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At the present time, the United States now rules when it comes to sexually transmitted infections (STIs). And not in a Whoohoo, go USA! kind of way. You've probably also heard that the rate of sexually transmitted infections in people 15-24 years old is exceptionally high.
Figuring out why isn't tricky for those who work in sexual health. Some people will say this is because teens are having more sex than ever (not true: you're having less sex than teens a generation or two before you did), or because people are having sex outside marriage (a fine fairy tale for those who don't see lab results for STIs among some married people or who don't know about the history of STIs). But those of us who work in direct care know why STI rates are so high and why they're so disproportionate in young people right now.
It's primarily because so many young people -- and namely those in the 18-24 group, as younger teens are often better with condom use than people of any other age group -- are not using latex or polyurethane condoms and other barriers to protect themselves and their partners, or are not using them correctly and consistently. As someone who talks with people every day about their sexual behavior, and who also tracks young people's sexual behavior and health over time, I know this all too well. We observe users who come to Scarleteen and see that those who have not used latex barriers at all or consistently are overwhelmingly the same users who eventually come to report an STI. Sure, every now and then we do hear from a user who always used condoms properly and who still got an STI. But that happens about as often as I find a $5 bill on the sidewalk.
There are other reasons the STI rate is so high in younger people. Cervical cell development of younger women isn't complete, making the cervix more prone to infection. People in your age group often tend to have more sexual partners and shorter relationships than older people. The overall rate of STIs is higher than it used to be, making it easier to land one. But we know that the main reason is that overwhelmingly, many people in your age group are either not using latex barriers at all, or are not using them all the time, every time, correctly. While many older adults aren't much better with condom use, it does matter more what you do because two thirds of all individuals who acquire STIs are younger than 25 years old.
It's not complicated: most people who acquire a sexually transmitted infection are simply not using condoms or are not using them every time and properly.
A report from Child Trends DataBank in October of 2008 (based on data from the CDC) found "53 percent of teen boys say they don't always use a condom. Among girls, about two-thirds say a condom isn't always used. Sexually transmitted infections (STIs), including HIV/AIDS, and unintended pregnancy are major health consequences associated with unprotected sexual activity. Although a similar percentage of teens are sexually active in the United States as in western European countries, the U.S. has much higher teen pregnancy and STI rates than does Western Europe. This is due to lower consistency and effectiveness of contraceptive use in the U.S." They add that "Condom use is higher among younger students than it is among older students. In 2007, 69 percent of sexually active ninth grade students, compared with 62 percent of eleventh graders and 54 percent of twelfth graders, used condoms. Part of this drop is due to higher levels of use of other forms of birth control among older students, although it is still a cause for concern since condoms are the only form of effective control against STIs for those who are sexually active."
Condoms work very well at reducing STI transmission: According to a 2000 report by the National Institutes of Health (NIH), correct and consistent use of latex condoms reduces the risk of HIV/AIDS transmission by approximately 85% relative to risk when unprotected, putting the seroconversion rate (infection rate) at 0.9 per 100 person-years with condom, down from 6.7 per 100 person-years. Analysis published in 2007 from the World Health Organization found similar risk reductions of 80–95%. The 2000 NIH review concluded that condom use significantly reduces the risk of gonorrhea for men. A 2006 study reports that proper condom use decreases the risk of transmission of human papillomavirus (HPV) to women by approximately 70%.
You can read more about STIs all over Scarleteen, like here and here and here and here and... you get the picture. But you probably already know why you should use condoms. Our users generally report higher use of condoms than the overall demographic, so maybe you don't even need to read what I'm about to say. But you've probably also heard or thought some things about condoms that might be keeping you or others from using them or from using them consistently, and I'm willing to bet you haven't heard everything I'm about to say. Even if you're already using condoms and using them every single time properly, I bet you know someone -- a sibling, a friend, maybe even a sexual partner -- who could stand to hear some of this. So, why use condoms and other barriers?
For more details on all of these points, keep reading.
I know: I've heard some people say that condoms and other barriers keep people from getting close, too. But the folks I hear say that rarely seem to be the folks whose relationships are all that close or intimate. The people I hear from who DON'T say that about condoms, and who practice safer sex in their relationships seem to be the ones getting closer and feeling closer to each other.
Avoiding potentially sticky or difficult conversations doesn't bring us closer: it keeps us apart. Asking someone to care for you in any way is not a barrier to intimacy: it's not asking that keeps space between you and yours. Having to discuss sexual anatomy, sexual health or even just how to use condoms and use them in a way that works for both of you is not something that keeps people apart, but that brings people closer together. Talking about these things together, working through any misunderstandings or emotional issues around them and having something that adds extra communication to any sex you're having are all the kinds of things that nurture closeness and real intimacy. Silence doesn't bring people closer: communication does.
A lot of what we hear young people say about not using condoms has to do with one or both partners finding it hard to assert themselves, or being worried about a negative reaction: that's not about closeness. Even more troubling is a conversation about condoms that starts with "I don't want to use them because I want to be close," and often leads to a bigger discussion in which what comes out is, "I'm scared to ask him to wear a condom."
Being outright afraid to ask someone to do something to help safeguard the health of you both shows a serious LACK of getting close (or a desire to avoid getting close enough to find out if someone is or isn't the person you currently think they are or hope them to be). We can't say we and someone else are very close and at the same time say we feel scared of, with or around them. When we're earnestly close to someone, we feel able to say or ask things when we don't know if we're going to get a positive response. If we want a close relationship, we have to not only say or bring up the things we know they'll like hearing, or have a positive reaction to, but the things when we're not so sure they'll like or which we know are loaded, but that we need to say and talk about for our well-being and health and the quality of our relationship.
I've been having a sense of déjà vu lately when hearing some hetero girls say they're "not into condoms" with a wink and a grin, or that they, unlike those other girls who use condoms and who they tend to frame as killjoys, are willing to go without condoms, in this way that rings of trying to aim for a certain social status by being the one willing to risk health and life for... well, a whole lotta nothing much.
Why I'm having déjà vu is because I'm old enough to remember when some gay guys were all about that. I remember seeing how many of them died and were part of others dying because of it, as well as how many of the men who barebacked only because they didn't know what we and you know now about how to protect ourselves died from barebacking. That trend in the gay community was not only lethal, it also resulted in those who were the least responsible defining a whole group of people culturally in a very negative way that is still strongly harming the GLBT community. It hurt all of us, not just the people it hurt directly.
On top of risking your life and health, any social status you might get from being the girl who'll take big risks other girls don't is likely to be temporary, and will also change very radically when you go from "That hottie who doesn't make guys use condoms," to "That [insert derogatory term for women of your choice here] who gave everyone Chlamydia."
Not a pretty thing to say, I know. But it is what tends to wind up happening in the real world. The tide turns very quickly on girls who are sexually active PERIOD in our culture, even responsibly, but all the more so for those who aren't responsible in their sexual behavior. I don't like that or the misogyny it's based in, as guys are rarely treated or talked about like that, but it's out there. It's tenuous enough to be a sexually active young woman, but when things go amiss and you do wind up with and spread an STI, it's usually going to be framed as being YOUR doing, not the doing of everyone or anyone else who had sex with you and made their choice not to use condoms, too. Those are strongly sexist double standards, but they are out there and they can really hurt when directed at you, especially if you have to suffer in silence alone, knowing part of that result had to do with your own choices and actions.
From my point of view, what I see in these cases is a young woman having some big esteem issues and who seems to feel it's worth it to risk her life and health for a temporarily increased sexual appeal. While our sexuality and our sexual relationships can support our self-esteem, they tend to be poor places to try and get self-esteem, especially if our sex lives involve a habit or precedent of not caring for ourselves and inviting or allowing others `to treat us without real care. Lack of self-care and solid self-esteem can't coexist. If we have good self-esteem, we see ourselves as valuable and worthy of care. If your esteem isn't so great, and you want it to be better, then insisting others treat us you care is one way to improve it: accepting or advertising yourself as open to being treated like a throwaway is a way to make sure your esteem gets even lower.
If you have sex with others without using condoms or other barriers correctly and consistently, you are likely to wind up with an infection at some point. And if you and your partner(s) don't also get tested regularly, you -- like most people with an STI -- won't even know you have one that you're spreading around.
When we have users who interact with us at the boards talking about how they're not using condoms, it's a bit like being able to see into the future. Because inevitably, someone like that who sticks to that habit of going without will eventually post about an STI they wound up with within a few years, if not sooner.
A lot of people have a false sense of security based on not having gotten an STI yet. Mind, some of those people haven't been tested to know their status, but some have. If you go without condoms or other latex barriers for a few months or a few years and didn't get an STI, it can be easy to believe that not using condoms is going to work out fine for you. But because we don't wind up with an infection in a month or a year or two of not using barriers doesn't mean we won't in time. The studies and statistics on STIs also tend to reflect that very clearly. The highest STI rates in young adults usually aren't in the youngest sexually active teens: the group with the highest rates is usually those 18 and over who have often been sexually active for a year or two already.
And of course, if and when your luck runs out and you get an STI, especially if it's one you can't get treated and which is then out of your system via that treatment, you will then either need to use condoms or be purposefully putting others at risk (and yourself at risk of infections you didn't get yet).
It's a lot easier to establish your sex life in the habit of using safer sex practices than it is to add them later. If you start using condoms (and getting tested) early in your sex life, continuing to do so is a no-brainer. You get to be an ace at using barriers sooner, get to learn how to have conversations about safer sex as you're learning to have all kinds of conversations about sex, and the more you do it and the sooner you start, the tougher it gets to space out safer sex, and the less and less it seems like any big deal. When it's a solid habit, you just reach for that condom instinctively. And when you reach for it like that? Partners tend to react just as instinctively and just put it on with no fuss.
Most people will need to use condoms at some point to avoid infections. If you're going to need to eventually anyway, why put it off, especially during the time in your life when you're at the highest risk of infections and most likely to get one?
Younger people are particularly prone to monkey-see/monkey-do. In other words, if you and yours don't use condoms, your friends are also less likely to. And then so are their friends. And theirs. And all young people.
Using condoms not only protects your health, it protects and can improve our global health. If you don't get and spread an STI, you're part of the solution to the problem: you, all by yourself, literally can help improve the public health just by not getting sick. Sexually transmitted infections impact our public health deeply. While many are easy to treat (once you get tested to know you have one, that is), and many won't impact the individual health of most who get them, we're not all at the same level of health nor do we all have the same level of access to healthcare and treatment. Some STIs that are no-big to most of us can be life-threatening to others because of preexisting conditions or suppressed immune systems. You might be able to get something treated easily because you have health insurance, but someone who winds up with an STI from your now-ex you gave one to might not have those same resources.
One thing I've always liked about using condoms is that I not only get to know I'm caring for my health and that of my partners, but that I am caring for your health, her health, his health and everyone's health. Using condoms is one way I can to care for the whole planet while at the same time caring for myself. And that's pretty awesome to be able to do with just a little piece of latex and an orgasm.
Say what? You thought condoms made things feel less good, right? Actually some studies (Sexual Pleasure and Condom Use, Mary E. Randolph, Steven D. Pinkerton, Laura M. Bogart, Heather Cecil, and Paul R. Abramson) find that those who report that are often those who do not use condoms, haven't in a while or who don't use them often. They have also found that men believe this is so (even without any actual experience) more than women do, and that belief influences men's experiences with condoms and whether or not men will use condoms. While yes, many people do report that unprotected sex feels better than protected sex, overall, people who use condoms and are used to using them tend to report experiencing greater pleasure with protected sex than those who often go without protection. In other words, people who use condoms often -- most likely because they have better attitudes walking in the door, and because they learn what condoms they like and how to use them well -- don't really express that using condoms decreases their overall pleasure or satisfaction. The more you use them, the more they feel good, and it's the people who don't use them at all who tend to complain about them the most.
Even for males who report a difference in pleasure between condom and no condom, though, the differential is pretty minor between them and those who don't report a difference. And in studies on women, there's most often no real difference in sensation reported at all. Physically -- when we're talking only about physical sensation -- for most men, condoms slightly decrease sensation. For women, that's rare, which isn't a shocker since unlike the clitoris, the vagina has few sensory nerve endings. The vagina tends to feel pressure, but not fine sensations, like the diff between a condom and bare skin. Mind, for some men, that decrease can be a bonus: for those who are looking to keep an erection around for longer, a decrease in sensation and the pressure a condom puts at the base of the penis can extend erection time for some men.
People who say they "can't feel anything" with a condom on are either a) being dishonest or b) not using condoms properly. While a lot of people are dishonest, a lot of people also don't know how to use condoms properly and what can help with pleasure. For instance, thinner condoms are just as safe as thicker ones. There are more condom types than what your average drugstore carries, and some kinds of condoms have all kinds of neat stuff going on to help increase pleasure, like extra headroom, textured dots on the inside, the works. Putting a few drops of lube inside the condom before it goes on as well as some lube outside the condom makes a big difference with sensation and can make sex feel better, full-stop. Having a partner put on a condom for you as part of the sex you're having -- rather than as an interruption -- is something a lot of people find enjoyable and sexy.
How something makes us feel with sex is also bigger than physics. A Kinsey Institute study in 2008 (Relationships between condoms, hormonal methods, and sexual pleasure and satisfaction: an exploratory analysis from the Women's Well-Being and Sexuality Study, Jenny A. Higgins, Susie Hoffman, Cynthia A. Graham and Stephanie A. Sanders, Sexual Health, Volume 5, Number 4) found that women who use both hormonal contraception (for those with male partners who need it) and condoms report higher overall sexual satisfaction than women who go without condoms or only use a hormonal method of birth control. In that study, women who used hormonal methods alone were least likely to report decreased pleasure, but they also had the lowest overall scores of sexual satisfaction compared with condom users. What does that mean? That pleasure as a whole is more than just mechanics or vaginal/penile sensation.
Sex is about our whole bodies, as well as other parts of our genitals than a condom touches and it's also about how we feel emotionally and intellectually and how sex is part of our whole relationships and our whole lives. It feels good to know you're taking care of yourself and others, and to have a partner give a hoot about your health and peace of mind. It feels good to have the self-esteem and the confidence to stand up for ourselves and what we need to stay healthy, and to only be in relationships where caring for ourselves is in alignment with what a partner wants: if that's at odds with what they want, we can't possibly expect to have a healthy, happy relationship with that person.
It feels good to approach partnered sex smartly and soundly. Knowing we'll be protected well before sex even starts is going to incline us to be more interested in having sex in the first place. When we know our risks of infections are highly reduced, it's much easier to relax before, during and after sex, and being able to relax more means our sexual response systems work better so we can get more sexually aroused and enjoy sex more. Worry and anxiety inhibits sexual response and limits pleasure.
Let's tell the truth right now. You don't want to risk getting an infection. You don't want to feel like you can't ask to be cared for and treated with care with anyone you're sexually intimate with. You don't want to argue about condoms when you want to be sexual. You don't want to be with someone even casually who cares more about getting themselves off than if they make you really sick in the process of doing it. You don't want to have a sex life where it's not okay to press pause for a sec for any reason, whether that's about a condom being put on or adjusting to find a position that feels best. You don't want to have to risk your health to prove your love to someone else.
There are some fictions that avoiding safety behaviors like condom use holds up, like the lie that sex should be all about either what pleases men, first and foremost, or about men calling all the shots, just because they can. Again, we're dropping denial here: many guys who say they can't get off with condoms are not telling the truth. Some haven't even used condoms, and are just saying what they think they're supposed to or because they're embarrassed to admit they're newbies with condoms, but some are outright lying. They have used condoms before and gotten off just fine, and they haven't refused to use them with other partners who they know won't have sex with them without a condom. And some, when they say they can't get off with condoms mean something else: that what they get off on is seeing if you'll sacrifice your health and life just to get them off. Not only does anyone want to avoid having sex without a condom with a partner like that, you don't want to sleep with someone like that, period. Heck, you probably are safest just staying off their block.
Many people still believe the propaganda that there are microscopic holes in condoms that pathogens can get through easily: but that isn't true, and we have always had every evidence that wasn't so. Some people have the idea that people only use condoms with partners they feel or think are "dirty," with sex workers, or for extramarital affairs. But in fact, even many married couples use condoms: according to a Population Reference Bureau survey in 2008, in developed countries condoms are the most popular method of birth control: around 28% of married people use condoms.
Another whopper? Only "promiscuous" people get STIs. I put that in quotes because we don't ever know what that term means. To one person, that means 300 partners, to another, 20, to another, anything more than one. Many people get an STI from just a first or second partner, and some people who have had 50 or even 100 partners have never had an STI. Plenty of unmarried people have never had an STI, while plenty of married people have: one of the first big waves of sexually transmitted infections here in the states after WWI was among marrieds. ALL kinds of people get STIs. The idea that no one can or is likely to get an STI through first-time sex, or sex with a first partner reminds me of the idea my mother's generation had that no one could get pregnant with first-time intercourse. It's understandable given how much cultural messaging cultivates this idea, but it's also just not true. People of all stripes get STIs every day: good people and not-so-good people. People of all colors and genders and orientations. People who grew up on this side of the tracks and people who grew up on that one. People who have had five or twenty partners and people who have had but one.
Then there's the fiction that it's not young people, or people who with their first or second partnership have to worry about STIs, but older people. You already saw the stats about who has the highest rate of STIs, so we've hopefully shredded that myth already. How about the one that says only gay men need to worry about STIs? Nope: the highest rates of STIs are in young, heterosexual women. Even HIV, once ignorantly called "the gay plague," is more likely to be transmitted via heterosexual partnerships than homosexual ones, and worldwide, heterosexual women account for around half of all cases of HIV: 98% of which are in developed nations like the U.S.
Let's not forget the one about how as long as people love and trust each other, or as long as people are lucky, no one is going to get sick; that STI transmission is all about luck or love or trust and not about something much more tangible and less arbitrary.
We can love someone all we want, but there are some things we can't control -- like how many of us are exposed to STIs via rape before we ever chose to have consensual sex, like how often partners -- even in otherwise loving relationships -- are dishonest or unfaithful, like how many people have already had sexual partners before they met a person they want to spend a life with. It's important that we don't base our ideas about STIs on a minority group or an unrealistic or unattainable ideal.
Viruses and bacteria don't care who loves who or who trusts who. If we're exposed to the genitals or fluids of others, we're potentially exposed to STIs. If we reduce that exposure either by not having genital sex or by using latex barriers when we do, we're much less exposed. If we go without, we're wide open to this stuff, just like we are when someone coughs in our face. If your partner has a cold, we may get it whether they love us or not. If our partner has Chlamydia, we may get it whether they love us or not.
If we can't be truthful in our sexual lives about our sexual health and about how we want support from partners in staying healthy, we're unlikely to be able to tell the much harder truths that are part of a great sex life: like to talk about what we like, what we fantasize about, what we're afraid of, what we're feeling emotionally, what we don't like. If we can't say no to sex without condoms, we also are unlikely to be able to say no to sex we don't want, full-stop. Asking someone to put on a condom is one of the easier things to ask for in our sex lives. If we can do that, asking for the other stuff also gets easier. The more truthful we can be about all aspects of our sexuality, including things like STIs and condoms, the better our sex lives are, both when it comes to our health and also when it comes to our sexual satisfaction.
Abstinence-only initiatives, for instance, get away with what they do in part because some of the things they say are true. Some young people really don't -- they say can't, and in certain numbers, it sure starts to look like a can't -- make smart choices with sex, even when they know better. If you read any newspapers or listen to any news, you know that the standard way teen and young adult sex gets presented is as a giant public health problem and a big, scary panic. When you face discrimination about your age and sexuality, that has a lot to do with that presentation.
Some of why it's presented and interpreted that way is because it is that way: not because young people are having sex, but because so many are without using safer sex and contraception. Right now, and over the last ten years, as a generation your sex life really is becoming a serious public health problem, primarily because you have not been using condoms, or using condoms consistently and correctly.
Do you really want to prove those folks right? Really? Do you want to be the person or group of people who they can use as evidence to show that people in their teens and twenties should be treated like children? I sure wouldn't want to help anyone disrespecting me to be able to keep on doing it, and doing it with evidence I'm handing right over to them wrapped in a bow. As a youth advocate, I can't tell you how many times I have had to argue that despite the way some youth behave, I know in my guts that you are all capable of handling your sexuality with care and maturity. It's so frustrating, because I really do know that you are that capable: I see plenty of young people doing a better job with their sexuality than plenty of older adults are, but what I see and know is continually overshadowed by those who don't have sex with care and caution and the reality of the level of STIs in your age group. Yep: I admit, I am asking you to use condoms to help make my job of advocating for you easier on me.
Perhaps your competitive spirit might also get riled by knowing my generation did a better job than yours with condom use. From that same AAP report I linked to earlier: "Among sexually active adolescent males 17 to 19 years old living in metropolitan areas, reported condom use at last intercourse increased from 21% in 1979 to 58% in 1988. Reported condom use at first intercourse among adolescent women 15 to 19 years old increased from 23% in 1982 to 47% in 1988. Data from the 1988 and 1995 National Surveys of Adolescent Males indicate that these increases continued, with reported condom use at last intercourse among 15 to 19-year-olds increasing from 57% in 1988 to 67% in 1995. The CDC data indicate increases in reported condom use at last intercourse from 38% to 51% among females and from 56% to 63% among males for those in grades 9 through 12 between 1991 and 1997."
What about after the mid-to-late nineties? By 2003 (when we were still around that 73%), those increases in condom use started to come to a standstill then backpedal. Current data shows that "only 45% of adolescent males report condom use for every act of intercourse and that condom use actually decreases with age when comparing males 15 to 17 years old with males 18 to 19 years old. Also, females report less frequent use of condoms during intercourse than males, presumably because many adolescent females are sexually active with older partners. Rates of pregnancies and STDs in females are unlikely to decrease beyond current levels unless condom use by adolescents and young adults continues to increase significantly in the years ahead. Condom use by one half to two thirds of adolescents is not sufficient to significantly decrease rates of unintended pregnancy and acquisition of STDs."
In a nationally representative sample of more than 3,000 U.S. men interviewed about condoms, the most frequently cited negative reactions were: reduces sensation, requires being careful to avoid breakage, requires withdrawing quickly, embarrassing to buy, difficult to put on, often comes off during sex, embarrassing to discard, shows you think partner has AIDS, and makes partner think you have AIDS.
Let's briefly deconstruct these:
While some of these attitudes come from guys who are simply uninformed or misinformed, for those who know better or should, some of this stuff is just plain foolish. And THAT's embarrassing, no? Male attitudes about condoms have more influence on whether or not condoms get used than female attitudes do. That's because a) women's attitudes tend to be better, b) men as a class still have more power than women (and men influence other men more than women do), and c) you're most often the ones wearing them or the ones who make a fuss about wearing them.
Being open about all parts of sex, not just about what you might do to someone to get them off, is sexy in most people's books. Being all ooh-ahh about giving a blow job or going down on someone, but then recoiling like a kid with mushy peas on their dinner plate about condoms doesn't tend to be a turn on for a lot of people. For some -- including the person with that response themselves -- it can be a pretty serious turn OFF. I'm older than our readers, but speaking for myself, when someone reacts that way when I pull out a condom (and they rarely do), I'm just done. It feels seriously uncomfortable, like I was about to be sexual with someone who isn't really ready for all of sex; like I was about to be with someone who is emotionally and intellectually many steps behind me. That's not sexy to me at all: it sends a very clear message to my brain -- the organ that drives most of our sexuality -- that turns all of my turn-on signals into turn-off signals in two seconds flat.
Assertiveness is sexy: look at who you and the world as a whole tends to find sexy and that's obvious. Being confident about caring for yourself and the firm belief and insistence anyone else you are sexual with must treat you with that same respect and care is sexy. Caring about yourself and your health, and caring about the health of others is sexy. Having limits and boundaries you don't let anyone else trample on is sexy. Coming to, addressing and responding to the things that keep everyone as safe as possible during sex is sexy. Being confident in yourself and someone else that they've got some real maturity and smarts when it comes to sex is sexy. And there is absolutely, positively, nothing UNsexy about handing someone a condom or a dental dam that you're giving them as a way of cementing a great, big, wholehearted "yes" to you two being sexual together. What could be unsexy about that?
Sexy is as sexy does. There is no one way to be sexy, no matter what anyone says. Being sexy is about how you feel sexy and sexual, and how you project those feelings to others when you're feeling them. So, for sure, if when it comes to safer sex you are a shrinking violet, that's probably not very sexy. But if you pull out or put on a condom with confidence and a smile, and if you get it in your head firmly that this is sexy, then it's likely to be perceived as sexy. If you feel sexy in it, and it's sexy to you, it's going to be to someone else. To everyone else? Probably not, especially since there is absolutely nothing in the world that is sexy to absolutely everyone. But.
People who claim their own sexuality in a real way and feel confident in it, which includes taking care of themselves and insisting on the same from others, tend to be the people who both express feeling the most sexy and who others perceive as sexy.
I'd hope that at this stage of my career as an educator, it's obvious that the primary reason I do what I do is simply out of love for all of you. The benefits are nonexistent, the pay blows chunks and sometimes I have to take a whole lot of crap from people who think I'm Satan incarnate for helping you out with sexuality: if I didn't love you and think that a good way for me to express that was by doing what I could to help you take care of yourself and have a healthy, happy sexuality, I wouldn't do this job at all.
Getting an STI is rarely the end of the world. While a couple are literally deadly serious, most are treatable and most will not have that great an impact on your life if you find out you have one early and get treated. But I don't want you to be sick if you can avoid it. If it can be avoided, I don't want you to have to deal with the negative feelings around an STI that are tough to avoid in a world that really stigmatizes STIs and the people who have them. I don't want you to have to get extra pap smears, to have to endlessly experiment with new drugs for HIV or to have to tell a potential partner you have a genital herpes outbreak. I'll support you if you do, and know that I don't think anything different about you than I think about someone who has the flu or leukemia, but whatever I can do to help prevent it in the first place is something I want to do.
I know that if you just don't have sex that you are even less likely to get an STI than if you use condoms. But I don't just tell you not to have sex because a) I know that most people, once they are into or past puberty, will have and want a sexual life with partners, b) I think that sexuality is part of who we are and can be a great part of our lives and c) I know that you can reduce your risks of unwanted consequences very well and still be sexual when that's what you want. I also know that a truly great sex life includes protecting yourself and others as best you can from negative or unwanted consequences of sex.
I know from my work and my own sexual life how much more enjoyable and less stressful sex is when you're safe and smart about it. Not having to worry about the complications of an infection, about giving an infection to someone else, or about taking huge risks with infection is nice: it's much less stressful than the alternative. It's often amazing to me, as someone who has had more sexual partners than most of you ever will given generational differences, to talk with many of you who are terrified about the risks you've taken after the fact within sexual lifestyles and scenarios that are comparatively more conservative than mine have been, but far less safe as far as protecting your sexual health goes. I don't panic after sex, and that's not because I have some secret or don't care about the bad stuff that can happen: I don't panic because I know I can keep myself very safe and still have the sex I want to, and I have more than two decades of doing so to look back on and see how well that's worked. I can see the same with the people I work with as users or clients in my sexual health work.
When it comes to sexuality, here's what I want for the people I love: I want it to be great for them and anyone they are sexual with. I want them to feel good about their sexual lives, not scared, freaked out, panicked or upset. I want them to stay healthy. I want them to feel empowered by their sexual choices, whatever they are. And I'm not sure how all of that can happen if and when anyone is taking unnecessary risks or avoiding asking for, and insisting on, sexual partners treating them with care, which certainly includes not exposing them to illness when that can be avoided. Because I love you, if and when you want a sex life with others, I want you to have one that is wonderful and enjoyable, but also as safe as it can be so that it can keep ON being wonderful and enjoyable.
I love you, so I want you to use condoms and other barriers if you're going to be sexually active, and to chillax with the genital sex that presents possible STI risks if you can't. It's just that simple sometimes.
Safer sex is a group of practices of which condom/latex barrier use is one part. The standard guidelines for safer sex suggested by public health agencies are that any two (or more) people who are new partners use condoms or other latex barriers for all vaginal, anal and/or oral sex for at least six months, and then only ditch them (if you want to) AFTER each has had a new round of testing for all STIs with negative results AND those two people have been sexually exclusive for six months.
If you and/or a partner didn't have previous sexual partners for ANY genital sex of any kind or it's been longer than those six months since either or both of you did, then if you get tested straightaway w/negative results if you had no partners or tested when it's been more than six months since a previous partner, then your risks are already very low. That doesn't mean after all that you'll have NO risks: rather, it means that so long as you both stay sexually exclusive afterward, at that point, your risks are likely very minimal.
To completely eliminate our risks of STIs, we need to not have sex. With anyone. Ever. We'd need to avoid the nonsexual behaviors that can transmit some infections, like IV drug use. We'd also need to avoid sharing towels and linens, kissing our aunt Mabel who has the cold sores sometimes, and a whole bunch of other things very few of us who live outside a hermetically-sealed bubble will be able to avoid.
If you want to see the safer sex guidelines other sound sexual health organizations advise, here are a few for you to peek at:
Very few people will not have sex with anyone in a lifetime: most young adults will also have at least one sexual partner before their 20's. If we're going to be sexual with partners, to reduce our risks and make oral, vaginal and/or anal sex safer we need to use latex barriers, get tested (and treated if we have any infections) and limit our number of sexual partners. Doing just one of any of those things can help some, but it's all three of those together that public health agencies make clear have been shown to be most effective.
We have much bigger piece on safer sex here. You can also find out about how to use condoms properly here, and find out what all your options are with condoms here. Have questions? Come on over to our message boards and we're glad to talk things over with you.