Everyone deserves to experience dating, love, and pleasure — regardless of their STI status. But if you have an STI diagnosis, you may wonder if it’s possible to have sex and date like you used to. Understanding the different types of STIs and how to have safer sex is the first step toward mitigating the risk of transmission, and being able to enjoy sex and pleasure.
Types of STIs and how they spread
There are two major categories of STIs: Infections that are transmitted through bodily fluids or substances and infections that are transmitted through skin-to-skin contact.
STIs transmitted through fluid/bodily substances
Some infections are transmitted through saliva, blood, or fecal matter, and quite a few infections are transmitted through genital secretions. Here are a few examples of bodily substances that transmit STIs.
- Saliva - intestinal parasites, mono, colds and flus
- Genital Secretions - chlamydia, gonorrhea, hep B, mycoplasma genitalium, trichomoniasis, zika
- Blood - hep B, hep C, HIV
- Fecal Matter - hep A, intestinal parasites
You can best reduce the risk of transmitting these STIs by using internal and external barriers.
STIs transmitted through skin-to-skin contact
These are infections that can be relatively easy to transmit, even while using barriers. Though most experts still advise people to use barriers as one of the ways to reduce transmission.
For infections like molluscum contagiosum, scabies, and pubic lice, one has to simply touch an infected area to contract the infection. That’s why these things can be transmitted through non-sexual activities.
For infections like herpes and HPV, however, the skin covering the majority of our body acts as a natural barrier. Those infections need a way to enter the body, either through tiny cuts, tears, and abrasions, or through places where there are mucous membranes (eyes, nose, ears, mouth, vulva, vagina, urethra, and anus). Wherever there are mucous membranes, the risk of contracting an infection is higher because that tissue is more porous.
- Surface - molluscum contagiosum, scabies, pubic lice
- Entry-point - herpes, HPV
How to have safer sex if you have an STI
Reducing transmission risk and/or mitigating the likelihood of contracting a new infection can be highly nuanced. Which infection you or your partner(s) have might determine which safer sex methods you’d like to employ. And it’s important to point out that your safer sex regimen might also change as you become more familiar with different risk reduction methods and as your partner(s) evolve as well. Here are a few comprehensive ways in which you can choose to reduce risk with (or without) an STI.
Get tested. - Try to get tested before and after each new partner and to keep track of the tests and the types of tests used.
Explore treatment options. If you test positive for a curable infection, like chlamydia, scabies, or trich, complete all prescribed treatment before engaging in partnered activities. Consider ongoing treatment for long-term or permanent infections, like hep B, herpes, or HIV. For example, post and pre-exposure prophylaxis are prescription options for reducing the risk of HIV transmission and taking suppressive therapy (a daily antiviral medication) while living with herpes will reduce the risk of viral shedding and transmission.
To find out whether a treatment is right for you, consult your doctor. However, it’s important to note that not all treatment options are accessible to, or right for, everyone. There should be no presumptions or pressure from partners to take specific therapy.
Communicate with your partner(s) about STI status. Sex is always safer when you can have open and honest conversations with your partner(s), STIs or not. Always tell your partner if you have an STD. Ask about your partner(s) experiences with STI tests, their results, which tests were administered, and if additional testing is worth considering. Discuss safer sex boundaries, and have ongoing conversations that include asking for permission before engaging in an activity, asking how they are feeling during an activity, and asking how they are doing after the activity.
Only have sex when you’re symptom-free. Consider only engaging in sexual activity if you are symptom-free, with no visible sores, bumps, ulcers, etc. Some infections, like syphilis or chancroid, for example, are primarily transmitted through open sores. Whereas, other infections are transmitted in a variety of ways, but a general rule of thumb is that everything is more contagious when there are signs or symptoms present.
Use barriers. Using barriers greatly reduces the risk of anything that is transmitted through bodily substances, and they will help reduce the risk for all other infections.
Use lube. Using lube creates a thin layer between you and a partner, and it helps reduce small cuts and tears, which naturally occur during sexual activities, that allow entry points of infection. Some things to keep in mind: a lack of natural lubrication is not necessarily an indicator that your partner is not aroused, the anus does not lubricate naturally, and most people report that sexual activities involving the addition of lube generally feel better!
Choose to engage in lower-risk activities. Certain sexual activities may be riskier than others when it comes to spreading an STI. Sex that involves body parts that house mucous membranes, or are more likely to sustain tiny cuts, tears, or abrasions, for example, is riskier. So you may choose to limit certain activities or utilize additional risk reduction methods when enjoying those activities. Broadly speaking, from lower to higher risk: manual sex, oral sex, vaginal penetrative sex, anal penetrative sex.
Reduce substances. The use of drugs or alcohol may inhibit your safer sex decision-making. They may reduce your safer sex communication skills, and they may limit your ability to advocate for your safer sex needs.
The safer sex methods you employ will be entirely up to you and your partner(s). The reality is, many sexually active people contract an STI at some point in their life. Someone with one infection is more likely to contract another, so there’s an ongoing, mutually shared risk for all folx involved. That’s why it’s important to be as informed and prepared as possible so you can make the decisions that will help you feel safer and better about all of your partnered sexual experiences and activities.