Get creative. Explore your options for sexual pleasure and intimacy.
First, learn about your sexual anatomy, how it works, and what feels good to you. Many of us fall short in this area. In fact, we often know a lot more about our other body parts. But, if we get informed, we can feel more "at home" in our own bodies, and with our sexuality.
When it comes to sexual expression, there's a big menu to choose from — such as kissing, touching, laughing, talking, massaging, holding each other, masturbating, oral sex, vaginal intercourse, and anal intercourse. And, you can engage in sexual activities with partners, or on your own (also known as masturbating).
Learn about the options, and find out what is most satisfying to you. What you like and don't like may be different than someone else. And, what feels good to you might change over time, or in different situations. So, keep checking out the options throughout your life.
Value and respect each other when you're intimate. Be sure that your partners verbally consent — freely and positively — to being sexually involved with you. Also, only engage in sexual activities that feel good to both of you. (See Action Step 3 to learn more about consent.)
Get up to speed on sexually transmitted infections (STIs), including HIV.
If you share body fluids with a partner, you can easily share STIs, including HIV. It's that simple. It's kind of like sharing the common cold or flu. It's just that it happens through sexual contact, and through semen, blood, or vaginal fluids. In fact, anyone who has unprotected vaginal, oral, or anal sex (without a condom) or who shares needles is at risk.
STIs and skin-to-skin contact. Some STIs, such as herpes, HPV, and syphilis, can be transmitted through skin-to-skin contact with an infected area or sore. Usually this happens when your genitals touch your partner's genitals or genital area.
While condoms can prevent many STIs, you can still get these specific STIs even if you use a condom. That's because condoms only cover the penis. Sores, rashes, or bumps can exist anywhere on a person's genitals. (However, these STIs are not transmitted through simple contact, such as holding hands.)
Usually, you can't tell if someone has an STI by looking. Many of these infections don't show any signs or symptoms. Either you or your partner could have an STI, and not even know it. And being with just one partner, or knowing your partner for a long time, doesn't protect you. Testing is the only way to know for sure.
STIs can be cured or managed. There's good news — bacterial STIs, like chlamydia, can usually be cured with antibiotics, while viral STIs (like HIV or herpes) can be well-managed with medications. (To learn more about recommended STI testing, go to Action Step 5.)
STI testing is good, but not enough. Keep in mind that STI testing alone doesn't protect you from future infections. If you are diagnosed with a new STI, you should tell your partner right away so that they can get tested and treated. And, most people still need to practice safer sex (e.g., use a condom) to avoid future infections.
Don't forget HIV is also an STI: HIV (human immunodeficiency virus) is still a serious problem in the U.S. Like most other STIs, HIV is usually transmitted through unprotected sex or sharing needles. But thanks to HIV testing, many people are getting early care and treatment, and living much longer and healthier lives.
The Centers for Disease Control and Prevention (CDC) recommends that everyone get tested for HIV at least once between ages 13-65, and more often if you're at risk. Currently, many tools are available to prevent HIV infection, including safer sex practices, condoms (male and female) and highly effective medicines that can prevent transmission. (See the Resource List at the end of this step.)
What's the difference between an STI and STD? "STI" stands for sexually transmitted infection and "STD" stands for sexually transmitted disease. "STD" used to be more common, but now people are often using the term "STI." Many believe "STI" is more accurate since people might have an infection that doesn't lead to disease or show symptoms. In fact, many STIs can be easily treated and cured. However, some STIs, like HPV, can lead to disease, such as cervical cancer.
Understand the risks of different sexual activities.
There are so many ways to express yourself sexually. And, these options have different levels of risk when it comes to sharing STIs, including HIV. But, you can learn about the risks, make informed choices that work for you, and take steps to protect your sexual health.
Different Sexual Activities: What's Your Risk of Getting STIs?
| Level of Risk | Activities |
|---|---|
| No risk | Abstaining from sexual activities (including vaginal, anal and oral sex), talking, clothed cuddling, masturbating, using sex toys by yourself |
| Lower risk | Kissing, fondling, touching, massage, "dry sex," (e.g., rubbing bodies together with clothes on), masturbating at the same time |
| Medium risk | Unprotected* oral sex, genital-to-genital rubbing together (no clothes on), sharing sex toys without cleaning |
| Higher risk | Unprotected* anal or vaginal intercourse |
* Unprotected sex means that you have anal, oral or vaginal sex without a male or female condom, or a dental dam (or dam). A dam is a thin square piece of rubber — usually made of latex — that can be used as a barrier during oral sex.
Make safer sex standard practice.
Safer sex means taking steps that can greatly reduce your risk (and your partner's) of getting an STI, including HIV, and/or of becoming pregnant. It can include choosing lower risk sexual activities, using condoms, dams, and/or other birth control methods.
Safer sex also means getting tested for STIs, and telling your partner if you currently have one before you get physical. If you have a viral STI, like herpes or HIV, you can take medicines and other steps to reduce the risk of sharing these infections. (See tips in chart below).
Note: it's called "safer" sex since only abstinence from sexual activities is 100% safe. But, practicing safer sex can greatly reduce your risk.
Making Sex Safer: Some Practical Guidelines
| Type of Sex/Health Status | Actions you can take to reduce risk |
|---|---|
| Oral sex (mouth on vagina, penis, or anus) | Use male condoms (latex or polyurethane) or dams |
| Vaginal intercourse (penis in vagina) |
Use male condoms (latex or polyurethane) or female condoms to prevent STIs and pregnancy. Can use water-based or silicone-based lubricants with condoms. Use other forms of birth control to prevent pregnancy. For dual protection against pregnancy and STIs, use condoms along with another birth control method. |
| Anal intercourse (penis in butt/anus) | Use male condoms (latex or polyurethane) and lubricants (water or silicone-based). Use a female condom. |
| Using sex toys (e.g. dildos, vibrators, strap-ons, butt plugs) | Clean toys before and after every use (follow the toy's instructions). If it will fit, put a condom on the toy and change it every time the toy is shared between partners or used in/on different parts of the body. |
| If you have HIV | Take antiretroviral therapy (ART) every day. This can reduce the risk of passing HIV to your partner by up to 96%. You can also use condoms, and get tested regularly for STIs. |
| If you don't HIV, but your partner has HIV | Take PrEP, a daily pill, which can reduce your risk of getting HIV by 92% or more. Get tested for STIs, including HIV, regularly. Use condoms. |
| If you have genital herpes | Take antiviral therapy (reduces outbreaks by up to 50%), avoid sex during outbreaks, and use condoms. |
| If you were just diagnosed with an STI | Tell your partner and encourage them to get tested, complete all medication/treatment, and get the OK from a healthcare provider before having sex again. |
Plan ahead. Don't wait for the heat of the moment. It's much easier to think clearly outside of the bedroom, before you get sexual with someone. Think about which sexual activities appeal to you, along with your boundaries. Bring condoms with you. (And, if you're using other birth control, make sure you start using it and that it's providing protection before you have sex.)
Talk with your partner(s) about safer sex, and the steps you'll take to protect each other. Whether it's a casual hook-up or a long-term relationship, you should both be on the same page when it comes to safer sex. And, remember — you always have the right to enjoy a safe and worry-free sex life. (See Action Step 3 for tips on having the conversation.)
Keep your wits about you. People often say that drinking alcohol helps them relax or even feel a little sexier. But, the truth is, too much can reduce your pleasure, and have a negative effect on sex.
Using alcohol and drugs might also lead you to do things you wouldn't normally do, and cloud your judgment when it comes to safer sex. It can weaken your decision and ability to use protection. Also, it's a lot easier to talk clearly about consent, safer sex, and your boundaries when you have a clear head.
Bring your own condoms — they are more popular and better than ever.
Condoms come in a variety of styles, flavors, and textures. And, many people say that feeling safe makes sex more fun, and relaxing. Condoms (both the male and female versions) are unique — they are the only method that protects against both STIs, including HIV, and pregnancy.
Men and women — you can easily carry condoms with you, so you're always prepared, even at a moment's notice. For the best protection, use condoms correctly every time you have sex.
Where can I get condoms?
Anyone — of any age — can buy male condoms without a prescription. They don't cost much, and you can get them at drug stores, supermarkets, convenience stores, or online. Public health or family planning clinics also often provide them for free.
Most women can get female condoms free-of-charge if they have health insurance. Get a prescription from your health care provider and then have it filled at your pharmacy. If you don't have insurance, you might qualify for free or low-cost female condoms. (See the Resource List at the end of this step.)
What types of male condom should I buy?
If you're using male condoms, choose condoms made out of latex or polyurethane. These condoms protect you from STIs and pregnancy. "Natural" condoms — made out of lambskin — protect against pregnancy but not against STIs, including HIV.
Make sure your condoms are not expired, store them in cool places, and only use water-based or silicone-based lubricants with them. (To learn more about how to use condoms correctly, see the Resources List at the end of this step.)
What is the female condom?
The female condom (sometimes called an internal condom) is a thin, loose-fitting rubber sheath that is inserted into the vagina, and held in place by two rings. Like the male condom, it provides a barrier to fluids, and can prevent both STIs and pregnancy. The female condom is made of nitrile, which is a safe, synthetic rubber. It is latex-free and hormone-free.
Since it can be inserted up to eight hours in advance of sex, it allows partners to have interruption-free sex. It can also be used for anal sex after removing the inside ring. To see what it looks like and learn how to use it check out the Resource List at the end of this step. It's best to practice inserting it a few times before you use it for real.
Are there other barriers for oral sex?
If you're having oral sex, other barrier methods, such as dams and latex gloves, can also reduce your risk. Dams are fairly inexpensive but can be hard to find. Your local family planning clinic may have them (just ask!), or you can buy them online. It's also really easy to make your own from a latex condom.
Do condoms prevent all STIs?
Condoms are best at preventing STIs — such as HIV and chlamydia — that are spread through body fluids. Condoms are less effective at preventing STIs that are spread by skin-to-skin contact, such as herpes, because condoms might not cover all of the infected areas. Yet, they still provide good protection, and are the best option available.
Take charge of your birth control.
Most women (who have sex with men) spend 30 years trying to avoid pregnancy, and just five years trying to get pregnant. But, 85% of women who don't use birth control will get pregnant within one year. Since most men only want to become fathers when they are ready, they can also play a key role when it comes to birth control.
The good news for women? There are many safe, effective, and easy-to-use methods that allow you to plan your pregnancies. Before you have sex, explore the wide range of options, talk with your health care provider, and find a method that's right for you.
Guys, there's also plenty for you to do. You can support your partner's decision to use birth control, pay for half of the cost, use condoms, and/or get a vasectomy, if you don't want to have children.
And, keep in mind that only one form of birth control — the condom — also prevents STIs, including HIV. All other methods only prevent pregnancy.
Consider highly effective, low maintenance methods
Many women use the IUD (Intrauterine device) or the implant, and like their "set it and forget it" quality. An IUD is a small t-shaped device that is inserted into the uterus. The implant is a very small rod inserted under the skin in a woman's arm.
These methods are safe, and over 99% effective in preventing pregnancy. Once they are in place, you are all set, and usually don't need to do anything for years. (And, only you have to know that they are in place). If you decide that you want to get pregnant, your health care provider can easily remove either method. These methods are often called LARCs — long-acting, reversible contraceptives.
Other effective methods are also available
Other safe, highly effective birth control methods include shots (e.g., Depo-Provera), oral pills, the patch, and the ring. When used by people in real life (typical use), the pill, patch, and ring are 91% effective (9/100 women will get pregnant each year). Shots are 94% effective in preventing pregnancy (6/100 women will get pregnant each year).
Hormonal birth control, such as the pill, patch, ring, and shots, can have other valuable benefits. These methods can reduce heavy menstrual bleeding and pain, prevent some cancers, and decrease acne.
Withdrawal is not very reliable
While many straight couples use withdrawal at some point, this method often fails to prevent pregnancy. In fact, at least one in five women who use withdrawal will get pregnant each year. (In contrast, only one in 100 women who uses an IUD will get pregnant). And, withdrawal offers zero protection from STIs.
Male and female condoms can prevent pregnancy
With typical use, the male latex condom is 82% effective (18/100 women will get pregnant) and the female condom is 78% effective (22/100 women will get pregnant). However, with perfect use, the male condom can be up to 98% effective, while the female condom can be up to 95% effective. ("Perfect use" means you use it correctly every time you have sex).
Consider using dual protection
Using a condom and another effective birth control method can help prevent both STIs, including HIV, and pregnancy. Guys, you can help out by being prepared with condoms and using them, while women can be on another type of effective birth control at the same time.
Can I get birth control for free?
If you have private health insurance or Medicaid, you should be able to get birth control for free (except for male condoms). If you don't have health insurance, you can often get birth control at low or no cost at family planning clinics, Planned Parenthood clinics, or community health centers. (See Action Step 5 to learn more.)
You can still date and have a sex life after an STI diagnosis.
You can still date, be in relationships, and have sex, but you should take extra steps to protect you and your partner. Specific guidelines for safer sex depend on the type of STI you have.
Just diagnosed with a new STI?
You should tell your current partner(s) right away. Encourage your partner(s) to get tested, and if needed, to get treated. Most bacterial STIs, like chlamydia, gonorrhea and syphilis, can be easily cured with simple antibiotics. Once you've been fully treated, ask your health care provider when it's ok to start having sex again, and consider using condoms and/or dams to protect both of you in the future. (See Action Step 3 for tips on talking with your partner.)
What if I have a viral STI?
If you have a viral STI, such as herpes, HIV or genital warts, you should tell your partner(s) before you become sexually involved. These are lifelong infections that can be managed, but can't be cured. It's up to your partner to consider what risks they are willing to take. If you decide to be sexually involved, you can discuss and agree upon the steps you will take to protect each other.
- For example, if you have herpes, taking antiviral medication, using condoms, and avoiding sex during outbreaks will reduce the risk of giving this infection to your partner.
- If you have HIV, taking antiretroviral medicine every day can reduce the risk of infecting your partner(s) by up to 96%.
- And, if you don't HIV, but your partner does, you can take a daily medicine called PrEP to reduce your risk of getting HIV by over 92%.
Note: Even if you already had sex with your partner, you should tell them that you have an STI. Quite simply, it's the right thing to do. If they’re concerned, they can get tested and you can make decisions together moving forward. (See Action Step 3 for more advice).
Things happen. What if I have unsafe sex?
Sometimes things happen in the heat of the moment. Or, you might worry that your birth control and/or condom failed. If you were sexually assaulted, you might have been forced to have unprotected sex. In each case, there are medications that can help you avoid HIV and unplanned pregnancy.
For women who had unprotected vaginal intercourse, but don't want to get pregnant:
- You can take Emergency Contraception (EC) pills. Several types of oral EC pills are now available over-the-counter at drug stores without a prescription to anyone. EC can greatly reduce the risk of becoming pregnant, but it must be taken within five days of unprotected sex. It's best to take it as soon as possible.
- Or, you can have a copper IUD inserted within five days of unprotected sex. It is 100% effective in preventing pregnancy, and can be left in place for up to twelve years.
If you had unprotected sex and are worried about getting HIV, talk with your health care provider about taking PEP (post-exposure prophylaxis). This medicine can help prevent HIV infection. To be effective, it should be taken within 72 hours of possible exposure to HIV, but the sooner the better.
If you had unprotected sex and you think you're at risk of contracting other STIs, you can get tested. To help make sure the results are accurate, ask your health care provider how soon you should be tested. After you’ve been exposed, it might take from one week to three months for the STI to be detected by a test.