Safer Sex Practices and Ethical Non-Monogamy

Safer Sex Practices and Ethical Non-Monogamy
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Safer Sex Practices and Ethical Non-Monogamy

One of the most important things to educate yourself about as a sexually active person is your sexual health. This becomes even more vitally important when you have multiple sexual partners simultaneously. We compiled some data that has proven helpful for many in the Houston Polyamory community. It starts with basic topics like consent and risk assessment and continues on to explore testing options.

How do you know if someone wants to have sex with you?

What are the risks of having non-monogamous sex?

  • When engaging in non-monogamous sex, whether it is ethical or not, you are increasing your risk pool of contracting an STI. You can lower these risks by adopting safer sex practices, but you cannot eliminate them completely.

What kind of testing schedule should you adopt as a non-monogamous person?

  • At a minimum, you should be tested annually, but the consensus seems to be somewhere between two and four times a year, depending on your level of involvement with new partners.

What is considered “safer sex” in the polyamory community?

  • Using Condoms: Condoms 101 from TWC – includes how to use a “female” or internal condom for both vaginal and anal sex.
  • Remember that condoms are not 100% effective at preventing STI transmission or pregnancy, but using them properly can help increase your odds of being protected. What does that mean? If you accidentally put the condom on upside down and can’t roll it down, don’t flip it over! Throw it away. It’s not safe anymore and you’ll need a new condom. Condoms cannot be washed and reused safely.
  • If you or your partner has a piercing on their penis, it must be removed in order to safely use a condom.
  • Other options for safer sex are using latex or nitrile gloves and dental dams to avoid skin contact or fluid transfer

What STIs should I educate myself about?

Where can you get tested for free (or cheap!)?

  • http://www.texaswearscondoms.com/get-tested/ – a comprehensive list of clinics in Texas where you can get walk-in STI testing.
  • AHF Houston – https://www.freestdcheck.org/ – free testing for HIV/AIDS, Gonorrhea, Chlamydia and Syphilis. They will only test for/treat herpes if there are lesions. Free condoms available here also. Limited hours, but has a mobile clinic that hangs out in the Montrose some weeknights.
  • Planned Parenthood
  • Galveston County Health District – Healthy Concepts Clinic offers STD, HIV, Syphilis, Hepatitis C, Chlamydia and Gonorrhea testing and FREE treatment. We’re open 9 a.m.-1 p.m. Mondays in Galveston at Island Community center, 4700 Broadway, Suite F101 and 1-5 p.m. Wednesdays in Texas City at 9850-B Emmett F. Lowry Expressway, Suite B103. All services are private and confidential.

What products do y’all recommend for safer sex? (comment with your favorites!)

  • Free condoms from TexasWearsCondoms.com – lubes, too!
  • If you have a partner who is HIV positive or experience a risk event, contact your doctor about PrEP.
  • “Female” or internal condoms
  • Assorted flavor dental dams – can be held in place with a garter belt!
  • Non-lubricated condoms for oral sex (can be cut in half to make a dental dam, too!)
  • If you or your partner have HSV1 or HSV2, you can reduce the risk of transmission to as low as 1-3% by taking a daily antiviral medication, famciclovir, acyclovir or valacyclovir on a suppressive regimen. Both oral and genital herpes can be either strain, although HSV1 is slightly more prevalent orally than genitally, and HSV2 is more prevalent genitally than orally. This risk is significantly lower than the risk of pregnancy when using condoms (18% risk when used in the real world). References: 1 2
  • Even without antiviral medicine, the risk of transmitting herpes is low, around 10%.

What else should I know about Herpes and HPV?

  • 80% of the population has HSV1, and between 20-30% of the population has HSV2.  They are visually identical and can occur anywhere on the body. Although HSV1 is more likely to be oral and HSV2 is more likely to be genital, both strains are on the rise in the opposite location, with many new cases of HSV1 occurring genitally.  
  • Doctors do not recommend testing for HSV1/2 (Herpes) as it is considered endemic due to the high carrier rates and high false-positive rates. Testing is recommended for pregnant women and those experiencing an outbreak.
  • Condoms do not protect against herpes transmission unless the condom covers the site where herpes lesions occur.  
  • Taking daily antiviral meds on a suppressive therapy regimen reduces the risk of transmission due to asymptomatic shedding from female to male to 1-3%, which is actually lower than the risk of pregnancy while using condoms. 
  • Anecdotal evidence indicates that washing with soap and water after sex may further reduce risk, but studies have not been done to back this up conclusively.  
  • You are at higher risk of contracting HSV from a partner who does not know their status than you are of contracting it from a partner on antiviral drugs to suppress outbreaks.
  • Safer Sex Practices – Each person has different standards for safer sex practices. Some include using condoms for penis-in-vagina or penis-in-anus sex, but not for oral sex.  Make sure you ask your partner what they include in their safer sex practices. Safer sex practices should also include regular testing.  Regular testing in this context refers to the 4-panel screening at least every year, and preferably every 6 months. 4-panel screening includes HIV, Gonorrhea, Syphilis, and Chlamydia.  
  • HPV is considered endemic to the population, and there is no test for HPV without a vagina, and most people clear it on their own within 2 years.  The HPV Vaccine is now recommended for everyone 13-45 and is covered by most insurance.
  • Disclosure of STI Status to 3rd parties – According to the HIPAA model of disclosure, a person’s medical diagnoses and any risks inherent with those diagnoses are no one’s business but that person’s, their doctor, and their immediate partners.  Some folks believe that as a metamour, they have the right to know the STI status of their partners’ partners, so this requires individual negotiation. When someone has an active, contagious infection that requires treatment with antibiotics, disclosure to a 3rd party is certainly warranted so that testing can be done and treatment obtained.
  • Anyone who is practicing open non-monogamy with other non-monogamous partners should assume they are at risk of HSV exposure at all times. Since HSV testing is not included in a “full STI panel,” many, many people do not know their own HSV status, and so requiring knowledge of the HSV status of their metamours is unnecessary and invasive. It’s safer to just assume that as long as you’re engaging in non-monogamy, you are always at a 10-15% risk of contracting herpes.
  • One of the reasons that HSV testing is not recommended is that since the 70’s when HSV antiviral drugs became available, drug companies ran campaigns to increase the stigma of having this common skin condition, and at this point in time, the fear and stigma of having herpes is far more detrimental to a person’s emotional health than the actual illness is. Educating yourself about this skin condition will help ease the stigma and reduce the exaggerated fear of contracting it.

Resources: 

Adam Ruins Everything – You Probably Have Herpes and That’s OK
Ella Dawson – STIs aren’t a consequence. They’re inevitable.

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