher information on sexual assault

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Negotiated strategies

Sometimes it helps to be direct and discuss with your partner about how you want to ensure that sex remains safe. It’s easy to make assumptions about what risks other people want to take. Your partner may be relieved that you’ve taken the initiative as they might be making assumptions about you too or may be they just got carried away in the heat of the moment.

One strategy a lot of couples use at the start of a relationship is to use condoms until they have both had an STI screen and HIV test.

They may then mutually decide not to use condoms when having sex with each other and either remain 100% monogamous or use condoms all the time outside the relationship.  This approach requires considerable trust.

Some couples may not reach this level of negotiation or trust and decide to continue to use condoms to prevent infections. It is wise to use another method of contraception as in real life condoms are still only about 85% effective in preventing unwanted pregnancies.

If you are dating with several partners and having sex with more than one then it is advisable to ensure you are protected as much as possible by using a condom for all sex and with all partners.

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Frequency of rescreening for STIs and HIV

We advise rescreening for STIs and HIV:

  • Every time you change partner.
  • Before conceiving a baby.
  • If you are worried by any other risks with respect to your partner.
  • For young people under 25 years the Department of Health recommend a chlamydia test every year as a minimum.
  • Following sexual assault.

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Risks from oral sex

Most people are aware of the risks of infections from vaginal or anal sex but many are not aware that both STIs and HIV can be transmitted through oral sex.

Oral sex includes the following oral (mouth) contact:

mouth/penis   or   mouth/vulva   or   mouth/anus

Herpes simplex, warts, gonorrhoea, chlamydia, syphilis, HIV, hepatitis B, and hepatitis C are all transmissible through oral sex.

In general the risk of transmission of STIs including HIV is:

  • Higher for the receptive (oral or mouth) partner.
  • Is much lower compared with vaginal or anal sex (except for herpes).
  • In gay men oral sex is a common way of catching syphilis – about one-third of syphilis infections in the UK are transmitted this way.
  • Higher if the receptive partner has poor oral hygiene or mouth ulcers.

Flavoured condoms that do not contain lubricant are available to use for oral sex. Alternatively dental dams may be used for mouth/vulva or mouth/anal contact.

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