Important note: Information in this article was accurate in July 1999. The state of the art may have changed since the publication date. Safer Sex Guidelines
Bulletin of Experimental Treatments for AIDS, Summer, 1999
Sexual activities fall along a continuum of risk. Unprotected anal sex carries the highest risk of infection, followed by unprotected vaginal sex. Oral sex on a man or a woman carries a much lower risk.
The most general definition of safer sex is any sexual practice that does not allow one partner's semen, vaginal fluids, or blood to come into contact with another person's blood, mucous membranes, or damaged skin.
Communication between partners is an important element of safer sex. Individuals must decide what risks they are willing to accept, and negotiate with their partners to determine mutually agreeable activities with which both are comfortable.
Latex or polyurethane condoms are the most effective way to prevent HIV transmission during anal or vaginal sex; natural lambskin condoms do not protect against HIV. A report published in the March/April 1999 issue of Family Planning Perspectives suggests that latex condoms may offer more protection against HIV than polyurethane condoms. Learn how to use condoms properly; squeeze the air out of the reservoir tip before unrolling the condom over the penis to reduce the chances of breakage. Keep condoms away from heat, and use before the expiration date. Use plenty of water-based lubricant; oil-based lubricants can degrade latex.
The Reality brand internal "female" condom presents another option for those who practice receptive vaginal or anal sex.
Oral sex can be made safer by using unlubricated condoms for fellatio and dental dams (latex barriers) or plastic food wrap for cunnilingus and oral/anal sex.
To reduce the risk of HIV transmission during oral sex without barriers, limit contact to the shaft of the penis and scrotum (balls); do not take cum or pre-cum into the mouth; do not brush or floss teeth immediately before and after oral sex to minimize abrasions; avoid oral sex if there are any sores or infections in the mouth; avoid unprotected oral sex on a woman who is menstruating.
Consult a doctor or clinic for diagnosis of any symptoms that may indicate a sexually transmitted disease (STD); prompt STD treatment may help reduce the likelihood of HIV transmission.
If partners wish to practice "negotiated safety," they should each receive an HIV antibody test. If the tests are negative, the partners should practice safer sex for six months during the "window period" during which HIV antibodies develop. If both partners receive a second negative test at the end of this period, they can assume, that they are uninfected as long as neither partner has had unprotected sex with any other persons.
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