Safe sex
Safe sex is regarded as a harm reduction strategy aimed at reducing the risk of STI transmission.
[4][5] A year before the HIV virus was isolated and named, the San Francisco chapter of the Sisters of Perpetual Indulgence published a small pamphlet titled Play Fair!
It specifically named illnesses (Kaposi's sarcoma and pneumocystis pneumonia) that would later be understood as symptoms of advanced HIV disease (or AIDS).
In May 1983—the same month HIV was isolated and named in France—the New York City-based HIV/AIDS activists Richard Berkowitz and Michael Callen published similar advice in their booklet, How to Have Sex in an Epidemic: One Approach.
"[5] Although safe sex is used by individuals to refer to protection against both pregnancy and HIV/AIDS or other STI transmissions, the term was born in response to the HIV/AIDS epidemic.
It is believed that the term safe sex was used in the professional literature in 1984, in the content of a paper on the psychological effect that HIV/AIDS may have on gay and bisexual men.
[11] Although the term safe sex was primarily used in reference to sexual activity between men, in 1986 the concept was spread to the general population.
The book was entitled "Safe Sex in the Age of AIDS", and had 88 pages that described both positive and negative approaches to sexual life.
"Safer sex" is thought to be a more aggressive term which may make it more obvious to individuals that any type of sexual activity carries a certain degree of risk.
The term safe love has also been used, notably by the French Sidaction in the promotion of men's underpants incorporating a condom pocket and including the red ribbon symbol in the design, which were sold to support the charity.
However, non-penetrative sex may not protect against infections that can be transmitted via skin-to-skin contact, such as herpes and human papilloma virus.
[18][19] Oil-based lubrication can break down the structure of latex condoms, dental dams or gloves, reducing their effectiveness for STI protection.
One study has suggested condoms might reduce HIV transmission by 85% to 95%; effectiveness beyond 95% was deemed unlikely because of slippage, breakage, and incorrect use.
This includes birth control pills, vasectomy, tubal ligation, periodic abstinence, IUDs and many non-barrier methods of pregnancy prevention.
However, a technical report from 2001[40] by the World Health Organization has shown that nonoxynol-9 is an irritant and can produce tiny tears in mucous membranes, which may increase the risk of transmission by offering pathogens more easy points of entry into the system.
If used properly, spermicidal condoms can prevent pregnancy, but there is still an increased risk that nonoxynyl-9 can irritate the skin, making it more susceptible for infections.
[40][41] The use of a diaphragm or contraceptive sponge provides some women with better protection against certain sexually transmitted infections,[42] but they are not effective for all STIs.
Women with copper intrauterine device may be subject to greater risk of infection from bacterial infectious such as gonorrhea or chlamydia, although this is debated.
[43] Coitus interruptus (or "pulling out"), in which the penis is removed from the vagina or mouth before ejaculation, may reduce transmission of STIs but still carries significant risk.
Additionally, the microbes responsible for some diseases, including genital warts and syphilis, can be transmitted through skin-to-skin or mucous membrane contact.
[44] Unprotected anal penetration is considered a high-risk sexual activity because the thin tissues of the anus and rectum can be easily damaged.
Regardless of whether anal penetration occurs by using a finger or the penis, the condom is the best barrier method to prevent transmission of STI.
[54] When anal–oral contact occurs, protection is required since this is a risky sexual behavior in which illnesses such as hepatitis A or STIs can be easily transmitted, as well as enteric infections.
[56] In cases in which one of the partners is treated for an STI, it is recommended that the couple not use sex toys until the treatment has proved to be effective.
[60] Abstinence-only sex education programs have been found to be ineffective in decreasing rates of HIV infection in the developed world[61] and unplanned pregnancy.
