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close this bookWhere Women Have No Doctor - A Health Guide for Women (Hesperian Foundation, 1997, 600 p.)
close this folderChapter 12: Sexual Health
close this folderGaining More Control over Your Sexual Health
View the document(introduction...)
View the documentSafer sex for sexual health
View the documentMaking changes for safer sex
View the documentFeeling more pleasure from sex

Safer sex for sexual health

In the past, the main danger from sex was unwanted pregnancy. Now STDs, including HIV/AIDS, have become a serious sexual health problem.

STDs are caused by germs that are passed from one person to another during sex. Some STDs, like genital warts and herpes, are spread by germs on the outer genitals of an infected person. Other STDs are passed by contact with germs in a man’s semen, the liquid in a woman’s vagina, or blood. Infection can happen when the germs pass through the cervix into the womb, or through breaks in the skin - especially in the vagina, onus, tip of the penis, or mouth.

¨ Safer sex can save your life.

Because STDs are spread through sexual contact, avoiding direct contact with an infected man’s genitals, semen and blood is the best way to avoid getting an STD. This is called ‘safer sex’.

When should a woman practice safer sex?

Everyone should always have sex safely. Women have many different kinds of sexual relationships. Some have one faithful sex partner their entire lives. Others have one sex partner at a time but several partners over the course of their lives. And others have multiple partners (or their partners have multiple partners) at one time. This means different women have different risks of getting STDs.

Many women think they are not at risk for an STD if they have just one sex partner. This is true ONLY if you and your partner know for sure that neither of you already has an STD, and that both of you have sex only with each other

Most women cannot be sure of this because:

· it is possible to have an STD and not know it. If a woman’s past partners - or her partner’s past partners - had an STD, she or her partner could have one, too.

· they do not know for sure that their partner does not have other sex partners now. If someone your partner has sex with has an STD, you can get it too.

You can be infected by past partners - and your partner’s past partners.

Fma’s story: Every woman should protect herself

Fma lives in a rural town called Belem - and she is dying of AIDS. When she was 17, she married a man named Wilson. He was killed a few years later in an accident at the cooperative where he worked. Fma had to leave her baby with Wilson’s parents and go to the city to find work. When she had extra money, she sent it back home. The work was hard, and she was very lonely.

When she learned that the government was building a highway near Belem, Fma got a job cooking for the road construction workers so that she could stay at home. It was there that she met Emanuel. He was handsome, had cash in his pockets, and charmed her little girl when he came around after work. When the work crew had to move on, he promised to return.

Emanuel did come back, but he never stayed long. He got a new job driving trucks that kept him on the road most of the time. Fma thought he probably had other women, but he always told her she was his only one. They had a baby boy, but he was small and sickly and died after a year. Soon Fma began to feel sick, too. The nurse at the health post gave her different medicines, but nothing helped. Finally she went to the hospital in the city. They did some tests, and later told her she had AIDS. When she asked how she could have got AIDS, the doctor replied, “You shouldn’t have slept with so many men.” Fma did not think she was at risk for HIV/AIDS - she had only had sex with 2 men in her life! She thought that only prostitutes and homosexuals in the cities got AIDS.

Practicing safer sex means using barriers that keep germs from being passed between you and your partner during sex (safer sex methods), and having sex in ways that make infection with an STD less likely (safer sex practices).

Safer sex methods condom for women

Using condoms for either men or women can protect you from STDs, including HIV/AIDS. If they are used correctly, they keep a man’s genitals and semen from touching your genitals. Condoms can also prevent unwanted pregnancy.

¨ The more often you use a condom, or avoid sex in the vagina or anus without one, the less likely you will be to get AIDS.


Note: Spermicides - chemicals that kill sperm - used alone or with a diaphragm, also provide some protection against the germs that cause gonorrhea and chlamydia.

To encourage your partner to use condoms:

If he says...


try saying...

It will not feel as good.

It may feel different, but it will still feel good. Here, let me show you.

You can last even longer and then we will both feel good!

I do not have any diseases.

I do not think I have any, either. But one of us could and not know it.

You are already using family planning.

I would like to use it anyway. One of us might have an infection from before that we did not know about.

Just this once without a condom.

It only takes one time without protection to get an STD or HIV/AIDS. And I am also not ready to be pregnant.

Condoms are for prostitutes. Why do you want to use one?

Condoms are for everyone who wants to protect themselves.


Do what you can to make sure that you both enjoy having sex with a condom. That way, it may be easier to get him to use one the next time.

Safer sex practices

Sexual practices in which there is less contact with a man’s semen are also less likely to spread STD germs, including HIV. The box below shows which kinds of practices are safer than others. Sex with the penis in the vagina (vaginal sex) is the most common kind of sexual practice for many men and women. But other couples give and receive sexual pleasure by using many different kinds of talk and touch. If your partner does not want to use condoms, try to get him to have other kinds of sex with you. These other practices may feel just as good to him - and mean less risk for you.

¨ Moke sex safer:

· Use a latex condom every time.
· Replace risky practices with touching and kissing.
· If you cannot use a condom, it is better to use spermicide alone or with a diaphragm.

Some kinds of sex are safer than others

Kissing. Kissing mouth-to-mouth is safe, even if your mouths are open or your tongues touch. But if you or your partner has a sore in the mouth, you should wait until the sore has healed.


Touching. Touching is always safe, as long as neither person has blood, discharge, or sores on the genitals or hands.


Oral sex. Oral sex is much safer than vaginal or anal sex. But the less time you have semen in your mouth, the better. So, if the man ejaculates into your mouth, you should swallow or spit right away, and rinse your mouth afterward. If you get a sore throat a couple of days after having oral sex, be sure to have it checked by a health worker. You can get gonorrhea in your throat and herpes sores in your mouth. The safest way to have oral sex is if the man’s penis is covered with a condom before you take it into your mouth.


Vaginal sex. Vaginal sex is less safe than oral sex, but safer than anal sex. Always use a condom to keep the semen from touching your vagina. If you cannot, try to have the man withdraw his penis before he ejaculates. You can still get HIV and you can still get pregnant, but it is safer because less semen gets into your body.


Anal sex. Sex in the anus is very dangerous because the skin there tears even more easily than the skin in the vagina. If you and your partner have anal sex, it is important that you use condoms and make the anus wet first. Never have sex in the vagina after having sex in the anus without the man washing his penis first, or you could get an infection.


Avoid ‘dry sex’. In some places people prefer to have sex when the vagina is very dry, so some women put herbs or powders in their vaginas or douche before sex. But if the vagina (or anus) is dry or irritated, it will tear easily during sex and make infection more likely. You can make the vagina less dry by not using powders, herbs, or douches, and by taking more time with sex to allow the body to make more of its own wetness. Or use saliva, spermicide, or lubricant to make the vagina slippery so the skin will not tear Do not use oil or petroleum gel, which can make a condom break.