Friday, April 21, 2017

Triangle of Self-Care: The Game of Safe and Satisfying Sex

By Carlos Diego A. Rozul

There are some things from our childhood that we leave behind. We throw away our old clothes, our old school books, and even our old security blanket. Not all things from our past are thrown away, however. There are a lot that we carry into adulthood such as the lessons we’ve learned, the memories we’ve formed with old friends, and for some of us, even our old toy collection! As we grow older, the games we play tend to get more and more complicated. From the simple rules of Snakes and Ladders to the complex dynamics of a strategic board game, we play to obtain the same objective - to win. When we realize our nature as sexual beings, we begin to play with trust, pleasure, and health. In the game of safe and satisfying sex, the choice is ours to pick what card to draw.


Mutual Masturbation and Dry Humping

The first card we may have drawn when first engaging in sex is manual sex and frottage. In more accessible terms, mutual masturbation (jack off or fingering) and dry humping. These practices pose the lowest risk for HIV infection as the virus has variable chances of survival depending on where the body fluids go. One would be at higher risk if the body fluids come into contact with an open wound, the anus, or the vagina. The mechanics for transmission are as follows:



Oral Sex

A tier up comes oral sex, which includes practices such as felatio (blowjobs), cunnilingus (kissing the clam), and analingus (tossing salad). Oral sex has higher risk due to the possibility of having tiny lesions on the gums or tongue that may go unnoticed after one’s daily hygiene routine. Some men and women may have sores (singaw) that they are not aware of having. It is important to know that one should not engage in oral sex at least two hours before and after brushing one’s teeth. The mechanics for transmission are as follows:


Penetrative Vaginal Sex

One option at the higher end of the risk spectrum is unprotected penile-vaginal contact or simply vaginal sex. The increased modes and mediums for HIV to effectively exit one body and enter another is noteworthy. The risk for transmission reaches its peak if sex is rough. The mechanics for transmission are as follows:


Penetrative Anal Sex

The most high-risk sexual activity one may engage in is penile-anal contact or simply anal sex. Despite it having similar risks to vaginal sex, the possibility of bleeding is much higher than with vaginal sex since the anus does not produce its own lubrication when aroused and penetrated. Unlike the vagina, the anus would require plenty of lubrication and less roughness for the decreased risk of bleeding during sex. The mechanics for transmission are as follows:


Risk Multipliers

Like many games, there are certain instances wherein one can multiply the damage points inflicted to the other player. For sex, certain practices increase the risk of infection. First is the use of different substances such as drugs and alcohol. This can impair one’s judgement to make better choices before and during sex. Second is not communicating clear intentions when meeting with a quick sex partner. It is important that one is clear about what one wants out of a certain meetup. This eliminates the possibility of getting pressured into a potentially unprotected situation.


Protection

A game isn’t complete without a way to protect oneself from the attacks of the antagonists. Similarly, not all defensive moves can deflect the onslaught of the enemy, so it is important to always keep oneself and one’s partner informed about the risks taken when engaging in sex.

First form of protection is the correct and consistent use of condoms (including dental dams) and lubricants. Correctly putting on a condom or dental dam is usually the first line of defense for HIV transmission. It would be best to check the condom before use. Make sure that the condom hasn’t passed its expiration date, and is not too sticky and odorous.

Using plenty of water-based lubricant also decreases the risk of the condom or dental dam being damaged. Silicon-based lubricant, however, may damage the condom or dental dam further due to the interaction of the silicon and plastic polymers.

A second option for protection can be Pre-Exposure Prophylaxis (PrEP). When taken regularly, PrEP can effectively protect you from getting infected with HIV even when having sex without a condom. It is important to note, however, that PrEP only protects you from HIV and not from other sexually transmitted infections (STIs). So, it is important to still wear a condom to avoid this from happening.



The game of safe and satisfying sex could easily be seen as an oppositional turn-based strategy game of who can pleasure the other better. However, it is important to realize that, in this game, you and your partner are teammates. You have the duty to support and protect each other from the real opponent - HIV and other STIs - which can alter your relationship and lifestyle. As teammates, it is important to communicate before sex.

As with any game, we won’t be winning all the time. Each sexual encounter is yet another game to win against HIV and STIs. When we feel the game didn’t go in our favor, we must take the time to step back, evaluate the situation, and act accordingly. This could range from changing the condom when changing positions and after ejaculation to getting tested with your partner after the window period (3 months). Don’t be afraid to talk to your partner about your concerns after sex.



Images by Christian Watson Vergara and Carlos Diego A. Rozul



References:
http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.183.7571&rep=rep1&type=pdf