A very personal little story, about how hard it is to conduct safer sex education in the dead-tree medium. It illustrates, I think, why the web an essential resource for honest discussion of safer sex aimed specifically at teenagers.
I used to be a Senior Writer at Sassy magazine, where I was responsible for the magazine's health column. One day in 1994 I realized that I'd been getting a bunch of suspiciously similar-sounding letters from teenagers urging me to write that condoms actually don't protect you from AIDS or pregnancy. "You need to tell your readers that condoms are ineffective because they slip off or break 50% of the time," the letters urged. Furthermore, they insisted, "the AIDS virus is small enough to slip through the holes in condoms."
Huh? This is flat-out wrong. According to the Centers for Disease Control and Prevention (CDC), when used consistently and correctly, condoms slip off or break less than one-half of one percent of the time. Latex condoms are very good protection from HIV and STDs; it's animal-skin condoms that are iffy (1). Obviously the letter writers weren't making any distinctions between latex and animal-skin.
I wondered why all the letters, from all over the country, authoritatively used this "condoms break 50% of the time" statistic. Where'd they get it? And why did they always pair it with the "fact" that even if condoms mysteriously managed to stay on (or miraculously failed explode like cherry bombs), the teeny and wily AIDS virus was no match for them? My belief is that so-called counselors with a religious and moral agenda were willfully feeding kids misinformation. Sunday school and health teachers in right-wing communities were telling kids the only way to stay safe was to be abstinent. Now, it's true that total abstinence is the only sure bet in the pregnancy and disease-protection sweepstakes. But telling kids "just say no" and offering no further information or advice is utterly unrealistic in a country where 75% of kids lose their virginity by 12th grade.
I wanted to write something in my column countering this misinformation kids were clearly getting. And most of all, I wanted to explictly tell readers how to use a condom. We've all heard the phrase a million times: "Condoms, when used consistently and correctly, prevent the spread of AIDS." But what does "consistently and correctly" mean, anyway? Not all kids know that condoms roll only one way (when a condom won't roll properly, it's probably inside out). Not all kids know that the guy wearing the condom should pull out fairly soon afer he cums (before he gets flaccid, lest the condom slip off when he pulls out). Not all kids know to hold the base of the condom when they pull out, to reach down and check periodically during sex that the condom is still on, to leave a bit of space at the end of a condom without a reservoir tip, or to avoid using oil-based lubes like hand cream, Vaseline or vegetable oil with condoms. Not all kids know that condoms can degrade in sunlight or in a battered wallet. In short "consistently and correctly," as a phrase, doesn't give you many specifics.
I thought it was especially essential for girls to get this information, especially since studies indicate that women are 10 to 20 times more likely than men to get HIV from unprotected sex with an infected male partner than vice versa. But when I tried to say what I just said in the previous paragraph, I was stymied. There was no way the word "cum" was gonna get by the publisher, the senior editor insisted. I tried "ejaculate," a stilted and giggle-inducing word which I felt made me sound like an uptight, nebbishy girdle-wearer. Nope. The publisher nuked it; advertisers would be horrified. Hands tied, I finally ended up writing, "If you're unclear on exactly how to use [a condom] properly (it's not just roll it on and go) read the direction or order a free borchure from the CDC's National AIDS hotline, 1-800-342-AIDS." Way to be helpful.
Later, in 1995, I was asked to write a safer sex book for an entertainment juggernaut (hint: a network that features the innovative convergence of music and images that rhymes with Femme Pee Wee). In my first meeting with the roomful of executives, I explained that I wanted the book to discuss non-penetrative sex, that I didn't want to relegate "the gay stuff" to chapter 17 or whatever in the way back of the book, and that I wanted to be realistic about the fact that teenagers are for the most part sexually active. At the time, the roomful of executives nodded eagerly. But when they actually saw the first draft, they felt it was "too pro-sex." They also felt that "the gay stuff," which I introduced in Chapter 2 as part of a general discussion of sexual identity, was "much too prominent." Finally, they were unsure about whether they wanted a book written for teenagers at all. Maybe it would be better to do a book that adults would buy for their teenage children. Or maybe they should collect a bunch of celebrities' stories about their sex lives (oh yeah, that'll glamorize safer sex!). And obviously I should only quote attractive kids who'd be willing to be photographed for the book. Reality check! By limiting the options that way, you eliminate any teenager who might say something private or stigmatizing.
We went around and around. The executives kept changing their mind about what they wanted. I felt I made compromises; I moved the gay stuff to the back of the book and added some pro-abstinence stuff to the front of the book. Finally it was decided that the entertainment juggernaut would bring the project in-house; I was paid off and set free. But I kept hearing gossip about the internal debates about the future of the book. To assuage my guilt, I ended up writing an impassioned letter to the president of the entertainment juggernaut begging her to do the right thing and publish a real safer sex guide, not some glitzy celeb-riddled volume made toothless by anxious lawyers. I never got an answer. Two years later, the book still hasn't come out. I presume they're still wrassling with it.
And now we have the World Wide Web. The lovely, link-y Web. Here we can have no page counts, no space restrictions, no skittish fashion advertisers, no censorship. (Yet, anyway.) Here we can let readers make up their own minds about thorny, still-debatable issues like the safety of oral sex rather than telling them what to do. Here readers can explore the specific topics that interest them, with ease and privacy.
And here I can chant "cum cum cum cum cum" as much as I want.
Used by permission.
Since 1977 there have been at least six patents awarded in the United States for a female applied condom, only one of which has made it to market. This condom is produced by the Female Health Company which is based in Chicago. The Female Health Company owns the worldwide rights to the female condom including international patents issued in the U.S., Japan, The European Union, The People's Republic of China, Canada and Australia. In the U.S. and Canada it used to be marketed under the name "Reality" and in the rest of the world under the name "Femidom".
This product is currently being marketed in the US with the name Female Condom.
This condom tends to be difficult to find in shops and when found is very expensive in comparison to normal latex male applied condoms. You can purchase it online through Condomania if either you are unable to find it at your local pharmacy or you are concerned about privacy.
While the FDA says that you can expect a 84% effectiveness rating for the female condom there is some controversy about this with some, such as the Female Health Company, believing the condom is under rated because of an inherent bias towards male applied condoms. With "perfect" usage efficacy may go up to as much as 95%, which fits nicely with the figures for "perfectly" applied male condoms, but this figure should not be relied upon. It should be noted that the condom is relatively new to the market and because it is a new technology the methodology for testing it may not be as complete as that for latex condoms.
As with any medical device the female condom is most appropriately used under the supervision of a doctor and should be used in conjunction with both STD and pregnancy counseling.
Women are one of the fastest-growing population with HIV, but
not much information has been written for or about them. Here
are some topics of special concern for women.
Download a Lesbian Safer Sex Guidelines cut-and-fold
display to stand up on your nightstand!
Yes!! There have cases reported since the mid 1980's which indicate that women are transmitting HIV (Human Immunodeficiency Virus) to each other. Despite these reports the Federal Government's Center for Disease Control (CDC) does not include female to female transmission in its AIDS (Acquired Immune Deficiency Syndrome) reports. Many lesbians mistakenly believe that they are not at risk. HIV is transmitted when blood, vaginal fluids, breast milk or semen from an HIV infected person enters your blood stream.
Lesbians can be infected with HIV through having unsafe sex (with women or men), donor insemination, sharing injectable drug works, piercing, tattooing and blood transfusions.
Because we do know how HIV is transmitted we can define some guidelines for safer sex and explain which risky sexual behaviors are
potentially risky.
Whether a sexual behavior is safe or unsafe depends on the chances of your partner's bodily fluids coming in contact with your blood.
NOT RISKY
Massage
Hugging
Fantasy
Voyeurism
Exhibitionism
Masturbation (Touching Yourself)
Vibrators or other sex toys (Not shared)
Dry Kissing
Body To Body Rubbing or "Tribadism" when fluids are not involved
POSSIBLY RISKY
Wet (French) Kissing
Shared hand & genital contact with a barrier such as a fingercot, glove, or latex dam (a square piece of latex)
Cunnilingus(Oral-Genital contact) using a barrier
Fisting using a barrier
PROBABLY RISKY
Shared hand, finger & genital contact
with cuts or sores
Cunnilingus (Oral or Tongue to genital contact)
without a barrier
VERY RISKY
Cunnilingus without a barrier during menstruation
Femal or male ejaculate in the mouth, vagina or anus
Rimming without a barrier
Fisting without a barrier such as a glove
Sharing sex toys without a barrier
Sharing needles of any kind, i.e.: to shoot drugs, pierce or tattoo the skin
If you inject drugs, don't share your equipment ("kit" or
"works"). If you have to share, clean the equipment between use by
flushing the syringe and needle with bleach and water, then flush it
with clean uncontaminated clear water.
If you have sex with a man or use donated sperm, make sure he has
two HIV tests six months apart and tested negative both times. The
first test should be six months after his last possible exposure to
HIV. The donor must have no possible exposure to HIV between his last
test and donation. All licensed sperm banks test their donors
carefully and test the sperm twice.
If you have sex with a man, the man must wear a condom for vaginal
and anal intercourse. Additionally, if you engage in oral sex, it is
necessary that a man wear a condom. HIV is in semen and pre-ejaculate.
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If you believe you have been exposed to the HIV virus,
get the HIV test. Early detection leads to early treatment
(intervention) which slows down the progression of the virus. to be
sure of your results, wait 3-6 months after your last risk before
retaking the test.
It is understandible to be scared if you think you might have been
exposed to HIV. Take a calm and realistic look at the risks you might
have taken. Take advantage of the resources we've listed to help you
answer any questions you have regarding risky behaviors.
Regardless of your HIV status you should practice safer sex now to
protect yourself and your parter form HIV and STD's (Sexually
Transmitted Diseases).
Southern California............................(800)922-2437
Bilingual Hotline (English/Spanish)............(800)400-7432
TDD............................................(800)553-2437
Northern California (English/Spanish/Tagalog)..(800)367-2437
TDD............................................(415)864-6606
National AIDS Hotline..........................(800)342-2437
In Spanish.....................................(800)344-7432
TDD............................................(800)243-7889
The Center: L.A. Gay & Lesbian Community Services Center
Art Direction & Production: Deborah Hanan
Photography: Maria Elena Boyd
Models: Jenny/Tina, Robbi/Tracy, Amazon, Nico
Used by permission
The recent launch of CDC's Prevention Marketing Initiative (PMI) and, especially, the airing of its new public service announcements have generated a flurry of public comments, most revolving around the abstinence versus condoms issue. Both messages are incorporated in the PMI repertoire because both are critically important strategies for preventing HIV infection.
Delaying the initiation of sexual activity, or practicing abstinence during adolescence, is a valuable health behavior for young people. It also prevents unintended pregnancy and the transmission of other sexually transmitted diseases (STDs), many of which can have severe or permanent side effects. (Many people are not aware of the extent and number of STDs in the United States—in addition to gonorrhea, syphilis, and herpes, other serious infections are widespread in the general population, such as chlamydia, human papillomavirus [genital warts], trichomonas, and hepatitis B.)
Abstaining from sexual activity is a 100 percent effective method of avoiding sexually transmitted infections. For most people, however, abstinence is not a lifelong goal, but a temporary, reasonable, and healthy strategy to adopt during certain periods of one's lifetime, e.g., during the emotionally vulnerable adolescent period or between marriages.
Having sexual intercourse with only one uninfected (and faithful) partner is equally as effective as abstinence, but is effective only if it is practiced consistently by both partners in the relationship. (Having a series of monogamous relationships is not a safe prevention strategy.)
To be sure that a person is not infected with HIV, two
separate HIV-antibody test results, 6 months apart, should be
obtained after any behavior that might have resulted in HIV
infection. If the second test is negative 6 months after engaging
in the risky behavior, that person can be reasonably certain that
HIV infection is not present.
Any activity that would allow the exchange of body fluids
(semen, vaginal secretions, or blood) could result in the
transmission of HIV if one of the partners is infected. This means
that all penetrative sexual intercourse (vaginal, oral, or anal)
is risky if latex condoms are not used, or are not used correctly.
Having anal intercourse presents an increased risk for both
homosexual men and heterosexual women. Most heterosexual
transmission occurs through vaginal intercourse, and oral
intercourse has also been reported to transmit HIV.
Kissing generally does not present a risk, but because of the
theoretical risk of HIV transmission through blood that might be present in the mouth, CDC does not recommend engaging in deep (French) kissing with an infected person, or a person whose infection status is unknown.
Using a latex condom correctly and consistently (i.e., for
each and every act of intercourse) provides a very high degree of
protection. To request a free brochure on the correct way to use
a condom, call the CDC National AIDS Hotline at 1-800-342-AIDS
2437).
Sexually transmitted diseases, including HIV infection, are
preventable. Individuals have several responsible prevention
strategies to choose from, but the effectiveness of each one
depends largely on using it consistently (every time). Those who
practice abstinence will find it effective only if they
consistently abstain. Similarly, those who choose any of the other
recommended prevention strategies, including using condoms, will
find them highly effective only if used correctly and practiced
consistently.
(CDC HIV/AIDS Prevention. Summer 1994. DISTRIBUTED BY GENA/aegis
(714.248.2836 * 8N1/Full Duplex). SOURCE: Department of Health and
Human Services.)
The following is a pamphlet written in June 1991 by Liz A. Highleyman and was last updated 3/22/93. AIDS knowledge increases and changes rapidly. For updated information, contact the numbers listed below.
Acquired Immune Deficiency Syndrome (AIDS) is believed to be caused by a virus called HIV, which weakens the immune system and makes the body less able to fight infection. A person who is HIV+ (tests positive for HIV antibodies) may have no symptoms, or may have opportunistic infections such as certain cancers or pneumonia. There is currently no cure for AIDS, but it can often be controlled with drugs. HIV+ people may be symptom-free for years, and people with AIDS (PWAs) may live for years with the disease.
In the age of AIDS, everyone should know about safer sex. HIV can infect anyone, regardless of sexual orientation, sex, age, race, or economic class. While the incidence of AIDS is much higher in some populations than in others, it is not who you are that can give you AIDS, but what you do.
Only you can decide what kind of sex is right for you and what risks you will take. Some people take all possible precautions with every partner for their own peace of mind and so they do not have to rely on others for their safety. Others choose to forgo some or all precautions depending on their relationships and lifestyle.
This brochure talks about various risk factors and offers suggestions for making sex as enjoyable and risk-free as possible.
THINKING ABOUT RISK: A CONTINUUM
Safer sex recommendations vary greatly. Many AIDS organizations and public health departments promote stringent guidelines. People rely on this advice to make life-and-death decisions, and it seems better to err on the side of too much rather than too little caution. Other people (especially those in groups with a low incidence of AIDS) figure that statistically most people have less chance of getting AIDS than of being struck by lightning. They are unwilling to restrict their sexual options in the face of such low odds, especially since this plays into the anti-sex agenda of moral conservatives. When people are told to restrict most of their favorite activities, they may ignore safer sex advice altogether. Given the low or indeterminate risk of certain activities (such as unprotected oral sex), some AIDS organizations and activists put an emphasis on avoiding the most risky ones (such as unprotected anal or vaginal intercourse).
SOME COMMENTS ABOUT RISK
"Low Risk" Myths
You cannot tell whether someone is infected by their appearance or lifestyle. Most HIV+ people do not look sick and may pass on the virus unintentionally. ``Nice people'' can and do get AIDS. Marriage, long-term relationships, and monogamy are no guarantee against AIDS if one partner has been previously infected. AIDS was recognized in 1981; the virus has been around even longer. A common rule of thumb is that a negative HIV test is not reliable unless the person was tested at least six months after he or she had engaged in any unsafe activity. One unprotected encounter with an infected person is enough to transmit the virus.
Sexual Orientation
Men who have sex with men account for most U.S. AIDS cases. People who have sex with members of the opposite sex make up a growing proportion, especially among women, urban populations, and IV drug users; in several countries heterosexual sex is the primary means of AIDS transmission. Women who have sex with women account for a small number of cases. The labels gay, lesbian, heterosexual, and bisexual are not reliable indicators of sexual behavior. Some gay men and lesbians have sex with the opposite sex, some heterosexuals have sex with the same sex, and bisexuals may have sex with either, both or neither sex. Current self-identification does not indicate past sexual activity.
"Unusual" Activities
Some sources recommend against unusual and stigmatized sexual practices such as s/m (sadomasochism), sex with multiple partners, fisting, and sex for money. With knowledge and precautions, these can be done with minimal risk of AIDS. Such warnings are based on moralism not medicine.
Drugs and Alcohol
Drugs, ``poppers,'' and alcohol may impair your judgement, leading you to take risks that you would not otherwise take. They can also weaken your immune system, making you more susceptible to infection with HIV and other illnesses.
If you're HIV+
Practice safe sex even with partners who are also positive. This can prevent infection with new strains of HIV (which could make you more ill), as well as other diseases which can be especially dangerous for a person with a weakened immune system.
Honesty
Communication is important, but consider carefully the wisdom of relying on honesty. It is possible that a partner might fail to remember or neglect to mention a risky activity, especially one that happened a long time ago or one that is stigmatized (such as same-sex sexual activity or needle use).
WHAT ACTIVITIES ARE RISKY?
The highest amounts of HIV are found in blood and semen. HIV is present in smaller amounts in vaginal and cervical fluid (especially if a woman has a vaginal or cervical infection). Recent studies show that pre-cum does contain HIV, although it is debated whether it is enough to transmit AIDS. There are no studies of the amount of HIV in female ejaculate. Very little HIV is present in saliva, sweat, and tears; these almost certainly cannot transmit AIDS. Anal and vaginal intercourse account for most documented cases of sexually transmitted AIDS, while oral sex accounts for a few cases. Other activities have not been shown to cause AIDS, but theoretically could present some risk because they can allow HIV-containing body fluids to get from one person to another. Studies show that HIV may be absorbed directly by cells in the mucous membranes. The safest activities are those that avoid any way in which HIV-infected blood, semen or vaginal fluid can get from one person's body to another person's mucous membranes or bloodstream.
HIGH RISK
/ Unprotected anal intercourse
/ Unprotected vaginal intercourseS
/ Sharing needles (for drugs, piercing)
-+ +- Sharing implements that draw blood (whips, knives)
| | Unprotected oral sex on a menstruating woman
| | Unprotected oral sex on a man with ejaculation
| | Unprotected oral-anal contact
| | Getting urine or feces in mouth, vagina, ass
| | Unprotected fisting or finger fucking
| | Unprotected oral sex on a man without ejaculation
| | Unprotected oral sex on a non-menstruating woman
| | Sharing uncovered sex toys
| | Anal intercourse with a condom
| | Vaginal intercourse with a condom
| | Oral sex on a man using a condom
| | Oral sex on a woman using a latex barrier
| | Oral-anal contact using a latex barrier
| | Fisting or finger fucking using a glove
| | Petting, manual-genital contact
| | Deep (French) kissing
| | Spanking, whipping that does not break the skin
| | Bonadge and discipline play
-+ +- Masturbation (alone or with partner)
/ Hugging, touching
/ Massage
/ Talking dirty, phone or net sex, fantasy
NO RISK
Sexual activities fall on a continuum from high risk to risk-free. Activities at the top carry a high risk of HIV transmission (especially for the receptive partner). Upper-middle range activities carry a minimal or indeterminate risk. Lower-middle range activities carry a theoretical risk. Activities at the bottom are completely safe.
SAFER SEX TIPS
Use latex condoms for vaginal and anal intercourse. Use a water-based lubricant (K-Y, Astroglide, Probe); oil-containing products (Crisco, Vaseline, baby oil, lotion, whipped cream) can destroy latex. A drop of lube inside the condom may increase sensitivity. Don't use saliva as a lubricant.
Other contraceptive devices do not protect against AIDS. Products containing Nonoxynol-9 (a spermicide) can kill HIV and may provide extra protection, but should not be relied on alone. Some studies show that Nonoxynol-9 can cause genital irritation that may promote HIV infection, especially with very frequent intercourse. The effects of ingesting Nonoxynol-9 are unstudied.
Blood-to-blood contact is the most direct route of HIV transmission. Sharing needles (for drugs, steroids, piercing or tattooing), razors, or any implement that draws blood is dangerous since blood may be left on used implements. Clean needles by rinsing several times with bleach then with water. Avoid contact with blood in s/m scenes. Whips or knives that break the skin should not be used on another person until disinfected with bleach or a cleaning solution.
Use an unlubricated condom for oral sex if a man will come in your mouth. For oral sex on a woman or oral-anal sex (rimming), use a dental dam (latex square), a condom or latex glove cut to produce a flat sheet, or non-microwaveable food wrap. Rinse powder off dams before use. Use all barriers only once and only on one person.
Oral sex on a man without ejaculation or on a non-menstruating woman is thought to be a low risk activity. There is a risk that HIV could enter through small cuts or openings in the mouth, gums or throat; avoid brushing your teeth two hours before or after oral sex to minimize abrasions.
If you share sex toys like dildoes or vibrators, put on a fresh condom for each user (and when going from anus to vagina), or clean with bleach, alcohol, or soap and water.
Use latex gloves for finger fucking or fisting to guard the wearer against infection through cuts on the hand or arm, and to guard the partner against injury from fingernails.
Touching and kissing are safe. It is safe to get cum, vaginal fluid or piss on unbroken skin. No AIDS cases have been traced to kissing, including deep (French) kissing.
Precautions against AIDS can protect you from other sexually transmitted diseases such as gonorrhea, syphilis, chlamydia, herpes, yeast infections, amoebiasis, and hepatitis B. Preventing other STDs can in turn minimize your chances of getting AIDS, since many STDs cause sores in the genital or anal area or around the mouth which can provide a path for HIV transmission.
RESOURCES:
CDC National AIDS Info Line: 1-800-342-AIDS
Spanish AIDS Info Line: 1-800-342-SIDA
AIDS Info for the Deaf: TDD/TTY 1-800-243-7889
Gay Men's Health Crisis (NY): 1-212-807-6655
San Francisco AIDS Foundation: 1-415-863-AIDS
Info on current clinical trials: 1-800-TRIALS-A
If you think you may be infected with HIV or if you want to be tested for HIV, call your public health department, a local AIDS resource office, or a local gay hotline. To get involved in the fights against AIDS, call your local AIDS service provider or your local chapter of ACT UP.
aware, putting condom machines in schools, or lecturing them on
abstinence. Unfortunately and tragically, our various
governments think so. Too many public health and educational
authorities unfortunately think so. Too many writers and
celebrities unfortunately think so. WE'RE GOING TO SHOW YOU
HOW, in upcoming articles, you can effectively teach, without
embarrassment, and get your kids to practice and develop the
habits of safer-sex and/or abstinence.
sex
because they are uncomfortable talking about their
decisions. They're too embarrassed to bring up the subject;
they fear rejection; or they just aren't sure how to say what
they want to say.
safety issues. And so it is no surprise that we were quick to respond
to the danger of HIV/AIDS. We were among the first to integrate safer
sex principles into our lives.
Unfortunately, the danger is not yet past.
Just Say Yes is an irreverent and unabashedly pro-safe-sex, pro-woman, pro-queer, and pro-choice comprehensive sex education pamphlet. It was originally written for Chicago High School students by the Coalition for Positive Sexuality Highly recommended, very opinionated (some people might disagree, for instance, about their negative opinion of IUDs and Norplant), but right on target.
What is safer sex anyway? We use the word safer because all sex can have consequences—from emotional consequences to diseases and pregnancy. If you decide to be sexually active, you owe it to yourself to learn about what behaviors are risky, and how much risk you want to take.
Plus how to talk to your partner about safer sex; AIDS-proofing
your kids. Safe S&M and more.
vaginal or anal sex. But how safe is it really?
Can you get HIV from giving a guy a blowjob?
not much information has been written for or about them. Here
are some topics of special concern for women.