Safer sex behaviors

Information:
SEXUALLY-TRANSMITTED DISEASE (STD)

Definition:
A contagious disorder where the disease is transferred to another person through sexual intercourse or other sexually-related behaviors.

Transmission of infection:
Many of the organisms that cause sexually-transmitted diseases live on the mucous membranes that line the urethra, vagina , anus, and mouth. Some also live on the skin.

Most of the infectious organisms are transferred by direct contact with a sore or lesion on the genitals or mouth. However, some organisms can live in body fluids without causing a visible lesion and are transferred by contact with the body fluid. Sexually-transmitted diseases are transmitted by both heterosexual and homosexual practices. They can be transferred to another person during oral, vaginal, or anal intercourse. Some sexual practices, such as anal intercourse, carry higher risk of transmission of certain diseases than other sexual practices, such as vaginal intercourse.

Some STDs can also be transferred by direct, nonsexual contact with infected tissues or fluids. A common mode of nonsexual transmission is by contact with infected blood. For example, sharing needles when using IV drugs is a major cause of HIV and hepatitis B transmission. Other nonsexual means of transmission include contaminated blood transfusions and blood products, through the placenta from the mother to the fetus, and rarely through breast feeding.


HIGH-RISK BEHAVIORS

Definition:
Those practices that increase the risk of acquiring a sexually-transmitted disease (STD).

Types of behaviors:
High-risk behaviors include:
  • having multiple sexual partners (or changing sexual partners)
  • having (yourself) a past history of any STD
  • having a partner with a past history of any STD
  • having a partner with an unknown history
  • using drugs or alcohol in a situation where sex might occur
  • having a partner who is an IV drug user
  • bisexual or homosexual partners
  • anal intercourse
  • having unprotected intercourse (sex without the use of a male or female condom) with an unknown partner
Drinking alcohol or using drugs increases the risk. These behaviors increase the likelihood that a person will participate in high-risk sexual activity. In addition, many of the organisms can be transferred through the sharing of used needles or other drug paraphernalia.

High risk groups include homosexual or bisexual men, intravenous drug users who share needles, the sexual partners of those in high risk groups, infants born to mothers with an STD, and people who received blood transfusions or clotting products between 1977 and 1985 (prior to standard screening for the HIV virus in the blood).


SAFER SEX BEHAVIORS

Definition:
Taking precautions, when participating in sexual relationships, that decrease the potential for transmitting or acquiring sexually transmitted diseases (STDs).

Specific examples of safer sex behaviors:
Abstinence is an absolute answer to preventing STDs but it is not practical nor, in most cases, desirable.

A monogamous sexual relationship with an individual known to be free of any STD is, in today's society, probably the most acceptable preventative measure that people can take. Know your partner. Before having sex with a new partner, it is prudent for each potential sexual partner to be screened for the presence of STDs, especially HIV and hepatitis B, and share the results of such evaluations with one another.

The use of CONDOMS , both male and female types, markedly decrease the likelihood of contracting a sexually transmitted disease but condoms must be used properly. The condom should be in place from the beginning to end of sexual activity and should be used EVERY time an individual engages in sexual activity with a nonmonogamous partner or other suspect partner. Condoms are inexpensive considering the consequences of contracting a sexually transmitted disease.

Other measures:
  • Know your partner.
This may sound obvious, but many people engage in sexual activity without first establishing a committed relationship that allows for trust and open communication. You should be able to discuss past sexual histories and any previous STD exposures or IV drug use, as well as current health status, with the sexual partner. There should be opportunities for either partner to initiate or terminate sexual activity, without feeling coerced or forced into having sex.
  • Use barriers to avoid contact with semen, vaginal fluids, or blood.
CORRECT AND CONSISTENT USE OF A CONDOM (male or female condoms ) is imperative. The additional use of lubricants may decrease the chance of barrier breakage. However, use only water-based lubricants because oil-based or petroleum-type lubricants can cause latex to weaken and eventually tear. The use of latex condoms is recommended for both vaginal and oral intercourse. People choosing to participate in sexual activities involving anal contact should seek further information for reducing risk from their own health care providers or counselors available at most STD clinics or HIV testing centers.
  • Stay sober.
The use of alcohol or drugs may impair judgment, communication abilities, and the coordination required to properly use barrier devises or lubricants. Alcohol and drugs can impair the ability to make appropriate choices about sex.
  • Be considerate of your partner.
People with AIDS or HIV infection should not donate blood, plasma, body organs, or sperm. From a legal, ethical, and moral standpoint, they should warn any prospective sexual partner of their HIV positive status. They should not exchange body fluids during sexual activity and must use whatever preventative measures (such as a latex condom) that will afford the partner the most protection.
Women with an STD should be counseled before becoming pregnant about the risk to their infant. She should ask about medical care which may help prevent the fetus from becoming infected. HIV positive women should not breast feed their infant.


SUMMARY
In summary, the implementation of safer sexual behaviors requires accurate information, prior planning, and optimal communication between partners. With such measures in place, couples can enjoy the pleasures of a sexual relationship while minimizing the potential risks involved.

Note:
Some individuals may also choose to extend the definition of safer sex behaviors to include precautions to avoid undesired pregnancy . However, this text applies only to the prevention of disease. For more information about prevention of pregnancy see contraception/family planning .


This is the initial lesion seen with syphilis. There may be single or multiple ulcers. The ulcers are usually painless unless there is also a bacterial infection. The lesion may be hidden from view in women, and subsequently go unnoticed until the rash of secondary syphilis appears.



This is a chancroid erosion on the shaft of the penis. Chancroid is a sexually transmitted disease (STD) that produces a painful ulcer at the site of initial infection. The ulcer can be mistaken for the primary ulcer of syphilis. Specific lab studies should be done to differentiate between the two.



Discharge of pus from the penis associated with gonorrhea. Gonorrhea is the most commonly reported infectious disease in the United States. Some estimates have suggested there are up to 4,000,000 new cases per year. In men, the disease may cause redness (erythema) of the opening of the penis, a discharge of pus (purulent urethral discharge), and discomfort when urinating.



Syphilis is the third most commonly reported infectious disease in the United States. The multiple chancres on this penis are associated with primary syphilis. There may be single or multiple ulcers and they are generally painless. The lesions may be hidden from view in women and subsequently go unnoticed until the rash of secondary syphilis appears.



An example of raised genital warts in the male. The virus which causes this condition is sexually transmitted. Genital warts are easier to treat in the male than the female. There is controversy as to whether the virus can be completely eliminated.



Ulcer formation on the labia associated with genital herpes. These lesions are extremely painful. Episodes may recur frequently or infrequently. The virus persists throughout life, although the frequency of outbreaks tends to decrease with time.



Syphilis is the third most commonly reported infectious disease in the United States. This is the initial lesion seen with syphilis (a chancre). There may be single or multiple ulcers that are generally painless. The lesion may be hidden from view in women, and subsequently go unnoticed until the rash of secondary syphilis appears. This lesion is on the scrotum.



Perianal (on the anus) warts in the male may resemble genital warts in the female, as the moist conditions promote growth of the warts.



This is a severe case of genital warts, also called condyloma (accuminata), on the labia.



This large ulcer on the penis is called a chancre and is typical of the lesions associated with primary syphilis.



A chancre on the penis caused by primary syphilis. The "chancre", a painless ulceration at the site of infection, is the classical presenting skin finding of syphilis. Chancres are highly visible in males but may go undetected in females.



This large mass of cauliflower-like tissue is caused by human papilloma virus (HPV) and is a sexually transmitted disease.



Granuloma inguinale - front view: Granuloma inguinale (Donovanosis) is a sexually transmitted disease that causes ulcers on the genitalia and massive enlargement of the lymph nodes in the groin (inguinal nodes). If left untreated, the nodes may ulcerate through the skin and drain. This disease can cause severe destruction of the genitalia and scarring.



Gonorrhea - discharge of pus from the penis: This photograph demonstrates both urethral discharge (pus at tip of penis) and superficial infection of the skin by the gonococcus (pustules on the head of the penis).



Chancroid is a highly infectious sexually transmitted disease that produces ulceration of the skin, seen here on the head of the penis. Multiple ulcers may be present. Following contact, the incubation period is approximately 3 to 5 days.



Chancroid erosion on the glans of the penis: Chancroid is a highly infectious sexually transmitted disease that produces ulceration of the skin. Multiple ulcers may be present. Following contact the incubation period is approximately 3-5 days. The ulcers often have sharp edges and a yellowish base. They may ooze purulent (pus) material.



Lymphogranuloma venereum is a sexually transmitted disease that causes ulcers on the genitalia and enlargement, drainage, and scarring of the inguinal lymph nodes and rectal lymph nodes. Scarring and rectal obstruction may result from this disease. This photograph demonstrates the inguinal lymph node enlargement and erosion to the surface on the patient's left side (seen on the right side of the picture).



Lymphogranuloma venereum - view of penile lesion: Lymphogranuloma venereum is a sexually transmitted disease that causes ulcers on the genitalia and enlargement, drainage, and scarring of the inguinal lymph nodes and rectal lymph nodes. Permanent scarring and/or rectal obstruction may result from this disease. This photograph demonstrates ulceration on the penis.



The blisters and ulcers of genital herpes are similar to those seen with the common cold sore. In this photograph, ulcers have formed on the shaft of the penis and are crusting over. The genital lesions are painful.



This photograph is a close-up of the shaft of the penis. The blisters and ulcers of genital herpes are similar to those seen with the common cold sore, however, the genital lesions are painful. The virus can be readily transmitted while in this stage.



The blisters and ulcers of genital herpes are similar to those seen with the common cold sore. Seen here are sores on the glans (head) of the penis. Genital lesions are very painful. The virus is highly contagious while in this stage.



Genital warts on the male are not usually large. However, they can be, as seen in this photograph. Genital warts are considered a sexually transmitted disease.



This is a severe case of genital herpes. Note the marked redness (erythema) and lesions scattered over a wide area of skin. The brownish discoloration is dried fluid that has seeped from the herpes lesions.



This is a severe case of genital herpes. Note the marked redness (erythema) and lesions scattered over a wide area of skin. The brownish discoloration is dried fluid that has seeped from the herpes lesions.