8

Safer Sex

WHY TALK ABOUT SAFETY?

ONE OF THE CONVERSATIONS PEOPLE SEEM TO dread the most is about safer sex and STI status. In fact, when I teach my Modern Dating class, people tell me that in their experience, people aren’t having these talks at all. That’s distressing for many reasons. For one, without talking about risk, it’s much harder to keep yourself safe. And if you feel like you can’t talk about safety and sexually transmitted infections with a partner, how are you going to talk about pleasure and what kind of touch you like? Skipping this conversation sets a bad precedent.

I find that in the kink and open relationship communities, people have gotten more used to this kind of communication and negotiation. In part I think this is because when people are used to engaging in higher-risk behaviors like kink, or trickier situations like juggling multiple partners, talking about it is more common. I think it’s also because people tend to put more effort into protecting others than themselves. So when the health of a partner is at stake, people are more on top of safety.

Having these conversations up front also sets the tone for honesty and transparency. One study showed that people who thought they were in monogamous relationships actually had a higher rate of STIs than people in open relationships. That’s because people who were cheating weren’t having safety talks with the people they were cheating with, often weren’t using barriers, and certainly weren’t talking to their spouses about these activities.⁶

Talking about safety is essential for your sexual well-being. The next two sections will show you how to figure out your personal risk tolerance and how to have this conversation with your partners.

RISK TOLERANCE

If you’ve ever done retirement planning or filled out 401(k) paperwork at your job, you’ve probably done a risk-tolerance worksheet. The idea is simple: they ask you a series of questions to determine how you’ll react to various changes in the market. This information helps financial planners decide how aggressively to invest your money. If you have a high risk tolerance, they invest aggressively, aiming for long-term growth but knowing it might be a rocky ride. If you have low risk tolerance, they make safer choices that won’t make as much money but also won’t lose value.

You can use a similar process to conceptualize your risk tolerance when it comes to sexual safety and STI risk. Just like a financial planner might ask how you’d react if the market dips, ask yourself how you’d react if you were to contract an STI. Would it feel fairly straightforward to get tested, get treatment, and tell your partner(s)? Or would you feel like it’s the end of the world?

Sit down and think about that for a minute. Imagine that you get a phone call from a partner saying they’ve tested positive for an STI, or that you’ve just gotten a positive test result yourself. How do you feel? When you think about making that call to someone else and telling them they need to get tested, how does that feel? Can you imagine having that conversation?

These are the kinds of things we need to be ready to talk about if we’re going to be having sex with other people. There’s no such thing as completely risk-free sex, even within a monogamous relationship. It’s possible for things to have been dormant for years, or for something to crop up that someone was never tested for or can’t be tested for.

Having sex with other people means accepting a certain amount of risk. It’s one of the responsibilities we take on when we agree to have sex. And having sex responsibly means limiting our own risk and limiting the risks we’re exposing other people to.

When you’re assessing risk tolerance, one of the first things you need to figure out is how you define risk. Are you considering the likelihood of catching/transmitting STIs as your main risk factor, are you thinking about pregnancy, or do you have other concerns that enter into the equation?

Once you’ve determined your risk tolerance, you aren’t done forever. Just like with financial risk tolerance, sexual risk tolerance changes over time. Maybe you feel one way when you’re single and another when you’ve met someone you’re really into. Maybe you feel one way when you’re younger and another when you’re older or planning a family. You’ll need to return to this idea every so often and see what, if anything, has changed for you.

When you’re having this conversation with your partner, you’ll also have to figure out if your risk-tolerance levels are the same, or if you fall in different places. If they’re different, you’ll have to decide how to navigate that discrepancy as you’re deciding on your safety protocols and your boundaries.

Part of accurately assessing your risk tolerance is being informed about what the actual risks are. You can read more information about STIs in the resources section through the links that are included. Keep in mind also that none of the risks are static—many of them are open to interpretation. With some STIs, the biggest issue is stigma, but with others, there can be serious health consequences. You’ll need to gather all of that information so you can make an informed choice about how you want to mitigate your risks.

One of the best ways to get a clear picture of your sexual health is by visiting a sex-positive doctor you can talk to openly about your activities. You should also get a full STI testing panel so you can share that information with partners and potential partners, and so that you’re already modeling that behavior when you ask for their test results.

When you’re thinking about testing and frequency of testing, it’s important to consider the incubation period for various sexually transmitted infections. Some things can lay dormant for ninety days or more, so it can actually take two tests, ninety days apart, to be relatively sure someone has no infections. And even this isn’t foolproof. Some infections or viruses can be dormant even longer or can be difficult to test for.

Knowing your personal risk tolerance—and the risk tolerance of your partner, if applicable—can help you decide how stringent your safer-sex protocols need to be. It’s important to decide what makes you feel safe in advance so you’re not making an impulsive decision when there’s a person in front of you that you’re eager to have sex with.

So here are some steps:

Figure out your personal risk tolerance.

Decide how often you want to get tested for STIs.

Think about how often you want your partner(s) to be tested.

Do you want to know what your partner has been up to since their last test?

Do you want to know about your partners’ partners?

What kind of barrier use do you want for yourself?

What kind of barrier policies do you want your partners to have with other people?

THE SAFER-SEX TALK

One of the main ways you can mitigate STI risk, along with other sexual-safety risks, is to talk to your partners and potential partners about risk and safety. I’d go so far as to say I think having these talks is essential to a healthy sex life. But I also understand that having these conversations can feel scary. It can help if you have a solid idea of what you want to talk about before you launch into the conversation.

Having a script in mind will help you know what you want to say, what questions you want to ask, and what answers to those questions are acceptable.

You need to decide when and how you feel best having the discussion. “Don’t negotiate naked” is a good rule to live by. When sex is imminent, there’s too much incentive to hurry through the talk or skip it altogether. So whenever possible, start this conversation in advance. That can mean via text or email before a date, or while you’re out in public together. For some, that just means on the couch before you get to the bedroom, or before clothes come off.

Make it clear early on that sexual safety is important to you so that the conversation doesn’t feel like it’s coming out of the blue. From there, you just need to decide on your own style or what you’re comfortable with.

Here are some things you might like to know about potential partners:

When were they last tested for STIs?

What were they tested for? Saying “everything” doesn’t count. Different doctors and clinics have different standard panels, so it’s important to ask for details.

What were their results?

How many partners have they had since their last test?

What are their barrier-use practices?

Do they have these talks with all of their partners?

If applicable, what birth control method are they using?

It can be helpful to share this information about yourself first and then ask your partner to reciprocate. That way you’ve opened the door to being vulnerable, and you’ve also modeled what you’d like to hear. It tends to work like magic. Although you might need to prompt if something you care about wasn’t covered, most people will mirror what you’ve said and share the same information.

When I’m initiating the talk, I tend to keep it fairly simple so that having the safety talk seems casual and natural, rather than a point of stress. I’ve often opened the topic via text already, but if I’ve gotten as far as making out with someone and things seem to be progressing, I’ll simply pause and say, “Can we have a chat?” For people who are used to safer-sex talks, they’ll usually know what comes next. Generally I’ll just launch into my own information: “I was last tested X months ago. I was tested for . . . and the results were . . . I’ve had X partners since my last test and we’ve used barriers for penetration, but not always for oral sex.” Whenever I’m done sharing my information, I end by saying, “What about you?” This indicates I’d like the same information from them.

Reid Mihalko, who coined the Safer Sex Elevator Speech, also suggests adding one thing you do like and one thing you don’t like sexually to the end of the chat, to help facilitate a transition into the rest of your negotiations.

Keep in mind that not everyone is used to having these talks. Some people may never have had them at all. So you might need to do some teaching or offer some guidance to get them used to the process.

A note on language—you may be used to hearing, or even saying, “clean” to mean negative test results. Although that might be a reflexive comment, think about what that’s saying. The opposite of clean is dirty, which suggests people with an STI are dirty. There are some STIs people live with their whole lives that can be well managed, and others people may have had and been treated for. Suggesting that someone is dirty for having an STI contributes to stigma and makes it less likely people will be willing to have these conversations, making everyone less safe.

When it comes to barriers, most people are used to condoms for penetrative sex. But what about dental dams? Or gloves? This is another area where you’ll need to educate yourself around safety, so you can decide what practices you’re most comfortable with for your own sex life and what you want your partners to be doing, or to have done, with their previous partners.

Just as important as the answers to these questions is how someone has this conversation. It’s true that some people may be taken off guard because they’ve never been asked about sexual safety before. But if someone seems angry, defensive, or evasive, that’s a red flag. I’ve heard people say, “Don’t you trust me?” And the answer is no, not if you can’t have this conversation.

When someone is clearly comfortable having the conversation, that’s a clue that they’ve done it before, and it’s even more likely that they’re talking to other partners about sexual-safety issues. These cues shouldn’t replace an explicit conversation, but they can be important hints as to how someone views safety issues.

If you’ve already set the precedent that you talk about things to do with sex and relationships, it shouldn’t come out of the blue when you want to talk about safety, too. And having this conversation before sex also makes it easier to transition into conversations about what kind of sex you’d like to have. After all, once you’ve done the stuff that feels scary, the rest is a piece of cake.

FLUID BONDING

Fluid bonding, generally, refers to people who have unprotected sex, and therefore share fluids. You’ll most often hear this term thrown around in open relationship communities, but it may come up with anyone who is sexually active. The term itself can be complicated, because people use it in different ways. Some people only mean penis-in-vagina sex; others are including oral sex. Yet other people take issue with the concept because they feel fluid bonding is used to designate priority, or that people use the added risk they’re taking on to control a partner’s other behaviors or choices. Politics aside, you should know that choosing to forgo barriers for oral or penetrative sex does expose you to more risk, and if you’re going to go there with someone, it should be someone you trust.

If you want to have a conversation about fluid bonding with a partner, you should give yourself plenty of time. Don’t expect to come to any decisions in just one chat. Give yourself time to think about it, and process your feelings on the subject, and to come back and ask questions.

If you and/or your partner have other partners, you should discuss this topic with them as well, as it could expose them to additional risk. And if there’s someone you have sex with, without the use of barriers, this should also be something you disclose to new potential partners.

If you want to dig into the relationship politics piece, check out some of the books on open relationships from the resources section.

 

6 Justin J. Lehmiller, “A Comparison of Sexual Health History and Practices Among Monogamous and Consensually Nonmonogamous Sexual Partners,” The Journal of Sexual Medicine 12, no. 10 (2015): 2022–2028. doi: 10.1111/jsm.12987.