Lifestyle

Safer Sex

What is Safer Sex?

Safer sex is more than avoiding infections, although this is often main message in safer sex discussions. Safer sex is about physical and emotional wellbeing in intimate relationships, where sex is based on consent and partners accept responsibility for reducing the risk of sexually transmitted infections (STI) and unplanned pregnancy.

Safer sex is about having confidence in your own beliefs and needs as well as knowing your body, so that sex you agree to is sex you want to have. Safer sex is about being able to talk to your partner(s) about what you each need in a sexual relationship. Knowing where to get help if you are feeling worried about your sexual and reproductive health is just as important.

Reducing the risk of sexually transmitted infection

1. Vaccination

Vaccination is the best way to prevent Hepatitis B infection and infection with Human Papilloma viruses (viruses which can cause genital warts and cancers of the genital skin and cervix).

Vaccination against hepatitis B has been provided to all babies born in Australia for almost 10 years, with catch-up vaccine programs delivered through schools. This still means that many young adults have not been vaccinated. Hepatitis B virus is easily passed on through kissing, sex and blood exposure. Hepatitis B infects the liver, and can make a person very unwell. Whilst most adults will eventually clear the infection, about 5% of adults who get hepatitis B will go on to have chronic hepatitis B, with the risk of liver failure and liver cancer. Vaccination is low cost and effective. If you are not sure if you have been vaccinated, your GP will be able to discuss your options with you.

Vaccination against Human Papilloma virus was introduced in Australia in 2006, primarily through school based programs but with a catch-up program for woman up to 27 years of age via GPs. The school based program is ongoing, but the catch-up program finished in June 2009. Again, vaccination is very effective, but unfortunately expensive outside of the school program. Two vaccines are approved in Australia for women aged between 10 and 45 years. Only one of the vaccines is proven to provide protection against genital warts, whilst both provide protection against cervical and other genital skin cancers. Again, your GP can discuss your options with you if you have not been vaccinated.

2. Healthy genital skin

Genital skin, just like the skin on the rest of our body, acts as a barrier to reduce the risk of infection. Genital skin that feels sore, irritated or splits easily will not be able to work as well to reduce the risk of getting infections such as genital warts or genital herpes.

A healthy vagina is also part of having sex safely, so if you are worried about vaginal infection or discomfort, discuss this with your GP. There is also lots of information in this website on vulvovaginal and genital skin problems.

3. Condoms

Condoms are very effective for preventing some sexually transmitted infections: chlamydia, gonorrhoea and HIV in particular. Of course, to be effective, condoms need to be used each time you have sex. A condom needs to be put on before genital to genital contact, as pre-cum can come out as soon as the penis is hard. Use water-based lubricant with condoms to reduce the risk of condom breaks, and help sex to stay comfortable and fun. There are a range of water-based lubricants at pharmacists, supermarkets and adult shops. It is worth trying to find one you like!

Condoms cannot completely reduce the risk of genital warts and genital herpes. These two viruses are complicated as both can infect skin that cannot be covered by a condom and both can be shed from genital skin even when there is no obvious infection. In addition, oral sex is a very effective way of passing on Herpes Simplex virus infection, causing genital herpes. And despite a lot of research, we still don’t have a vaccine against genital herpes.

Other STIs can be passed on through oral sex, in particular gonorrhoea and syphilis. Condoms are good for reducing risks associated with oral sex, and for sex toys. Dams (thin sheets of latex to stretch over the vulva before oral sex) are available but not widely used.

If you or your partner has HIV, specialist care includes advice on safer sex and HIV post-exposure prophylaxis if something goes wrong.

4. STI testing

STI testing is simple and readily available through GPs. Sexual health centres also provide testing for those at higher risk of acquiring STIs.

Many couples start out using condoms but find it difficult to use one every time they have sex, or decide to stop using condoms as their relationship becomes more established.

Unless you have both had STI testing before the start of the relationship, it is well worth both getting tested before stopping condom use. Remember that STIs often have few or no initial symptoms, even though they can have long-term consequences for health and fertility.

5. Talking with your partner(s)

Sex carries risks - both physical and emotional. Many of us have already had an STI, including genital warts or genital herpes. Many others may have asymptomatic STI. Others may have been tested but have had more partners since. Trying to talk openly with partners about the risks of STI that each of you brings to the relationship builds trust and helps decision making about reducing risks to each other. This is not just at the start of a relationship: discussing how to keep each other safe is either of you has other partners whilst in the relationship is also important.

Where can I get help?

Advice about sex, sexuality, contraception, sexually transmitted infections, and if you have been sexually abused or assaulted:

  • Your GP
  • Family planning clinics
  • Sexual health clinics
  • Women’s health centres

Additional support and advice if you have been sexually abused or assaulted is available to men and women from Rape Crisis Centres throughout Australia.

For more information on STI, condom use and where to get help, see http://www.sti.health.gov.au.