Safe Sex Practices: A Comprehensive Guide
Evidence-based information about protecting yourself and your partners during sexual activity through safer practices, communication, and informed choices.
Medically reviewed by healthcare professionals
Last updated: April 2025
What Are Safe Sex Practices?
Safe sex practices (also called safer sex) are behaviors that reduce the risk of contracting or transmitting sexually transmitted infections (STIs) and prevent unintended pregnancy. These practices help protect the physical and emotional well-being of all participants while maintaining a satisfying sexual relationship.
Key Components of Safe Sex
- Physical protection - Using barrier methods and other preventive tools
- Communication - Discussing boundaries, desires, and health status
- Consent - Ensuring enthusiastic agreement to all sexual activities
- Regular testing - Knowing your status and encouraging partners to know theirs
- Risk awareness - Understanding the relative risks of different activities
- Sobriety - Making decisions with a clear mind
Physical Protection Methods
Barrier methods and other physical protection strategies are essential components of safer sex:
External (Male) Condoms
Proper Usage:
- Check the expiration date and package integrity
- Open the package carefully (don't use teeth or scissors)
- Make sure the condom is right-side out (it should look like a sombrero, not a beanie)
- Pinch the tip to leave space for semen
- Roll the condom all the way down the shaft
- After ejaculation, hold the base of the condom while withdrawing
- Remove the condom away from your partner
- Dispose of it in the trash (not in the toilet)
Material Options:
- Latex - Most common, highly effective
- Polyurethane - For those with latex allergies, slightly more prone to breakage
- Polyisoprene - Synthetic latex alternative for those with allergies
- Lambskin - Natural material, prevents pregnancy but NOT effective against STIs
Common Mistakes
- Using expired condoms
- Storing condoms improperly (heat damages them)
- Using oil-based lubricants with latex condoms
- Putting on a condom inside-out
- Not leaving space at the tip
- Using a condom that doesn't fit properly
- Re-using condoms
- Using two condoms at once (creates friction)
Internal (Female) Condoms
Internal condoms are inserted into the vagina or anus and provide an alternative barrier method.
Advantages:
- Can be inserted up to 8 hours before sexual activity
- Gives receptive partner control over protection
- Covers more external genital area, potentially offering better protection against some STIs
- Made of nitrile, so safe for people with latex allergies
- Can be used with any type of lubricant
- Can be used during menstruation
How to Use:
- Check the expiration date and package integrity
- Find a comfortable position (standing with one foot up, squatting, or lying down)
- Squeeze the smaller ring at the closed end and insert like a tampon
- Push the inner ring up as far as it will go, near the cervix
- The outer ring should remain outside the body
- Guide the penis or sex toy into the condom, not beside it
- After sex, twist the outer ring to seal in fluids and gently pull out
- Dispose of it in the trash
Dental Dams
Dental dams are thin, flexible squares of latex or polyurethane used as a barrier during oral sex on the vagina or anus.
How to Use:
- Remove from package and inspect for holes
- Place over the vulva or anus before oral contact
- Hold the dam in place during oral sex
- Use a new dam if you switch from oral-anal to oral-vaginal contact
- Never reuse or flip over a used dental dam
DIY Option
If commercial dental dams aren't available, you can make one from an external condom:
- Carefully unroll the condom
- Cut off the tip
- Cut along one side to create a rectangular sheet
- Place this over the genital or anal area for oral sex
Alternatively, you can cut a latex glove (cut off the fingers and cut along the side opposite the thumb) or use plastic wrap as a barrier (though this is less studied and potentially less effective).
Lubricants
Lubricants reduce friction, increase comfort, and can help prevent condom breakage.
Types of Lubricants:
- Water-based - Safe with all condoms and sex toys, may dry out quicker
- Silicone-based - Longer-lasting, safe with most condoms (except silicone toys)
- Oil-based - NOT safe with latex or polyisoprene condoms
- Hybrid - Combination of water and silicone
Important Considerations
- Never use oil-based lubricants (including petroleum jelly, baby oil, coconut oil) with latex or polyisoprene condoms
- Avoid lubricants with spermicide for regular use as they can cause irritation
- Some lubricants can affect vaginal pH and may increase risk of infections
- If trying to conceive, use fertility-friendly lubricants
Other Prevention Methods
Additional methods can complement barrier protection:
Pre-Exposure Prophylaxis (PrEP):
- Medication taken by HIV-negative people to prevent HIV infection
- When taken as prescribed, reduces the risk of getting HIV from sex by about 99%
- Does NOT protect against other STIs or pregnancy
- Available as a daily pill or, in some regions, as an injection
Post-Exposure Prophylaxis (PEP):
- Emergency medication taken after possible HIV exposure
- Must be started within 72 hours of potential exposure
- Not a substitute for regular prevention methods
Vaccinations:
- HPV vaccine - Protects against most types of HPV that cause cancer and genital warts
- Hepatitis B vaccine - Protects against hepatitis B, which can be sexually transmitted
- Hepatitis A vaccine - Recommended for men who have sex with men and some other groups
Communication and Consent
Physical protection methods are most effective when paired with open communication and clear consent.
Discussing Sexual Health
Talking about sexual health with partners is essential for safe sex:
Topics to Discuss:
- STI testing history and status
- Birth control methods and preferences
- Safer sex practices you want to use
- Boundaries and comfort levels
- Desires, preferences, and dislikes
Tips for Effective Conversations:
- Time it right - Have these conversations before becoming intimate, not in the heat of the moment
- Be direct and honest - "I'd like to talk about how we can protect each other"
- Use "I" statements - "I always use condoms with new partners" rather than "You need to wear a condom"
- Be matter-of-fact - Approach it as a health discussion, not an accusation
- Listen actively - Hear your partner's concerns and preferences
- Be prepared with information - Know where to get tested, how different methods work
- Respect differences - If you can't agree on safety measures, it may be best to postpone or reconsider sexual activity
Conversation Starters
- "Before we go further, I'd like to talk about protection. I always use condoms—is that okay with you?"
- "When was the last time you got tested for STIs? I was tested [time] ago and my results were [results]."
- "I care about both of us staying healthy. Can we talk about what we'll use for protection?"
- "I brought condoms/dental dams. Do you have a preference for what we use?"
Understanding Consent
Consent is a clear, enthusiastic, ongoing agreement to engage in sexual activity. It's a fundamental aspect of safe sex.
Key Elements of Consent:
- Freely given - Without pressure, manipulation, or under the influence of substances
- Reversible - Anyone can change their mind at any time
- Informed - Everyone understands what's happening
- Enthusiastic - Everyone actively wants to participate
- Specific - Saying yes to one activity doesn't mean yes to others
Consent Do's:
- Ask before initiating or changing activities
- Respect "no" or hesitation without question
- Check in regularly, especially with new partners
- Discuss boundaries before becoming intimate
- Pay attention to non-verbal cues (though these alone aren't sufficient for consent)
Consent Don'ts:
- Assume consent based on past experiences
- Pressure or coerce someone who's hesitant
- Ignore signs of discomfort or reluctance
- Assume consent for one activity means consent for all activities
- Seek consent from someone incapacitated by alcohol or drugs
Remember
Asking for consent doesn't have to be awkward or "ruin the mood." It can be incorporated into intimacy in ways that are respectful and even enhance the experience:
- "Do you like this?"
- "Is this okay?"
- "Can I...?"
- "I'd like to... How does that sound?"
- "Tell me what you'd enjoy."
Understanding Risk Levels
Different sexual activities carry different levels of risk for STI transmission. Understanding these differences can help you make informed choices.
| Risk Level | Activities | Protection Methods |
|---|---|---|
| No Risk |
|
Not needed for STI prevention |
| Lower Risk |
|
|
| Moderate Risk |
|
|
| Higher Risk |
|
|
Important Context
Risk levels vary based on several factors:
- STI status of partners - If both partners have recently tested negative and haven't had other partners, risk is much lower
- Viral load - For HIV-positive individuals with an undetectable viral load, the risk of transmission is effectively zero
- Proper use of protection - Consistent, correct use of barriers significantly reduces risk
- Pre-existing conditions - Open sores, cuts, or other infections can increase risk
Regular Testing and Treatment
Regular STI testing is a crucial component of safe sex practices, even when using protection consistently.
Recommended Testing Schedule:
- All sexually active people: Get tested at least once for HIV, more frequently if at risk
- Sexually active women under 25: Annual screening for chlamydia and gonorrhea
- Women 25+ with new or multiple partners: Annual screening for chlamydia and gonorrhea
- Pregnant women: Testing at first prenatal visit
- Men who have sex with men (MSM):
- Sexually active: Annual HIV and syphilis screening
- Multiple or anonymous partners: 3-6 month STI screening
- On PrEP: STI screening every 3 months
- Anyone with symptoms: Get tested immediately
- After unprotected sex with a new partner: Get tested
- After being notified by a partner with an STI: Get tested and treated as recommended
Testing Options
In-Person Testing:
- Primary care providers
- Sexual health or family planning clinics
- Community health centers
- College/university health centers
- Urgent care facilities
- Local health departments
At-Home Testing:
- Self-collection kits (mail to lab)
- Self-testing kits (results at home)
- Available for various STIs including HIV, chlamydia, gonorrhea
- Option for those who prefer privacy or have limited access to clinics
Treatment and Partner Notification
If you test positive for an STI:
- Complete the full course of prescribed treatment, even if symptoms disappear
- Abstain from sexual activity until you and your partner(s) have completed treatment
- Notify all sexual partners who may have been exposed
- Get retested after treatment if recommended by your healthcare provider
Partner Notification Resources
If notifying partners is difficult, several resources can help:
- Anonymous notification services through health departments
- Online tools like TellYourPartner.org or inSPOT.org
- Provider-assisted notification (where healthcare providers notify partners)
Safe Sex in Different Contexts
Long-Term Relationships
Safe sex practices in long-term relationships may evolve over time:
- Get tested together before considering changes to your protection methods
- Discuss exclusivity expectations and how you'll handle any changes
- Consider backup contraception if pregnancy prevention is important
- Maintain open communication about sexual health and preferences
- Revisit safer sex discussions if relationship circumstances change
Casual Encounters
For casual or one-time encounters, extra precautions are important:
- Always use barrier protection for all types of sexual contact
- Bring your own condoms/dental dams to ensure quality and availability
- Discuss safer sex practices before becoming intimate
- Minimize substance use that might impair judgment
- Consider PrEP if you have multiple or frequent casual partners
- Get tested regularly based on your level of activity
When Trying to Conceive
If you're trying to get pregnant, safe sex takes a different approach:
- Both partners should get comprehensive STI testing before trying to conceive
- Treat any infections before attempting pregnancy
- Consider ongoing protection if either partner has sexual contact outside the relationship
- Talk to a healthcare provider about specific recommendations for your situation
- For HIV-discordant couples (where one partner has HIV), discuss options like PrEP, U=U (undetectable = untransmittable), and sperm washing with a specialist
For Those with Chronic STIs
If you or your partner has a chronic STI like herpes, HIV, or HPV:
- Be open about your status with sexual partners
- Learn about transmission risks specific to your condition
- Follow medical advice about reducing transmission risk:
- For herpes: suppressive therapy, avoiding sex during outbreaks
- For HIV: antiretroviral therapy to achieve undetectable status
- For HPV: vaccination for partners who aren't already infected
- Use appropriate barriers based on your specific situation
- Regular check-ups to monitor your condition
Remember
Having an STI doesn't mean you can't have a healthy, satisfying sex life. With proper management, communication, and precautions, you can minimize risks to partners while maintaining intimacy.
Creating a Safer Sex Kit
Being prepared is key to practicing safer sex consistently. Consider creating a personal safer sex kit that includes:
Basic Kit Contents
- External condoms (in correct size)
- Water-based or silicone-based lubricant
- Dental dams or plastic wrap
- Latex or nitrile gloves (for manual stimulation)
- Alcohol-free wipes (for cleaning hands)
Additional Considerations
- Internal condoms (for receptive partners)
- Variety of condom sizes/types
- Non-latex options for those with allergies
- Birth control backup (if applicable)
- STI testing information or home test kits
- PrEP medication (if prescribed)
Storage Tips
- Store condoms and other barriers in a cool, dry place
- Avoid keeping condoms in wallets, glove compartments, or other places with temperature fluctuations
- Check expiration dates regularly and replace expired items
- Use a discreet container that protects contents from damage
Sources & References
1. Centers for Disease Control and Prevention. (2022). Sexually Transmitted Infections Treatment Guidelines, 2021.
2. World Health Organization. (2022). Safer Sex Practices.
3. American Sexual Health Association. (2022). Safer Sex Guidelines.
4. Planned Parenthood. (2022). Safer Sex.
5. Mayo Clinic. (2022). Sexually transmitted diseases (STDs) - Prevention.
6. Journal of Sexual Medicine. (2021). Barrier Method Effectiveness and Acceptability.
7. UNAIDS. (2022). HIV Prevention.