Infection Transmission

How Infections Get Passed Along

Not all STIs/STDs are transmitted the same way. Here are the basics about how infections can be passed through intimate play:

UNPROTECTED VAGINAL OR ANAL INTERCOURSE — HIGH RISK FOR

UNPROTECTED ORAL CONTACTS— HIGH RISK FOR

PLAY WITHOUT INTERCOURSE — RISK FOR

•        HSV
•        CMV
•        HPV
•        pubic lice
•        scabies

Lower-risk play includes

•        masturbation
•        mutual masturbation
•        erotic massage
•        body rubbing
•        kissing
•        deep kissing
•        vaginal intercourse with a latex or female condom
•        anal intercourse with a latex or female condom

If You Are a Woman...

In general, a woman's risk of infection is higher than a man's. The vagina and rectum are more easily infected than male organ. A woman's chance of being infected by a man with HIV is twice as great as a man's chance of being infected by a woman with HIV.

Women generally have fewer symptoms than men. You are less likely to know if you are infected. Lots of damage can be done — even if you have no symptoms.
Many women develop pelvic inflammatory disease (PID) because they don't know they are infected with chlamydia or gonorrhea. PID increases the risk of sterility and ectopic pregnancy, especially if untreated.

If You Are a Man...

STIs/STDs do not only affect women. You can also have an infection and not know it. And if an infection is left untreated, it can cause damage.
For example, chlamydia can spread from the urethra to the testicles and cause sterility.
If untreated, chlamydia infections in the testicles can cause reactive arthritis, which can lead to permanent disability.

When You Have a Checkup...

Don't assume you're getting tested for STIs/STDs. You need to ask your clinician to do it. Otherwise, it probably won't happen.
"Everybody is different. Everyone has to decide what risks they are prepared to take — then decide what to do." — a 26-year-old African-American woman

Outercourse

Intimate relations can be very satisfying without intercourse. There are a lot more than penetration. It's about exploring the many ways you can turn your partner on. It's exploring the many ways that you can be turned on.

Don't be shy about your pleasure. Partners who explore safer contacts may discover new excitements. They can be clear about how and where they like to be caressed. They help each other enjoy even more.

For many years, women and men were taught that "good relations" only meant having an orgasm during vaginal intercourse. Nothing could be less true. Most women don't have orgasms from vaginal stimulation.
Most women have them when the clitoris is stimulated. Men also enjoy play — even if they're shy about letting their partners know.

Alternatives

Kissing — Many people explore different ways of kissing. They may also explore kissing different body parts.

Masturbation — Many people enjoy masturbating — touching their own organs for pleasure. Partners can masturbate alone or together.

Erotic Massage— Many couples touch and rub each other's organs with their hands, bodies, or mouths.

Body-to-body Rubbing/Frottage — Many couples rub their bodies together for pleasure and orgasm.

Fantasy — Couples can read or watch stories or pictures together. It can also be exciting to share fantasies. People do it in person, on the phone or Internet, or through e-mail.

Toys — Vibrators,  and other toys can be used to explore and caress the body. Condoms need to be used if partners share the same toy. Follow the cleaning instructions that come with toys.

Condoms

Condoms are the best protection when enjoying sexual intercourse. Condoms help make pleasure last longer by preventing premature ejaculation.

(Written by Jon Knowles, Revised by Jennifer Johnsen, MPH)