Guide to Safer Sex [part 1]

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1. Introduction

1.1 Goal

The goal of this guide is to give people of all genders, orientations, and preferences the information they need to perform a wide variety of sexual acts safely, pleasurably, and comfortably.

It should be noted that this guide uses more sophisticated vocabulary and covers more material than most safer sex brochures; people who find this guide to be at all overwhelming might be better served by some of the simpler and more direct documents produced by mainstream STD prevention and public health organizations, or by the more concise version of this guide (written by the same authors).

As much as possible we try to avoid telling you what you “should” do. Think of this guide as a collection of techniques that can make whatever safer sex standards that you might choose to follow both graceful and effective. If you decide, for example, that you want to use barriers of some kind for oral sex, you’ll find detailed information on how to do so in this guide; if you decide that this risk is low enough for you and choose not to use barriers for oral sex, then feel free to ignore that section of this guide. The choice of how much risk to assume is yours.

We actually do recommend that before reading this guide you first read the more concise version of it, which may help you both to put your choices in perspective and to see the bigger picture.

1.2 Credits

Material for this guide was compiled from a variety of sources, including first-hand experiences of STD counselors and educators, advice from a variety of highly sexually active people, and existing literature. For more rigorous documentation and referencing of various medical STD studies, see Choices: Sex in the Age of STD’s by Jeffrey S. Nevid, or Human Our Sexuality by Robert Crooks and Karla Baur.

1.3 Disclaimer

The authors of this guide accept no liability for any injury which may befall any individual as a result of performing activities described herein, and make no guarantees or warranties concerning this document. As safety recommendations often change based on new medical discoveries, we urge you to augment this guide with the best and most current information available to you.

2. Comments on Contraception

The subject being dealt with in this document is STD prevention, not birth control. Of all of the STD-preventative supplies and techniques that will be discussed, only condoms and spermicidal products are also effective tools for contraception, and then only when they are used together and are used properly and consistently by male/female couples engaging in penile/vaginal intercourse. We urge you to see a health care provider, student health clinic, or Planned Parenthood clinic if you need an effective means of birth control.

3. Terminology

3.1 Sex

Sex is any activity that one engages in for erotic pleasure or reproduction. Sex includes, but is not limited to, vaginal intercourse, anal intercourse, oral intercourse, manual manipulation of the anus or genitals, SM play, mutual masturbation, solo masturbation, fantasy, cunnilingus, analingus, penetration with dildos, etc. Sex is still sex whatever the gender, orientation, preferences, or number of the participants.

3.2 Safe, Safer, and Unsafe

• “Safe Sex” is sex which affords NO risk for disease transmission or injury. Fantasy, masturbating yourself, hot talk, and non-sexual massage on healthy skin, for example, fall in this category.
  
• “Safer Sex” is sex which affords ALMOST NO risk for disease transmission or injury. When using effective barriers, vaginal/anal intercourse, cunnilingus/analingus, fellatio, and manual penetration all fall in this category.
  
• “Unsafe Sex” is sex which affords a HIGH risk for infection or injury. Anal or vaginal intercourse without a condom falls in this category.

For the purposes of this document, we will for the most part limit ourselves to discussions of “safe, safer, and unsafe” in the context of disease transmission. However, some comments are in order on the subject of consensuality.

For sex to be consensual, partners must heed each others’ requests to slow down, back off, or stop. If you feel that your partner would not honor a direct request to stop doing something to your body, you might consider whether any sex with that person is “safe.” Even when sex is consensual, it is important to be sufficiently sober, sane, communicative, and aware to effectively sense pain or danger and communicate that to a partner. There are a variety of excellent books and techniques available that are designed to help people communicate better about sexual matters, and we urge you to browse your local bookstore for one that suits you.

3.3 Barriers

A barrier is any physical object which allows sex that would otherwise be unsafe to be safer or safe by preventing transmission of body fluids. Barriers discussed in this document include condoms, gloves, and oral barriers.

4. Positive Benefits of Safer Sex

4.1 Pleasurable

• Can become eroticized over time through association with pleasure
  
• Gives one greater peace of mind
  
• Can help penile/vaginal intercourse to last longer, if that is desired
  
• Allows greater comfort when penetrating an anus with a hand, and makes the practice of anal eroticism more attractive for some people

4.2 Practical

• Keeps your sex toys clean
  
• Can provide additional protection against pregnancy for penile/vaginal intercourse
  
• Protects one from diseases which are lethal (such as HIV/AIDS), as well as from a range of others that, though non-lethal, are very annoying and very common

4.3 Social

• Demonstrates courtesy and respect towards one’s partner
  
• Avoids awkwardness or embarrassment with new partners who practice safer sex exclusively
  
• Allows one to “fit in” better into many sex-positive communities (some of the safe sex precautions described here are often required for modern sex or SM parties)
  
• Frees one from having to depend exclusively on a partner knowing and telling you the truth about their disease status

5. Tips for Great Safer Sex

5.1 Use of Sufficient Lubricant

Most penetrative sex or manual stimulation feels much better for both parties when sufficient lubricant is used. Lubricants also improve the efficacy rate of barriers. In general, water-based lubes are the most versatile.

5.2 Manual Stimulation

5.2.1 Women (the Clitoris and G-spot)

Many women experience orgasm and/or highly pleasurable sensations through intentional stimulation of the clitoris or G-spot (the G-spot is often located on the forward wall of the vagina, just beyond the pubic bone) more easily than they experience it through ordinary vaginal penetration by a penis or dildo. Ordinary “thrusting” sex, if that is desired, is often MUCH more enjoyable for women after arousal or orgasm. G-spot stimulation is usually easiest to accomplish with a (possibly gloved) hand, and clitoral stimulation is usually easiest to accomplish with either a (possibly gloved) hand, a vibrator, or a tongue (possbily with an oral barrier). Many women find that consistent, reliable, protracted clitoral stimulation best assists in achieving clitoral orgasm; as is also the case with G-spot stimulation, paying attention to your partner’s body language and listening to her feedback will help more than anything else.

5.2.2 Men (the Prostate Gland)

Stimulation of the prostate gland can often cause an increase in the pleasure caused by penile stimulation, or can feel great even without penile stimulation. Prostate stimulation is usually easiest to accomplish with a gloved hand, exerting mild pressure against the forward wall of the anus. The prostate gland is typically more easily palpable than the G-spot, and often feels like a gentle dome. As is the case with the G-spot, one should listen to the feedback of one’s partner when finding the prostate gland, as its location can vary from person to person. For additional pleasure for the recipient, one may stimulate the prostate gland at the same time one is masturbating the penis. In general, most men prefer a firmer touch on their genitals than many women assume would be comfortable, and many enjoy firm tugging on the scrotum.

5.3 Deep Breathing

Breathing rhythmically and deeply before and during sex can increase one’s pleasure. See Annie Sprinkle’s videotape Sluts and Goddesses for a humorous demonstration of this technique. In general, meditation and “focusing” techniques such as this are often used to great effect by Tantric sex practitioners, and by others who may have a purely secular viewpoint. Elements of atmosphere and ritual, such as turning off the telephone, putting good music on the CD player (on repeat play), engaging in rhythmic touching/caressing, keeping protracted eye contact, and lighting candles, are also helpful for many people.

5.4 PC Muscle Contraction

Contraction of a special muscle called the PC (Pubococcygeus) muscle can increase sexual pleasure, and is valuable for both women and men. See a text such as The New Good Vibrations Guide to Sex for details on how to identify this muscle, exercise it, and utilize it during sex. Briefly, though, the muscle of interest may be located when urinating, by noticing what muscle you contract to stop the flow of urine. This is the PC muscle, and it may be exercised by contracting it repeatedly and rhythmically, or by contracting/inhaling and relaxing/exhaling. It may be used during sex by contracting it when close to orgasm.

5.5 Good Communication

There isn’t a substitute for being able to tell your partner during sex when something doesn’t feel good, or when it does. There isn’t a substitute for actually asking for what you want, and for learning over time what your partner likes. Higher levels of communication on sexual matters will tend to increase both the pleasure and the safety of all involved. Furthermore, knowledge of your partner’s fantasies will allow one to construct verbal/theatrical fantasies and hot talk for them during sex to heighten their pleasure. Many people find that it is easier for them to reveal their fantasies to someone else while they are being sexually stimulated. “Tell me your deepest fantasy or I’ll stop moving my hand” works wonders with many folks.

5.6 Learning More and Trying New Things

An EXCELLENT book on general sexuality is The New Good Vibrations Guide to Sex, by Cathy Winks and Anne Semans. This book will also provide details on all of the techniques mentioned above. You can also browse the Society for Human Sexuality web site for more information.

6. Safer Sex Supplies

6.1 Barriers (Condoms, Gloves, and Oral Barriers)

6.1.1 General Use Guidelines

To be most effective, barriers must be used from start to finish, correctly, every time you have sex. Use a new barrier with every partner, check the barrier periodically during sex, and discard used barriers immediately. One may also wish to set out before having sex all the barriers one might use and place them within easy reach; this can save one from fumbling later.

Also, there are occasions where one would wish to change barriers with the same partner. The classic example of this is having a fresh glove or condom when you switch from the anus to the vagina, as transferring bacteria found in the anus to the vagina can often cause vaginitis.

One general comment with barriers is that you should be careful removing them after use if possibly infected materials are present on them. If they cannot be removed without you coming into contact with possibly infected materials, then remove them with some sort of tissue paper or towelette between you and the barrier (this is especially effective for condoms), or have the partner who came into contact with the outside of that barrier remove it for you. If neither of these are options, then just avoid touching your eyes, urethra, or vagina with your hands before you have a chance to wash your hands.

Used latex materials should not be flushed down the toilet (as they tend to cause clogging), but rather should be discarded in a trash receptacle, preferably one with a disposable plactic liner.

6.1.2 Making Barriers More Pleasurable

6.1.2.1 General Comments

The use of any barrier can become more pleasant over time, as it becomes associated with pleasurable stimuli and one becomes more skilled with its use.

6.1.2.2 Things that Make Your Barrier Taste Better

When people complain about barriers tasting bad, it is usually because the barriers have been coated with something unpleasant. Plain latex, nitrile, polyurethane, etc. have no taste of their own. Common coating taste offenders are Nonoxynol-9 (HORRIBLE taste!) and the powder which is present on some non-lubed condoms and pre-powdered gloves (though note that you can rinse the powder off the outside of gloves with running water). The taste of pre-lubed condoms without N-9 depends on the type of lube used; Kimono MicroThin condoms, for example, taste fine to me.

Using flavored barriers (ala Sheik or Lifestyles mint condoms or Glyde “Lollyes"), using a flavored water-based lube on the barrier, or dipping the material in something more tasty (and fat free, in the case of latex barriers...) are also options.

6.1.3 Specific Barrier Materials

6.1.3.1 Latex

This is the most popular material for barriers. Latex condoms, gloves, and oral barriers have been shown to protect against the transmission of HIV and other STD’s. Latex barriers are inexpensive and commonly available in a wide variety of different styles.

Any barrier made out of latex should not be exposed to anything with oil in it as oils will cause the latex to disintegrate. Thus, water-based and silicone-based lubes only should be used with latex. Latex can also be damaged by excessive exposure to air, sunlight, heat, or cold. The simplest storage solution is to keep latex condoms out of wallets/glove compartments and in their packages, and to keep latex oral barriers and latex gloves either in their boxes or in a plastic bag within one’s toy bag. If latex appears sticky, marbled, discolored, brittle, or damaged, don’t use it.

Some people are allergic to latex, or have developed latex sensitivity through continued exposure to it (generally in the medical field). Such folks will generally be more than aware of their sensitivity, and you will need to use barriers made of some other material when playing with them.

6.1.3.2 Polyurethane

Polyurethane does not degrade when it comes into contact with oil, and it may transmit sensation better then latex. It may also be valuable for people with latex allergies.

According to lab tests, polyurethane should provide protection against transmission of HIV and other STD’s. However, the only two barriers this substance has been formed into, the Avanti male condom and the Reality female condom, do not suit everybody in terms of construction and shape.

6.1.3.3 Nitrile

Nitrile does not degrade when it comes into contact with oil, and it may transmit sensation better than latex. According to lab tests, it provides protection against transmission of HIV and other STD’s.

Currently, the only barrier this substance is formed into is nitrile gloves, which are definitely valuable in cases of latex allergy/sensitivity. Some people find the texture of these gloves to be unpleasant, while others prefer their texture to latex. Nitrile is more puncture-resistant than latex, but tears in it spread more rapidly.

6.1.3.4 Saran Wrap

Saran Wrap doesn’t degrade in the presence of oil, and may transmit sensation better than latex. Lab tests indicate it can prevent transmission of Herpes, which is smaller than HIV. There is no reason to believe that “Microwaveable” Saran Wrap provides any less protection than regular Saran Wrap. Saran Wrap’s STD prevention use is limited almost exclusively to forming a barrier for cunnilingus and analingus.

6.1.3.5 Lambskin, etc.

Barriers made of lambskin and similar materials are often too porous to dependably prevent transmission of viruses such as HIV, and are therefore not recommended by health organizations for STD prevention.

The only real safer sex purpose that comes to mind for a lambskin condom (which is the only type of barrier this material is made into) would be if a man was allergic to latex, and so he wore a latex condom over a lambskin one, or if his partner was allergic to latex, and so he wore a lambskin condom over a latex one. However, one could also use a polyurethane condom in this case and hence avoid having to wear any condom but that one (assuming that polyurethane condoms fit him properly). Although a lambskin condom is better than nothing, most people will have no need to purchase them.

6.1.3.6 Vinyl

Often, one finds gloves in medical or veterinary supply stores made of a substance called vinyl. Vinyl has not been tested as thoroughly as latex for its efficacy as an STD barrier, and most people find the feel of it to be less pleasant than latex. The use of vinyl gloves is not recommended.

6.2 Lubricants

6.2.1 Purpose and Use

Lubricants can protect barriers against friction that might otherwise tear them. The use of sufficient lube on the outside of a condom can help prevent condom slippage, as long as it is reapplied when necessary.

Lubricants can increase the pleasure and comfort of anally or vaginally penetrative sex and masturbation. Most experts recommend the use of lubricants for anal sex in all cases, and almost everyone reports that vaginal sex and masturbation feel much better when it is being used.

As most lubricants transmit thermal energy well, they can increase the sensation transmitted through a barrier; they can also cause the barrier to move in a stimulating way against the skin. These are the rationales behind putting a small drop of lube inside a condom at the tip or on the genital/anal side of an oral barrier. The hope is that it will increase sensitivity and pleasure. Lubes are available with and without Nonoxynol-9; however, see the portion of this document which discusses Nonoxynol-9 for information that will help you decide whether to use it or not.

One technique which experts at anal play sometimes use is to connect the syringe applicator that is packaged with the yeast infection product Miconazole to a tube of KY lube. One may then fill the syringe from the KY tube and inject it into the anus; this tends to release just the right amount, in just the right place. The same applicator should not be used with more than one person and should not be used for anal play purposes if it has already been used with Miconazole for medicinal purposes (similarly, one should not generally share the nozzles from enema equipment, etc.).

6.2.2 Common Lubricant Materials

6.2.2.1 Water-Based Lubes

These are safe to used with latex and any other barrier material. Currently popular brands include I-D, ForPlay, and Wet.

Water-based lubes tend to dry out during prolonged use. One may either reapply them, or spray the area with water from a spray bottle to reconstitute the lube.

If you find that irritations such as vaginitis are a persistent problem (and assuming you have eliminated the possibilities of being allergic to any spermicide being used and of being allergic to the barrier material itself), then try switching to a lube which does not contain glycerin, such as Liquid Silk. Glycerin irritation is rare, and I think I’ve only met one person in my life who had run into this as an issue, but in the interest of being thorough I thought it was worth mentioning…

6.2.2.2 Silicone-Based Lubes

These are safe to use with latex and any other barrier material. Popular brands are I-D “Millenium” and Wet “Platinum”. The primary benefit of these lubes is that they will work underwater (which is valuable for sex in hot tubs) and that they don’t need to be reapplied as often. As is the case with most sexual issues, whether one prefers water-based lube or silicone-based lube is a matter of personal preference; at this time water-based lube is still the most universally-accepted choice, so if you are sexually active and like silicone-based lube it would still be a good idea to own some water-based lube.

6.2.2.3 Oil-Based Lubes

No lube with oil in it should be used with a latex barriers. Oil causes latex to degrade and ultimately tear; many of the reported failures of latex condoms occur because an oil-based lube was used as a lubricant. Also, oil-based lubes used in the vagina may increase the probability of vaginitis. Note that many products such as hand and body lotions contain oils.

Since most barriers available are latex based (nitrile and polyurethane are rare), you should assume that a barrier is latex, and hence shouldn’t come into contact with anything bearing oil, unless you KNOW otherwise.

If oil-based lubes are going to be used (and again, they should only be used with barriers made out of substances other than latex, such as nitrile or polyurethane), it is preferable from a health standpoint to select a vegetable-based product, such as sunflower oil or Crisco, instead of a petroleum based product, such as Vaseline.

6.3 Nonoxynol-9

6.3.1 As a Contraceptive

Nonoxynol-9 (N-9) is a substance which is commonly used as a spermicide; when placed in the vagina, and used in conjunction with another form of birth control such as condoms, it is a very effective contraceptive.

6.3.2 As an STD Preventative

There is plenty of evidence that N-9 is an effective contraceptive. However, there is less evidence from the field (as opposed to the laboratory) that it is nearly this effective in STD prevention. N-9 can be chemically harsh to the sensitive linings of the vagina, anus, and penile urethra, and in some cases it may cause microtears that could INCREASE the probability of pathogen transmission. If you are allergic to N-9 (evidenced by itching, burning, etc.) or experience ANY discomfort while using it which you do not experience when using comparable products without spermicides, then don’t expose yourself to products containing N-9. Even mild discomfort may be a sign that any STD-preventative capabilities are being lost due to the mechanism described above. In addition, the fact that safer sex is being made uncomfortable for you will make you more likely to use safer sex precautions inconsistently; this is much worse than any theoretical benefit the N-9 could have provided.

If one is allergic or sensitive specifically to Nonoxynol-9, an alternative might be using products with Nonoxynol-15 or Octoxinol. As barriers, spermicides, and lubricants with these alternative spermicides are not nearly as commonly available as those with Nonoxynol-9, they will not be mentioned specifically in this document; however, you may substitute them for Nonoxynol-9 products if necessary. None of these spermicidal products should be used in the mouth, and most experts recommend that they not be used anally. 

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