Our Bodies, Ourselves (58 page)
Read Our Bodies, Ourselves Online
Authors: Boston Women's Health Book Collective
For protection for deep manual sex, consider using latex gloves. For finger play, you can use finger cots, which cover only a single finger. Change them with each use.
This term refers to sex partners urinating on each other. This is relatively low risk, as long as there is no blood in or mixed with the urine. Men's urine carries a slightly higher risk because urine comes through the same channelâthe urethraâas semen, and might pick up a virus or trace bacteria as it leaves the body. Protect your eyes, and avoid any broken skin or cuts. Urine itself is sterile.
Kissing, hugging, massages, hand jobs, and mutual masturbation are all low risk.
Avoid getting your partner's semen or vaginal fluids on your skin if you have small cuts or sores. Also avoid getting semen in your eye during sex play, as STIs can be transmitted this way.
Male condoms, used on the penis during vaginal and anal intercourse and oral sex, are the most accessible and best-known barrier protection. When used consistently and correctly, male condoms are highly effective in preventing STIs. Most male condoms are made of latex. People with latex allergies can also get good protection from nitrile, polyurethane, and polyisoprene male condoms. Lambskin condoms do
not
provide STI protection. Using a lubricant with a condom can help prevent condom breaks and also prevent tears or abrasions in the vagina.
Female condoms, which are designed to be inserted into a woman's vagina, can also be used for protection. While most women use these vaginally, some also prefer them to male condoms for protection during anal sex. The only female condom currently approved for sale in the United States is the FC2. It can be used for vaginal and anal sex, and for oral sex on a woman. While the research on female condoms is not as extensive as that on male condoms, consistent and correct use of the female
condom appears to provide a level of protection against STIs, including HIV infection, similar to the male condom.
4
FLUID BONDING
Fluid bonding means sharing body fluids with only one person, and using protection with all others. This reduces risk, though only if you have both been tested beforehand for the full range of STIs. Fluid bonding requires that both partners use protection consistently with other partners and never have unprotected sex with anyone else, not even “just this once.” Exposure to several partners, either your own or your partner's partners, increases your chances of getting an STI.
I started having safe(r) sex with everyone but my primary partner about a year and a half ago, and my concerns about STIs changed with that new context. Now I'm obligated to keep not only myself but also my partner STI-free, and I take that very seriously. It has to do with the practicality of being fluid bonded and both STI-free, and also with this pact that we made that's got to do with keeping our relationship primary. Now I don't feel like I can push boundaries at all when it comes to safe sex.
Both male and female condoms offer protection against HIV, gonorrhea, and chlamydia, which are spread through body fluids. Condoms also offer some protection against infections like herpes simplex virus (HSV) and human papillomavirus (HPV) that are spread through skin-to-skin contact. But these infections can still be transmitted by sores or warts that may not be visible and by contact with parts of the genitals not covered by the condom. Because the female condom covers more surface area, it may potentially offer more protection against HPV and herpes than male condoms.
You can get female condoms at some retail drugstores (including CVS and Walgreens), HIV/AIDS outreach clinics, family-planning clinics, and sex shops, and on some college campuses. You can also buy them online, including at Amazon.com. A pack of five condoms costs about $12. If you've used female condoms in the past and found that they were too noisy, you might want to give them another tryâthey have recently been redesigned, and the material now used is nitrile, which is soft and quiet.
Other barrier methods can be used for mouth-to-vagina or mouth-to-anus contact, or to protect infected areas not covered by a condom. Squares of latex (dams) are available online, in some drugstores, at Planned Parenthood centers, and at sex shops. (For more information, see “Dental Dams and Do-It-Yourself Barriers” below.)
The following guidelines provide basic information on male and female condom and lubricant use for safer sex. (For more information on condom use for birth control, see
Chapter 9
, “Birth Control.”)
⢠Store condoms in a cool, dry place. Do not use a condom if the packaging is torn or damaged.
⢠Avoid using a condom that's been in a pocket or the bottom of a purse for a long time, or in a glove compartment or vending machine, where it may have been compromised by heat or otherwise damaged. Never use condoms that are brittle, sticky, or an unusual color.
DENTAL DAMS AND DO-IT-YOURSELF BARRIERS
If you're engaging in mouth-to-vagina or mouth-to-anus contact, you can protect yourself and your partner by using a barrier such as a dental dam. These rubber sheets, also used by dentists, tend to be small and thick, although some sex boutiques carry ones that are larger, thinner, and flavored. A special kind of dam, Sheer Glyde, has been approved by the FDA specifically for safer sex.
Female condoms can also be used for oral sex on a woman. Once the female condom is inserted in the woman's vagina, gently pull the outer ring forward and use the condom as a barrier between your mouth and your partner's vagina and anus. Many women like this because it is already lubricated. You don't need to hold the female condom in place with your hands once it is in, and the ring can also be moved over the clitoris to increase your partner's pleasure.
The following do-it-yourself (or DIY) techniques may have some merit in extreme circumstances. However, there is no guarantee of quality control when you make or use these and you may be increasing the risk of barrier failure.
⢠You can adapt a male condom to use as a barrier by vertically cutting it with scissors.
⢠You can also turn a latex glove into a barrier: First, wash out the powder, then cut off the four fingers, and slit it up the side, leaving the thumb intact. Try lubricating the side that touches your partner. Be sure to keep the same side against her vulva, and keep track of which side is which so you don't touch the body fluids you are trying to avoid.
Remember that male and female condoms, dams, and other barriers don't protect you from getting infected in places they don't cover.
⢠Check the expiration date on each condom before you use it. Generally, condoms without spermicide are good for up to five years; condoms with spermicide last about two years. If you are not sure how old a condom is, throw it away and use a new one.
⢠Put the condom (male or female) on before any genital, oral, or anal contact occurs. The male condom has to be on the penis when it's erect and before it touches your body, especially the vulva, mouth, or anus. Likewise for a female condom; insert it before any skin-to-skin contact occurs.
⢠Use a new condom each time you have sex. Have more than one with you in case you have sex again or if a condom is damaged. If you are having both anal and vaginal intercourse, put on a new condom after anal intercourse and before beginning vaginal intercourse. Or try what this woman suggests and insert female condoms in both the anus and the vagina.
They can be lubed well (inside and out), then insertedâone into the anus and a second one into the vagina. When this is done, the male or other insertive partner can go back and forth
freely from anus to vagina as the couple's energies desire without fear of infection
.
If you or a partner experiences irritation with latex male condoms, don't despair! The irritation may be due to spermicide (chemicals that kill sperm) on the condom, so try a brand without spermicide. If you experience itching, a rash, or dryness, you might be sensitive to latex. Try using a polyurethane, polyisoprene, or nitrile condom. Sometimes vaginal irritation with condoms can be due to attempting intercourse too soon, before you're aroused enough and the vagina is lubricated.
Lubricants help to prevent condom breaks and also prevent tears or abrasions in the vagina or rectum. They can also make sex more pleasurable for you and your partner. Use only water-soluble lubricants, not oil-based ones, with latex condoms. Oil-based products include Vaseline, baby oil, suntan lotion, massage oils, and some hand creams. These can damage a latex condom within minutes and destroy its protection.
Oil-based lubricants, however, have no effect on nitrile or polyurethane condoms. If you prefer oil-based lubricants, make sure that the condom you are using is made of polyurethane, polyisoprene, or nitrile.
Lubricants can be applied directly to the clitoris, labia, or anus, or inside the vagina. Putting a tiny amount in the tip of a male condom may give the man extra pleasureâwhich could be a plus in persuading him to use condoms. Be careful to use only a tiny drop, and only in the tip, not the sides, so the condom won't get loose and slip off.
The birth control chapter has more information on condom use. For detailed instructions on how to use a
male condom
. For instructions on how to use
a female condom
.
© Donna Alberico
You can use prelubricated male condoms. However, avoid using condoms prelubricated with spermicide, as the main ingredient, Nonoxynol-9 (N-9), can cause vaginal and rectal irritation and increase STI risk. (For more information, see “Safety of Nonoxynol-9 When Used
for Contraception,”
) Many condoms are available without added N-9; visit your local pharmacy to find a brand that works for you.
For more information on lubricants, see
“Lubrication.”
Female and male condoms, gloves, and dental dams are known to stop the transmission of STIs, including HIV. Yet many of us don't protect ourselves consistently or effectively. Why?
Who, me? ⦠I'm not a gay man or an addict ⦠I'm too young ⦠I can tell who's infected ⦠I love him so muchâhe'd never do anything to hurt me ⦠If I bring a condom, he'll think I'm a slut ⦠I'm a lesbian, why do I need protection? ⦠I'm afraid he'll refuse ⦠She's too important to risk losing ⦠I can't carry condoms aroundâmy mother would find them ⦠He knows I need the drugs, so I can't make trouble ⦠I'm not worth protecting ⦠He'll get mad ⦠Talking about sex is too embarrassing ⦠I just can't deal â¦
Many of us have had at least one of these thoughts or conversations in our heads or with friends. Even when we know what's right, it can be incredibly difficult to follow through. It's all too easy to forget that our healthâand our partners' healthâis
our
responsibility.
A woman who works in HIV prevention says:
It can be particularly awkward when you are in love and don't want to do anything to upset your partner or to imply that you can't trust each other. When love comes into the relationship, condoms often go out the window
.
Another woman says it is one thing to talk about being responsibleâand much harder to take action in the moment.
It is hard to imagine murmuring into someone's ear at a time of passion, “Would you mind slipping on this condom just in case one of us has an STI?” Yet it seems awkward to bring it up any sooner if it's not clear between us that we want to make love
.
Or, to put it more directly:
A condom seems to pour cold water on the romance by saying, “Okay, to be brutally honest, we've both slept with other people.” The condom seems like a statement of distrust: “You could give me a disease; you could kill me.”
Sometimes, you might be the one resisting safer sexâmaybe because you think that a partner will like you more if you agree to sex without condoms. Some of us may feel that using barriers implies we are untrustworthy or “dirty,” or that if we suggest using a barrier, a partner may make those kinds of assumptions about us. Others feel that condoms reduce intimacy or closeness.
If you are the resistant partner, check in with yourself and balance what you know about risks to your health or that of a partner with attitudes that discourage using protection.
Other factors may make it more difficult to acquire and consistently use protection.
â¢
Drug and alcohol use.
Even with the best of intentions, intoxication can compromise judgment and weaken resolve to use protection. If a sex partner is also under the influence of drugs or alcohol, practicing safer sex becomes even less likely.