Understanding sexual practices risk levels and prevention

Sexual practices and risk levels for Sexually Transmitted Infections (STIs) including Human Immunodeficiency Virus (HIV) infection

When counselling patients about safe sex, it is important to remember that STIs such as genital herpes, genital warts, pubic lice (crabs), and scabies are not necessarily prevented by condom use and may be transmitted by close body contact alone.

  • There is negligible risk for activities which do not involve transfer of body fluids, for example kissing, masturbation, massage.
  • Oral sex (cunnilingus, fellatio) poses a high risk for transmission of herpes simplex infection but its risk for other STIs is poorly defined.
  • Vaginal and anal sex pose a definite risk for all the STIs.
  • Condom use reduces the risk of transmission for all STIs.

Points on prevention

The following practices will provide some protection from STIs/blood borne diseases.

Condoms

Recommend the regular use of condoms with a water based lubricant, for example KY jelly, Wet Stuff.

Check-ups

Recommend:

  • STI check-ups when patients have been exposed to risk.
  • patients who have recently changed sexual partners that they use condoms for the first 3 months, and then have an STI screen. If the tests are negative the need for ongoing condom use within the relationship can be discussed.

Clean needles and syringes

Advise injecting drug users of needle exchange programs (Drug and Alcohol Services SA can be contacted for information on locations and times).

Only new needles, syringes and other injecting equipment should be used. Cleaning and bleaching used equipment does not protect the user against hepatitis C.

Clinical presentation

Suggest that people do not have sex if an STI is suspected until a negative diagnostic test. If an STI is diagnosed, suggest no sex until test of cure, or completion of medication.

Alternatives

To lower risk, suggest alternatives to penetrative sexual practices when condoms are not available.