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STDs (Expert Forum)
safe practices
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
safe practices
by youngnparanoid, Mar 20, 2006 12:00AM
First I want to say I really appreciate this site and its information, as many doctors I have visited are usually short with their time and explanations.
My situation is this: I am 23 y/o female. I started having sex at 13 and have had a rather promiscous past, about 20 partners (mostly with condoms except for my long term relationships (3) and oral sex). I am regretful of my past and constantly worry about it. I have always been a hypochondriac. I get tested every year for STDs, except for HIV (not smart, I know, but I couldnt live with a postive result). The only test I came up positive for is a high-risk strain of HPV, which I am monitoring. (I actually came up negative, postive, negative, postive for Herpes in that order with an IGM test, which as Ive read here is unrealiable and have never had symptoms). Since the HPV result, I've decided to abstain. However, abstinence requires real self-restaint, especially since every male I meet wants some sort of physical action.
Basically my question is what is safe to do without having sex. You make mention in other threads about it being safe to "finger" or give "hand jobs", but is that true when he has touched himeself and then touches me or if he licks his fingers and then inserts them? Is kissing risky when its so-called "passionate" or when there's cuts in your mouth? Is "dry humping" safe if the only clothing between genitals is underware? Is it extremly risky to have unprotected oral sex (I've always thought it wasn't but so many people on here make reference to symptoms after unprotected oral sex). I want to belive I am being careful since I'm not actually having intercourse, but I'm not sure if other sexual acts carry a heavy risk. It's kind of depressing to have to constanly worry about what you're doing, and I'd really just like to be able to get physical with someone but also rest a little easier.
I really appreciate your time for answering this and any advice you have for me.
My situation is this: I am 23 y/o female. I started having sex at 13 and have had a rather promiscous past, about 20 partners (mostly with condoms except for my long term relationships (3) and oral sex). I am regretful of my past and constantly worry about it. I have always been a hypochondriac. I get tested every year for STDs, except for HIV (not smart, I know, but I couldnt live with a postive result). The only test I came up positive for is a high-risk strain of HPV, which I am monitoring. (I actually came up negative, postive, negative, postive for Herpes in that order with an IGM test, which as Ive read here is unrealiable and have never had symptoms). Since the HPV result, I've decided to abstain. However, abstinence requires real self-restaint, especially since every male I meet wants some sort of physical action.
Basically my question is what is safe to do without having sex. You make mention in other threads about it being safe to "finger" or give "hand jobs", but is that true when he has touched himeself and then touches me or if he licks his fingers and then inserts them? Is kissing risky when its so-called "passionate" or when there's cuts in your mouth? Is "dry humping" safe if the only clothing between genitals is underware? Is it extremly risky to have unprotected oral sex (I've always thought it wasn't but so many people on here make reference to symptoms after unprotected oral sex). I want to belive I am being careful since I'm not actually having intercourse, but I'm not sure if other sexual acts carry a heavy risk. It's kind of depressing to have to constanly worry about what you're doing, and I'd really just like to be able to get physical with someone but also rest a little easier.
I really appreciate your time for answering this and any advice you have for me.
Doctor's Answer
by H. Hunter Handsfield, M.D., Mar 20, 2006 12:00AM
, Mar 20, 2006 12:00AM
First, congratulations on your new dedication to sexual safety.
Second, keep up the regular STD testing, and start including HIV. It is irrational to avoid it because you "couldn't live" with a positive result. To be honest, I simply have no patience with such demented reasoning. (Sorry if this sounds harsh. Call it tough love.)
Third, the main keys to safe sex are:
1) Know your partner. Hopping in the sack with someone you just met, especially bar pick-ups and the like, is very high risk. Ask about symptoms or recent STD diagnosis, and always specifically ask whether a partner has HIV or is at particularly high risk for it (bisexual men, injection drug uers, etc).
2) A corollary to knowing your partner: Avoid situations that are obviously tempting or that impair judgment, e.g. getting high or drunk in a bar or other meat market setting.
3) Use condoms for vaginal or anal sex with new or non-committed partners.
4) Oral sex is much safer than vaginal or anal sex, for all STDs except for exposure to type 1 herpes simplex virus--and that is pretty effectively avoided by asking and looking for active cold sores (or any unexplained sores on or near thhe mouth). The risk of oral sex is low enough that most people don't think condoms or barriers for cunnilingus (dental dams, plastic wrap) are worth the hassle. However, it is a personal decision and some people use barriers even for fellatio or cunnilingus. But I agree with you that it really isn't practical and I don't think it's all that important. Obviously, you're going to avoid oral contact if either partner has a genital or oral lesion, discharge, or other abnormality.
5) Genital apposition ("outercourse", ie genital contact without penetration) is pretty safe; some risk of HPV and herpes remains, but much lower than with intercourse. It's probably just about as safe as condom-protected intercourse. Of course if clothed there is zero risk.
6) Don't worry at all about kissing or hand-to-genital contact. They carry no risk of STD/HIV transmission.
Finally, I agree with monkeyflower's advice below. Don't get so hung up on all this that you forego a satisfying sex life. With the protections above, you can expect to remain free of new STDs.
Good luck-- HHH, MD
Second, keep up the regular STD testing, and start including HIV. It is irrational to avoid it because you "couldn't live" with a positive result. To be honest, I simply have no patience with such demented reasoning. (Sorry if this sounds harsh. Call it tough love.)
Third, the main keys to safe sex are:
1) Know your partner. Hopping in the sack with someone you just met, especially bar pick-ups and the like, is very high risk. Ask about symptoms or recent STD diagnosis, and always specifically ask whether a partner has HIV or is at particularly high risk for it (bisexual men, injection drug uers, etc).
2) A corollary to knowing your partner: Avoid situations that are obviously tempting or that impair judgment, e.g. getting high or drunk in a bar or other meat market setting.
3) Use condoms for vaginal or anal sex with new or non-committed partners.
4) Oral sex is much safer than vaginal or anal sex, for all STDs except for exposure to type 1 herpes simplex virus--and that is pretty effectively avoided by asking and looking for active cold sores (or any unexplained sores on or near thhe mouth). The risk of oral sex is low enough that most people don't think condoms or barriers for cunnilingus (dental dams, plastic wrap) are worth the hassle. However, it is a personal decision and some people use barriers even for fellatio or cunnilingus. But I agree with you that it really isn't practical and I don't think it's all that important. Obviously, you're going to avoid oral contact if either partner has a genital or oral lesion, discharge, or other abnormality.
5) Genital apposition ("outercourse", ie genital contact without penetration) is pretty safe; some risk of HPV and herpes remains, but much lower than with intercourse. It's probably just about as safe as condom-protected intercourse. Of course if clothed there is zero risk.
6) Don't worry at all about kissing or hand-to-genital contact. They carry no risk of STD/HIV transmission.
Finally, I agree with monkeyflower's advice below. Don't get so hung up on all this that you forego a satisfying sex life. With the protections above, you can expect to remain free of new STDs.
Good luck-- HHH, MD
So, while you wait for Dr. Handsfield's reply, I thought I'd offer some suggestions on how to stay safe. Get tested for STDs regularly (which you already do :-)). Talk to your partners about their STD status. Keep condoms with you and always use them for vaginal and anal intercourse. Unprotected oral is pretty safe; most people don't use condoms or dental dams for oral. Dry humping is safe. Deep kissing is safe. Handjobs/fingering are safe.
But my main suggestion would be to consider seeing a sex therapist, because it sounds like your fear and anxiety is seriously interfering with your enjoyment of life. Your past certainly doesn't seem unusual or extreme in any way, but it clearly bothers you a lot - much more than I think sounds healthy. After all, for most people sex is an integral part of a fulfilling, healthy, and happy life. You may also want to consider talking with your regular doctor about your anxiety in general, and whether medication might be helpful :-)
monkey is correct in what he states in regard to HIV
other sexual practices such as oral are definately NOT safe for other STI such as gonorrhea, syphilis, herpes, chlamydia, & molluscum - since many STIs often do not present with symptoms, they can be easily aquired and spread through casual unprotected activities without the partners even knowing they have STIs - I find it highly irresponsible to state that unprotected oral is safe when it is known to be a vector for other STIs - this board addresses STIs - all of them - not just the "big one"
just my thoughts
I recently "made out" with a man I knew little about (I know, stupid........). Fast forward - - he fingered me until I came and I gave him a hand job (no ejaculation). Our genitals never touched.
Per this post, there was no risk of any STD