From the Guidelines
Safe sex practices include consistently using barrier methods like condoms, dental dams, or finger cots during all sexual activities to prevent sexually transmitted infections (STIs) and unwanted pregnancy, as recommended by the most recent guidelines 1. To reduce the risk of STIs and unwanted pregnancy, it is essential to use barrier methods correctly and consistently. This includes using a new condom for each act of intercourse, as advised by the Centers for Disease Control and Prevention 1. Some key safe sex practices are:
- Using condoms, dental dams, or finger cots during all sexual activities
- Getting tested regularly for STIs, ideally before each new partner
- Discussing test results openly with partners
- Considering pre-exposure prophylaxis (PrEP) medication like Truvada or Descovy (taken daily) if at high risk for HIV
- Using water-based or silicone-based lubricants with condoms to prevent breakage
- Combining barrier methods with hormonal options like birth control pills, patches, rings, or long-acting reversible contraceptives (LARCs) such as IUDs or implants for maximum protection against pregnancy
- Limiting the number of sex partners and avoiding sex with persons from known high-risk groups or persons about whom little is known 1
- Seeking counseling to reduce risky sexual behavior and being tested at least once a year for HIV infection 1 These practices work by creating physical barriers to prevent exchange of bodily fluids, reducing skin-to-skin contact where infections can spread, and in the case of contraceptives, preventing ovulation, fertilization, or implantation. Communication with partners about boundaries, consent, and sexual health status is equally important for comprehensive safe sex practices.
From the Research
Safe Sex Practices
- The use of condoms is a highly effective method for preventing the transmission of HIV and other sexually transmitted infections (STIs) 2, 3.
- Consistent and correct use of condoms can reduce the overall risk of sexual transmission of HIV 3.
- However, condom breakage and slippage rates can vary during anal intercourse and may be higher than during vaginal intercourse 2, 3.
- The use of additional lubricant can increase the risk of condom slippage during vaginal sex, but may reduce the risk of slippage during anal sex 2.
- Education messages concerning the use of additional lubricant may need to be revised to take into account the varied nature of lubricant use practices and the differential effects of lubricant with respect to sexual practices 2.
Post-Exposure Prophylaxis (PEP)
- PEP is a recommended public health intervention after a sexual assault to prevent HIV infection 4.
- A single-tablet regimen of emtricitabine/tenofovir disoproxil fumarate plus cobicistat-boosted elvitegravir can increase adherence to PEP and attendance of a follow-up visit to the STI clinic 4.
- A single oral dose of antiretroviral drugs taken before or after sex may be a desirable alternative to daily PrEP or PEP, and can be effective in preventing HIV infection 5.
- Raltegravir, tenofovir DF, and emtricitabine may be a useful 3-drug regimen for PEP, with a high level of safety, tolerability, and adherence 6.
Pre-Exposure Prophylaxis (PrEP)
- Daily oral PrEP is highly effective in preventing HIV infection, but many people find it challenging to adhere to a daily oral regimen 5.
- A single oral dose of antiretroviral drugs taken before or after sex may be a desirable alternative to daily PrEP, and can be effective in preventing HIV infection 5.