Safer sex

Written by: 
Dr Sarah Brewer

Why is safer sex important and what does it involve? Here's a practical guide.

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Practising safer sex means taking steps to reduce your risk of acquiring a sexually transmissible infectionInvasion by organisms that may be harmful, for example bacteria or parasites. (STI). While the risk of catching an STI is not a reason to avoid sex, it is a very good reason to be careful at all times.

STIs are common and if you have sex without a condom, you put yourself at risk, whether you are young, old, straight, gay, have sex several times a day or only once a year. The most effective protection is always to use a condom.

Although you cannot completely avoid the risk (other than by not having sex), there are a number of sensible precautions you can take to minimise your chances of contracting an STI:

  • Limit your number of sexual partners. Having casual sex, especially with multiple partners, increases the risk; limiting your partners reduces it. If you have sex with anyone except a regular, faithful partner, it's important to use a condom
  • Take precautions during foreplay. Not all sex has to involve penetration, but while other activities can be less of a risk, it's still wise to take precautions if you have foreplay
  • Be prepared. Keep a good supply of condoms at home, and always carry condoms with you if there is any possibility at all that you may have sex when you're out or away from home
  • Watch out for the effects of alcohol, drugs and spiked drinks. These lower your resistanceThe ability of a microbe, such as a type of bacteria, to resist the effects of antibiotics or other drugs. to having casual sex and make it more likely that you will neglectLack of attention or disregard; a condition in which one side of the body or visual field are neglected. safer sex precautions.

Using a condom

The most common reason why people fail to practise safer sex is because they associate condom use with decreased sexual pleasure. Condoms can, however, be used in a sensual and pleasurable way.

A condom has to be put on before you start to have penetrative sex, but this can be incorporated into foreplay in a fun and playful way, without making it feel less spontaneous.

Also, using a condom during oral sex further protects you against many sexually transmitted infections. Condoms are available in a range of different flavours, and you can experiment to find those you like. Small barrier sheets, known as dental dams, can provide protection when giving oral sex to a woman.

Tip: Use only condoms that carry the recognised quality mark for your country, such as the European CE Mark, or which have FDA or ISO approval

Choosing the right condom

When it comes to condoms it is no longer true that one size fits all, and it makes sense to experiment with the different shapes of condom available to find out what best suits you.

Shaped condoms can provide extra comfort, a feeling of roominess or a snugger fit than the traditional straight-up-and-down design. The table below lists some of the main types of condoms available.

Condom type Benefits
Straight (same width up and down) Good for men who are used to the traditional shape
Flared (wide head, tapered at the tip) Provides extra comfort; condom feels larger and less restrictive; useful for men who usually find condoms too tight
Contoured (wide head and neck) Anatomically shaped for a better fit - it is flared over the glans at the top of the penis and fits snugly below. Improved sensitivity and comfort; helps to prevent slippage; excellent starter condom
Contoured (wide head and smaller neck) Anatomically shaped for better fit over the glans. Width at base of penis provides a closer fit. Helps to prevent slippage; a closer and firmer fit for those who need it
Textured (ribs or dots on the surface) Designed for increased friction and heightened sensation. Use with water-based lubricant to prevent soreness. Not suitable for oral sex
Ultra-thin (slightly thinner latex) For greater sensitivity; only for experienced users
Super-strong (thicker latex - for example, 50 per cent thicker than normal) For extra-vigorous sex
With non-spermicide lubricant (has no spermicide coating) For use if either partner is allergic to spermicides
With integral applicator (so it can be applied using a no-touch technique) For those who prefer the no-touch technique, who have difficulty applying a normal condom or who regularly burst condoms on opening the packet or donning the condom
Polyurethane For improved sensitivity and for those who are allergic to latex; stronger and less likely to tear than latex condoms

The female condom

The female condom is a pre-lubricated, loose fitting, disposable, polyurethane sheath that fits inside the vagina. It acts as both a contraceptiveA term used to describe something that prevents pregnancy. and a barrier against some sexually transmissible infections.

Like the male condom, each female condom should be used only once and must be changed for each additional act of intercourse in the same session.

Using lubricant

You can try increasing the sensations experienced when wearing a condom through a technique called 'gel charging'.

This involves placing a small amount of water-based lubricating gel (around a teaspoon, or 5ml) in the tip of the condom, before putting it on in the usual way. (It helps to warm the tube of gel in warm water first so it isn't too cold.)

During sex, the gel warms further and liquefies, and the result is that sex feels more natural. Gel charging should be tried only with a shaped condom (contoured or flared - see the table above), which will retain the gel more easily and is less likely to slip off during use.

Applying extra lubricant outside the condom reduces the chance of tearing, especially during anal sex. But take care to use water-based lubricants only with latex condoms.

Oil-based lubricants, baby oil and petroleum jelly weaken latex condoms and increase the chance of tearing. You can use oil-based lubricants with a polyurethane condom, however.

What you're protecting yourself against

When used consistently and properly, condoms offer a good level of protection against most sexually transmitted infections. They also reduce the chance of an unplanned pregnancy, though it is advisable to use additional methods of contraceptionA means of preventing pregnancy. if this is an important consideration.

If you make safer sex non-negotiable, you are protecting yourself as well as your partners. Using a condom consistently can reduce the transmission of:

  • HIV (human immunodeficiency virusA microbe that is only able to multiply within living cells.), the cause of AIDS, by 80 to 95 per cent
  • Human papillomavirus (HPVAn abbreviation for human papilloma virus, a sexually transmitted virus that can cause genital warts and may also have a role in the development of various cancers.), which causes genital warts and can lead to cervical cancerAbnormal, uncontrolled cell division resulting in a malignant tumour that may invade surrounding tissues or spread to distant parts of the body., by 50 to 70 per cent
  • Herpes simplex virusA microbe that is only able to multiply within living cells. (HSV), which causes genital herpesA sexually transmitted infection caused by the herpes simplex virus., by 50 to 74 per cent
  • Chlamydia by between 42 and 82 per cent
  • Gonorrhoea by between 42 and 82 per cent
  • Syphilis by 70 per cent
  • Trichomonas, which can cause an irritating vaginal discharge, by 30 per cent.

Although using a condom also helps to protect you against the hepatitis B virusA microbe that is only able to multiply within living cells. (HBV), vaccination is the best safeguard. If you have multiple sexual partners or other risk factors for HBV, talk to your doctor about receiving a vaccination.

Tip: Even if both you and your partner are HIV-positive, it is important that you continue to practise safer sex. Re-infectionInvasion by organisms that may be harmful, for example bacteria or parasites. with HIV, or additional infectionInvasion by organisms that may be harmful, for example bacteria or parasites. with herpes or hepatitis B, will further harm your health and may hasten the progress of your disease

Other safer sex tips

  • Cover cuts, sores and other damage to the skin on your fingers with waterproof plasters or latex gloves
  • Insert a non-spermicidally lubricated condom over any finger to be used for penetration
  • Always wash your hands and change your finger condom after anal foreplay, and before touching the vagina
  • Use a condom on sex toys, and wash them thoroughly after use, especially between partners if they are used with more than one person
  • Take particular care to protect yourself from exposure to bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. if having sex during menstruation, or if drawing bloodA fluid that transports oxygen and other substances through the body, made up of blood cells suspended in a liquid. during S&M (sadomasochistic) foreplay.

Woman to woman

There is a common belief that sexually transmitted infections (STIs) cannot be passed from woman to woman during sex, but this is not the case.

Women can acquire STIs during sexual activity with other women, especially if they use sex toys for penetration. In addition, a bacterial imbalance, called bacterial vaginosis, can also be passed from one woman to another.

Safer practices for women having sex with other women include washing hands, using latex gloves during manual stimulation, using a condom on sex toys (which should be changed before use on each partner), cleaning sex toys properly and using a dental dam (a thin barrier sheet) for oral sex.