💊 This article has been written by a working medical professional.
What counts as “sex”?
Before we can define what unsafe sex is, we should address the fact that “sex” itself can look different for every person, and mean a diverse range of things to different people. You can go solo, or have sex with partner(s) and or toys. Phone sex, oral sex, penetrative sex, kink play, BDSM, roleplay and more: all of these experiences are sex in and of themselves. Penetration is not “the gold standard” of a sexual experience. There is no one act that defines an experience as sexual, nor a way to measure sexual experiences against some perceived (false) “norm”. We are all diverse and each person will experience, understand and enjoy sex in a range of different ways, which is vital to bear in mind when considering the question of safety.
What is “Unsafe Sex”?
What, then, is “unsafe sex” ? Unsafe sex is any type of sex that threatens the physical, mental, or emotional wellbeing of anyone involved. This can include but is not limited to unprotected sex; STI and pregnancy prevention will be discussed in more detail below. Unsafe sex is not always the result of deliberate malice, either. This is why it is important to educate yourself as much as you can, and to communicate openly with yourself and with partners to create as safe and considered a space as possible when it comes to sex and intimacy.
Mental, Physical, And Emotional Safety
Physical Safety During Sex
Bodies are always changing; what may feel good to you or your partner/s in one moment may not feel right at a different time. It is important that if something does not feel right, or is uncomfortable or painful, the sexual activity stops.
This does not need to be the end of sexual play, though it can be. If all parties still want to continue a sexual experience, the focus can be redirected to different things through shared communication, and a reevaluation of what will work for each body at that time. This could mean switching positions, having a cuddle, connecting with your breath, or any number of other options.
It is therefore crucial that you and your partners discuss and agree upon a way to pause or stop play at any time during a sexual experience. Many people like to use safe words and or accompanying physical movements, in case they are not able to verbalise the safe word. Safe words help to prevent harm during sex, and set expectations that the act will cease or pause if someone requires a break, or needs something to stop.
Note: Sometimes “stop” can be a word that is incorporated into sexual play, so be clear with your partners that whatever word you choose (whether it be “pickle,” “cloud” etc.) will not be mistaken as part of a scene, or “dirty talk”.
“Yes” And “No”
It is also important that all parties have an understanding of each person’s “yes” and “no” with regards to sexual activities. This is not only in terms of conversations about what your partner/s do and don’t like, but also in terms of how they might express enthusiasm and discomfort in the moment. For example, some people may be able to let you know that, if they stop verbalising during sex, they are shutting down and need a break. For others, going quiet might mean they are fully immersed in the sensations.
Don’t assume that each partner will respond in the same way, that verbal or non-verbal cues will mean the same thing, or even that one partner will consistently respond and communicate in the same way over time. Frequently check in during play to ensure the sexual activities remain within boundaries, and to test whether you’re understanding their responses correctly.
If something starts happening that may have been a “yes” on another day, or with another partner, that starts to feel like a “no”, it is crucial that any person can have the power to redirect or stop the activity.
Mental And Emotional Safety During Sex
As ecstatic as sex can make us feel, it can also make us vulnerable to emotional harm and trauma. While there are intentional forms of sexual harm, there are also inadvertent actions that can be damaging. Examples could include calling someone a term that they find offensive, or accidentally fetishising someone. So, how can we achieve harm reduction when there isn’t always malice?
By frequently checking in with, and getting the go-ahead from, your partner/s there is less of a chance of inadvertently inflicting emotional harm through sex. And if you want to explore a fantasy or roleplay that involves non-consensual activity, this can be done through practising consensual non consent.
Aside from mastering the practice of consent, there are other ways to help your partner/s and yourself feel safer emotionally and mentally when it comes to sex. The key to feeling safe with a partner is communication. We need to intentionally and tell our partners what we want and are comfortable with sexually, without shame, and ensure they are doing the same for us.
It’s good to talk prior to engaging in sexual activities, and you can also keep the conversation open throughout. For some, having conversations afterwards can also be rewarding and/or reassuring, particularly when trying something new or exploring BDSM, fantasies or roleplay.
Now we will switch gears to the next topic which delves into methods of protection against STIs and pregnancy.
Sex without protection: when can it be/ can it ever be “safe sex”?
Many people want to know if there’s a way to have safe sex without protection (specifically meaning sex without condoms or birth control). While condoms can prevent the transmission of STIs, and various forms of birth control can be effective at preventing pregnancy, no method is 100% effective in either regard. In fact, no birth control or STI prevention measure is without a failure rate. So, can it really ever be 100% “safe sex”? Maybe not. But we can strive to have safer sex, and there are some additional protective measures we can use.
Additional methods for safer sex
What are some ways to avoid pregnancy besides birth control?
Although it may be less effective than hormonal birth control pills, “pulling out” or avoiding sex during your fertile window are two additional ways to avoid getting pregnant. Neither of these are recommended as reliable methods of birth control.
Are there other ways to dodge STIs besides using condoms?
You may choose to decrease your risk by limiting the number of partners with whom you have sex. You could also get certain vaccines (against strains of HPV, for instance) or take medications to avoid contracting an STI, like in the case of HIV and PrEP. Routine STI screening for yourself and partner/s can also be a really effective way to stop the transmission of STIs.
While there are a multitude of ways to protect ourselves during sex, barrier methods such as condoms, dental dams and gloves are still the gold-standard for preventing the spread of STIs and prescription birth control has some of the best documented rates of pregnancy avoidance. If you want to have the safest sex possible, consider using more than one method of protection at once to give yourself the best chance of avoiding an unwanted pregnancy or STI. By which we mean using multiple different methods – using more than one condom will actually reduce their efficacy.
STI Testing – how it works, and at-home STI test
When you hear the phrase “pap smear,” what’s the first body part to come to mind? For most, it’s not likely to be the anus. While pap smears were initially developed to screen for cervical cancer, they are now also used to screen for anal cancer. Did you know that the STI called HPV is not only a primary cause of cervical cancer, but also most throat and anal cancers? Timely sexual health screenings aid in early detection and treatment, which can literally save your life.
How often should I get an STI Test?
Guidelines for STI testing vary by region, medical history, and the infection being tested but you can take charge of your health and request tests based on your judgement, too.
You may consider getting tested for certain STIs with every new sexual partner, monthly, annually, or if you have concerning symptoms. However, it’s important to note that waiting for symptoms can lead to serious problems as some infections may not show symptoms (like chlamydia) and others don’t show up on tests right away (like HIV). Regular screenings, therefore, are really important as STIs can potentially have long term consequences if diagnosis or treatment is delayed. For example, chlamydia could impact fertility, and HIV can lead to deadly infections if not effectively treated. This is why routine screenings, as well as testing with any new partners or symptoms, is a smart idea.
It’s really important to know that there are STIs out there that you may not be tested for if you go to your doctor and request routine screening. Often the routine STI panel only includes a handful of tests, usually the ones that are more common or easier to test for. Some infections are hard to test for (such as HPV in men) or are just not a part of the routine panel (like trichomonas in some places). This is yet another reason to explore and implement more than one protective measure at once, even if you get the “all clear” from your doc.
Can you get an STI from sharing underwear? Or Sex toys?
Short answer: yes you can. Pubic lice (aka crabs), molluscum contagiosum (an infection that causes spots on the skin), and scabies could actually be transmitted via undies and/or certain objects and fabrics. You can rest assured, though, that the majority of STIs cannot live on fabric and are only transmitted via sexual contact.
At-Home STI Tests
Feeling overwhelmed? Take a deep breath, because many governments and businesses are working hard to increase access to STI tests – including for those who cannot afford to purchase them.
In the UK, you can get the Virgin Care STI kit (perhaps an unlikely brand name for the cause) delivered to your door through the NHS, and Planned parenthood is one of many groups that now offer at-home testing in the United States.
While increased access comes with many benefits, there are a few potential downsides to keep in mind. Firstly, not all tests can be done at home, such as looking in the throat for HPV-related changes. Another concern is whether some home tests are as accurate as clinic-based tests. Finally, some may find it daunting to receive a diagnosis virtually, without in-person guidance from their provider. One strategy would be to go in person to a clinic for annual checkups and symptoms, but to utilise at-home testing for more frequent, in-between checks.
Different Types Of Condoms
Condoms come in many forms because STIs can threaten the spectrum of orifices! There are three main materials of which condoms are made. Latex is the most common and most effective. For those with a latex allergy, polyurethane or synthetic rubber condoms can be used, although they are slightly weaker and break more easily. Lambskin condoms are not recommended over the other two types because while effective at preventing pregnancy, they aren’t effective protection against STIs.
Different Kinds Of Condoms
External Condoms And Gloves
External condoms are used to cover a penis or sex toy. Gloves (either the whole glove or just the finger part) can be used to cover/protect a hand, finger, smaller penis, or sex toy. Why in the world would we bother using condoms on sex toys and fingers? Well, both implements can potentially transfer STIs from one person to another. Also, even small cuts on your hands would make you more susceptible to infection.
Next up is the dental dam, which is basically condom material in flat sheet form. It is used to cover the vulva or the anus during oral sex. The CDC has some great instructions and visuals illustrating how to use dental dams. If you don’t have a dental dam to hand, you can enjoy some DIY condom crafting by cutting an external condom open into a square.
The internal condom is another type of condom that is inserted deep into the vagina or rectum, and is held in place by a firm, but flexible, ring in the tip.
Lube And Condoms
To increase the effectiveness of condoms, use only water or silicone based lubricants (oil-based will break down the condom) and also replace the condom every time you have sex, if it breaks, or if you switch from one orifice to another. This is especially important if you are moving from anal to another kind of penetrative sex. It may also be a good idea to replace the condom part way through sex if you are having a particularly long sesh. For a more thorough rundown of condom use, safety, and fun tips, this piece is where to go next.
Ultimately, safe sex is a team effort: communication about needs, wants, and boundaries is essential. Whether we’re talking about mental, emotional, or physical safety, utilising multiple protective methods at once is your best shot at achieving the safest sex possible.
Nurse Leslie (she/her) is a board certified nurse practitioner who specializes in reproductive and sexual health. She lives with her son and husband, and in her free time enjoys veggie gardening and hanging out with her three chickens and two rabbits.