We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual-health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. This week’s topic: Everything you need to know about having sex without a condom.
Q: I always use condoms when I have sex. I'm not on the pill, but the thing is, sometimes I miss unprotected sex (I was on the pill before). Sometimes I'll let a guy just duck in for a minute or two if he doesn't think he has pre-cum. How dangerous is that? If I go down on a guy without a condom is that a risk of anything? Just wondering how strict I have to be.
A: Let’s all be real for a moment — the materials condoms are made of often don’t feel quite as delicious as good old fashioned skin-on-skin contact.
So what do you do when you’re in the moment and it feels so good to be touching the person you love or really really like or think is smokin’ hot, but there’s that nagging mom voice screaming at you about how Nietzsche went crazy because of syphilis?
Luckily for you, we've compiled all the information you need to help you decide how to best protect yourself, while still following your bliss. Please note that much of the information that follows is focused on heterosexual sexual activity (per your question). That said, much of this information should be useful for anyone who's thinking about unprotected sex.
Sexually Transmitted Everything, A Brief Overview
First things first ... I know it sounds obvious, but it bears repeating: when it comes to sexually transmitted diseases (STDs), if your partner doesn’t have it, you can’t get it — I don’t care how kinky your sex is. That said, let’s start with a little refresher of the ways you can end up with a STD. Please take out your notebooks and number two pencils. Ahem ... STDs can be transmitted through a number of bodily fluids:
You can become infected with an STD if certain fluids enter your bloodstream or a mucous membrane cavity (vagina, anus, urethra, throat). HPV and herpes are a little different, because they can also be transmitted through skin-to-skin contact with genital warts or lesions, respectively.
The thing to remember is: if no transmission fluids have entered your bloodstream (either directly into the vein or through a mucus membrane), you can’t get infected with most STDs. Your partner is HIV positive and came all over your chest? You’re fine! You have a scab on your finger from a paper cut you got this morning and you fingered your girlfriend who has chlamydia? It ain’t getting into your bloodstream that way!
Your skin is basically a suit of armor that works tirelessly to vanquish all manner of sickness that wants to set up shop inside you. Condoms act as a barrier to all STDs that are transmitted via semen, pre-cum, and vaginal fluid, and also help to protect you from the ones you can get through skin-to-skin contact by covering most of the infected skin.
OK, So What About ... Everything in Between?
For those of us who use condoms for penetrative sex but maybe not ... well ... all the time, or the whole time, there are a few specific considerations. Let's break it down.
Pre-Ejaculate, or Pre-Cum
You know that your partner’s semen could be carrying some cooties, but semen comes at the end right? So do we really have to put on the condom at the beginning, when there’s oh so much to be done before the big finale? Fantastic question!
The reason why sex health educators urge rolling on the rubber at the very beginning is because of pre-ejaculate. This substance is also called pre-seminal fluid or Cowper’s fluid because it’s made by the Cowper’s gland, but most of us know it as pre-cum because it comes before you, um, cum. Pre-cum is that clear lubrication that comes out of the tip of the penis when things are getting hot and heavy. Some researchers have found traces of sperm in this viscous appetizer while others dispute that claim. However, scientists have definitively concluded that a number of STDs can live in pre-cum, including HIV, gonorrhea, and chlamydia.
If you lover says he doesn’t emit any pre-cum, he may be right. The amount of pre-cum excreted during penile excitement varies between men, with some creating none at all and some up to 5ml. It’s up to you if you want to take his word for it (or even do a little visual/tactile science experiment of your own) and forgo a condom for the first few minutes of penetration. The research shows that this probably won’t get you a bun in the oven, but it could leave you tearing your hair out at the clinic waiting for your STD results (see the chart above for the STDs you can catch from pre-cum).
For those wanting to go even further without barrier contraception, there is the pulling out method, in which partners engage in penetrative sex until just before the point of male ejaculation, and then pull out so that his cum goes ... elsewhere. The sexual health site Bedsider has delineated a number of misconceptions around the pros and cons of the pulling out method.
The main thing to remember about the pulling out method is that it is actually pretty difficult to do correctly: you have to stop just when the passion is at its peak and do exactly the opposite of what your body wants to do: keep going. This method requires immense trust and communication between partners to ensure that pregnancy does not occur. And don’t forget that, even when done perfectly, the pulling out method involves no protection for any of the STDs that can be transmitted through pre-cum or skin-to-skin contact.
Giving Oral Sex
Despite the condom industry’s push to make us think latex is delicious through flavored offerings (although banana is delightfully giggle-worthy), it’s become pretty standard practice to play that skin flute in its birthday suit. However, you can catch a number of STDs from giving fallatio, including HPV, oral herpes, chlamydia, gonorrhea, syphilis, hepatitis, and HIV. For many of these, contraction through licking your partner’s nude disco stick results in an STD of the mouth or throat, which is pretty much as bad as it sounds. You can then transmit these through your own mouth to a partner’s naughty bits, in an unfortunate transmission spiral.
Some good news is that your saliva contains badass enzymes that break down HIV, making giving head a very low-risk activity for becoming HIV-infected if your mouth is healthy (as in, doesn’t have any open sores). All of this information is true for cunnilingus as well.
Should you panic about this? That’s a really good question, and one you have to answer for yourself. Blowjobs are a lower-risk activity than penetrative sex for STD transmission, but the potential to catch something definitely exists. Talk to your partner and do what feels most comfortable for you.
Receiving Oral Sex
Getting an STD while you’re receiving oral sex is much more difficult. Saliva isn’t a high-risk transmission fluid — good news for all of us who like to kiss other people! However, if your partner has an outbreak of oral herpes or syphilis sores, or gonorrhea in his throat, he can transfer that to your netherbits. This method of transmission is pretty rare, but if you see an open sore on your honey’s mouth, you probably want to ask him to hold off on the pussy worship and take him on a romantic date to the clinic to get checked out.
OK, But How Likely Are You To Get Pregnant?
Why hello there ladies who are really truly only worried about catching a tiny human from your partner. Thank you for meeting me over here at camera two. So you’re doing a great job using condoms, but perhaps you're wondering if you have to wrap his tool at the very beginning of penetrative sex.
As mentioned above, there is some conflicting research about the presence of sperm in pre-ejaculate. While some researchers haven’t found any viable sperm in pre-cum, one study found that a subset of men leak sperm into their pre-cum. The results of this study indicate that it’s not about how much pre-cum your partner makes, but whether he’s one of the lucky ones who doesn’t leak. Unfortunately, all available research has very small sample sizes, which means they aren’t really looking at enough men to tell us for sure what’s going on. If any research-minded readers want to answer this question once and for all, you will have generations of thankful couples throwing themselves at your feet for the duration of your career.
Further, while I'm never one to tell anyone to follow the crowd, I would be remiss not to tell you that the pulling out method is becoming a widespread method of birth control, with around one-third of young women in the U.S. reporting this method. Research shows that typical (translation: imperfect) pulling out pregnancy rates are around the same as typical (again: imperfect) rates with condoms with 27 out of 100 women getting pregnant each year. However, if you do it correctly every time, that number goes down to 4 out of 100.
In other words, the research shows that a bit of pre-cum (whether you catch it in that couple-minute window before you put on a condom or go for the full-on pulling out method) is not a no-risk activity, but does has a low risk of getting you pregnant. Talk to your partner about it and find your shared comfort level with the risks involved.
Weigh The Risks
If all this information freaks you out, well, that’s somewhat to be expected. When I start feeling this way, I like to think about the Risk or Harm Reduction model.
This model was created first to understand and support individuals who use drugs, and resulted in such enlightened interventions as needle exchange programs, where users can get clean needles to stop the spread of HIV and other blood-borne illnesses, without being castigated for the way they choose to live their lives. The model has since been adopted to support individuals who are engaging in sexual behaviors that put them at risk for STD infection.
Taking a Risk Reduction approach to your condom use (or non-use) means starting from the baseline knowledge that sex without condoms has a number of draws — yes, it feels great, and it can be more intimate and spontaneous. However, there are also a number of checks in the negative column: pregnancy when you don’t want it is never fun, and getting a STD can at minimum be an annoyance and at maximum result in a lifelong health struggle.
The Risk Reduction model recognizes that humans will do things to feel good, and urges that you couple your pleasure-seeking behavior with actions that help you minimize your risk of consequence. This is where the term safer sex comes from — sex is never completely safe, as the efficacy percentages of all contraception options will tell you and abstinence advocates will scream in your face.
The bottom line? Sex without a condom will always have risks. All sexual activity comes with risks (excuse me while I crawl into a human-sized bubble in the fetal position). It's up to you to collaborate with your partner (or partners) to figure out the amount of risk you feel comfortable taking on. And always remember: you are in charge of your own reproductive health. Don't let anyone tell you otherwise.
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