Widening the spectrum of safer sex through barriers and behaviours.

When it comes down to “getting down”, there is a whole world of opportunity that I haven’t even touched on. Maybe that’s a part of only being a couple years into exploring my sexuality and the communities that surround being a young gay man, or, as I’m learning, it may just be a lack of exposure. I once  knew that sex with a condom was safe, and sex without one wasn’t. That was that.

I can assure you that nowadays there are a lot more types of people who have a lot more types of sex. Consequently my conversations have expanded to include a lot more than just condoms when it comes to talking safer sex. Some of these prevention techniques are things most people will understand from their name, others might take a little more explaining, but we all know that when it comes to choosing what protection is realistic when it comes to sexual pleasure, not all choices are real options.

Barriers

We have started to accept that there are people who have allergies to latex; so we give them latex-free condoms and send them on their way. We have accepted that there can be gender dynamics that inhibit condom negotiation for receptive partners (or because their partner doesn’t find them comfortable, is “too big”, or can’t stay erect with a condom on) so we give them an insertive condom and send them on their way.

Since we’ve started to talk about it… there are a million and one excuses that people have not to use a condom. From allergies and availability to comfort and cock size, I’ve heard it all and have retorts to them all as well, but when it comes down to it, people who don’t want to use condoms, won’t be using condoms. Does this mean all these people are irresponsible? No.

There are a good number of people out there for whom some of these excuses are a very real issue, especially when it comes to availability and comfort. Don’t get me wrong, we are lucky to have as many places giving out free condoms (such as here at HIV Community Link) as we do, and convenience stores on every corner for those people who can afford them, but those are only really handy when the clothes are still on and the mood isn’t being killed.

Behaviours

Whether it’s that awkward conversation with your parents about the birds and the bees, or a linguistic overhaul at the Centre for Disease Control, the language of our prevention messages aren’t just responsible for not transmitting diseases, they also prevent shame and stigma when talking about our sexual health. There are a lot of people to thank for condoms not being the only messaging that we use when we talk about sexual safety and HIV prevention; our kinky crowds, our toy teasers, our lesbian lovers, our PrEP poppers, and all of our advocating allies, amongst others. And so begins the conversation on condomless sex that is, remarkably, not inherently unsafe or unprotected.

Consider the previous post here on the A Word about undetectable viral loads. In the context of harm reduction, engaging in sexual acts with an HIV positive person who is on medications and has an undetectable viral load has reduced your risk of transmission compared to having the same sex with someone who does not have an undetectable viral load… this is safer sex.

Let’s stay with this person and talk even safer sex. The concept of strategic positioning is something that I have only recently come to know well. What it refers to is the intentional choice of a person living with HIV, particularly in sexual acts involving two or more men, to be the receptive partner. By doing so, the surface area of exposed points of contact for HIV transmission is minimized… this is safer sex.

These situations are all possible thanks to the people who are being tested on a regular basis and are disclosing their statuses with sexual partners. Testing leads to safer sex. But we all know that not all of us have been tested with each partner that we have been with and lapsed the waiting period for HIV anti-bodies to be detectable in the bloodstream. I’m talking here about the people who are tested and have a confirmed HIV-negative test result but engage with sexual partners who may not know their HIV status. By taking anti-retroviral medications in the form of pre-exposure prophylaxis or PrEP, HIV-negative people who are having sex with HIV-positive or HIV-unknown partners are able to prevent HIV from taking hold in the body following an exposure… this is safer sex.

So what is safer sex? It is a spectrum of barriers and behaviours, choices and chances that, when given consideration and put into place with considerable education, reduce the risk of transmission of HIV and other STIs. Sex without a condom is no longer necessarily unprotected sex, and our conversations around how we manage having safer sex are broadening to include the realities of many people for whom, due to allergies and availability, comfort and cock size, or pleasure and preference not all safer sex choices are choices at all times.