A
contagious disease that can be transferred to another person through sexual intercourse
or other sexual contact.
Transmission
of infection:
Many
of the organisms that cause sexually-transmitted diseases live on the mucous membranes
that line the urethra, vagina, anus, and mouth. Some also live on the skin.
Most
of the infectious organisms are transferred by direct contact with a sore or lesion
on the genitals or mouth. However, some organisms can live in body fluids without
causing a visible lesion and are transferred by contact with the body fluid. Sexually-transmitted
diseases are transmitted by both heterosexual and homosexual practices. They can
be transferred to another person during oral, vaginal, or anal intercourse. Some
sexual practices, such as anal intercourse, carry higher risk of transmission
of certain diseases than other sexual practices.
Some
STDs can also be transferred by direct, nonsexual contact with infected tissues
or fluids. A common mode of nonsexual transmission is by contact with infected
blood. For example, sharing needles when using IV drugs is a major cause of HIV
and Hepatitis B transmission. Other nonsexual means of transmission include contaminated
blood transfusions and blood products, through the placenta from the mother to
the fetus, and sometimes through breast feeding.
HIGH-RISK
BEHAVIORS
Definition:
Those
practices that increase the risk of acquiring a sexually-transmitted disease (STD).
Types
of behaviors:
High-risk
behaviors include:
having
multiple sexual partners (or changing sexual partners)
having (yourself) a
past history of any STD
having a partner with a past history of any STD
having
a partner with an unknown history of STDs
using drugs or alcohol in a situation
where sex might occur
having a partner who is an IV drug user
anal intercourse
having unprotected intercourse (sex without the use of a male or female condom)
with an unknown partner Drinking alcohol or using drugs increases the risk.
These behaviors increase the likelihood that a person will participate in high-risk
sexual activity. In addition, some diseases can be transferred through the sharing
of used needles or other drug paraphernalia.
High
risk groups include people that engage in sexual relations with multiple partners,
intravenous drug users who share needles, the sexual partners of those in high
risk groups, infants born to mothers with an STD, and people who received blood
transfusions or clotting products between 1977 and 1985 (prior to standard screening
for the HIV virus in the blood).
SAFER
SEX BEHAVIORS
Definition:
Taking
precautions, when participating in sexual relationships, that decrease the potential
for transmitting or acquiring sexually transmitted diseases (STDs).
Specific
examples of safer sex behaviors:
Abstinence
is an absolute answer to preventing STDs, although it is not always practical
or desirable.
A
monogamous sexual relationship with an individual known to be free of any STD
is probably the least risky approach that sexually active people can take. Know
your partner. Before having sex with a new partner, it is prudent for each potential
sexual partner to be screened for the presence of STDs, especially HIV and Hepatitis
B, and share the results of such evaluations with one another.
The
use of CONDOMS, both male and female types, markedly decrease the likelihood of
contracting a sexually transmitted disease but condoms must be used properly.
The condom should be in place from the beginning to end of sexual activity and
should be used EVERY time an individual engages in sexual activity with a nonmonogamous
partner or other suspect partner.
Other
measures:
Know
your partner.
Many people engage in sexual activity without first establishing
a committed relationship that allows for trust and open communication. You should
be able to discuss past sexual histories and any previous STD exposures or IV
drug use, as well as current health status, with the sexual partner. There should
be opportunities for either partner to initiate or terminate sexual activity,
without feeling coerced or forced into having sex.
Use
barriers to avoid contact with semen, vaginal fluids, or blood.
CORRECT AND
CONSISTENT USE OF A CONDOM (male or female condoms) is imperative. The additional
use of lubricants may decrease the chance of barrier breakage. However, use only
water-based lubricants because oil-based or petroleum-type lubricants can cause
latex to weaken and eventually tear. The use of latex condoms is recommended for
vaginal, anal, and oral intercourse.
Stay sober. The use of alcohol or
drugs may impair judgment, communication abilities, and the coordination required
to properly use barrier devises or lubricants. Alcohol and drugs can impair the
ability to make appropriate choices about sex.
Be
considerate of your partner.
People with AIDS or HIV infection should not
donate blood, plasma, body organs, or sperm. From a legal, ethical, and moral
standpoint, they should warn any prospective sexual partner of their HIV positive
status. They should not exchange body fluids during sexual activity and must use
whatever preventative measures (such as a latex condom) that will afford the partner
the most protection.
If
pregnant, take precautions.
Women with an STD should be counseled before becoming
pregnant about the risk to their infant. She should ask about medical care which
may help prevent the fetus from becoming infected. HIV positive women should not
breast feed their infant.
SUMMARY
In
summary, the implementation of safer sexual behaviors requires accurate information,
prior planning, and optimal communication between partners. With such measures
in place, couples can enjoy the pleasures of a sexual relationship while minimizing
the potential risks involved.
Note:
Some
individuals may also choose to extend the definition of safer sex behaviors to
include precautions to avoid undesired pregnancy. However, this text applies only
to the prevention of disease. For more information about prevention of pregnancy
see contraception/family planning.
Last
Reviewed: 12/5/2001 by Camille Kotton, M.D., Infectious Diseases Division, Massachusetts
General Hospital and Brigham and Women's Hospital, Boston, MA. Review provided
by VeriMed Healthcare Network.
