Barrier methods
Barrier methods are an effective way to prevent, or reduce the risk, of STIs. They work by physically stopping an infection from being passed from one person to another.
Even during a single sexual encounter, there are times where you might need to use a new barrier, such as moving from vulva play to arse play. If you are having sex with multiple partners during a session, you are going to need multiple barriers and change them between partners!
Barriers are most commonly made of latex, but there are alternatives (like nitrile) available for those with latex allergies.
Need safe sex supplies?
If you live in NSW and you’re LGBTQ+, ACON can send you a free play pack!
The rest of this section will focus on reducing the risk of STI transmission. Check out our section on contraception and abortion.
Condoms
Condoms are designed to be worn over a penis or penetrative toy. They’re great protection against STIs that are passed through bodily fluids (such as chlamydia, gonorrhoea, HIV), but they’re less effective against STIs which can be passed through skin-to-skin contact (like Herpes, HPV, and syphilis).
When using a condom, make sure to check the expiry date as expired condoms have a higher chance of breaking.
Gloves
Hands and fingers are often overlooked when it comes to safer sex. Gloves are an easy, effective and sexy way to create a physical barrier to protect both partners. They’re great for covering any skin conditions, cuts, or fresh tattoos that might increase the risk of spreading an STI.
Gloves are handy (pun intended), for fingering, fisting and any other activities involving hands and bodily fluids.
Dams
A dental dam is a thin piece of latex that can be used to practice safer oral sex. It prevents direct oral-genital or oral-anal contact while still allowing for plenty of feel-good stimulation. Using a dam can help reduce the risk of transmitting herpes, and using a dam while rimming reduces the risk of Hep A and bacterial infections like Shigella.
When using a dam, pop some lube on the side which will be touching the body rather than the mouth. Hold it down tight on the sides and make sure it doesn’t flip over while you’re using it. Dams aren’t as common as condoms and can be awkward but remember it’s sexy to be safe and everyone involved will have a better time if they feel comfortable and protected. Dams can be hard to find or expensive, but they’re pretty simple to make from a condom.
Lubes
When thinking about barriers, lube probably isn’t the first thing that comes to mind, but it should! Lube is a crucial and often overlooked tool when it comes to pleasure and safety. Lube helps by reducing friction and making things nice and slippery. Not only does this tend to feel better, leading to more pleasure, but it also reduces the likelihood of your barriers (or sensitive areas) tearing.
Lubes can be water, silicone, or oil-based. Water based lubes wash away easily so they’re the easiest to clean up (but not great for any activities in water). You can get a range of consistencies from super thick to thin and watery. Vulvas and vaginas can be easily irritated by lube ingredients, but something water-based and glycerin-free without other additives is a great place to start.
Silicone-based lubes are less slippery and longer lasting than water-based lubes. These ones are best for anal play or watery sessions (for example bath or shower sessions). Silicone lubes can be used with latex barriers but can cause silicone toys to degrade over long-term use.
Oil-based lubes, including natural oils like olive or coconut, are best used for heavier penetration activities like fisting. They can break down latex barriers so don’t use these with regular condoms or dams. Oils can also linger in some holes and cause infection so wash yourself carefully after using these.
HIV Biomedical Prevention
PrEP
What is PrEP?
PrEP stands for pre-exposure prophylaxis. PrEP is a prescription pill that you take once a day* to protect yourself against HIV.
PrEP is very effective – it works even if you don’t use any other kind of protection – but it requires pre-planning! For the best protection, start PrEP at least a week before any potential HIV risk and continue taking it daily for ongoing protection.
If you decide to stop taking PrEP, wait until it’s been 28 days since your last risky contact (e.g. condomless anal sex).
Although new research has shown that there are other ways of taking PrEP that are also effective (*On-demand PrEP), these dosing options are currently only recommended for cis men who have sex with men.
PrEP does not protect you from other STIs so it’s still important to consider other forms of protection such as condoms and regular testing.
Is PrEP right for me?
PrEP is recommended for anyone considered to be at risk of getting HIV.
Examples of when PrEP may be a good option for you include:
You have a partner who is HIV positive but isn’t on treatment and/or hasn’t been able to achieve an undetectable viral load;
You have anal sex with gay, bisexual, or queer men and don’t always use a condom.
You want to get pregnant using sperm from someone who has HIV.
You share injecting equipment with someone who has HIV.
These are common examples doctors use to assess HIV risk, but they don’t cover every scenario. If you think PrEP could be right for you, get personalised advice from a healthcare provider. You don’t need to see a specialist. In Australia, all general practitioners can prescribe PrEP. Talk to your doctor or call the NSW Sexual Health Infolink to get a free assessment over the phone.
Can I afford PrEP?
If you have Medicare, PrEP is subsidised which means the maximum you have to pay at the pharmacy is $30 per script or $7.30 if you have a concession card.
If you don’t have Medicare, you can import low-cost PrEP and even get additional discounts online. Check out PrEP Access Now for more info.
Keep in mind, you also have to pay for the cost of seeing a doctor and getting routine tests while taking PrEP. These services are free at sexual health clinics, or at a ‘bulk billing’ GP if you have Medicare.
For people without Medicare, the total cost of getting PrEP from a GP can cost up to $400 or more (including the cost of assessment and testing). Sexual health clinics are always free, even without Medicare.
PEP
What is PEP?
PEP is prescription medication that reduces your chance of getting HIV after you’ve had an exposure to HIV. It must be taken within 72 hours of a potential HIV exposure.
Is PEP right for me?
PEP is only recommended for people who may have been exposed to HIV within the past 72 hours. If you think you’ve had an HIV risk, it’s important to act fast. PEP is more effective the sooner you start.
For advice about whether PEP is right for you, call your local sexual health clinic or the NSW PEP Hotline. PEP is available from sexual health clinics, hospital emergency departments (open 24 hours), and general practitioners.
Can I afford PEP?
PEP is medication you take every day for a month. PEP commonly costs $30-40 for a generic prescription (even if you don’t have Medicare), however some regimens can be more expensive than that.
Keep in mind, you also have to pay for the doctor visit and baseline tests in addition to the cost of the prescription itself. These services are free at sexual health clinics, or at a ‘bulk billing’ GP if you have Medicare.
For people without Medicare, the total cost of getting PEP from a GP or hospital can run up to $400 or more. To get PEP from a hospital without Medicare, payment is required before you can see a doctor. Sexual health clinics are always free, even without Medicare.
Undetectable Viral Load (UVL)
What is UVL?
UVL stands for undetectable viral load, which is also known as being undetectable.
These days, people who are HIV positive can easily manage the virus with medication. Treatment can suppress the virus to such a small quantity that it is referred to as an ‘undetectable viral load’ or UVL.
We now have years of research to show that people living with HIV who have an UVL can’t pass the virus on through sex, even if condoms aren’t being used. In other words: undetectable = untransmissible (U=U).
What sort of protection does UVL provide?
For HIV negative people, UVL removes the risk of getting HIV from an-HIV positive partner as long as they are undetectable.
For people living with HIV, staying undetectable over time eliminates the possibility of transmitting the virus to other people. Being undetectable helps protect your organs and nervous system which can by untreated HIV. It also allows your immune system to work properly, protecting you from everyday infections as normal, and giving you a similar life expectancy as your HIV negative peers.
