safesexFor many years, safe sex and safer sex have been terms intended to minimize sexual risks such as unwanted pregnancies and sexually transmitted infections (STIs). There have been government guidelines and health, education and other organizations which have promulgated their own rules and guidelines.

Most of the rules have focused on using condoms consistently and carefully. It is known that using condoms lowers the risk of unwanted pregnancies and STIs, but it is also known that condoms can break or come off, which increases risks.

Condoms do not totally protect against herpes transmission if the shedding of the virus is not fully covered with a condom. Since herpes can shed without sores, condom use is a good idea to lower the risk of herpes transmission.

When I discuss safer sex with clients or with an audience, I focus on condom use unless both people test negative for STIs such as HIV, HPV (genital warts may result from HPV), chlamydia, hepatitis B, gonorrhea and syphilis, and they are sure that their relationship is monogamous, or that they at least are using condoms with others. The tests for herpes may not be fully informative, in that you may find out that a person has been exposed to the virus, including a cold sore, but you cannot be sure the person is transmitting herpes, or specifically, genital herpes.

I also focus on conducting a Pre-Sex Discussion (PSD) as part of safer sex. In such a discussion, you each ask questions about any history of STIs, and you ascertain whether effective birth control is to be used (see my book, The Naked Truth About Sex, for a thorough discussion of a PSD). It is smart to use more than one method of birth control. Condoms can break. Using an IUD, the pill or another method is appropriate.

We must balance sexual risks with the benefit of sexual pleasure. It would not be pleasurable to have a problem such as an STI or unwanted pregnancy because the lovers did not use condoms when they were not reasonably certain of the sexual risks going in. I always caution clients to use commonsense about safer sex. I explain risks and ways to minimize them. In the end, each person must calculate their own sexual risks with their lovers, and decide together about precautions they will take. We are all responsible for our own sexual behavior, but we must be honest in our discussions of potential and actual sexual risks.