safe sexually used to mean just playing it smart. Back then,
that mostly meant using some form of birth control. But today,
playing it safe has a whole new meaning.
HIV (the virus that causes AIDS) and a list of other sexually-transmitted
diseases (or STD's) has shifted both the context and meaning
of being "safe" sexually. It used to mean staying childless;
now it means staying alive.
it safe" message plays to a different audience today, too:
married couples as well as singles, gays and lesbians as well
unprotected sex is riskier today than ever -- at least since
the discovery of penicillin took the sting (and stigma) out of
syphilis, gonorrhea, and other "social" diseases.
But this time,
there's no penicillin on the horizon, and no panacea for the
fear that AIDS arouses. And from the best available evidence,
a lot of the fear is justified:
- As many as a million Americans
may already be symptom-free HIV carriers.
- At least 36 million people around
the world are now infected, according to the World Health Organization,
and 75 percent of all new infections are transmitted through
- New strains of the AIDS virus
have been identified in Asia and Africa that may be 50 times
more easily transmitted through vaginal sex than earlier forms.
And while the
simple fact is that it still isn't easy to "catch"
AIDS through casual contact, casual sex seems another matter
altogether. And if you're sexually active, your safety zone may
be fast disappearing.
What can you
do? Lots, if you're sexually active. Even more, if you're not.
it safe sexually today still means playing it smart. The stakes
are just higher, that's all.
..So what is 'safe sex'?
sex is tricky -- and it's been part of a highly-charged debate
for years. But strictly speaking, the only sex that's guaranteed
safe is no sex at all.
there are risks linked to every form of sex, "protected"
or otherwise. And the only way to totally avoid those risks is
to avoid sex outside of a monogamous relationship with someone
you know is HIV-free.
Short of that,
though, there are ways for sexually-active people to reduce risk.
sex" since the early years of the AIDS crisis, these practices
lower the risk of contracting HIV and other STD's by reducing
exposure to blood, semen, or other bodily fluids that can transmit
the AIDS virus.
that it has to reduce, though. Safer sex shouldn't be a hassle
or a hindrance. And it doesn't have to stop spontaneity or take
the love out of lovemaking. But it does show that you care enough
about yourself and your partner to limit your exposure to HIV.
What it does
is show that you care enough about yourself and your partner
to limit your exposure to HIV.
..I thought AIDS was basically cured. Isn't
Not at all.
several drug therapies have been approved for treating AIDS symptoms
and restoring immune system function (which AIDS can destroy),
none is considered a "cure"-and some don't work at
all for many people.
avoiding exposure to HIV is so important.
..What's the connection between AIDS and
AIDS is primarily
a sexually-transmitted disease. It's spread by direct contact
with the bodily fluids of an infected person.
While gay and
bisexual men still account for 42 percent of new U.S. cases (and
I.V. drug users 32 percent more), AIDS is hardly limited to those
groups. The heterosexual toll is rising -- with some 78,000 U.S.
cases thus far in which male-female sexual contact is the only
known risk factor.
particularly vulnerable to heterosexual exposure.
study estimated a woman's risk of infection at 17.5 times that
of a man, since the virus passes more "efficiently"
from infected males to females.
A main reason
for the breakout beyond original affected groups is that there
are no immediate signs of infection. In fact, researchers warn
that it may take six months to ten years (even longer, in some
cases) for symptoms to appear.
symptoms show up sooner or later, most people who are exposed
to HIV eventually develop more serious problems associated with
or not, all seem able to pass the virus on to others.
And if a million
Americans already are symptom-free carriers of the disease, safer
sex may be the only way a sexually-active person can keep from
finding out who is disease-free -- and who isn't -- the hard
..What sexual activities increase the AIDS
This is where
things get tricky. Because any sexual contact outside a long-standing
monogamous relationship carries at least some degree of risk.
sexual activities are riskier than others. High-risk activities
Contact that causes chafing or
tearing of vaginal, rectal, or other body tissues;
Practices that involve direct contact with bodily fluids or broken
skin (oral sex and vaginal or anal intercourse without condoms,
urination, oral/anal contact).
And even though
HIV is also found in saliva, most experts don't consider kissing
a particularly high-risk activity. In fact, one recent report
labelled even "passionate kissing" a very low-risk
..That doesn't leave much. What's safe
in sex these days?
A lot of things.
Because sex can be safer -- and still be sexy. It just takes
a little planning -- or a lot of self-control.
But since centuries
of experience with other STD's have shown how unreliable self-control
can be, we're going to pitch planning -- and "safer sex"
-- from here on out.
Safer sex is
exactly what it's advertised to be: Safer than unprotected sex.
Just how much safer that degree of safety is depends to a great
extent on the people involved.
Safer sex activities
can include all sorts of sexual contact, with one critical exception:
Bodily fluids -- especially semen and blood -- aren't exchanged.
..How do you keep from doing that?
planned use of barrier contraceptives -- especially the condom.
In case you somehow missed it, condoms fit over the penis and
create a latex barrier against pregnancy, HIV, and other sexually-transmitted
diseases. A new plastic condom for women has even been developed
which fits inside the vagina.
How good a
barrier do condoms provide? Good enough, according to most authorities.
In fact, one study found that latex condoms blocked passage of
the AIDS virus even after three weeks of direct exposure.
On the other
hand, quality is an issue.
In one study
of condom effectiveness, the 8 top-rated condom brands revealed
no HIV leakage, while lower-rated brands failed 10 percent of
away from animal membrane (or "skin") condoms if you
want to stay away from HIV. The pores in skin condoms can be
so big that they allow penetration by HIV, and so they may not
help at all in reducing risk of exposure.
are better, and the new polyvinyl condoms may even be better,
to avoid oil-based lubricants (like baby oil or Vaseline) with
latex condoms. Oily lubricants can damage latex, causing condoms
to stretch or break -- leaving you holding the bag, literally
No longer recommended
is the spermicide nonoxynol-9, once thought to kill HIV on contact.
According to research reported in March, 2001 by the U.S. Centers
for Disease Control, women using nonoxynol-9 gel actually had
a higher incidence of HIV infection than women using no protection
..What else can I do to avoid AIDS?
giving up sex altogether, the best bet is giving up any illusions
you might have about your own invulnerability.
since that reduces the risk of all sexually-transmitted diseases,
not just HIV.
Don't mix sex
with drugs or alcohol. Drugs may only directly cause AIDS when
they're injected with an infected needle, but they can lead to
the kind of impulsiveness that can lead to problems.
In fact, both
research and common sense tells us that when alcohol or other
drugs are added to a sexual encounter, condoms and other good
intentions get left out. And one dumb choice is all it takes
to undo a lifetime of smart choices.
into sexual encounters. Plan ahead if you plan on staying alive
and healthy. Keep condoms on hand even if you only think you
might need them. And don't be afraid to say no to sex for now
if that's what's right for you.
And if all
the self-scrutiny and preparation seems like more trouble than
they're worth, just consider the three-quarters of a million
Americans who've contracted AIDS thus far and the 440,000 who've
died and the million or so more who are symptom-free carriers,
And draw your
..Sidebar | Safer
Sex: Making Love Less Risky
and what's just-asking-for-AIDS these days is still a matter
of some debate. For one thing, no one knows completely all the
factors (and co-factors) that play a role in the spread of HIV.
For another, moral considerations often make discussing safer
sex difficult, if not impossible.
And on top
of everything else, there's no guarantee that even following
the guidelines presented here will absolutely protect you from
HIV and other sexually-transmitted diseases.
"safer sex" may not be entirely risk-free, a lot of
the people who practice it seem to think that it's better than
the sexual alternatives.
- Sex in an unexposed monogamous
- Mutual masturbation (on unbroken
- Vaginal intercourse with latex
- Oral sex with condoms latex
condoms (or dental dams)
- Intercourse without condoms
- Oral sex without condoms
- Oral/anal contact
- Violent or
abusive sexual contact