20,000 condoms and counting

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Now that Pride weekend is behind us, I think it’s a good time to have another “check-in” regarding sexual health. A lot of patients disclose to me that they tend to engage in more sexual activity during Pride weekend due to all of the social events and celebrating that surrounds the weekend. In many ways, this is a mindset. With this is mind, I think it is fair to say that what happens during Pride weekend doesn’t always stay at Pride weekend … in other words, this could be a good time for everyone to reflect on any risky sexual behavior they may have engaged in over the weekend, and perhaps get some testing done.

I was very pleasantly surprised to hear that one agency distributed well over 20,000 condoms at the Pride Festival. My hope is that they are all going to good use, or rather they are being used and not just tossed in the garbage or on the streets. I often hear from patients that they don’t consider condom use during sexual activity and they don’t want to hear about condoms from public health officials. Patients now use terminology like “condom fatigue,” which speaks to a growing apathy, particularly within the gay community about condoms. This apathy seemed to follow the height of the HIV and AIDS epidemic where people were dying and there was a lot of fear around HIV. Fortunately, with the advent of HIV antiretrovirals, the face of HIV has changed dramatically since the 1980s and ’90s, and I find that men want to reclaim their own sexual paradigms.

The Salt Lake County Health Department certainly endorses condom use, particularly for individuals who have multiple sex partners, as one of the best ways to stay healthy and disease free. Public health care also recognizes that when it comes to sexual behavior and risk, people need to be able to choose and develop their own plan; the hope is that at the very least, everyone is informed about disease transmission and empowered with the facts.

The facts are simply that anyone can have a sexually transmitted disease (STD), including HIV and not know it. You cannot tell if someone has an STD or HIV by simply knowing or looking at them. The majority of people with an STD have no symptoms at all. STD’s do not discriminate;  anyone who has ever been sexually active may have an STD. You can get an STD during anal or oral sex, you can also get an STD during anal sex if someone pulls out before he ejaculates.You can get an STD from rimming and from mutual masturbation; although, these last two sexual activities are not going to transmit HIV. Having an STD, such as chlamydia, gonorrhea or syphilis, dramatically increases your risk of getting HIV.  The reason for this is the fact that bacterial infections cause an inflammation of the membranes in the genital and reproductive tissue that makes them more susceptible to HIV.

When used appropriately and when used 100 percent of the time during anal and oral sex, condoms have a 97.9 percent risk of protecting you from an STD. These odds are quite good. If condoms are not an option for you, you need to recognize that your risk of getting an STD is much higher and therefore you should be be tested for all STDs at least twice a year.  Using lubricant regularly during rectal intercourse and during any masturbation is a risk-reduction method.

If you have multiple sex partners, your risk of getting an STD is increased. Knowing your partners does not make it any safer than not knowing your partners. If you have multiple sex partners, your risk is high and you should be tested for all STDs at least twice a year.  A risk-reduction activity that you should take when you have multiple partners is to simply ask each of your sexual partners to be tested for all STDs at least twice a year, and agree to let each other know if anyone tests positive, so that everyone can be treated around the same time. If everyone gets tested during the same time period, say around the same week, there is a better chance of getting everyone treated quickly before re-exposures can occur.

If you have a primary partner with whom you engage in unprotected sex, and you also have sexual partners outside of the relationship, you can reduce your risk of getting an STD by always using condoms with your sexual partners outside of the relationship. This way you are not as likely to bring any diseases back to the sexual relationship between you and your primary partner, where there is high vulnerability due to the unprotected sex. It is also important to know that you can get an STD such as chlamydia, gonorrhea, syphilis, HPV or herpes during unprotected oral sex. I often counsel patients that it is safer to engage in protected rectal sex, than unprotected oral sex.

This is just a quick briefing around safer sex. One of the best things that you can do for yourself is to value your sexual health and have a good plan. If you have any questions regarding ways to reduce your risk of acquiring an STD and would like to speak with a counselor one on one about this, or if you simply want low cost STD testing, please call the Salt Lake County Health Department STD clinic at 385-468-4242.

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