Last Friday was World AIDS Day. The subject is neither funny nor sexy.
This is an opportunity to give you a little recap on STDs and STIs … And above all, on how to protect yourself, especially in a swingers environment, because a liberated sexuality does not necessarily imply collecting microbes.
I’m not going to lecture you, or to throw injunctions at you. Zero risk does not exist unless you copulate in space suit (and even then …). But a few precautions are enough to significantly reduce the danger, allowing one to flirt at will, while preserving his health and those of others.
Anyway, the first step is to be well informed. Then it’s up to you to decide how much careful you want to be.
Here are some tips to minimize the risks, especially even more so for swingers. These tips are also valid for non-swingers but one-night stand adepts or those who have random partners.
Some facts about HIV
How many people have HIV?
In the US, an estimated 1.2 million people are living with HIV. In the UK, it’s estimated at 102 000 people.
In France, where we live, it’s 153 000 people and every year, about 6,000 people discover their HIV status, and the number of HIV-positive people who do not know it is estimated at 25,000.
In the US, it’s estimated that 15% of people who have HIV are unaware of it.
What is the risk of contamination when exposed to HIV?
First, it depends on the type of sexual intercourse. Several studies have yielded estimates:
- In a passive anal relationship: 1.4%
- A passive vaginal relationship: 0.08%
- Active anal relationship: between 0.06 and 0.062%
- Active vaginal relationship: 0.04%
- Regarding oral sex, three studies took place, during which no contamination was observed. However, these studies focused on too few people and too short a period to conclude that the risk of transmission during oral sex is zero.
Factors increasing risk
These figures can seem pretty low, they could almost seem “reassuring” for some of them. But these are the “average” risk for a single sexual intercourse.
Other factors come into play and can increase this risk of contamination :
- The viral load [FR, need EN Link] of the affected person: it is the amount of viral particles in the blood, which decreases or becomes undetectable when taking anti-HIV treatment. When the viral load is high, the risk of infection is (roughly) multiplied by 50. However, the HIV-positive people most likely to have unprotected sex are those who are unaware of their HIV status (and who, therefore, do not take any treatment).
- These numbers are calculated for a single intercourse. It’s not because you’ve had unprotected sex with someone who is HIV-positive, were lucky and have not been contaminated, that it won’t happen to you if the next time. The risk is multiplied with the number of intercourse. You may also be contaminated during the first intercourse. Running out of luck just once is enough to be in trouble for life.
- Small wounds, bleeding, etc., as well as sexually transmitted infections, greatly increase the risk of transmission.
Other STDs and STIs
Let’s talk about other diseases and sexually transmitted infections. The goal is not to be traumatized by viewing tons of photos of pustular and oozing sexes, nor to detail precisely each disease, but to know what to look out for, to minimize the risks as possible. (For photos of diseases at excessively advanced stages: Google images. For clinical details: prevention websites and Wikipedia).
This list is not exhaustive, but other sexually transmitted infections that you’ll want to avoid include:
Hepatitis B is a disease that can lead to complications and become chronic. More contagious than HIV, it is transmitted during unprotected sex, but can also be transmitted when sharing toiletries such as toothbrushes, nail clippers, tweezers etc. A Vaccine is available.
Life-threatening illness, hepatitis C can cause serious liver damage or death. It is mainly transmitted by blood, although it is less common, it can also be transmitted sexually during unprotected sex. There is no vaccine.
Syphilis is extremely contagious, during penetration, but also during oral sex (30 to 40% of “chances” to be contaminated during an intercourse with a person affected).
Chlamydia and gonorrhea
Chlamydia and gonorrhea are two STIs, asymptomatic or painful depending on the case, which can lead to complications in the long term (including sterility) if they are not treated for lack of screening. They are treated with antibiotics.
There are several types of herpes, including herpes labialis (the famous “cold sore”) and genital herpes. The virus stays for life, but is only result in blisters during short (days or weeks long) episodes. It can also be asymptomatic. Indeed, the World Health Organization estimates that 67% of the world’s population carries the herpes labialis virus. But even if there is a good chance that you already carry the virus, you still have to pay attention, because both versions can be transmitted from one zone to another, even on the same person. To avoid being infected (or avoid collecting its versions), no contact with areas where an herpes outbreak occurs, as long as it is not fully healed (oral sex, but also kisses in case of cold sore).
HPV (or papillomavirus), which can increase the risk of cervical cancer if the infection persists in the long term, is transmissible during unprotected vaginal penetration, or oral sex. There is a vaccine.
Now that we have listed the various microbial inconveniences you may be dealing with, let’s get to the point: how to avoid them ?
In a swingers environment or for a one-night stand, you can not ask your partners to do a test. Well, you can, but it will not be reliable enough. A negative HIV test done in the lab attests that everything was fine one month before the blood test. It absolutely does not check what happened in the meantime. For a self-test sold in pharmacies, there is a period of three months. Are you ready to believe a stranger about his claimed all-the-time use of condoms during the 3 months, when he is already ok to go bareback with you ? It seems more than risky.
Essential minimum precautions
- If there is penetration: never without a condom (except if it is between you and your loved one, with whom you have already done all the necessary tests). Make sure that the condom is the right size, and put correctly. If there is alternation between several partners, of course, it is necessary to systematically change the condom. You must not be afraid of wasting condoms: if the current one undergoes anything that can make you doubt his condition or positioning, do not hesitate to unwrap a new one.
- If you use sex toys, cover them with a condom. If the sex toy is shared between several people, even in the heat of the action, think about changing it systematically from one person to another. Avoid porous sex toys, which are nests for microbes and can not be properly disinfected. Dildos made of metal, glass and pure silicone are preferred because they can be boiled for sterilization.
- No sperm in the mouth. Swallowing or spitting does not change anything, it is the contact between the sperm and the oral mucosa that presents a risk. The longer the liquid stays in the mouth, the higher the risk.
Other precautions to take
- Avoid oral sex in case of very small wounds in the mouth (if you have a sore mouth, if you have bitten your cheeks, etc.). Beforehand, avoid anything that could cause small cuts or irritation in the mouth, ultra-minty chewing gum, crisps and other crisp aperitifs, etc … Do not brush your teeth and do not do not use dental floss within one hour.
- After oral sex, rinse your mouth with water, or with an alcohol-free mouthwash (no alcoholic mouthwashes, which can irritate and increase risk, or brushing within an hour).
- In general, avoid as much as possible having body fluids in your mouth.
- Observe the bodies of your partners. If you see anything that seems to be a potential sign of a contagious health problem (a pimple, a wart, a sore, a secretion that seems unusual to you), find an excuse for leaving (in a courteous and discreet way, if possible).
For absolute safety
- Condom for oral sex, dental dam (or condom cut to make a rectangle) for cunni or rim job, condom on fingers or latex gloves for penetration. People are not necessarily used to it, and the topic may be embarrassing to discuss, but if you want to absolutely maximize the precautions, you have the right to refuse to do without.
Screening for STIs and STIs
This goes for swingers and non-swingers: it is very important to do regular testing.
Doing a test does not cost a lot of effort, and allows:
- To be reassured: it’s nice to know that we do not have anything.
- To be treated ASAP if you have caught something. This is especially important as many STIs are benign if treated soon, and can have serious consequences if left unchecked.
- To be certain not to give anything: To get an STI is not a fun thing, but it is the kind of intimate things that nobody wants to share.
How to do test for STDs and STIs ?
Medical clinics, community health centers, and hospitals
In the US, we’r going to quote the HIV govt website:
You can ask your health care provider for an HIV test. Many medical clinics, substance abuse programs, community health centers, and hospitals offer them too.
You can find where to be tested on gettested.cdc.gov ( more information and other ways to find where to get tested on hiv.gov/… /where-to-get-tested )
In the UK, we found this web page i-base.info/guides/testing/where-can-i-test-in-the-uk to be very informative. It includes links to the NHS HIV search by location as well as other community sites.
In the US HIV self-test (OraQuick) is sold on many physical or online places, including Amazon, for around 35 to 45 usd.
In the UK, you can also buy online, the BioSURE for less than £35
The advantage: you will not be accountable to anyone, and the result is immediate.
The inconvenient: it only detect HIV, and the result is less accurate. The self-test tests for risks taken more than three months ago, compared to one month for the “regular” blood test.
Source of illustrations: Flickr galleries of Peter Rivera, Kerry J, Guillaume Paumier, SerjforiuS, Arte_ON, thaths, Owen Byrne, Fred Dunn, Draco2008, and AIDS / AIDS NB, license Creative Commons.