We’re all concerned with our health and safety, right? I certainly hope we are. Well, here are some things I’ve learned when considering my health and safety that I’d like to share with you.
From the CDC website:
“Sexually transmitted diseases (STDs) are passed from one person to another through intimate physical contact – such as heavy petting – and from sexual activity including vaginal, oral, and anal sex. STDs are very common. In fact, CDC estimates 20 million new infections occur every year in the United States. STDs can mostly be prevented by not having sex. If you do have sex, you can lower your risk by using condoms and being in a sexual relationship with a partner who does not have an STD. STDs do not always cause symptoms, so it is possible to have an infection and not know it. That is why it is important to get tested if you are having sex. If you are diagnosed with an STD, know that all can be treated with medicine and some can be cured entirely.“ [My emphasis added]
In this post, I will list the most common sexually transmitted diseases or infections, their prevalence, and my transmission reduction strategies. No sex is completely, perfectly safe but there are measures I take to significantly reduce the chances of myself contracting or unknowingly passing on STDs. My top two strategies are 100% condom usage for all genital-to-genital contact and a constant eye on cleanliness. I wash my body with soap before and after each encounter to remove as much sloughing skin as possible (carriers of HSV and HPV, among others), I use gloves for giving anal simulation, I rinse my mouth with alcohol based mouthwash after giving oral sex, I cover any cuts or scrapes with a waterproof barrier, and I keep linens and surfaces in my incall clean and regularly disinfected.
Where appropriate, I will mention other additional transmission reduction strategies.
HSV – Herpes
“Nationwide, 15.7 % of persons aged 14 to 49 years have HSV-2 infection2, however, the prevalence of genital herpes infection is higher than that because an increasing number of genital herpes infections are caused by HSV-1
Infections are transmitted through contact with HSV in herpes lesions, mucosal surfaces, genital secretions, or oral secretions. 5 HSV-1 and HSV-2 can be shed from normal-appearing oral or genital mucosa or skin. 7,8 Generally, a person can only get HSV-2 infection during genital contact with someone who has a genital HSV-2 infection. However, receiving oral sex from a person with an oral HSV-1 infection can result in getting a genital HSV-1 infection. 2 Transmission commonly occurs from contact with an infected partner who does not have visible lesions and who may not know that he or she is infected. 7In persons with asymptomatic HSV-2 infections, genital HSV shedding occurs on 10.2% of days, compared to 20.1% of days among those with symptomatic infections. 8”
In addition to my standard reduction strategies: Prior to oral or genital contact, if I see anything that appears blister-like on or near your mouth or genitals, I’ll avoid contact with the area so keep that in mind when scheduling. This may mean no kissing, no giving or receiving of oral sex, or no sex at all. I will not give you your money back if you show up with a sore and we don’t have sex. I also specifically ask my doctor to order HSV tests with my routine checks as HSV is not on the standard STD panel.
A further transmission reduction strategy I do not employ is taking a daily antiviral medication. This method is used by anyone positive for the infection and helps prevent passing it on to an uninfected partner. Were I ever to contract HSV I would add this to my transmission reduction strategies. Should you find yourself positive for HSV I would take it as a great kindness if you would talk to your doctor about adding this to your daily multivitamin regime.
HPV (warts)
“79 million Americans, most in their late teens and early 20s, are infected with HPV
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. HPV can be passed even when an infected person has no signs or symptoms.”
Pay REALLY close attention to this one, guys. It is safe to assume that every single provider you meet has come into contact with HPV and may be positive for one or more strains. You can’t test for HPV the way you can test for other STDs; it shows up on a pap smear as an irregular pap, or as warts, or as cancer. There are so many different strains that it’s simply not practical to find out about and all research is going into vaccines for a few strains.
Gentlemen: if you have daughters and you’d like to protect them from everything from embarrassment to death, please please please get them the vaccine before they are at risk of contracting it. The CDC recommends vaccinating as young as 9 years old, depending on the individual. No one wants to think of their nine year old as at risk for the kind of contact that exposes her to HPV but don’t dwell on it, just do it. This will protect her for her entire life; don’t let your discomfort keep you from protecting her, and don’t wait until you think she’s probably sexually active because, while it’s never too late to get vaccinated against everything we can, vaccines work best when you get them before exposure to the virus. My first likely exposure was around age 15 and I didn’t get the vaccine until 10 years later. Don’t let that happen.
As for you: wash your penis and the surrounding area thoroughly with soap both before and after your appointments This not only makes it nicer for your provider but helps wash off dead skin cells which is where the virus rubs off onto your partner. You’re looking to spend good time with any skin that comes into contact with hers: the base of your penis, balls, the surrounding area, probably inner thighs and up your belly depending on how wet she gets, and obviously your face. Also: If you’re going to manscape, the safest and easiest is not to shave but to trim close with an electric trimmer. I prefer about a half inch of fuzz to act as a cushion. I am extremely sensitive to stubble and razor burn compromises the skin, increasing the potential for transmission so simply be aware. If you cut yourself shaving, wait until it heals over to see anyone.
Chlamydia
“Any sexually active person can be infected with chlamydia. It is a very common STD, especially among young people.3 It is estimated that 1 in 20 sexually active young women aged 14-24 years has chlamydia.5
Chlamydia is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner. Ejaculation does not have to occur for chlamydia to be transmitted or acquired.”Gonorhea
“In 2016, 468,514 cases of gonorrhea were reported to CDC.
Gonorrhea is transmitted through sexual contact with the penis, vagina, mouth, or anus of an infected partner.”Syphillis
“You can get syphilis by direct contact with a syphilis sore during vaginal, anal, or oral sex. You can find sores on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth.”
Chlamydia, Ghonnorhea, and Syphillis are all serious but treatable. Signs and symptoms may include rashes, pain with urination, bad smell, and more but the best and only way to know if you have one of the above is to get tested. Testing is simple, easy, and at Planned Parenthood it’s not expensive. You as a client should be getting tested yearly; please do not lean 100% on your provider to manage your sexual health. My transmission and harm reduction strategy, as with other STDs, is cleanliness and barriers. There are reports of an antibiotic resistant Ghonorrhea in the UK which, due to the globalization of our world, may not stay there. Until I start hearing reports of it closer to home I still choose not to use barriers with oral sex but I am happy to oblige anyone who requests them and can refer you to colleagues who do as part of their routine practices.
HIV
CDC does not cite prevalence statistics
“You can get HIV from anal or vaginal sex or blood to blood contact such as shared needles. The presence of other STDs can increase the risks of passing HIV to sex partners and can also suggest the presence of other risk factors.”Hepatitis C
“HCV infection is the most common chronic bloodborne infection in the United States, with an estimated 2.7 million persons living with chronic infection (222). HCV is not efficiently transmitted through sex (170, 223).”
HIV and Hep C are blood-borne pathogens. My additional transmission reduction strategy for both is to avoid things like tooth-brushing or eating scratchy foods right before an appointment and covering cracks or cuts on my hands with a liquid bandage. Also not being an IV drug user or a member of a health profession that comes into contact with blood helps me avoid possible direct contact with infected blood. If you want really detailed info on blood barriers and such, ask Mistress Matisse. She cuts people up all the time and does it safely so I’ll leave her with that. As for me, I simply try to avoid it as best as I can and use medical exam gloves any time I might be exposed to it.
For anyone positive for HepC or HIV, there are antiretrovirals that decrease the viral load to virtually zero, making the incidence of transmission low enough to be worth the risk for most. For anyone likely to encounter HIV, there is a series of pills (I’m pretty sure it’s pills but I could be wrong) that you can take before (pre-Exposure Prophylaxis or PrEP) or after (Post-Exposure Prophylaxis or PEP) your potential exposure to infected blood or sexual fluids. I know a few providers who are on it regularly, others who take it the weeks leading up to and following porn shoots, and have a few friends who take it because they are in love with an HIV+ person.
As an economically privileged woman who has sex with men, does not use IV drugs, and who uses condoms properly with each sex act, I am in a low risk category for HIV but it’s a high consequence risk so I take it seriously. I have chosen not to take PReP or PEP due to the side effects but you are welcome to ask your doctor.
Trich (this one is new to me – I’ve never even heard of it until this post)
“Trichomoniasis is the most common curable STD. In the United States, an estimated 3.7 million people have the infection. However, only about 30% develop any symptoms of trichomoniasis. Infection is more common in women than in men.
The parasite passes from an infected person to an uninfected person during sex. In women, the most commonly infected part of the body is the lower genital tract (vulva, vagina, cervix, or urethra). In men, the most commonly infected body part is the inside of the penis (urethra). During sex, the parasite usually spreads from a penis to a vagina, or from a vagina to a penis. It can also spread from a vagina to another vagina. It is not common for the parasite to infect other body parts, like the hands, mouth, or anus.”BV (Bacterial Vaginosis)
“Bacterial vaginosis is the most common vaginal infection in women ages 15-44.
Researchers do not know the cause of BV or how some women get it. We do know that the infection typically occurs in sexually active women.”Trich and BV aren’t something you’ll likely get as a penis-owner and fall into the yeast and Urinary Tract infections category: Annoying, uncomfortable, serious if not treated, but easily done away with for most. You can help me avoid suffering from these by keeping your hands and face either soft and clean or away from my pussy. Condoms provide a great deal of protection from what’s on and around your penis but it’s nice if that’s reasonably clean, too.
Other Information:
You may see claims that the prevalence of STDs is higher in sex work populations. Nearly every study in the US of sex workers does not include indoor sex workers in their sample group but instead focuses primarily or exclusively on street based sex workers. While I consider Street based sex workers my sisters, they are very often associated with high risk factors such as poverty, drug use, abusive relationships, undernutrition, and a high incidence of unprotected vaginal or anal sex. These are far more indicative risk factors than whether or not someone accepts items of value in exchange. Note that there is a fascinating subset of providers who choose to work as street based sex workers but avoid the attendant risk factors so, as with all things, never assume.
We know that every sex worker working in the legal brothels of Nevada is STD free because weekly testing is in their contract. We also know that in Australia where sex work is decriminalized in most states, “Currently, there is no evidence that sex workers in Australia have higher rates of STIs than the general population.” The same page from the Australian Sexual Health Alliance states, as I said earlier, “High priority groups include street based sex workers, sex workers who inject drugs, culturally and linguistically diverse sex workers, Aboriginal and Torres Strait Islander sex workers and male and transgender sex workers.“ Though in the US you might replace “Aboriginal and Torres Straight Islander sex workers” with “sex workers of color or native descent” in the United States.
So what do we know? Well, we know that we are in a higher risk category to contract the more common sexually transmitted infections due to our higher incidence of sexual contact. We also know that as religious and informed users of carefully selected and properly stored condoms we are in a low-risk category. We know that we are in lower risk categories also due to our avoidance of IV drug use, our avoidance of drug and heavy alcohol use during sexual encounters, and our regular testing routines.
One of the reasons that young people and people in marginalized communities are at higher risks for STDs is that they are often under pressure to have unprotected sex or participate in other risky activities. If you’re drunk when you bang and the condom breaks, you’re a lot less likely to notice. If you’re young and inexperienced, you’re a lot more likely to give in to someone asking for unprotected sex. If you’re certain that you’ll notice if you get an STD so you avoid testing, you’re more likely to have an unnoticed infection.
So what do we do now? I get tested every three months; you should get tested every year simply because you’re having sex with me and I have sex with other people. You should absolutely get tested every year if you’re seeing providers as well as me and you should get tested at least twice yearly if you’re on tinder, Grindr, or other hookup sites and see new sexual partners in less informed demographics. You can have an STD and not know it. Your provider can have an STD and not know it. Knowledge is power; don’t give it away because you’re lazy.
This isn’t to scare you, it’s to remind you. I want us to have the safest sex we can reasonably have because I fucking love sex when I’m not anxious. If I’m concerned that you’re not committed to safer sex practices, I’ll be much less able to relax. One of the sexiest things you can possibly do is check the condom to make sure it’s in place and unbroken. (You don’t have to as I’m on top of it but it is reassuring.)
Side note: this isn’t a hint. I’m not slyly suggesting that I caught something and you should check for it, this is just something I think about a lot and felt like it would be useful to share.
All my STD statistics and about quotes are from the CDC STD info sheets at https://www.cdc.gov/std/default.htm. The quote about sex workers in Australia is from http://www.sti.guidelines.org.au/populations-and-situations/sex-workers#testing-advice.
Thank you and happy humping!!