Avoiding sexual contact — including anal, vaginal, and oral — is the only surefire way to prevent the spread of a sexually transmitted disease or infection. But skipping sex completely usually isn’t a realistic or palatable option. Common STIs are often easily treatable. While no one wants chlamydia, gonorrhea, or syphilis, they can be cured with antibiotics. If you come down with a case of pubic lice, also known as “crabs,” you can get over-the-counter treatment at a drugstore. But if you contract a viral STI like HIV or herpes, you’ll need to take more precautions. Probably for life.
If you do contract a chronic STI, there are ways you can practice safer sex to better protect your partner or partners. For starters, always use a barrier method like a condom over the penis or a female condom for vaginal or anal sex. Dental dams should be used if you’re engaging in oral sex.
Depending on the STI, there might be additional steps you can take to be safe. Here are a few guidelines.
Oral and genital herpes
Herpes is more bothersome than it is dangerous. Once you’re exposed to the virus, it lives in your body forever. While it’s highly stigmatized, there are a lot of people who have herpes. More than half of the population has oral herpes — a.k.a. cold sores or fever blisters — and one in six people ages 14-49 have genital herpes. It’s likely that you or someone you know is walking around with the virus, which can live in the body without causing symptoms.
The painful blisters that show up on or around your face, commonly called cold sores, are usually caused by herpes simplex virus type-1. While this type most often affects the mouth, the virus can spread through skin-to-skin contact to someone’s genitals. Herpes simplex virus type-2 is more associated with genital herpes, but can also spread to the face. If you want to lessen your partner’s exposure to either type, use a dental dam or condom during oral, vaginal, or anal sex.
Tell your partner if you’re living with herpes, even if you don’t have an outbreak. The disease is most contagious when there is an open sore, but it’s possible to spread even without a visible outbreak, especially if the area can’t be covered by a barrier method. There isn’t a cure for herpes, but talk to your doctor about taking daily valacyclovir, an antiviral oral medication that helps suppress the virus and decreases the chances of spreading it to your partner.
HIV, the virus that causes AIDS, can spread when bodily fluids like blood, semen, vaginal fluids, or breast milk come into contact with mucous membranes or exposed tissue that can transmit the virus into the bloodstream. If your partner currently has an STI, they’re more likely to contract HIV. If you have the virus, make sure to use a barrier every time you have vaginal, anal, or oral sex. To reduce transmission chances even more, take daily antiretroviral therapy (ART) to lower the amount of the virus in your blood and body fluids.
Protection should also be used during oral sex. There’s a smaller risk of transmitting the virus this way, but it’s still possible. Oral contact with menstrual blood or having open sores or cuts in the mouth or on genitals can increase the risk.
Genital warts are caused by the human papillomavirus (HPV), the most common STI. You can get one sore or a cluster of painful, itchy warts. If you have an outbreak, avoid sexual contact. But even after the sores resolve, make sure to use a condom or dental dam every time you have sex. Genital warts can also show up on, around or inside the mouth of someone exposed.
HPV can hang around in your bloodstream, even if you haven’t had an outbreak in awhile. You can also pass warts to your partner even if you don’t have visible warts. Certain strains of HPV can also cause cancer, so make sure to get regular Pap smears to monitor your symptoms or get a DNA test to see which type you’ve contracted.
If you have a new partner who is younger than 27, they should consider getting the HPV vaccine. Women and transgender adults up through age 26, and men 21 and under are encouraged to get the vaccine.
If you aren’t sure you have an STI, or you frequently have new partners, get tested periodically. If you are living with a chronic STI, consider outercourse like kissing or mutual masturbation, always use a barrier method with sex, and make sure to inform your partners about your condition before engaging in sexual activity. No one should be kept in the dark about their exposure to an STI, and talking openly can help reduce the stigma surrounding sexual diseases.