Sunday, March 23, 2008

More on Safer Sex

The only safe sex is complete abstinence. If you can't live with that, then you have to work with "safer sex." As a sexually active gay guy, I have my own notion of safer sex. I like the definition on one of Planned Parenthood's web sites:

Safer Sex is about getting maximum pleasure out of your sex life with minimum risk!
The article goes on to discuss some safer sex stories, and some safer sex guidelines. It's a good place to start.

So let's examine this definition a little more: The first part of the definition is, "getting maximum pleasure out of your sex life." You really have to know what kinds of sexual behaviors you want, or want to try out. What are your fantasies? What turns you on?

I believe that you don't have to give up what you want, although you may have to temper it with some prudence, which brings us to the second part of the definition: "with minimum risk." You need to know the risks associated with different sexual acts. You need to know your partners' sexual histories (as well as you own). You have to develop the communication skills to communicate with your partners.

Much information is available about risks associated with different sexual behaviors. Some behaviors, such as mutual masturbation, are much safer, say, than anal sex. That is, a range of risks can be associated with a range of behaviors. Using condoms and other barriers significantly and dramatically reduces risk of infections, if the barriers are used correctly. The important point, here, is to get educated about the risks associated with the different behaviors, and the risks that you are okay with.

You also need to know your own sexual history. What do you do in bed? How risky is your behavior? When was the last time you were tested for HIV, hepatitis B, and other STDs? What is your HIV and hepatitis B status? Have you been vaccinated for hepatitis A and B? How many sexual partners do you have? Do you know your partners?

Ask your partner about his history. When was he last tested? Does he know you? What kind of sex does he want with you (other than "hot"). What's his HIV and hepatitis B status? Do you trust him? Is he telling the truth?

So how do you have this conversation with your partner? The conversation can start in many ways. For example, if you have a profile on a sex site, you can include some of your sexual history in your profile, and you can look for profiles of potential partners that include similar sexual histories. Talk with your partner before you have sex! A phone call or an email is a good place to begin. It may be easier than face-to-face. Then again, before you take off your clothes, talk to him and ask him his expectations, review your sexual histories, and tell him what's acceptable to you, and what's not.

This safer sex conversation is a big deal, and it's probably the hardest part of safer sex. So how do you prepare for the conversation? Role play the conversation with yourself out loud with a friend, or in front of a mirror. Rehearse the talk, until you feel comfortable with it. Then use that talk with your sexual partners. Other than always using a condom or other barrier, this conversation is the single most important element in reducing your risk.

Finally, learn how to act on this conversation. If your partner wants to do things that you think are too risky, either say "No" or negotiate for a less risky behavior that matches your mutual desires.

If you and your partner want to play in ways that would ordinarily be considered risky (for example, bareback anal sex) you really have to evaluate your situation. Do you trust him to be telling you the truth about his sexual history? How long have you known him? How long has it been since you both were tested? Are you both disease free? Is this behavior worth the risk of contracting a life-threatening disease? Even in this situation, you have choices, just think through the choices before you take off your clothes.