Talking Sex: Keeping it safe in the era of HIV
By, Dr Alverston Bailey, The Jamaica Gleaner, March 8, 2008
Safe sex (also called safer sex or protected sex) is a set of practices that are designed to reduce the risk of infection during sexual intercourse to avoid developing sexually transmitted diseases (STDs). On the other hand, unsafe sex refers to engaging in sexual intercourse without the use of any barrier contraception or other preventive measures against STDs.
Safe sex practices became a buzz word in the late 1980s as a result of the AIDS epidemic. Promoting safe sex is now a critical component of sex education. Safe sex should be regarded as a harm reduction strategy. Please note that safe sex is about risk reduction, not risk elimination.
Sexual contact is the most common route of HIV transmission. By December 2001, 51 per cent of all HIV infections among adolescents and adults reported to the U.S. Centers for Disease Control and Prevention (CDC) were sexually transmitted. Worldwide and in Jamaica, heterosexual transmission is the most common route of HIV infection.
Researchers consistently detect HIV in blood, semen and cervical secretions of infected persons. Infectious HIV exists in saliva, tears and urine. However, it has only been recovered from these fluids at extremely low titers, therefore, saliva, tears, and urine are unlikely sources of HIV transmission.
Infectious HIV has also been isolated in breast milk, and transmission from HIV-infected mothers to nursing infants is well documented. Breast milk is not commonly encountered during sexual intercourse. However, should you accidentally or intentionally come in contact with HIV-infected breast milk during sex, care should be taken to avoid contact with your eyes and mouth.
Let us now describe various sexual practices and the associated risks of HIV infection:
No-risk practices. These sexual activities cannot transmit HIV:
Masturbation
Touching, massaging, hugging, caressing
Social (dry) kissing
Any type of sexual intercourse between partners who are certain that they are uninfected.
Extremely low-risk practices. These activities carry a small (based on case reports) or theoretical risk of HIV transmission between partners of unlike or unknown HIV serostatus:
French (wet) kissing
Mutual masturbation (if no cuts on hands, and no ulcers or lesions on genitals of either partner)
Vaginal sex with a male or female condom (with proper use, including putting latex or polyurethane condom in place before any penetration)
Fellatio with condom (with latex condom placed on penis before oral contact)
Cunnilingus with dental dam (with latex dam placed over vaginal area before oral contact)
Contact with urine (only with intact skin, avoiding contact with mouth)
Using one's own sex toys (without sharing of any toys that contact body fluids)
Low-risk practices. Epidemiological studies have found these sexual activities to have a low probability of HIV transmission between partners of unlike or unknown HIV serostatus:
Fellatio without condom (Risk of HIV infection to insertive partner is extremely low, risk to receptive partner is increased if ejaculation occurs in mouth.)
High-risk practices
These sexual activities carry the highest risk, based on epidemiological studies of transmitting HIV between partners of unlike or unknown HIV serostatus:
Vaginal intercourse without a male or female condom
Anal intercourse
Anal penetration with the hand (fisting) or other rectal trauma
To minimise the risk of STDs and HIV, I will now describe a variety of safe sex techniques:
Abstinence
The only effective way to avoid the risks associated with sexual contact is to abstain from sexual activity entirely; this will eliminate the chances of contracting STDs and HIV.
Monogamy
Monogamy practice faithfully is very safe (as far as STDs and HIV are concerned) when your partner is uninfected.
Sex by yourself
Known as autoeroticism, solitary sexual activity (including 'phone sex' - mutual masturbation at a distance with the aid of technology and 'cybersex') is relatively safe. However, some practices, such as self-bondage and autoerotic asphyxia, are made considerably more dangerous by the absence of people who can intervene if something goes wrong. Masturbation is safe, so long as contact is not made with other people's discharged body fluids.
Non-penetrative Sex
A range of sex acts, sometimes called outercourse can be enjoyed by lovers with significantly reduced risks of infection and no risk of pregnancy. Non-penetrative sex (also known as outercourse) is sexual activity without vaginal and possibly oral penetration, as opposed to intercourse. No bodily fluids should be exchanged,
There are many options for non- penetrative sex as outlined below:
Axillary intercourse: where a man rubs his penis in his partner's armpit, also known as bagpiping.
Frottage: any form of consensual sexual rubbing, whether naked or clothed
Handsex: stimulating genitals with the hand
Foot sex: stimulating genitals with the feet
Limiting fluid exchange
Various devices are used to avoid contact with blood, vaginal fluid, and semen during sexual activity:
Male condoms: Condoms cover the penis during sexual activity. They are most frequently made of latex, but can also be made out of polyurethane. Polyurethane is thought to be a safe material for use in condoms, since it is nonporous and viruses cannot pass through it.
Female condoms: are inserted into the vagina prior to intercourse
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.
Medical gloves: may be used as a dental dam during oral sex, or to protect the hands during mutual masturbation. Hands may have invisible cuts on them that may admit pathogens that are found in the semen or the vaginal fluids of STD infectees.
In the absence of a vaccine, practising safe sex is the only effective means we have at our disposal to halt the spread of HIV and STDs. The options I have described are many and varied; discuss them with your partner and have a safe and satisfying sex life.
Dr Alverston Bailey is a medical doctor and is also the immediate past president of the Medical Association of Jamaica. Send comments to editorial@gleanerjm.com or Fax: 922-6223.
Source: http://www.jamaica-gleaner.com/gleaner/20080308/features/features4.html
Safe sex (also called safer sex or protected sex) is a set of practices that are designed to reduce the risk of infection during sexual intercourse to avoid developing sexually transmitted diseases (STDs). On the other hand, unsafe sex refers to engaging in sexual intercourse without the use of any barrier contraception or other preventive measures against STDs.
Safe sex practices became a buzz word in the late 1980s as a result of the AIDS epidemic. Promoting safe sex is now a critical component of sex education. Safe sex should be regarded as a harm reduction strategy. Please note that safe sex is about risk reduction, not risk elimination.
Sexual contact is the most common route of HIV transmission. By December 2001, 51 per cent of all HIV infections among adolescents and adults reported to the U.S. Centers for Disease Control and Prevention (CDC) were sexually transmitted. Worldwide and in Jamaica, heterosexual transmission is the most common route of HIV infection.
Researchers consistently detect HIV in blood, semen and cervical secretions of infected persons. Infectious HIV exists in saliva, tears and urine. However, it has only been recovered from these fluids at extremely low titers, therefore, saliva, tears, and urine are unlikely sources of HIV transmission.
Infectious HIV has also been isolated in breast milk, and transmission from HIV-infected mothers to nursing infants is well documented. Breast milk is not commonly encountered during sexual intercourse. However, should you accidentally or intentionally come in contact with HIV-infected breast milk during sex, care should be taken to avoid contact with your eyes and mouth.
Let us now describe various sexual practices and the associated risks of HIV infection:
No-risk practices. These sexual activities cannot transmit HIV:
Masturbation
Touching, massaging, hugging, caressing
Social (dry) kissing
Any type of sexual intercourse between partners who are certain that they are uninfected.
Extremely low-risk practices. These activities carry a small (based on case reports) or theoretical risk of HIV transmission between partners of unlike or unknown HIV serostatus:
French (wet) kissing
Mutual masturbation (if no cuts on hands, and no ulcers or lesions on genitals of either partner)
Vaginal sex with a male or female condom (with proper use, including putting latex or polyurethane condom in place before any penetration)
Fellatio with condom (with latex condom placed on penis before oral contact)
Cunnilingus with dental dam (with latex dam placed over vaginal area before oral contact)
Contact with urine (only with intact skin, avoiding contact with mouth)
Using one's own sex toys (without sharing of any toys that contact body fluids)
Low-risk practices. Epidemiological studies have found these sexual activities to have a low probability of HIV transmission between partners of unlike or unknown HIV serostatus:
Fellatio without condom (Risk of HIV infection to insertive partner is extremely low, risk to receptive partner is increased if ejaculation occurs in mouth.)
High-risk practices
These sexual activities carry the highest risk, based on epidemiological studies of transmitting HIV between partners of unlike or unknown HIV serostatus:
Vaginal intercourse without a male or female condom
Anal intercourse
Anal penetration with the hand (fisting) or other rectal trauma
To minimise the risk of STDs and HIV, I will now describe a variety of safe sex techniques:
Abstinence
The only effective way to avoid the risks associated with sexual contact is to abstain from sexual activity entirely; this will eliminate the chances of contracting STDs and HIV.
Monogamy
Monogamy practice faithfully is very safe (as far as STDs and HIV are concerned) when your partner is uninfected.
Sex by yourself
Known as autoeroticism, solitary sexual activity (including 'phone sex' - mutual masturbation at a distance with the aid of technology and 'cybersex') is relatively safe. However, some practices, such as self-bondage and autoerotic asphyxia, are made considerably more dangerous by the absence of people who can intervene if something goes wrong. Masturbation is safe, so long as contact is not made with other people's discharged body fluids.
Non-penetrative Sex
A range of sex acts, sometimes called outercourse can be enjoyed by lovers with significantly reduced risks of infection and no risk of pregnancy. Non-penetrative sex (also known as outercourse) is sexual activity without vaginal and possibly oral penetration, as opposed to intercourse. No bodily fluids should be exchanged,
There are many options for non- penetrative sex as outlined below:
Axillary intercourse: where a man rubs his penis in his partner's armpit, also known as bagpiping.
Frottage: any form of consensual sexual rubbing, whether naked or clothed
Handsex: stimulating genitals with the hand
Foot sex: stimulating genitals with the feet
Limiting fluid exchange
Various devices are used to avoid contact with blood, vaginal fluid, and semen during sexual activity:
Male condoms: Condoms cover the penis during sexual activity. They are most frequently made of latex, but can also be made out of polyurethane. Polyurethane is thought to be a safe material for use in condoms, since it is nonporous and viruses cannot pass through it.
Female condoms: are inserted into the vagina prior to intercourse
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.
Medical gloves: may be used as a dental dam during oral sex, or to protect the hands during mutual masturbation. Hands may have invisible cuts on them that may admit pathogens that are found in the semen or the vaginal fluids of STD infectees.
In the absence of a vaccine, practising safe sex is the only effective means we have at our disposal to halt the spread of HIV and STDs. The options I have described are many and varied; discuss them with your partner and have a safe and satisfying sex life.
Dr Alverston Bailey is a medical doctor and is also the immediate past president of the Medical Association of Jamaica. Send comments to editorial@gleanerjm.com or Fax: 922-6223.
Source: http://www.jamaica-gleaner.com/gleaner/20080308/features/features4.html
posted by AIDS-Care-Watch at 9:43 am
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