Safe sex practices became more prominent in the late 1980s as a result of the AIDS epidemic. Promoting safe sex is now a principal aim of sex education. From the viewpoint of society, safe sex can be regarded as a harm reduction strategy. The goal of safer sex is education and risk reduction.
In contrast to protected sex is unprotected sex, which can refer to:
Although safe sex practices can be used as a form of family planning, the term refers to efforts made to prevent infection as well as conception. Many effective forms of contraception do not offer protection against STDs.
|Type of exposure||Likelihood of infection after a single exposure (%)||Global total (%)|
|Injecting drug use||0.5-1.0|
|Breast milk||12 (long term continuos breast feeding)|
|Blood products||Not quantified|
|Organ transplantation||Not quantified|
|Artificail insemination||Not quantified|
|Health care work||0.1-1.0||<0.01|
Much attention has focused on controlling HIV, the virus that causes AIDS, through the use of condoms. However, as many STDs can be transmitted through other activities, some sex educators recommend that barrier protection be used for all sexual activities which have the potential for disease transmission, such as manual penetration of the anal or vaginal cavities, or oral stimulation of the genitals.
Modern technology does permit some activities, such as "phone sex" and "cybersex", that allow for partners to engage in sexual activity without being in the same room, eliminating the risks involved with exchanging bodily fluids.
A range of sex acts, sometimes called "outercourse", can be enjoyed by lovers with significantly reduced risks of infection and pregnancy. U.S. President Bill Clinton's surgeon general, Dr. Joycelyn Elders, tried to encourage the use of these practices among young people, but her position encountered opposition from a number of outlets, including the White House itself, and resulted in her being fired by President Clinton in December of 1994.
If a latex barrier is being used, any lubrication must not be oil based, as this can break down the structure of the latex and undo the protection it gives.
Condoms (male or female) may be used along with other forms of contraception to protect against STDs and improve contraceptive effectiveness. For example, simultaneously using both the male condom and spermicide (applied separately, not pre-lubricated) is believed to reduce perfect-use pregnancy rates to those seen among implant users. However, two condoms should not be used simultaneously (male condom on top of male condom, or male condom inside female condom), since this increases the chance of condom failure.
The spermicide Nonoxynol-9 has been claimed to reduce the likelihood of STD transmission. However a recent study 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. Condoms with Nonoxynol-9 lubricant do not have enough spermicide to increase contraceptive effectiveness and are not to be promoted.
Coitus interruptus (or "pulling out"), in which the penis is removed from the vagina, anus, or mouth before ejaculation, is not safe sex and can result in STD transmission. This is because of the formation of pre-ejaculate, a fluid that oozes from the urethra before actual ejaculation. In opposition to conventional wisdom, some recent studies awaiting confirmation suggest that pre-ejaculate may not contain sperm; it can, however, contain pathogens such as HIV.
If you keep ejaculate fluid out of any orifices this will do a great deal to help protect pregnancy and diseases. Especially important to note if you have cuts in your mouth. In addition, open sores on either partner can permit transmission, as can microscopic breaks in the skin which arise due to friction, or other irregularities in the skin of either partners genitalia or other body parts.
Anal sex is more risky than vaginal, since being very thin tissues of anus and rectum can be easily damaged during such sex activities as anal intercourse or use of anal toys. Even slight injuries can become "open gates" for various bacteria and viruses, including HIV. This implies that anal sex does require some certain safety measures. First of all, any partners who practice anal sex should be aware of the necessity of using a condom. The condom must be put on properly, otherwise it does not provide reliable protection. Users should keep in mind that oil-based lubricants damage latex. For this reason water-based lubricants should be used for anal sex. Those who have allergy to latex should consider use of non-latex condoms, for instance polyurethane condoms that are compatible with both oil-based and water-based lubricants.
Condoms should also be used with sex toys. Through putting a condom on the sex toy a user provides better hygiene and prevents transmission of infections if the sex toy is shared. Cleaning of anal sex toys is also a very important matter as many anal sex toys are made of porous materials. Pores retain viruses and bacteria. For this reason users should clean anal toys (plugs, anal vibrators) thoroughly, preferably with use of special sex toy cleaners. Glass sex toys are more preferred for sexual uses because of their non-porus nature and ability to be sterilized between uses.
Some groups, notably some American evangelical Christians and the Roman Catholic Church oppose sex outside marriage, and object to safe-sex education programs because they believe that providing such education promotes promiscuity. Virginity pledges and sexual abstinence education programs are often promoted in lieu of contraceptives and safe-sex education programs. This can place some teenagers at higher risk of unintended pregnancy and STDs, because about 60 percent of teenagers who pledge virginity until marriage do engage in pre-marital sex and are then one-third less likely to use contraceptives than their peers who have received more conventional sex education.
STDs may also be transmitted through non-sexual means. Thus, abstinence from sexual behavior does not guarantee complete protection against STDs. For example, 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.