Dr. Lindsey Doe: There are all kinds of sexual behaviors - well over 150, but are any of them "safe"?

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This episode on safer sex is sponsored by Adam & Eve. When I first started sex educating, we would talk about "Safe Sex." The idea was that if you used a condom, or only had one partner, and you were both STI-free, then it was "safe" and you could go right on ahead with your sexy selves. But we were wrong. So we changed our language and message from "safe sex" to "Safer sex." This time to mean "it's safer with a condom than without one, and it's safer knowing your status than not, but neither are completely safe.

When the genitals come in contact with each other, mouths, anuses, toys, or miscellaneous shared objects, then there's risk. There are least five viruses, two ectoparasites, and one bacterium that are transmitted skin-to-skin, meaning even without exchanging body fluids or penetration, these eight infections pose a threat to your health.

If you count everything that's transmitted sexually, the list is much larger. 

Donovanosis is more common in tropical areas, like India, Guyana and New Guinea. There are only about 100 cases a year in the US. It's a bacterial infection, so it's curable, but if you let it go, it quote "slowly spreads and destroys genital tissue."

Cytomegalovirus is one that you can't cure. It stays with you for life, and many people have it without knowing. All of these highlighted sexually transmitted infections can be in your body without showing signs.

So how do you have sex with all these bugs about to get you? A cool strategy called "harm reduction."

Some of you just aren't going to abstain, which would be the safe option, so we aim to reduce the harm which is the "safer" option.

First, identify where your behaviors are on the continuum. Under no risk there's things like: dry kissing, embracing, massage, and sexting. Mutual masturbation, wet kisses, oral sex with protection, digital and manual play are low risk. Medium includes: vaginal/penile sex with a condom, unprotected oral, and anal with a condom. High: unprotected vaginal and sharing sex toys; and the highest being unprotected receptive anal sex. (Mainly because the inside of the anus is highly susceptible to tearing and has no protective layer to block pathogens.) 

The goal with harm reduction is to move a person towards the no-risk end in ways that they're willing to. It could be something like teaching them how to use a dam during cunnilingus (oral sex on a vulva) and analingus (oral sex on the anus.)

You can make your own dam with a condom by slightly unrolling it, removing the tip, cutting the band, then unrolling it. With non-microwavable cling wrap or with a glove, by removing the middle to pinky fingers, cutting along the pinky and then opening. Dams reduce the risk of face herpes from becoming genital herpes and yeast infections in the vagina from becoming  thrush in the mouth.

Shifting someone from highest risk to high risk is even achievable: add lube. Whoo! The anus doesn't naturally lubricate like the vagina and mouth, so adding a good quality lubricant to play time means less friction, fewer abrasions and more pleasure. Try putting lube in the tip of the condom, or on the outside. Or going with an in-condom that is already heavily lubricated on the inside and outside. In-condoms are similar to on-condoms, but have more coverage. These go in the inside of the body, like the vagina or the anus, and also cover some of the outside. That's less risk of chancroid, warts, and herpes.

If you're having a difficult time coming up with harm reduction options, have you considered: getting vaccinated for HPV, HepA, and HepB; getting tested and treated for STIs; talking with your partner about your results, taking medications like "PReP"; dry humping; fewer partners; regular check-ups; good hygiene; being assertive about safety; understanding your sexual identity; improving the quality of lower risk activities; being more prepared, and asking for help. Ask a sex educator for help! A good sex educator is going to help you identify where you are on the spectrum and work with you to slide you this way.

Adding pleasure, not taking it away! We want safer sex to feel amazing, because that will get you to do it again! Still don't believe me? Ask for harm reduction strategies in the comments and I'll leave you a response. I love problem solving great sex with lower risk! I love safer sex!

So does Adam & Eve. Their founder, Phil Harvey, started selling condoms by mail in 1969 as part of his masters thesis. It was so successful, Harvey began selling other sex-positive materials to customers and there you have Adam & Eve. If you visit adamandeve.com you'll find these condoms for safer sex with your toys, penises, to make into dams or blow up for entertainment. Samplers, ribbed,  their signature marathon pack, and my favorites. Promo code: DOE will get you 50% off of any one item and free shipping in the US. Let the safer sex company know you appreciate their support of Sexplanations and stay curious!