Written by Lola Méndez
Practicing safer sex is important for your health, whatever your sexual orientation, because Sexually Transmitted Infections (STIs) don’t discriminate. Anyone who’s sexually active is at risk of catching an STI, especially if you don’t use protection. But having safer sex can be especially challenging for some members of the LGBTQ+ community.
The issue is the lack of inclusive sex education in schools. In fact, only 29 U.S. states have compulsory sex education, and a recent study by LGBTQ+ education activists GLSEN highlights that just 5 percent of LGBTQ+ students saw any representation in their sex-ed classes. In the U.K., Stonewall found just one in five pupils has been taught about safe sex in same-sex relationships.
This means when two people who have vulvas engage in sexual activities, for example, the odds are they didn’t learn in school about the importance of using dental dams or vaginal condoms to protect themselves from STIs. Others might question the need to use condoms at all if pregnancy is not a concern. You can read our LGBTQ+ birth control guide here.
To make safer sex the norm for everyone, we spoke to medical experts to find out exactly what LGBTQ+ people need to know about STIs, along with best practice for sharing sex toys and why it’s so important to have an open conversation with your partner about your sexual health.
Everyone deserves to have a fulfilling sex life, and ensuring your safety — and the safety of your partners — is a super important part of that.
“All STIs can be transmitted through oral, manual, and anal sex, which is why they’re called STIs and not penetrative infections or vaginally transmitted infections,” Dr. Sarah Yamaguchi, an LA-based gynecologist, tells Flo. “People just don’t think about sexual infections being transferred through manual or anal sex.”
The fact is, bodily fluids are where most STIs live. Chlamydia, gonorrhea, and syphilis can be passed from partner to partner through oral sex, as the Centers for Disease Control and Prevention (CDC) points out. That’s why practicing safer sex and having regular STI tests is so important.
Indigo Stray Conger, a bisexual sex and relationship therapist who works with the LGBTQ+ community in the U.S., says: “These conditions can have a serious impact on a person’s health, but if they’re detected early, they’re easily treatable.”
Human papillomavirus (HPV) and Herpes Simplex Virus (HSV or herpes) can also easily spread during oral sex. “HPV and HSV are relatively easy to transmit, particularly if a partner has a breakout or there are cuts/abrasions in a partner’s mouth,” Conger says.
Conger stresses that HPV and HSV can also be transmitted through manual sex, such as handjobs or fingering. “Risk is relatively low, particularly if a breakout is not present,” she explains. Using latex gloves or finger cots if you have any cuts or abrasions on your hand can significantly reduce the risk. “If manual stimulation is over clothing, the likelihood of contact with sufficient sexual fluid in a cut or abrasion to transmit an STI is extremely low,” she says.
HIV can also be transmitted orally or during manual sex through a cut or abrasion. Thanks to preventative medicines (AKA PrEP) and long-term HIV treatments, people with the virus can live long and healthy lives.
Developments in HIV treatment also mean that if you’re HIV-positive and undergoing antiretroviral therapy (ART), the virus in your bloodstream can be reduced to undetectable levels so you don’t pass it to others. This is what many people refer to as “U=U,” which means “undetectable means untransmittable.” When a person is undetectable, condoms aren’t required to prevent HIV transmission, but being undetectable does not protect against other STIs.
PrEP, or pre-exposure prophylaxis, can be taken by people who are HIV-negative before and after they have sex, in order to prevent them from getting HIV. PrEP makes sex safer because it contains tenofovir and emtricitabine, which are drugs used to treat HIV.
In the U.K., you may also hear PrEP referred to as Truvada. In the U.S., an alternative to PrEP, Descovy, has been approved. If you’re in the U.S., your health insurance should cover some of the cost of HIV treatment. The use of barriers, like condoms, in addition to PrEP can help protect from HIV transmission.
Remember too that most STIs can be transmitted anally. “Because the lining of the anus is thin, the skin is more likely to sustain a rupture during sexual activity,” Conger says. “Therefore, the risk of STI infection during anal sex is higher than when engaging in other kinds of sex.” That means barriers, such as condoms or dental dams, are a must for safe anal play. We’d also recommend using an anal safe lube to reduce the risk of cuts or tears.
“Oral-to-anal sexual contact without barriers can result in an E.coli infection for the partner using their mouth on the anus during sex or after giving a blow job to a partner whose penis has been used in unbarriered anal contact,” she adds.
If sex toys play a part in your sex life, Conger explains that you should consider using barrier protection methods with toys just like you would with genitalia. “Put a condom on a dildo or use a dental dam over an egg vibrator,” she says. “Never use toys both vaginally and anally, as this can cause infection.”
Always thoroughly disinfect a sex toy before — and after — using it on yourself or your partner. “Any sex toy that’s around the bodily fluid of another could introduce infection to you,” Dr. Yamaguchi says. She suggests washing your sex toys with warm water and gentle soap. “Treat your sex toys like you would sensitive hands,” she advises. “Don’t use harsh chemicals, since you don’t want them to transfer to you and irritate your skin.”
Safer sex starts in the bedroom. Barrier methods of protection, such as latex gloves, dental dams, or condoms, are great for preventing STI transmission.
“Get tested regularly if you have new partners in your relationship landscape — or one of your partners does — to minimize the risk of a more serious STI going undetected,” Conger says.
Getting tested isn’t a big deal — most STIs can be tested for with a swab or a blood/urine test that’s relatively quick and pain-free. Remember, talking openly about STI transmission prevention dispels myths and reduces stigmas, so there’s nothing to be ashamed of.
It’s no secret that communication is the key to better sex, but it’s also the key to safer sex. “If you cannot trust your partner to tell you truthfully if they’re with other people, then no matter how careful you are, you’re still going to be exposing yourself to risk,” Dr. Yamaguchi stresses. Finding a partner you trust — whether for a casual encounter or a committed relationship — will empower you to have safer and more enjoyable sex.
Conger echoes a similar sentiment, stating that unsafe sex is about more than STI risk. “Safe sex is knowing your boundaries and having the tools to communicate them well with a partner that you trust,” she says.
There are a number of platforms and advocacy groups that can provide advice and support around safer sex. We’ve shared links to them below.
Please note these resources are just for reference and are in no way associated with Flo
If you’ve been affected by anything in this piece or are struggling with your mental health and would like to speak to someone, Flo has gathered links to support services that might be helpful. Please visit this page for helplines in different countries.