Practicing Safer Sex

The AIDS Virus

AIDS is caused by a virus. When a person has AIDS this means the virus has seriously damaged the body's ability to protect itself against disease. To develop AIDS you must first be infected with the AIDS virus. The virus is very difficult to catch. There is one basic rule of transmission.

The Basic Rule of Transmission

For the virus to be passed on semen, blood or vaginal fluids must pass from an infected person directly into the bloodstream of another person. If the virus cannot do this, you cannot be infected. For example, you cannot catch the virus from casual contact. The AIDS virus does not hang around in the air, in food, in water or on toilet seats.

The Basic Rule of Safe Sex

Safe sex is any sex activity in which semen, blood or vaginal fluids do not pass from an infected person directly into the bloodstream of another person. Let's look at some of the key points of these basic rules.

Semen, blood or vaginal fluids
The virus has been found in semen and blood in high concentrations. Semen and blood can easily transmit the AIDS virus. The virus has also been found in vaginal fluids, but only in low concentrations. Studies have shown, however, that the AIDS virus can be passed from women to men through vaginal intercourse. The virus has been found in urine, faeces and breast milk. Pre-ejaculatory fluid (pre-cum) may carry the virus and should also be suspected until proven otherwise. The virus is not transmitted through saliva.

From an infected person
What you do not have, you cannot give. If you are absolutely certain that another person could not have been infected, or is not at risk of infection, then there is no way the person can give you the virus whatever you do.

Directly into the bloodstream
The virus is not active for long outside the body. It can be immediately killed with soap and hot water, bleach, chlorine or other cleaners. To enter directly into the bloodstream the virus a) must find a break in the skin like a cut, open sore or bleeding gums or b) must pass through the lining of the rectum or vagina or c) must enter the tip of the penis and pass through the lining of the urethra.

Measuring Your Risk

Now, we look at each of the most popular ways of having sex in the light of the basic rule. Sexual activities are grouped into three categories:

! Safe: Semen, blood or vaginal fluids do not pass from one person to another. There is no evidence the virus is transmitted this way.

? Uncertain: Semen, blood or vaginal fluids can be passed from one person to another, but not usually into the bloodstream. There is no evidence that the virus is transmitted this way.

X Unsafe: Semen, blood or vaginal fluids pass from one person to another. There is clear evidence the virus is transmitted this way.

! Kissing

There is no evidence that the AIDS virus is spread by kissing. The AIDS virus cannot be transmitted through saliva. Open mouth sores, open cuts or bleeding gums involve blood, so may pose a risk if both partners have these breaks in the skin.

! Mutual Masturbation

There is no risk with masturbation. Massage, body stroking and licking have no risk. Ejaculating on someone has no risk unless semen comes into contact with open cuts or open sores.

? Oral Sex (mouth to penis or mouth to vagina, contact)

Studies have shown oral sex to be a minimal risk activity. The AIDS virus has been passed on or picked up through oral sex in a very small number of cases. There is a risk because blood or vaginal fluids can come in contact with cuts in the mouth.

X Receptive Anal Intercourse (another's penis in your rectum)

Without a condom this is the most dangerous way of having sex. Infected semen easily enters the bloodstream through the membranes of the rectum and through cuts that may occur during intercourse. Condoms, properly used, prevent this risk.

X Insertive Anal Intercourse (your penis in another's rectum)

Without a condom this is a dangerous way of having sex. The virus is found in the cells that line the rectum. It enters the penis through the opening at the tip or through cuts and scratches. Condoms, properly used, prevent this risk.

X Receptive Vaginal Intercourse (another's penis in your vagina)

Studies show the virus can be transmitted this way. The virus is found in semen and can enter the bloodstream through vaginal intercourse. Condoms, properly used, prevent this risk.

X Insertive Vaginal Intercourse (your penis in another's vagina)

Studies show the virus can be transmitted this way. The virus has been found in vaginal blood and secretions. It can enter the penis through the opening at the tip or through cuts and scratches. Condoms, properly used, prevent this risk.

X Coitus Interruptus (withdrawing before orgasm)

You might think this practice prevents virus transmission. This is not so because a) blood or vaginal fluids can still come into contact with cuts or sores on the penis or enter the opening at the tip, b) withdrawal before orgasm sometimes does not happen, c) pre-cum, which would carry the virus, can still enter the rectum or vagina. Condoms, properly used, prevent this risk.

Can I Tell If My Partner Has an STD or AIDS?

Many STDs have no obvious symptoms. While some STDs may produce sores or rashes on the penis or around the vagina, a person with no sores or rashes could still have an STD. Any sexual partner you do not know and trust intimately, and who has not been tested for STDs, could be carrying an STD. You cannot tell if a partner is infected by seeing whether they "look healthy". Even if you do know your partner intimately, you cannot be sure they do not have an STD unless they have tested for it. This is particularly true for AIDS. Many people have caught STDs, including AIDS, from spouses or regular partners.

Can I Have Safe Sex with a Partner Who Has HIV?

HIV infection cannot be cured. But HIV-infected people may look and feel perfectly healthy for may years before they develop AIDS. Many will wish to remain sexually active during that period. You should be aware that an HIV-infected person, no matter how healthy they look, can pass on infection to others. But it is safe to have sex with an HIV-infected person if the rules for safe sex outlined here are followed.

If a sexual partner tells you that they have HIV infection, the are being honest with you because they care about your health. Decide together on the kind of sex that will be safe and satisfying for you both.

Condoms

Condoms are highly recommended as a good way of reducing the risk of catching all sexually transmitted diseases through anal, vaginal and oral sex. Laboratory tests show that the AIDS virus cannot pass through a condom.

Condoms must be used properly so that they do not break. The main points to remember are:

Some Other Points About Your Risk

Drugs and alcohol
Drugs and alcohol reduce your ability to stick to decisions about what is safe and what is not. Decide what you will do before you use drugs or alcohol. Make sure that you can stick to your decisions.

Sharing needles
Sharing needles and syringes has been shown to be a major way the AIDS virus is transmitted. Small amounts of blood remain in needles or syringes and can be injected directly into the bloodstream of another person. If you inject drugs, do not share needles and syringes.

The AIDS antibody test
The key points about the AIDS antibody test are: