People are wonderfully diverse and so is sex. Just as it is paramount to make sure you are enjoying the sex you are having, making sex safer for you and your partner(s) is also important. The risk of getting an STI or HIV depends on the kind of sex you have and whom you have it with. Below is some general information on STIs, HIV, and some ways to have safer sex.
● Sexually transmissible infection (STIs) are infections that are transmitted during sex through body contract or the exchange of bodily fluid.
● STIs can be caused by viruses (e.g. HIV, herpes, and genital warts), bacteria (e.g. chlamydia and gonorrhoea), or parasites (e.g. crabs and scabies).
● Infection rates for some STIs, such as HIV, are much higher among gay, bi and other men who have sex with men (MSM) in comparison to the general population.
● Trans-masculine individuals and trans men who have recently undergone bottom surgery and have unhealed skin can be at greater risk of acquiring/passing on HIV.
● Taking hormones can also increase the risk of bleeding during penetrative frontal/anal sex. For example, testosterone can cause vaginal/frontal dryness and reduced levels of oestrogen can affect the thickness of the walls (both rectal and vagina/frontal). The use of condom and lube is even more important in these cases.
● Women who have sex with women are also at risk of STIs, and the risk depends on what kind of sex they have and whom they have it with. For example, trans women are at higher risk of HIV than that cis women.
● Trans-feminine individuals and trans women who have recently undergone bottom surgery and have unhealed skin might be at greater risk of acquiring/passing on HIV.
● The risk also depends on the type of surgery they have had. For example, if their vagina was made from part of their colon, instead of penile/scrotal skin, it may be easier to get some STIs. Your vagina also might not naturally lubricate, so the use of condoms and lube is especially important in this case.
General “safer” sex tips include:
Condoms
Whether you are having penetrative sex with a penis, or using toys like a dildo or vibrator, condoms are a simple and easy way to keep your body safe.
If you are using a toy on someone’s anus and then their vagina, it is important to use a new condom in order to prevent bacteria from the anus from getting to the vagina and causing infections such as a UTI.
Using condoms can help prevent the transmission of some other STIs, but not all STIs.
Dams
Dams are sheets of latex that you stretch across the genitals and anus to act as a barrier and are used during oral sex. They can reduce the risk of you getting cold sores and genital herpes.
Gloves:
When you’re fingering or fisting, medical gloves can be used to keep you safe. They are also great at protecting your vagina or anus from fingernails.
Lube:
Lubes are great for any kind of penetration
Condoms and gloves are less likely to break when used with water and silicon-based lube.
Get tested regularly.
The best way to prevent HIV transmission is to use a condom and water/silicon-based lubricant for penetrative sex, pre-exposure prophylaxis (PrEP) and Post-exposure prophylaxis (PeP), or have an Undetectable Viral Load (UVL).
Condoms & lube
Condoms prevent or reduce the exchange of semen, vaginal fluid or blood between partners during sex. When used with lube, condoms are a highly effective way to prevent HIV transmission.
PrEP keeps HIV negative people from contracting HIV.
PrEP does not prevent the transmission of other STIs, which can, in turn, increase the possibility of HIV infection. This is why people who are taking PrEP are encouraged to check in with their sexual health provider regularly.
Post-exposure prophylaxis (PeP): anti-HIV treatment drugs you can take if you think you may have been exposed to HIV. It can, in most cases, prevent you from becoming HIV-positive if they are taken in time (within 72 hours of exposure) and correctly over the next 28 days.
People who have anal and/or vaginal/frontal sex can consider using PrEP and PeP to further reduce the risk of HIV.
UVL & Treatment as Prevention (TasP)
When a person living with HIV is on effective treatment, they often achieve what is called an “undetectable viral load”. This means that the amount of virus in their bodies is so low that HIV is no longer able to be detected.
In terms of HIV prevention, there has never been a case of a person with an undetectable viral load passing on HIV to a sexual partner.
U=U: Undetectable = untransmittable
TasP is an effective way to limit risk of HIV transmission, where HIV positive people take their medication as prescribed and regularly get tested to ensure their viral load stays undetectable.
Risk Reduction Strategies
Ensuring HIV-negative partners are insertive (i.e. the ‘top’).
Ensuring partners have the same HIV status (i.e. pos-pos or neg-neg).
For further information, please refer to Thorne Harbour Health - supporting LGBTIQ+ communities and people living with HIV | Thorne Harbour Health
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