fbpx
Wikipedia

Safe sex

For the Greek film, see Safe Sex (film).

Safe sex is sexual activity using methods or devices (such as condoms) to reduce the risk of transmitting or acquiring sexually transmitted infections (STIs), especially HIV. "Safe sex" is also sometimes referred to as safer sex or protected sex to indicate that some safe sex practices do not eliminate STI risks. It is also sometimes used colloquially to describe methods aimed at preventing pregnancy that may or may not also lower STI risks.

Male (or "external") condoms can be used to cover the penis (or fingers or other body parts) for safer sex when inserting into body cavities
Dental dams can be used to cover the vulva or anus when engaging in cunnilingus or anilingus, respectively, for safer sex
Female condoms ("internal" condoms) can be used by receptive partners for safer sex

The concept of "safe sex" emerged in the 1980s as a response to the global AIDS epidemic, and possibly more specifically to the AIDS crisis in the US. Promoting safe sex is now one of the main aims of sex education and STI prevention, especially reducing new HIV infections. Safe sex is regarded as a harm reduction strategy aimed at reducing the risk of STI transmission.

Although some safe sex practices (like condoms) can also be used as birth control (contraception), most forms of contraception do not protect against STIs. Likewise, some safe sex practices, such as partner selection and low-risk sex behavior,[example needed] might not be effective forms of contraception.

Contents

This section needs additional citations for verification. Please help improve this article by . Unsourced material may be challenged and removed.
Find sources: "Safe sex"news · newspapers · books · scholar · JSTOR
(March 2018) ()

Although strategies for avoiding STIs like syphilis and gonorrhea have existed for centuries and the term "safe sex" existed in English as early as the 1930s, the use of the term to refer to STI-risk reduction dates to the mid-1980s in the United States. It emerged in response to the HIV/AIDS crisis.

A year before the HIV virus was isolated and named, the San Francisco chapter of the Sisters of Perpetual Indulgence published a small pamphlet titled Play Fair! out of concern over widespread STIs among the city's gay male population. It specifically named illnesses (Kaposi's sarcoma and pneumocystis pneumonia) that would later be understood as symptoms of advanced HIV disease (or AIDS). The pamphlet advocated a range of safe-sex practices, including abstinence, condoms, personal hygiene, use of personal lubricants, and STI testing/treatment. It took a casual, sex-positive approach while also emphasizing personal and social responsibility. In May 1983—the same month HIV was isolated and named in France—the New York City-based HIV/AIDS activists Richard Berkowitz and Michael Callen published similar advice in their booklet, How to Have Sex in an Epidemic: One Approach. Neither publication used the term "safe sex" but both included recommendations that are now standard advice for reducing STI (including HIV) risks.

A poster promotes condom use.

Safe sex as a form of STI risk reduction appeared in journalism as early as 1984, in the British publication The Daily Intelligencer: "The goal is to reach about 50 million people with messages about safe sex and AIDS education."

Although safe sex is used by individuals to refer to protection against both pregnancy and HIV/AIDS or other STI transmissions, the term was born in response to the HIV/AIDS epidemic. It is believed that the term safe sex was used in the professional literature in 1984, in the content of a paper on the psychological effect that HIV/AIDS may have on gay and bisexual men.

A poster aimed at lesbians says "Low risk isn't no risk". It uses the expression "safer sex".

A year later, the same term appeared in an article in The New York Times. This article emphasized that most specialists advised their AIDS patients to practice safe sex. The concept included limiting the number of sexual partners, using prophylactics, avoiding bodily fluid exchange, and resisting the use of drugs that reduced inhibitions for high-risk sexual behavior. Moreover, in 1985, the first safe sex guidelines were established by the 'Coalition for Sexual Responsibilities'.[who?] According to these guidelines, safe sex was practiced by using condoms also when engaging in anal or oral sex.

Although the term safe sex was primarily used in reference to sexual activity between men, in 1986 the concept was spread to the general population. Various programs were developed with the aim of promoting safe sex practices among college students. These programs were focused on promoting the use of the condom, a better knowledge about the partner's sexual history and limiting the number of sexual partners. The first book on this subject appeared in the same year. The book was entitled "Safe Sex in the Age of AIDS", and had 88 pages that described both positive and negative approaches to sexual life.[citation needed] Sexual behavior could be safe (kissing, hugging, massage, body-to-body rubbing, mutual masturbation, exhibitionism, phone sex, and use of separate sex toys); possibly safe (use of condoms); or unsafe.

In 1997, specialists in this matter promoted the use of condoms as the most accessible safe sex method (besides abstinence) and they called for TV commercials featuring condoms. During the same year, the Catholic Church in the United States issued their own "safer sex" guidelines on which condoms were listed, though two years later the Vatican urged chastity and heterosexual marriage, attacking the American Catholic bishops' guidelines.[citation needed]

A study carried out in 2006 by Californian specialists showed that the most common definitions of safe sex are condom use (68% of the interviewed subjects), abstinence (31.1% of the interviewed subjects), monogamy (28.4% of the interviewed subjects) and safe partner (18.7% of the interviewed subjects).

The term safer sex in Canada and the United States has gained greater use by health workers, reflecting that risk of transmission of sexually transmitted infections in various sexual activities is a continuum. The term safe sex is still in common use in the United Kingdom, Australia and New Zealand.

"Safer sex" is thought to be a more aggressive term which may make it more obvious to individuals that any type of sexual activity carries a certain degree of risk.

The term safe love has also been used, notably by the French Sidaction in the promotion of men's underpants incorporating a condom pocket and including the red ribbon symbol in the design, which were sold to support the charity.

A range of safe-sex practices are commonly recommended by sexual health educators and public health agencies. Many of these practices can reduce (but not eliminate) risk of transmitting or acquiring STIs.

Phone sex/cybersex/sexting

Sexual activities, such as phone sex, cybersex, and sexting, that do not include direct contact with the skin or bodily fluids of sexual partners, carry no STI risks and, thus, are forms of safe sex.

Non-penetrative sex

Main article: Non-penetrative sex

A range of sex acts called "non-penetrative sex" or "outercourse" can significantly reduce STI risks. Non-penetrative sex includes practices such as kissing, mutual masturbation, rubbing or stroking. According to the Health Department of Western Australia, this sexual practice may prevent pregnancy and most STIs. However, non-penetrative sex may not protect against infections that can be transmitted via skin-to-skin contact, such as herpes and human papilloma virus. Mutual or partnered masturbation carries some STI risk, especially if there is skin contact or shared bodily fluids with sexual partners, although the risks are significantly lower than many other sexual activities.

Condoms, dental dams, gloves

Barriers, such as condoms, dental dams, and medical gloves can prevent contact with body fluids (such as blood, vaginal fluid, semen, rectal mucus), and other means of transmitting STIs (like skin, hair and shared objects) during sexual activity.[citation needed]

How to put a male condom on a penis
  • External condoms can be used to cover the penis, hands, fingers, or other body parts during sexual penetration or stimulation. They are most frequently made of latex, and can also be made out of synthetic materials including polyurethane and polyisoprene.
  • Internal condoms (also called female condoms) are inserted into the vagina or anus prior to sexual penetration. These condoms are made of either polyurethane or nitrile. If external and internal condoms are used at the same time, they may break due to friction between the materials during sexual activity.
  • A dental dam (originally used in dentistry) is a sheet of latex used for protection when engaging in oral sex. It is typically used as a barrier between the mouth and the vulva during cunnilingus or between the mouth and the anus during anal–oral sex.
  • Medical gloves made out of latex, vinyl, nitrile, or polyurethane may be used as a makeshift dental dam during oral sex, or can cover hands, fingers, or other body parts during penetration or sexual stimulation, such as masturbation.
  • Condoms, dental dams, and gloves can also be used to cover sex toys such as dildos during sexual stimulation or penetration. If a sex toy is to be used in more than one orifice or partner, a condom/dental dam/glove can be used over it and changed when the toy is moved.

Oil-based lubrication can break down the structure of latex condoms, dental dams or gloves, reducing their effectiveness for STI protection.

While use of external condoms can reduce STI risks during sexual activity, they are not 100% effective. One study has suggested condoms might reduce HIV transmission by 85% to 95%; effectiveness beyond 95% was deemed unlikely because of slippage, breakage, and incorrect use. It also said, "In practice, inconsistent use may reduce the overall effectiveness of condoms to as low as 60–70%".p. 40.

Pre-exposure prophylaxis (PrEP)

Pre-exposure prophylaxis (often abbreviated as PrEP) is the use of prescription drugs by those who do not have HIV to prevent HIV infection. PrEP drugs are taken prior to HIV exposure to prevent the transmission of the virus, usually between sexual partners. PrEP drugs do not prevent other STI infections or pregnancy.[citation needed]

As of 2018, the most-widely approved form of PrEP combines two drugs (tenofovir and emtricitabine) in one pill. That drug combination is sold under the brand name Truvada by Gilead Sciences. It is also sold in generic formulations worldwide. Other drugs are also being studied for use as PrEP.[citation needed]

Different countries have approved different protocols for using the tenofovir/emtricitabine-combination drug as PrEP. That two-drug combination has been shown to prevent HIV infection in different populations when taken daily, intermittently, and on demand. Numerous studies have found the tenofovir/emtricitabine combination to be over 90% effective at preventing HIV transmission between sexual partners.

Treatment as prevention

Treatment as Prevention (often abbreviated as TasP) is the practice of testing for and treating HIV infection as a way to prevent further spread of the virus. Those having knowledge of their HIV-positive status can use safe-sex practices to protect themselves and their partners (such as using condoms, sero-sorting partners, or choosing less-risky sexual activities). And, because HIV-positive people with durably suppressed or undetectable amounts of HIV in their blood cannot transmit HIV to sexual partners, sexual activity with HIV-positive partners on effective treatment is a form of safe sex (to prevent HIV infection). This fact has given rise to the concept of "U=U" ("Undetectable = Untransmittable").

Other forms of safe sex

Other methods proven effective at reducing STI risks during sexual activity are:

  • Immunization against certain sexually-transmitted viruses. The most common vaccines protect against hepatitis B and human papilloma virus (HPV), which can cause cervical cancer, penile cancer, oral cancer, and genital warts. Immunization before initiation of sexual activity increases effectiveness of these vaccines. HPV vaccines are recommended for all teen girls and women as well as teen boys and men through age 26 and 21 respectively.
  • Limiting numbers of sexual partners, particularly casual sexual partners, or restricting sexual activity to those who know and share their STI status, can also reduce STI risks. Monogamy or polyfidelity, practiced faithfully, is very safe (as far as STIs are concerned) when all partners are non-infected. However, many monogamous people have been infected with sexually transmitted diseases by partners who are sexually unfaithful, have used injection drugs, or were infected by previous sexual partners. The same risks apply to polyfidelitous people, who face higher risks depending on how many people are in the polyfidelitous group.
  • Communication with sexual partners about sexual history and STI status, preferred safe sex practices, and acceptable risks for partnered sexual activities.
  • Engaging in less-risky sexual activities. In general, solo sexual activities are less risky than partnered activities. Sexual penetration of orifices (mouth, vagina, anus) and sharing body fluids (such as semen, blood, vaginal fluids, and rectal mucus) between sexual partners carry the most risk for STIs.
  • Regular STI testing and treatment, especially by those who are sexually active with more than one casual sexual partner. It is possible to attain and show proof of STD-free-verification through online dating apps and websites.
  • Penile circumcision. Some research suggests that circumcising (removing) the foreskin of the penis can reduce the risk of contracting HIV. Some advocacy groups dispute these findings.

General

Most methods of contraception are not effective at preventing the spread of STIs. This includes birth control pills, vasectomy, tubal ligation, periodic abstinence, IUDs and many non-barrier methods of pregnancy prevention. However, condoms are highly effective for birth control and STI prevention.[citation needed]

The spermicide nonoxynol-9 has been claimed to reduce the likelihood of STI transmission. However, a technical report by the World Health Organization has shown that nonoxynol-9 is an irritant and can produce tiny tears in mucous membranes, which may increase the risk of transmission by offering pathogens more easy points of entry into the system. They reported that nonoxynol-9 lubricant do not have enough spermicide to increase contraceptive effectiveness cautioned they should not be promoted. There is no evidence that spermicidal condoms are better at preventing STD transmission compared to condoms that do not have spermicide. If used properly, spermicidal condoms can prevent pregnancy, but there is still an increased risk that nonoxynyl-9 can irritate the skin, making it more susceptible for infections.

The use of a diaphragm or contraceptive sponge provides some women with better protection against certain sexually transmitted diseases, but they are not effective for all STIs.

Hormonal methods of preventing pregnancy (such as oral contraceptives [i.e. 'The pill'], depoprogesterone, hormonal IUDs, the vaginal ring, and the patch) offer no protection against STIs. The copper intrauterine device and the hormonal intrauterine device provide an up to 99% protection against pregnancies but no protection against STIs. Women with copper intrauterine device may be subject to greater risk of infection from bacterial infectious such as gonorrhea or chlamydia, although this is debated.

Coitus interruptus (or "pulling out"), in which the penis is removed from the vagina, anus, or mouth before ejaculation, may reduce transmission of STIs but still carries significant risk. This is because pre-ejaculate, a fluid that oozes from the penile urethra before ejaculation, may contain STI pathogens. Additionally, the microbes responsible for some diseases, including genital warts and syphilis, can be transmitted through skin-to-skin or mucous membrane contact.[citation needed]

Anal sex

Unprotected anal penetration is considered a high-risk sexual activity because the thin tissues of the anus and rectum can be easily damaged. Slight injuries can allow the passage of bacteria and viruses, including HIV. This includes penetration of the anus by fingers, hands, or sex toys such as dildos. Also, condoms may be more likely to break during anal sex than during vaginal sex, increasing the risk of STI transmission.

The main risk which individuals are exposed to when performing anal sex is the transmission of HIV. Other possible infections include hepatitis A, B and C; intestinal parasite infections like Giardia; and bacterial infections such as Escherichia coli.

Anal sex should be avoided by couples in which one of the partners has been diagnosed with an STI until the treatment has proven to be effective.

In order to make anal sex safer, the couple must ensure that the anal area is clean and the bowel empty and the partner on whom anal penetration occurs should be able to relax. Regardless of whether anal penetration occurs by using a finger or the penis, the condom is the best barrier method to prevent transmission of STI. Enemas should not be used as they can increase the risk of HIV infection and lymphogranuloma venereum proctitis.

Since the rectum can be easily damaged, the use of lubricants is highly recommended even when penetration occurs by using the finger. Especially for beginners, using a condom on the finger is both a protection measure against STI and a lubricant source. Most condoms are lubricated and they allow less painful and easier penetration. Oil-based lubricants damage latex and should not be used with condoms; water-based and silicone-based lubricants are available instead. Non-latex condoms are available for people who are allergic to latex made out of polyurethane or polyisoprene. Polyurethane condoms can safely be used with oil-based lubricant. The "female condom" may also be used effectively by the anal receiving partner.

Anal stimulation with a sex toy requires similar safety measures to anal penetration with a penis, in this case using a condom on the sex toy in a similar way.

It is important that the man washes and cleans his penis after anal intercourse if he intends to penetrate the vagina. Bacteria from the rectum are easily transferred to the vagina, which may cause vaginal and urinary tract infections.

When anal-oral contact occurs, protection is required since this is a risky sexual behavior in which illnesses as hepatitis A or STIs can be easily transmitted, as well as enteric infections. The dental dam or plastic wrap are effective protection means whenever anilingus is performed.

Two sex toys intended for anal use (note the flared bases)

Putting a condom on a sex toy provides better sexual hygiene and can help to prevent transmission of infections if the sex toy is shared, provided the condom is replaced when used by a different partner. Some sex toys are made of porous materials, and pores retain viruses and bacteria, which makes it necessary to clean sex toys thoroughly, preferably with use of cleaners specifically for sex toys. Glass is non-porous and medical grade glass sex toys more easily sterilized between uses.

In cases in which one of the partners is treated for an STI, it is recommended that the couple not use sex toys until the treatment has proved to be effective.

All sex toys have to be properly cleaned after use. The way in which a sex toy is cleaned varies on the type of material it is made of. Some sex toys can be boiled or cleaned in a dishwasher. Most of the sex toys come with advice on the best way to clean and store them and these instructions should be carefully followed. A sex toy should be cleaned not only when it is shared with other individuals but also when it is used on different parts of the body (such as mouth, vagina or anus).

A sex toy should regularly be checked for scratches or breaks that can be breeding ground for bacteria. It is best if the damaged sex toy is replaced by a new undamaged one. Even more hygiene protection should be considered by pregnant women when using sex toys. Sharing any type of sex toy that may draw blood, like whips or needles, is not recommended, and is not safe.

When using sex toys in the anus, sex toys "...can easily get lost" as "rectal muscles contract and can suck an object up and up, potentially obstructing the colon"; to prevent this serious problem, sex toy users are advised to use sex "...toys with a flared base or a string".

Sexual abstinence reduces STIs and pregnancy risks associated with sexual contact, but STIs may also be transmitted through non-sexual means, or by rape. HIV may be transmitted through contaminated needles used in tattooing, body piercing, or injections. Medical or dental procedures using contaminated instruments can also spread HIV, while some health-care workers have acquired HIV through occupational exposure to accidental injuries with needles. Evidence does not support the use of abstinence-only sex education. Abstinence-only sex education programs have been found to be ineffective in decreasing rates of HIV infection in the developed world and unplanned pregnancy. Abstinence-only sex education primarily relies on the consequences of character and morality while health care professionals are concerned about matters regarding health outcomes and behaviors. Though abstinence is the best course to prevent pregnancy and STIs, in reality, it leaves young people without the information and skills they need to avoid unwanted pregnancies and STIs.

  1. Compact Oxford English Dictionary, Oxford University Press, 2009, Accessed 23 September 2009
  2. "Global strategy for the prevention and control of sexually transmitted infections: 2006–2015. Breaking the chain of transmission"(PDF). World Health Organization. 2007. Retrieved26 November 2011.
  3. Chin HB, Sipe TA, Elder R, Mercer SL, Chattopadhyay SK, Jacob V, et al. (March 2012). "The effectiveness of group-based comprehensive risk-reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy, human immunodeficiency virus, and sexually transmitted infections: two systematic reviews for the Guide to Community Preventive Services". American Journal of Preventive Medicine. 42 (3): 272–94. doi:10.1016/j.amepre.2011.11.006. PMID 22341164.
  4. Stephey MJ (11 December 2008). "A Brief History of Safe Sex". Time. Retrieved14 September 2018. In the 1540s, an Italian doctor named Gabriele Fallopius — the same man who discovered and subsequently named the Fallopian tubes of the female anatomy — wrote about syphilis, advocating the use of layered linen during intercourse for more "adventurous" (read: promiscuous) men. Legendary lover Casanova wrote about his pitfalls with medieval condoms made of dried sheep gut, referring to them as "dead skins" in his memoir. Even so, condoms made of animal intestine — known as "French letters" in England and la capote anglaise (English riding coats) in France — remained popular for centuries, though always expensive and never easy to obtain, meaning the devices were often reused.
  5. "The meaning and origin of the expression: Safe sex". The Phrase Finder. Retrieved14 September 2018.
  6. Joseph S (17 May 2013). "How to have sex in an epidemic: 30th anniversary". POZ. Retrieved14 September 2018.
  7. Merson MH, O'Malley J, Serwadda D, Apisuk C (August 2008). "The history and challenge of HIV prevention". Lancet. 372 (9637): 475–88. doi:10.1016/S0140-6736(08)60884-3. PMID 18687461. S2CID 26554589.
  8. Berkowitz R (2003). Stayin' Alive: The Invention of Safe Sex. Boulder, CO: WestView. ISBN 9780813340920.
  9. Blair TR (June 2017). "Safe Sex in the 1970s: Community Practitioners on the Eve of AIDS". American Journal of Public Health. 107 (6): 872–879. doi:10.2105/AJPH.2017.303704. PMC5425850. PMID 28426312.
  10. "How Do Californians Define Safe Sex?"(PDF). Archived from the original(PDF) on 12 August 2006. Retrieved28 July 2010.
  11. Gross, Jane (22 September 1985). "HOMOSEXUALS STEPPING UP AIDS EDUCATION". The New York Times. The New York Times Company. Retrieved26 September 2021.
  12. "Sexual Health". NHS. 26 April 2018. Retrieved8 April 2019.
  13. "How You Can Prevent Sexually Transmitted Diseases". Centers for Disease Control. 30 March 2020. Retrieved2 April 2021.
  14. "Safer Sex ("Safe Sex")". Retrieved23 September 2009.
  15. LaRosa, Judith; Bader, Helaine; Garfield, Susan (2009). New Dimensions In Women's Health. Jones & Bartlett Learning. p. 91. ISBN 978-0763765927. Retrieved31 August 2013. Outercourse is the sharing of sexual intimacy with behaviors such as private part kissing, petting, and mutual masturbation. The advantages of outercourse include no risk of pregnancy without penile-vaginal penetration and the behaviors permit emotional bonding and closeness.
  16. White, Lois; Duncan, Gena; Baumle, Wendy (2011). Medical Surgical Nursing: An Integrated Approach, 3rd ed. Cengage Learning. p. 1161. ISBN 978-1133707141. Retrieved1 September 2013. Some people consider outercourse to mean sex play without vaginal intercourse, while others consider this to mean sex play with no penetration at all (vaginal, oral, or anal).
  17. "STDs (Sexually Transmitted Diseases)". Archived from the original on 2 February 2014. Retrieved23 January 2014.
  18. Corinna H (2016). S.E.X.: The All-You-Need-to-Know Sexuality Guide to Get You Through Your Teens and Twenties. New York: Da Capo Lifelong Press. ISBN 978-0738218847.
  19. Moon A (2018). Girl Sex 101. Lunatic Ink. ISBN 978-0983830900.
  20. Corinna H (2016). S.E.X.: The All-You-Need-to-Know Sexuality Guide to Get You Through Your Teens and Twenties (second ed.). New York: Da Capo Lifelong Press. p. 294. ISBN 978-0738218847.
  21. Varghese B, Maher JE, Peterman TA, Branson BM, Steketee RW (January 2002). "Reducing the risk of sexual HIV transmission: quantifying the per-act risk for HIV on the basis of choice of partner, sex act, and condom use"(PDF). Sexually Transmitted Diseases. 29 (1): 38–43. doi:10.1097/00007435-200201000-00007. PMID 11773877. S2CID 45262002. Archived from the original(PDF) on 24 July 2011.
  22. "Pre-Exposure Prophylaxis (PrEP)". Centers for Disease Control and Prevention. 19 September 2016. Retrieved14 March 2017.
  23. "U=U". Prevention Access Campaign. 2017. Retrieved11 September 2018.
  24. "Prevention - STD Information from CDC". www.cdc.gov. 28 May 2019. Retrieved5 August 2019.
  25. Kahn JO, Walker BD (July 1998). "Acute human immunodeficiency virus type 1 infection". The New England Journal of Medicine. 339 (1): 33–9. doi:10.1056/NEJM199807023390107. PMID 9647878.
  26. Daar ES, Little S, Pitt J, Santangelo J, Ho P, Harawa N, et al. (January 2001). "Diagnosis of primary HIV-1 infection. Los Angeles County Primary HIV Infection Recruitment Network". Annals of Internal Medicine. 134 (1): 25–9. doi:10.7326/0003-4819-134-1-200101020-00010. PMID 11187417. S2CID 34714025.
  27. Do you know his STD status? There’s an app for that
  28. Tinder adds link to healthvana for STD-checking purposes
  29. "Circumcision (male)". Mayo Clinic. Retrieved10 May 2020.
  30. "WHO agrees HIV circumcision plan". BBC World News. BBC. 3 March 2007. Retrieved12 July 2008.
  31. "Circumcision and HIV - the Randomised Controlled Trials". www.circumstitions.com.
  32. "Circumcision and AIDS". Archived from the original on 23 July 2008.
  33. "Technical Consultation on Nonoxynol-9"(PDF). WHO. October 2001. Retrieved10 March 2018.
  34. "How Do I Make Sex Safer? | Common Questions and Answers". www.plannedparenthood.org. Retrieved2 August 2019.
  35. Fackelmann KA (1992). "Diaphragm and sponge protect against STDs - sexually transmitted diseases". Science News. Archived from the original on 4 April 2010. Retrieved5 April 2010.
  36. Hubacher D (November 2014). "Intrauterine devices & infection: review of the literature". The Indian Journal of Medical Research. 140 Suppl (Suppl 1): S53-7. PMC4345753. PMID 25673543.
  37. Dean J, Delvin D. "Anal sex". Netdoctor.co.uk. Retrieved29 April 2010.
  38. Voeller B. AIDS and heterosexual anal intercourse. Arch Sex Behav 1991; 20:233–276. as cited in Leichliter, Jami S. PhD, "Heterosexual Anal Sex: Part of an Expanding Sexual Repertoire?" in Sexually Transmitted Diseases: November 2008 – Volume 35 – Issue 11 – pp 910–911 [1] Accessed 26 January 2010
  39. "Can I get HIV from anal sex?". Retrieved19 August 2011.
  40. "Anal Sex". CDC. Retrieved10 March 2018.
  41. Carballo-Diéguez A, Bauermeister JA, Ventuneac A, Dolezal C, Balan I, Remien RH (November 2008). "The use of rectal douches among HIV-uninfected and infected men who have unprotected receptive anal intercourse: implications for rectal microbicides". AIDS and Behavior. 12 (6): 860–6. doi:10.1007/s10461-007-9301-0. PMC2953367. PMID 17705033.
  42. de Vries HJ, van der Bij AK, Fennema JS, Smit C, de Wolf F, Prins M, et al. (February 2008). "Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high-risk behavior". Sexually Transmitted Diseases. 35 (2): 203–8. doi:10.1097/OLQ.0b013e31815abb08. PMID 18091565. S2CID 2065170.
  43. Steiner M, Piedrahita C, Glover L, Joanis C, Spruyt A, Foldesy R (1993). "The impact of lubricants on latex condoms during vaginal intercourse"(PDF). International Journal of STD & AIDS. 5 (1): 29–36. CiteSeerX10.1.1.574.1501. doi:10.1177/095646249400500108. PMID 8142525. S2CID 9271973.
  44. "Condoms". NHS. 21 December 2017. Retrieved10 March 2018.
  45. "Clinical Prevention Guidance - 2015 STD Treatment Guidelines". www.cdc.gov. 10 October 2017. Retrieved10 March 2018.
  46. "Anal Sex - Facts and Safe Sex Information". Archived from the original on 4 April 2010. Retrieved5 April 2010.
  47. Van Dyk AC (2008). HIVAIDS care & counselling : a multidisciplinary approach (4th ed.). Cape Town: Pearson Education South Africa. p. 157. ISBN 9781770251717. OCLC 225855360.
  48. "The Safety Dance: Sex Toy Safety for a New Generation". Kinsey Confidential. Archived from the original on 4 June 2017. Retrieved9 May 2017.
  49. "Are sex toys safe?". Retrieved31 March 2010.
  50. "Are sex toys safe? - Health questions - NHS Choices". 27 June 2018.
  51. Nuzzo R. "Good Vibrations: U.S. Consumer Web Site Aims to Enhance Sex Toy Safety".
  52. Do AN, Ciesielski CA, Metler RP, Hammett TA, Li J, Fleming PL (February 2003). "Occupationally acquired human immunodeficiency virus (HIV) infection: national case surveillance data during 20 years of the HIV epidemic in the United States". Infection Control and Hospital Epidemiology. 24 (2): 86–96. doi:10.1086/502178. PMID 12602690. S2CID 20112502.
  53. Ott MA, Santelli JS (October 2007). "Abstinence and abstinence-only education". Current Opinion in Obstetrics & Gynecology. 19 (5): 446–52. doi:10.1097/GCO.0b013e3282efdc0b. PMC5913747. PMID 17885460.
  54. Underhill K, Operario D, Montgomery P (October 2007). Operario D (ed.). "Abstinence-only programs for HIV infection prevention in high-income countries". The Cochrane Database of Systematic Reviews (4): CD005421. doi:10.1002/14651858.CD005421.pub2. PMID 17943855.
  55. Santelli JS, Kantor LM, Grilo SA, Speizer IS, Lindberg LD, Heitel J, et al. (September 2017). "Abstinence-Only-Until-Marriage: An Updated Review of U.S. Policies and Programs and Their Impact". The Journal of Adolescent Health. 61 (3): 273–280. doi:10.1016/j.jadohealth.2017.05.031. PMID 28842065.
Wikimedia Commons has media related toSafer sex.

Safe sex
Safe sex Article Talk Language Watch Edit For the Greek film see Safe Sex film Safe sex is sexual activity using methods or devices such as condoms to reduce the risk of transmitting or acquiring sexually transmitted infections STIs especially HIV 1 Safe sex is also sometimes referred to as safer sex or protected sex to indicate that some safe sex practices do not eliminate STI risks It is also sometimes used colloquially to describe methods aimed at preventing pregnancy that may or may not also lower STI risks Male or external condoms can be used to cover the penis or fingers or other body parts for safer sex when inserting into body cavities Dental dams can be used to cover the vulva or anus when engaging in cunnilingus or anilingus respectively for safer sex Female condoms internal condoms can be used by receptive partners for safer sex The concept of safe sex emerged in the 1980s as a response to the global AIDS epidemic and possibly more specifically to the AIDS crisis in the US Promoting safe sex is now one of the main aims of sex education and STI prevention especially reducing new HIV infections Safe sex is regarded as a harm reduction strategy aimed at reducing the risk of STI transmission 2 3 Although some safe sex practices like condoms can also be used as birth control contraception most forms of contraception do not protect against STIs Likewise some safe sex practices such as partner selection and low risk sex behavior example needed might not be effective forms of contraception Contents 1 History 2 Practices 2 1 Phone sex cybersex sexting 2 2 Non penetrative sex 2 3 Condoms dental dams gloves 2 4 Pre exposure prophylaxis PrEP 2 5 Treatment as prevention 2 6 Other forms of safe sex 3 Ineffective methods 3 1 General 3 2 Anal sex 4 Sex toys 5 Abstinence 6 See also 7 References 8 External linksHistory EditThis section needs additional citations for verification Please help improve this article by adding citations to reliable sources Unsourced material may be challenged and removed Find sources Safe sex news newspapers books scholar JSTOR March 2018 Learn how and when to remove this template message Although strategies for avoiding STIs like syphilis and gonorrhea have existed for centuries and the term safe sex existed in English as early as the 1930s the use of the term to refer to STI risk reduction dates to the mid 1980s in the United States It emerged in response to the HIV AIDS crisis 4 5 A year before the HIV virus was isolated and named the San Francisco chapter of the Sisters of Perpetual Indulgence published a small pamphlet titled Play Fair out of concern over widespread STIs among the city s gay male population It specifically named illnesses Kaposi s sarcoma and pneumocystis pneumonia that would later be understood as symptoms of advanced HIV disease or AIDS The pamphlet advocated a range of safe sex practices including abstinence condoms personal hygiene use of personal lubricants and STI testing treatment It took a casual sex positive approach while also emphasizing personal and social responsibility In May 1983 the same month HIV was isolated and named in France the New York City based HIV AIDS activists Richard Berkowitz and Michael Callen published similar advice in their booklet How to Have Sex in an Epidemic One Approach Neither publication used the term safe sex but both included recommendations that are now standard advice for reducing STI including HIV risks 6 7 8 A poster promotes condom use Safe sex as a form of STI risk reduction appeared in journalism as early as 1984 in the British publication The Daily Intelligencer The goal is to reach about 50 million people with messages about safe sex and AIDS education 5 Although safe sex is used by individuals to refer to protection against both pregnancy and HIV AIDS or other STI transmissions the term was born in response to the HIV AIDS epidemic It is believed that the term safe sex was used in the professional literature in 1984 in the content of a paper on the psychological effect that HIV AIDS may have on gay and bisexual men 9 A poster aimed at lesbians says Low risk isn t no risk It uses the expression safer sex A year later the same term appeared in an article in The New York Times This article emphasized that most specialists advised their AIDS patients to practice safe sex The concept included limiting the number of sexual partners using prophylactics avoiding bodily fluid exchange and resisting the use of drugs that reduced inhibitions for high risk sexual behavior 10 Moreover in 1985 the first safe sex guidelines were established by the Coalition for Sexual Responsibilities who According to these guidelines safe sex was practiced by using condoms also when engaging in anal or oral sex 11 Although the term safe sex was primarily used in reference to sexual activity between men in 1986 the concept was spread to the general population Various programs were developed with the aim of promoting safe sex practices among college students These programs were focused on promoting the use of the condom a better knowledge about the partner s sexual history and limiting the number of sexual partners The first book on this subject appeared in the same year The book was entitled Safe Sex in the Age of AIDS and had 88 pages that described both positive and negative approaches to sexual life citation needed Sexual behavior could be safe kissing hugging massage body to body rubbing mutual masturbation exhibitionism phone sex and use of separate sex toys possibly safe use of condoms or unsafe 10 In 1997 specialists in this matter promoted the use of condoms as the most accessible safe sex method besides abstinence and they called for TV commercials featuring condoms During the same year the Catholic Church in the United States issued their own safer sex guidelines on which condoms were listed though two years later the Vatican urged chastity and heterosexual marriage attacking the American Catholic bishops guidelines citation needed A study carried out in 2006 by Californian specialists showed that the most common definitions of safe sex are condom use 68 of the interviewed subjects abstinence 31 1 of the interviewed subjects monogamy 28 4 of the interviewed subjects and safe partner 18 7 of the interviewed subjects 10 The term safer sex in Canada and the United States has gained greater use by health workers reflecting that risk of transmission of sexually transmitted infections in various sexual activities is a continuum The term safe sex is still in common use in the United Kingdom 12 Australia and New Zealand Safer sex is thought to be a more aggressive term which may make it more obvious to individuals that any type of sexual activity carries a certain degree of risk The term safe love has also been used notably by the French Sidaction in the promotion of men s underpants incorporating a condom pocket and including the red ribbon symbol in the design which were sold to support the charity Practices EditA range of safe sex practices are commonly recommended by sexual health educators and public health agencies Many of these practices can reduce but not eliminate risk of transmitting or acquiring STIs 13 Phone sex cybersex sexting Edit Sexual activities such as phone sex cybersex and sexting that do not include direct contact with the skin or bodily fluids of sexual partners carry no STI risks and thus are forms of safe sex 14 Non penetrative sex Edit Watercolor of manual stimulation of the penis Johann Nepomuk Geiger 1840 Main article Non penetrative sex A range of sex acts called non penetrative sex or outercourse can significantly reduce STI risks Non penetrative sex includes practices such as kissing mutual masturbation rubbing or stroking 15 16 According to the Health Department of Western Australia this sexual practice may prevent pregnancy and most STIs However non penetrative sex may not protect against infections that can be transmitted via skin to skin contact such as herpes and human papilloma virus 17 Mutual or partnered masturbation carries some STI risk especially if there is skin contact or shared bodily fluids with sexual partners although the risks are significantly lower than many other sexual activities 14 Condoms dental dams gloves Edit Barriers such as condoms dental dams and medical gloves can prevent contact with body fluids such as blood vaginal fluid semen rectal mucus and other means of transmitting STIs like skin hair and shared objects during sexual activity citation needed How to put a male condom on a penis External condoms can be used to cover the penis hands fingers or other body parts during sexual penetration or stimulation 18 They are most frequently made of latex and can also be made out of synthetic materials including polyurethane and polyisoprene Internal condoms also called female condoms are inserted into the vagina or anus prior to sexual penetration These condoms are made of either polyurethane or nitrile If external and internal condoms are used at the same time they may break due to friction between the materials during sexual activity A dental dam originally used in dentistry is a sheet of latex used for protection when engaging in oral sex It is typically used as a barrier between the mouth and the vulva during cunnilingus or between the mouth and the anus during anal oral sex Medical gloves made out of latex vinyl nitrile or polyurethane may be used as a makeshift dental dam during oral sex or can cover hands fingers or other body parts during penetration or sexual stimulation such as masturbation 18 19 Condoms dental dams and gloves can also be used to cover sex toys such as dildos during sexual stimulation or penetration 18 19 If a sex toy is to be used in more than one orifice or partner a condom dental dam glove can be used over it and changed when the toy is moved Oil based lubrication can break down the structure of latex condoms dental dams or gloves reducing their effectiveness for STI protection 20 While use of external condoms can reduce STI risks during sexual activity they are not 100 effective One study has suggested condoms might reduce HIV transmission by 85 to 95 effectiveness beyond 95 was deemed unlikely because of slippage breakage and incorrect use 21 It also said In practice inconsistent use may reduce the overall effectiveness of condoms to as low as 60 70 21 p 40 Pre exposure prophylaxis PrEP Edit Main article Pre exposure prophylaxis Pre exposure prophylaxis often abbreviated as PrEP is the use of prescription drugs by those who do not have HIV to prevent HIV infection PrEP drugs are taken prior to HIV exposure to prevent the transmission of the virus usually between sexual partners PrEP drugs do not prevent other STI infections or pregnancy citation needed As of 2018 the most widely approved form of PrEP combines two drugs tenofovir and emtricitabine in one pill That drug combination is sold under the brand name Truvada by Gilead Sciences It is also sold in generic formulations worldwide Other drugs are also being studied for use as PrEP citation needed Different countries have approved different protocols for using the tenofovir emtricitabine combination drug as PrEP That two drug combination has been shown to prevent HIV infection in different populations when taken daily intermittently and on demand Numerous studies have found the tenofovir emtricitabine combination to be over 90 effective at preventing HIV transmission between sexual partners 22 Treatment as prevention Edit Main article Treatment as prevention Treatment as Prevention often abbreviated as TasP is the practice of testing for and treating HIV infection as a way to prevent further spread of the virus Those having knowledge of their HIV positive status can use safe sex practices to protect themselves and their partners such as using condoms sero sorting partners or choosing less risky sexual activities And because HIV positive people with durably suppressed or undetectable amounts of HIV in their blood cannot transmit HIV to sexual partners sexual activity with HIV positive partners on effective treatment is a form of safe sex to prevent HIV infection This fact has given rise to the concept of U U Undetectable Untransmittable 23 Other forms of safe sex Edit Other methods proven effective at reducing STI risks during sexual activity are Immunization against certain sexually transmitted viruses The most common vaccines protect against hepatitis B and human papilloma virus HPV which can cause cervical cancer penile cancer oral cancer and genital warts Immunization before initiation of sexual activity increases effectiveness of these vaccines HPV vaccines are recommended for all teen girls and women as well as teen boys and men through age 26 and 21 respectively 24 Limiting numbers of sexual partners particularly casual sexual partners or restricting sexual activity to those who know and share their STI status can also reduce STI risks Monogamy or polyfidelity practiced faithfully is very safe as far as STIs are concerned when all partners are non infected However many monogamous people have been infected with sexually transmitted diseases by partners who are sexually unfaithful have used injection drugs or were infected by previous sexual partners The same risks apply to polyfidelitous people who face higher risks depending on how many people are in the polyfidelitous group Communication with sexual partners about sexual history and STI status preferred safe sex practices and acceptable risks for partnered sexual activities Engaging in less risky sexual activities In general solo sexual activities are less risky than partnered activities Sexual penetration of orifices mouth vagina anus and sharing body fluids such as semen blood vaginal fluids and rectal mucus between sexual partners carry the most risk for STIs Regular STI testing and treatment especially by those who are sexually active with more than one casual sexual partner 25 26 It is possible to attain and show proof of STD free verification through online dating apps and websites 27 28 Penile circumcision Some research suggests that circumcising removing the foreskin of the penis can reduce the risk of contracting HIV 29 30 Some advocacy groups dispute these findings 31 32 Ineffective methods EditGeneral Edit Most methods of contraception are not effective at preventing the spread of STIs This includes birth control pills vasectomy tubal ligation periodic abstinence IUDs and many non barrier methods of pregnancy prevention However condoms are highly effective for birth control and STI prevention citation needed The spermicide nonoxynol 9 has been claimed to reduce the likelihood of STI transmission However a technical report 33 by the World Health Organization has shown that nonoxynol 9 is an irritant and can produce tiny tears in mucous membranes which may increase the risk of transmission by offering pathogens more easy points of entry into the system They reported that nonoxynol 9 lubricant do not have enough spermicide to increase contraceptive effectiveness cautioned they should not be promoted There is no evidence that spermicidal condoms are better at preventing STD transmission compared to condoms that do not have spermicide If used properly spermicidal condoms can prevent pregnancy but there is still an increased risk that nonoxynyl 9 can irritate the skin making it more susceptible for infections 33 34 The use of a diaphragm or contraceptive sponge provides some women with better protection against certain sexually transmitted diseases 35 but they are not effective for all STIs Hormonal methods of preventing pregnancy such as oral contraceptives i e The pill depoprogesterone hormonal IUDs the vaginal ring and the patch offer no protection against STIs The copper intrauterine device and the hormonal intrauterine device provide an up to 99 protection against pregnancies but no protection against STIs Women with copper intrauterine device may be subject to greater risk of infection from bacterial infectious such as gonorrhea or chlamydia although this is debated 36 Coitus interruptus or pulling out in which the penis is removed from the vagina anus or mouth before ejaculation may reduce transmission of STIs but still carries significant risk This is because pre ejaculate a fluid that oozes from the penile urethra before ejaculation may contain STI pathogens Additionally the microbes responsible for some diseases including genital warts and syphilis can be transmitted through skin to skin or mucous membrane contact citation needed Anal sex Edit Unprotected anal penetration is considered a high risk sexual activity because the thin tissues of the anus and rectum can be easily damaged 37 38 Slight injuries can allow the passage of bacteria and viruses including HIV This includes penetration of the anus by fingers hands or sex toys such as dildos Also condoms may be more likely to break during anal sex than during vaginal sex increasing the risk of STI transmission 39 The main risk which individuals are exposed to when performing anal sex is the transmission of HIV Other possible infections include hepatitis A B and C intestinal parasite infections like Giardia and bacterial infections such as Escherichia coli 40 Anal sex should be avoided by couples in which one of the partners has been diagnosed with an STI until the treatment has proven to be effective In order to make anal sex safer the couple must ensure that the anal area is clean and the bowel empty and the partner on whom anal penetration occurs should be able to relax Regardless of whether anal penetration occurs by using a finger or the penis the condom is the best barrier method to prevent transmission of STI Enemas should not be used as they can increase the risk of HIV infection 41 and lymphogranuloma venereum proctitis 42 Since the rectum can be easily damaged the use of lubricants is highly recommended even when penetration occurs by using the finger Especially for beginners using a condom on the finger is both a protection measure against STI and a lubricant source Most condoms are lubricated and they allow less painful and easier penetration Oil based lubricants damage latex and should not be used with condoms 43 water based and silicone based lubricants are available instead Non latex condoms are available for people who are allergic to latex made out of polyurethane or polyisoprene 44 Polyurethane condoms can safely be used with oil based lubricant 45 The female condom may also be used effectively by the anal receiving partner Anal stimulation with a sex toy requires similar safety measures to anal penetration with a penis in this case using a condom on the sex toy in a similar way It is important that the man washes and cleans his penis after anal intercourse if he intends to penetrate the vagina Bacteria from the rectum are easily transferred to the vagina which may cause vaginal and urinary tract infections 46 When anal oral contact occurs protection is required since this is a risky sexual behavior in which illnesses as hepatitis A or STIs can be easily transmitted as well as enteric infections The dental dam or plastic wrap 47 are effective protection means whenever anilingus is performed Sex toys Edit Two sex toys intended for anal use note the flared bases Putting a condom on a sex toy provides better sexual hygiene and can help to prevent transmission of infections if the sex toy is shared provided the condom is replaced when used by a different partner Some sex toys are made of porous materials and pores retain viruses and bacteria which makes it necessary to clean sex toys thoroughly preferably with use of cleaners specifically for sex toys Glass is non porous and medical grade glass sex toys more easily sterilized between uses 48 In cases in which one of the partners is treated for an STI it is recommended that the couple not use sex toys until the treatment has proved to be effective All sex toys have to be properly cleaned after use The way in which a sex toy is cleaned varies on the type of material it is made of Some sex toys can be boiled or cleaned in a dishwasher Most of the sex toys come with advice on the best way to clean and store them and these instructions should be carefully followed 49 A sex toy should be cleaned not only when it is shared with other individuals but also when it is used on different parts of the body such as mouth vagina or anus A sex toy should regularly be checked for scratches or breaks that can be breeding ground for bacteria It is best if the damaged sex toy is replaced by a new undamaged one Even more hygiene protection should be considered by pregnant women when using sex toys Sharing any type of sex toy that may draw blood like whips or needles is not recommended and is not safe 50 When using sex toys in the anus sex toys can easily get lost as rectal muscles contract and can suck an object up and up potentially obstructing the colon to prevent this serious problem sex toy users are advised to use sex toys with a flared base or a string 51 Abstinence EditSexual abstinence reduces STIs and pregnancy risks associated with sexual contact but STIs may also be transmitted through non sexual means or by rape HIV may be transmitted through contaminated needles used in tattooing body piercing or injections Medical or dental procedures using contaminated instruments can also spread HIV while some health care workers have acquired HIV through occupational exposure to accidental injuries with needles 52 Evidence does not support the use of abstinence only sex education 53 Abstinence only sex education programs have been found to be ineffective in decreasing rates of HIV infection in the developed world 54 and unplanned pregnancy 53 Abstinence only sex education primarily relies on the consequences of character and morality while health care professionals are concerned about matters regarding health outcomes and behaviors 55 Though abstinence is the best course to prevent pregnancy and STIs in reality it leaves young people without the information and skills they need to avoid unwanted pregnancies and STIs 55 See also Edit Human sexuality portal Bareback sex Celibacy Masturbation Human sexual activity Misconceptions about HIV AIDS Party and play Post exposure prophylaxis Sisters of Perpetual Indulgence Terrence Higgins TrustReferences Edit Compact Oxford English Dictionary Oxford University Press 2009 Accessed 23 September 2009 Global strategy for the prevention and control of sexually transmitted infections 2006 2015 Breaking the chain of transmission PDF World Health Organization 2007 Retrieved 26 November 2011 Chin HB Sipe TA Elder R Mercer SL Chattopadhyay SK Jacob V et al March 2012 The effectiveness of group based comprehensive risk reduction and abstinence education interventions to prevent or reduce the risk of adolescent pregnancy human immunodeficiency virus and sexually transmitted infections two systematic reviews for the Guide to Community Preventive Services American Journal of Preventive Medicine 42 3 272 94 doi 10 1016 j amepre 2011 11 006 PMID 22341164 Stephey MJ 11 December 2008 A Brief History of Safe Sex Time Retrieved 14 September 2018 In the 1540s an Italian doctor named Gabriele Fallopius the same man who discovered and subsequently named the Fallopian tubes of the female anatomy wrote about syphilis advocating the use of layered linen during intercourse for more adventurous read promiscuous men Legendary lover Casanova wrote about his pitfalls with medieval condoms made of dried sheep gut referring to them as dead skins in his memoir Even so condoms made of animal intestine known as French letters in England and la capote anglaise English riding coats in France remained popular for centuries though always expensive and never easy to obtain meaning the devices were often reused a b The meaning and origin of the expression Safe sex The Phrase Finder Retrieved 14 September 2018 Joseph S 17 May 2013 How to have sex in an epidemic 30th anniversary POZ Retrieved 14 September 2018 Merson MH O Malley J Serwadda D Apisuk C August 2008 The history and challenge of HIV prevention Lancet 372 9637 475 88 doi 10 1016 S0140 6736 08 60884 3 PMID 18687461 S2CID 26554589 Berkowitz R 2003 Stayin Alive The Invention of Safe Sex Boulder CO WestView ISBN 9780813340920 Blair TR June 2017 Safe Sex in the 1970s Community Practitioners on the Eve of AIDS American Journal of Public Health 107 6 872 879 doi 10 2105 AJPH 2017 303704 PMC 5425850 PMID 28426312 a b c How Do Californians Define Safe Sex PDF Archived from the original PDF on 12 August 2006 Retrieved 28 July 2010 Gross Jane 22 September 1985 HOMOSEXUALS STEPPING UP AIDS EDUCATION The New York Times The New York Times Company Retrieved 26 September 2021 Sexual Health NHS 26 April 2018 Retrieved 8 April 2019 How You Can Prevent Sexually Transmitted Diseases Centers for Disease Control 30 March 2020 Retrieved 2 April 2021 a b Safer Sex Safe Sex Retrieved 23 September 2009 LaRosa Judith Bader Helaine Garfield Susan 2009 New Dimensions In Women s Health Jones amp Bartlett Learning p 91 ISBN 978 0763765927 Retrieved 31 August 2013 Outercourse is the sharing of sexual intimacy with behaviors such as private part kissing petting and mutual masturbation The advantages of outercourse include no risk of pregnancy without penile vaginal penetration and the behaviors permit emotional bonding and closeness White Lois Duncan Gena Baumle Wendy 2011 Medical Surgical Nursing An Integrated Approach 3rd ed Cengage Learning p 1161 ISBN 978 1133707141 Retrieved 1 September 2013 Some people consider outercourse to mean sex play without vaginal intercourse while others consider this to mean sex play with no penetration at all vaginal oral or anal STDs Sexually Transmitted Diseases Archived from the original on 2 February 2014 Retrieved 23 January 2014 a b c Corinna H 2016 S E X The All You Need to Know Sexuality Guide to Get You Through Your Teens and Twenties New York Da Capo Lifelong Press ISBN 978 0738218847 a b Moon A 2018 Girl Sex 101 Lunatic Ink ISBN 978 0983830900 Corinna H 2016 S E X The All You Need to Know Sexuality Guide to Get You Through Your Teens and Twenties second ed New York Da Capo Lifelong Press p 294 ISBN 978 0738218847 a b Varghese B Maher JE Peterman TA Branson BM Steketee RW January 2002 Reducing the risk of sexual HIV transmission quantifying the per act risk for HIV on the basis of choice of partner sex act and condom use PDF Sexually Transmitted Diseases 29 1 38 43 doi 10 1097 00007435 200201000 00007 PMID 11773877 S2CID 45262002 Archived from the original PDF on 24 July 2011 Pre Exposure Prophylaxis PrEP Centers for Disease Control and Prevention 19 September 2016 Retrieved 14 March 2017 U U Prevention Access Campaign 2017 Retrieved 11 September 2018 Prevention STD Information from CDC www cdc gov 28 May 2019 Retrieved 5 August 2019 Kahn JO Walker BD July 1998 Acute human immunodeficiency virus type 1 infection The New England Journal of Medicine 339 1 33 9 doi 10 1056 NEJM199807023390107 PMID 9647878 Daar ES Little S Pitt J Santangelo J Ho P Harawa N et al January 2001 Diagnosis of primary HIV 1 infection Los Angeles County Primary HIV Infection Recruitment Network Annals of Internal Medicine 134 1 25 9 doi 10 7326 0003 4819 134 1 200101020 00010 PMID 11187417 S2CID 34714025 Do you know his STD status There s an app for that Tinder adds link to healthvana for STD checking purposes Circumcision male Mayo Clinic Retrieved 10 May 2020 WHO agrees HIV circumcision plan BBC World News BBC 3 March 2007 Retrieved 12 July 2008 Circumcision and HIV the Randomised Controlled Trials www circumstitions com Circumcision and AIDS Archived from the original on 23 July 2008 a b Technical Consultation on Nonoxynol 9 PDF WHO October 2001 Retrieved 10 March 2018 How Do I Make Sex Safer Common Questions and Answers www plannedparenthood org Retrieved 2 August 2019 Fackelmann KA 1992 Diaphragm and sponge protect against STDs sexually transmitted diseases Science News Archived from the original on 4 April 2010 Retrieved 5 April 2010 Hubacher D November 2014 Intrauterine devices amp infection review of the literature The Indian Journal of Medical Research 140 Suppl Suppl 1 S53 7 PMC 4345753 PMID 25673543 Dean J Delvin D Anal sex Netdoctor co uk Retrieved 29 April 2010 Voeller B AIDS and heterosexual anal intercourse Arch Sex Behav 1991 20 233 276 as cited in Leichliter Jami S PhD Heterosexual Anal Sex Part of an Expanding Sexual Repertoire in Sexually Transmitted Diseases November 2008 Volume 35 Issue 11 pp 910 911 1 Accessed 26 January 2010 Can I get HIV from anal sex Retrieved 19 August 2011 Anal Sex CDC Retrieved 10 March 2018 Carballo Dieguez A Bauermeister JA Ventuneac A Dolezal C Balan I Remien RH November 2008 The use of rectal douches among HIV uninfected and infected men who have unprotected receptive anal intercourse implications for rectal microbicides AIDS and Behavior 12 6 860 6 doi 10 1007 s10461 007 9301 0 PMC 2953367 PMID 17705033 de Vries HJ van der Bij AK Fennema JS Smit C de Wolf F Prins M et al February 2008 Lymphogranuloma venereum proctitis in men who have sex with men is associated with anal enema use and high risk behavior Sexually Transmitted Diseases 35 2 203 8 doi 10 1097 OLQ 0b013e31815abb08 PMID 18091565 S2CID 2065170 Steiner M Piedrahita C Glover L Joanis C Spruyt A Foldesy R 1993 The impact of lubricants on latex condoms during vaginal intercourse PDF International Journal of STD amp AIDS 5 1 29 36 CiteSeerX 10 1 1 574 1501 doi 10 1177 095646249400500108 PMID 8142525 S2CID 9271973 Condoms NHS 21 December 2017 Retrieved 10 March 2018 Clinical Prevention Guidance 2015 STD Treatment Guidelines www cdc gov 10 October 2017 Retrieved 10 March 2018 Anal Sex Facts and Safe Sex Information Archived from the original on 4 April 2010 Retrieved 5 April 2010 Van Dyk AC 2008 HIVAIDS care amp counselling a multidisciplinary approach 4th ed Cape Town Pearson Education South Africa p 157 ISBN 9781770251717 OCLC 225855360 The Safety Dance Sex Toy Safety for a New Generation Kinsey Confidential Archived from the original on 4 June 2017 Retrieved 9 May 2017 Are sex toys safe Retrieved 31 March 2010 Are sex toys safe Health questions NHS Choices 27 June 2018 Nuzzo R Good Vibrations U S Consumer Web Site Aims to Enhance Sex Toy Safety Do AN Ciesielski CA Metler RP Hammett TA Li J Fleming PL February 2003 Occupationally acquired human immunodeficiency virus HIV infection national case surveillance data during 20 years of the HIV epidemic in the United States Infection Control and Hospital Epidemiology 24 2 86 96 doi 10 1086 502178 PMID 12602690 S2CID 20112502 a b Ott MA Santelli JS October 2007 Abstinence and abstinence only education Current Opinion in Obstetrics amp Gynecology 19 5 446 52 doi 10 1097 GCO 0b013e3282efdc0b PMC 5913747 PMID 17885460 Underhill K Operario D Montgomery P October 2007 Operario D ed Abstinence only programs for HIV infection prevention in high income countries The Cochrane Database of Systematic Reviews 4 CD005421 doi 10 1002 14651858 CD005421 pub2 PMID 17943855 a b Santelli JS Kantor LM Grilo SA Speizer IS Lindberg LD Heitel J et al September 2017 Abstinence Only Until Marriage An Updated Review of U S Policies and Programs and Their Impact The Journal of Adolescent Health 61 3 273 280 doi 10 1016 j jadohealth 2017 05 031 PMID 28842065 External links EditWikimedia Commons has media related to Safer sex Prevention Sexually Transmitted Disease AGUM Association of Genital Urinary Medicine Guidelines British Association for Sexual health and HIV BASHH Retrieved from https en wikipedia org w index php title Safe sex amp oldid 1055423769, wikipedia, wiki, book,

books

, library,

article

, read, download, free, free download, mp3, video, mp4, 3gp, jpg, jpeg, gif, png, picture, music, song, movie, book, game, games.