What safe intimacy really means — & how to practice it, according to the pros

How to Have Safe Intimacy: Types of Protection

From condoms to birth control to vaccinations, there are numerous forms of protection, whether you’re trying to reduce the risk of STIs or unplanned pregnancies (or both).

They include:

• Barrier protection for STIs

• Contraceptives

• Regular STI testing

• Vaccines

• HIV prevention

• Avoiding high-risk behaviors

Barrier Protection for STIs

Just as it sounds, barrier protection provides a barrier between bodies to prevent the exchange of fluids and reduce the risk of STI infection.

The best barrier protection for intimacy includes:

• Condoms

• Internal condoms

• Dental dams

Condoms

Male condoms, which can be worn on the privates or used with a adult toy, have evolved significantly from early historical forms like those used in ancient Japan. With correct and consistent use, today’s condoms are around 97 percent effective in protecting against most STIs and pregnancy.

Condoms are made of various materials, including polyurethane, latex, and natural lambskin. Latex condoms are less porous than natural condoms and more flexible than polyurethane condoms, making them a highly effective barrier.

Some condoms are pre-lubricated for comfort, but you can always add more lube to reduce friction. We recommend a water-based lube over an oil-based one, as oil can cause condom breakage.

It’s important to note that using condoms does not offer 100 percent protection from STIs. Infections spread through skin-to-skin contact, like HPV or herpes sores, can still be transmitted if you come into direct contact with them. A condom only offers protection from the area of skin it covers.

Internal Condoms

Also known as female condoms, internal condoms are worn inside the privates. With correct and consistent use, they are about 95 percent effective in reducing the risk of infection against STIs and pregnancy.

Internal condoms should never be used in combination with male condoms, as this can lead to tearing and breakage.

Dental Dams

Dental dams can help prevent the spread of STIs during intimacy. They are most useful in preventing infections spread through fluid exchanges but not as useful in protecting against skin-based infections like herpes or HPV.

If you don’t have access to a dental dam, you can make one out of a condom by cutting off both ends so the condom appears like a tube. Then cut vertically down one side, so you have a flat piece of material to place over the privates.

Contraceptives

Contraceptives, also known as birth control, are methods, medications, and devices that help prevent pregnancies.

They include:

• Condoms

• Birth control pills

• IUDs

• Spermicide

• Diaphragms

• Emergency contraception

Condoms

You already know how effective condoms are in preventing STIs and pregnancy. But to remain effective, they must be worn consistently and correctly. If you fail to use condoms during every intimate encounter or use them incorrectly, pregnancy rates increase to 13 in every 100 women each year.

Follow these tips to help prevent condom failure.

• Wear condoms every time you have intimacy

• Put a condom on before you start.

• Never use a condom past its expiration date

• Avoid using multiple condoms at once — the added friction increases the risk of breakage

• Use water-based (not oil-based) lubricants with condoms

• Ensure you’re wearing the right size condom

• Use condoms in combination with other forms of birth control, like oral contraceptives

Birth Control Pills

When used consistently, prescription birth control pills are 99 percent effective in preventing pregnancy, but as Planned Parenthood points out, most people aren’t perfect. Because it’s easy to forget or miss pills, this form of contraception is more like 93 percent effective.

To increase efficacy, birth control pills can be used in combination with condoms, which offers the added bonus of STI protection. Oral contraceptives only help prevent pregnancy, not STIs.

IUDs

Intrauterine devices (IUDs) are more than 99 percent effective, making them one of the most reliable forms of birth control.

This tiny device is placed directly inside the uterus, offering 24/7 protection from pregnancy for up to 12 years (or less, depending on the type used). IUDs can also be removed at any time.

There are two types of IUDs: hormonal and copper. Both types prevent sperm from reaching the egg, thus preventing fertilization and pregnancy. Some hormonal types also help prevent ovulation.

IUDs are only available with a prescription and should only be inserted by a healthcare professional.

Spermicide

Spermicide consists of chemicals like nonoxynol-9, which prevent sperm from reaching the egg by blocking entry to the cervix. It comes in the form of gels, foams, and creams, which are inserted deep into the privates before intimacy.

When used consistently, spermicide is only 79 to 86 percent effective in preventing pregnancy. It is more effective when paired with another form of birth control, like condoms. In fact, some condoms come pre-lubricated with spermicide solutions.

Diaphragms

Diaphragms are around 94 percent effective when used perfectly every time or about 83 percent effective with typical use.

Shaped like a little disc, these devices are worn inside the privates and block the cervix, preventing sperm from reaching the egg. When used in combination with other birth control methods like condoms and/or spermicide, diaphragms are even more effective.

Emergency Contraception

Emergency contraception refers to contraceptive methods that are used after intimacy to prevent pregnancy. This method can be useful if you had unprotected intimacy or if you fear the contraception you used failed.

Some forms of emergency contraception include copper IUDs and emergency contraceptive pills. These methods should be used within five days of intercourse but are more effective the earlier they are used.

Regular STI Testing

Knowing your STI status is another important way to prevent the spread of infections. You shouldn’t wait until you have symptoms before getting tested because many STIs are asymptomatic. If you’re intimately active, STI testing should be routine.

According to the CDC, everyone between the ages of 13 to 64 years should be tested at least once for HIV. If you’re intimately active, you may want to test for syphilis, chlamydia, gonorrhea, and HIV at least once a year (or more frequently if you have multiple or anonymous partners).

If you have intimacy you can also ask your healthcare provider about throat and rectal testing options.

Vaccines

Some pre-exposure vaccines can help prevent STIs.

Currently, there are vaccinations for:

• HPV. The HPV vaccine has a high efficacy rate of nearly 100 percent in preventing HPV. It’s typically recommended you get vaccinated by age 26 when the risk of being exposed to the virus is lower.

• Hepatitis A. Some individuals have a higher risk of contracting hepatitis A, such as international travelers, men who have intimacy with men, and those who use or inject drugs. Getting vaccinated for this disease is a safe and highly effective way of reducing your risk.

• Hepatitis B. The hepatitis B vaccine offers 80 to 100 percent protection against contracting the disease. All adults 19 to 59 years old should be vaccinated. Risk factors include having a partner with the disease, having multiple partners, having certain health conditions like diabetes, or using injectable drugs.

HIV Prevention

Pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) are medications taken before or after intimacy to prevent HIV infection.

According to HIV.gov, PrEP reduces the risk of getting HIV from intimacy by about 99 percent and reduces the risk of HIV from injection drug use by at least 74 percent. However, the medication only protects against HIV, so you should use condoms to reduce the risk of other STIs.

PEP, which is taken after a single high-risk event, must be taken at least 72 hours after the event to help prevent HIV. It is considered an emergency method and can be useful if a condom broke, if you share needles, or if you were assaulted.

Avoiding High-Risk Behaviors

You can also minimize your risk of STIs and unplanned pregnancies by avoiding high-risk behaviors.

To help reduce your risk, try the following:

• Don’t have unprotected intimacy

• Limit your number of partners

• Avoid substance abuse

• Properly clean adult toys

Consider exploring mutual self-stimulation

How Can You Have Safe Intimacy With STIs?

There are many ways you can make intimacy safer if you have STIs, from being open about your intimate history to using condoms consistently.

You can reduce the risk of infecting your partner with an STI by doing the following:

• Be open about your STI status and discuss your intimate history and history of drug use with your partners

• Use condoms and dental dams consistently and correctly

• Avoid having intimacy during a herpes outbreak or if you notice any unexpected lesions, irritation, or abnormal discharge

• If you have herpes, consider taking antiviral drugs like valacyclovir

• Try not to have intimacy when drinking or taking drugs when you’re more likely to engage in risky behaviors

• If you’re taking medication for a curable STI like chlamydia or syphilis, remember to take all of your medication as directed and don’t have intimacy until you complete treatment

• Always clean adult toys after using them