Sexuality 4: Health Risks of Common Sexual Practices

Health Risks of Common Sexual Practices

The wide range of sexual practices between consenting individuals can provide pleasure and allow for creative self-expression. By implementing the protective measures described here, clients can be assured healthy enjoyment of the following sexual practices.

Masturbation
(manual or other nonpenetrative stimulation of oneself or a partner for sexual pleasure)

Self-stimulation involves no risk of pregnancy or transmission of STIs.
In partner or group masturbation, there is a possibility of disease transmission from one person to another because body fluids and infections can be transmitted by contact with the hands or objects used. To maintain general hygiene, partners should wash their hands and any objects used before and after masturbating themselves or each other.
Note: Masturbation should not be performed on a part of the body that has skin lesions, sores, or abnormal discharge, because there is a risk of spreading infection (e.g., herpes, syphilis) to other parts of the body.

Vaginal penetration
(penile-vaginal penetration, manual penetration of the vagina, or penetration of the vagina with objects)

Because semen, vaginal fluids, and other body fluids are transferred between partners, unprotected penile-vaginal sex can result in pregnancy or, if one partner is infected, in transmission of STIs.
The best way to avoid transmission of HIV or other STIs is to engage in unprotected penile-vaginal sex only with an uninfected partner. Or, if the partner is known to be infected or the STI status is unknown, it is important to cover the penis with a new condom every time you engage in penile-vaginal sex with an infected partner or any partners whose STI status is unknown.
“Dry sex” (using herbs, cloths, or other materials to dry out the vagina and increase friction) can be a painful and harmful practice. Lubrication provides the vagina with moisture to facilitate penetration while allowing for pleasurable friction from thrusting. Dry sex increases a woman’s chances of experiencing tears, scrapes, or other damage to the vagina and may increase a woman’s risk of contracting HIV or other STIs.
Objects used to penetrate the vagina should be clean and nonbreakable, should have no sharp edges, and should not be shared with other people. Whenever possible, cover the object with a new, lubricated condom each time before it is used to penetrate the vagina. If a condom is not used, always wash the object immediately before and after any act of penetration.
If anal penetration precedes vaginal intercourse, change the condom on the penis or object after anal penetration and before inserting the penis or object into the vagina to avoid bacterial infection. If a condom is not used, wash the penis or object before insertion into the vagina.

Oral-genital/oral-anal sex
(stimulation of the male or female sexual organs or anus by sucking or rubbing or licking with the lips, mouth, or tongue)

Since body fluids and infections can be transmitted by oral-genital contact, transmission of STIs is possible. To reduce the risk of infection, engage in unprotected oral-genital sex only with a partner who is not infected with an STI. Or, if a partner is infected or the STI status is unknown, with female partners, use a thin piece of rubber, latex dental dam, female condom, or cut-open, unlubricated male condom, placing it between the mouth and the vulva before any oral contact is made. With male partners, cover the penis with an unlubricated condom before any oral contact is made.
Avoid oral-genital sex with partners who have sores on their genitals or abnormal discharge from the vagina or penis.
Body fluids and infections can be transmitted by oral-anal contact. During oral-anal contact, use a barrier (such as a thin piece of rubber, latex dental dam, or cut-open, unlubricated condom) between the mouth and the anus to avoid transmission of infection.

Anal penetration
(penile-anal penetration, manual penetration of the rectum, penetration of the rectum with objects)

Most STIs can be transmitted by anal or rectal contact. Anal sex is especially risky for transmission of STIs such as HIV because inserting and thrusting the penis or other objects in the anus can cause tears and bleeding in the rectum, facilitating transfer of blood-borne germs. Intestinal infections and diarrheal diseases can also be transmitted by anal and rectal contact.
To reduce the risk of infection, engage in unprotected anal or rectal penetration or stimulation only with partners who are not infected with an STI. With all other partners, use latex or plastic gloves on hands that will come in contact with the anus or rectum, put a condom over the touching finger(s), or cover the penis or object with a condom.
The anus and rectum do not have natural lubrication, so artificial lubricant should always be used before anal penetration. If using a condom, to avoid breakage use one with extra water-based lubricant and change the condom before inserting the penis or object into the vagina or mouth after rectal penetration. If a condom is not used, wash the penis or object before putting it into the vagina or mouth.
Always wash hands thoroughly before and after touching the anal or rectal areas. Avoid inserting fingers into the rectum if open sores are present on the hands or fingers.
Objects used to penetrate the rectum should be clean and nonbreakable, should have no sharp edges, and should not be shared with other people. Cover the object with a lubricated condom before it is used to penetrate the rectum. Do not insert the object too deeply into the rectum. Rarely, an object inserted in the rectum may break or may become lodged and cannot be retrieved. In these cases, medical help will be needed.