‘Safe sex’ is having sexual contact while minimising the risk that you will get a sexually transmissible infection (STI). Sexual contact that doesn’t involve the exchange of semen, vaginal fluids or blood between partners is considered to be safe sex. If used correctly, condoms can dramatically reduce the risk of most sexually transmitted infections and unintended pregnancy.

Safe sex’ is having sexual contact while minimising the risk that you will get a sexually transmissible infection (STI). Sexual contact that doesn’t involve the exchange of semen, vaginal fluids or blood between partners is considered to be safe sex.

Unsafe sex may pass on STIs such as chlamydia, HIV or gonorrhoea, or result in an unintended pregnancy. Safe sex is also called ‘safer sex’ to highlight the fact it is not a 100 per cent guarantee but it significantly reduces the risk of sexually transmissible infections.

ow to stay safe
Having sex with only one partner, when neither of you has any STIs, is the safest way to have sex. If you have more than one partner or have not been tested for STIs, other suggestions include:

• Be infection-free – get tested for STIs and have treatment if necessary. Avoid sexual contact until the doctor or nurse tells you that you are no longer infectious.
• Use male condoms – if used correctly, condoms can dramatically reduce the risk of unwanted pregnancy and most STIs.
• Use female barrier methods – these are the female condom, which resembles a regular condom but is inserted into the vagina, and the dental dam, which is a sheet of latex worn over the female genitals during oral sex.
• Use other barrier methods – for example, use condoms on dildos and other penetrative sex toys and wear a latex glove for digital penetration of the vagina or anus.

Condoms are not 100 per cent safe
Condoms, even when used correctly, don’t guarantee 100 per cent protection against STIs or unplanned pregnancy. Issues to consider include:

• Sex with a condom may still spread an infection if the condom does not fully cover the infected area. For example, the genital wart virus may be on the scrotum.
• Some infections, such as pubic lice and scabies, are spread by close contact, regardless of whether or not a condom is used.
• A condom may break, particularly if it has not been stored properly or the right (water based) lubricant has not been used. Do not expose a condom to prolonged heat. Don’t use a condom that is past its use-by date. Don’t try to re-apply a used condom and don’t use oil based lubricants like baby oil and Vaseline.

Safe sexual activities
Sexual contact that carries a low risk of STI transmission includes:

• Kissing
• Cuddling
• Massage
• Masturbation
• Mutual masturbation
• Ejaculating on unbroken skin.

Low-risk sexual activities
Activities that probably won’t involve the exchange of bodily fluids include:

• Open-mouthed kissing – also called deep or French kissing. This type of kissing is fine if neither of you has a mouth sore and no blood is present.
• Sexual intercourse using barrier contraception – such as a condom or female condom. Remember that a diaphragm (a cap worn high in the vagina to cover the cervix) offers good protection against pregnancy but low protection against STIs.

High-risk or unsafe sexual activities
Unsafe sex outside of a monogamous relationship is risky. Examples of unsafe sexual activities include:

• Having sex without a male condom or female condom
• Withdrawing the penis before ejaculation instead of using condoms (pre-ejaculatory fluid may be infectious and can also contain sperm)
• Trying to re-use a condom or using a condom that is past its use-by date
• Using a condom incorrectly or continuing to have sex once the condom is broken
• Doing anything that involves blood-to-blood contact
• Getting bodily fluids like menstrual blood, semen or vaginal fluids inside another person’s body (for example, mouth, vagina or anus).

Things to remember

• ‘Safe sex’ is sexual contact that doesn’t involve the exchange of semen, vaginal fluids or blood between partners.
• If used correctly, condoms can dramatically reduce the risk of most sexually transmissible infections (STIs) and unintended pregnancy.
• Having regular STI screening and reducing the number of sexual partners also reduces the transmission risk of STIs.

Like all sexual activity, oral sex carries some risk of HIV transmission when one partner is known to be infected with HIV, when either partner’s HIV status is not known, and/or when one partner is not monogamous or injects drugs. Even though the risk of transmitting HIV through oral sex is much lower than that of anal or vaginal sex, numerous studies have demonstrated that oral sex can result in the transmission of HIV and other sexually transmitted diseases (STDs). Abstaining from oral, anal, and vaginal sex altogether or having sex only with a mutually monogamous, uninfected partner are the only ways that individuals can be completely protected from the sexual transmission of HIV. However, by using condoms or other barriers between the mouth and genitals, individuals can reduce their risk of contracting HIV or another STD through oral sex.

Oral Sex is a Common Practice

Oral sex involves giving or receiving oral stimulation (i.e., sucking or licking) to the penis, the vagina, and/or the anus. Fellatio is the technical term used to describe oral contact with the penis. Cunnilingus is the technical term which describes oral contact with the vagina. Anilingus (sometimes called “rimming”) refers to oral-anal contact. Studies indicate that oral sex is commonly practiced by sexually active male-female and same-gender couples of various ages, including adolescents. Although there are only limited national data about how often adolescents engage in oral sex, some data suggest that many adolescents who engage in oral sex do not consider it to be “sex;” therefore they may use oral sex as an option to experience sex while still, in their minds, remaining abstinent. Moreover, many consider oral sex to be a safe or no-risk sexual practice. In a national survey of teens conducted for The Kaiser Family Foundation, 26% of sexually active 15- to 17-year-olds surveyed responded that one “cannot become infected with HIV by having unprotected oral sex,” and an additional 15% didn’t know whether or not one could become infected in that manner.

Oral Sex and the Risk of HIV Transmission

The risk of HIV transmission from an infected partner through oral sex is much less than the risk of HIV transmission from anal or vaginal sex. Measuring the exact risk of HIV transmission as a result of oral sex is very difficult. Additionally, because most sexually active individuals practice oral sex in addition to other forms of sex, such as vaginal and/or anal sex, when transmission occurs, it is difficult to determine whether or not it occurred as a result of oral sex or other more risky sexual activities. Finally, several co-factors may increase the risk of HIV transmission through oral sex, including: oral ulcers, bleeding gums, genital sores, and the presence of other STDs. What is known is that HIV has been transmitted through fellatio, cunnilingus, and anilingus.

Other STDs Can Also Be Transmitted From Oral Sex

In addition to HIV, other STDs can be transmitted through oral sex with an infected partner. Examples of these STDs include herpes, syphilis, gonorrhea, genital warts (HPV), intestinal parasites (amebiasis), and hepatitis A.

Oral Sex and Reducing the Risk of HIV Transmission

The consequences of HIV infection are life-long. If treatment is not initiated in a timely manner, HIV can be extremely serious and life threatening. However, there are steps you can take to lower the risk of getting HIV from oral sex.

Generally, the use of a physical barrier during oral sex can reduce the risk of transmission of HIV and other STDs. A latex or plastic condom may be used on the penis to reduce the risk of oral-penile transmission. If your partner is a female, a cut-open condom or a dental dam can be used between your mouth and the vagina. Similarly, regardless of the sex of your partner, if your mouth will come in contact with your partner’s anus, a cut-open condom or dental dam can be used between your mouth and the anus.

At least one scientific article has suggested that plastic food wrap may be used as a barrier to protect against herpes simplex virus during oral-vaginal or oral-anal sex. However, there are no data regarding the effectiveness of plastic food wrap in decreasing transmission of HIV and other STDs in this manner and it is not manufactured or approved by the FDA for this purpose.

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