Safe Sex & Getting TestedNSW Women Partners of Bisexual Men

If there’s a chance your partner might have sex with someone else, whether it is with a woman or a man, it’s important to protect yourself from contracting HIV and other sexually transmitted infections.

Your choices…

You have the right to only have sex that you feel comfortable with.

Participating in sex (or not) is your choice because it involves your body.

If you feel pressured to have sex in order to keep your relationship intact, or because you feel a threat to your personal safety, we recommend discussing this with a counsellor or doctor.

Safe Sex means having a clear, spoken agreement about sex within and outside your relationship, or using a condom every time you have vaginal, anal or oral sex.

Being prepared can also help to make sex safer:

  • Discuss with your partner how you will both protect yourselves sexually.
  • Have a supply of condoms ready (Sometimes condoms are provided free at women’s health centres, sexual health clinics and Family Planning).
  • Become familiar with how to use condoms correctly. Read the instructions on the packet carefully, check use-by dates and use water-based lubricant. These days there are lots of choices of condoms, so try a variety to find what best suits you and your partner.
  • Have routine check-ups with your partner at a sexual health clinic (free of charge).

What should I do if I have had unprotected sex?

If you have had unprotected sex and think you may be at risk you should seek medical advice as soon as possible, whether or not you have any symptoms. Many STIs can be treated, but delaying treatment could have consequences.

 If you believe you have been exposed to HIV within the last 72 hours you can begin taking PEP (post-exposure prophylaxis). It is believed PEP may prevent HIV infection if you have been exposed to the virus – however you need to act fast. To be effective, PEP must be started as soon as possible after exposure, preferably within a few hours. PEP is unlikely to work if it is started more than 72 hours after exposure to HIV.

PEP is a four week course of anti-HIV (retroviral) medication.

You can be assessed for PEP at a sexual health clinic (during the day), Hospital emergency departments (open 24 hours), and by doctors who specialize in HIV.

For more information about PEP call 1800 737 669 or go to www.health.nsw.gov.au/sexualhealth

For the list of sexual health in NSW go to http://www.health.nsw.gov.au/sexualhealth/Pages/sexual-health-clinics.aspx

Many women ask ‘Why should I be worried about Safe Sex?’ The answer is really very straightforward… If you are in a relationship with a man who is sexually attracted to other men it is important that you look after your own health as your first priority. Perhaps your partner hasn’t acted on his homosexual attractions at this point. However, if he does, it might be difficult for him to tell you at first. It’s therefore important for you to take steps to avoid the risk of contracting sexually transmitted infections (STIs), including HIV.

Some people say ‘people like me don’t get sexual diseases!Anyone who is sexually active can get a sexually transmitted infection (STI). Any sexual activity which includes the exchange of semen, vaginal fluid or blood can transmit infections, and other STIs can be transmitted by skin contact.

‘How can I tell if my partner or I have an STI?‘ Some STIs will have symptoms (e.g. unusual discharge, bleeding, rash, sores, blisters, itchiness, lumps or pain in the genital area). However, it is possible to be infected without showing any symptoms at all. The only way to be sure is to have a medical check from your doctor or sexual health clinic (see Getting Tested). Treatments are available for all STIs, not all are curable but most can be effectively managed with the correct treatment. Untreated STIs may cause long-term health problems such as infertility or sickness.

Other women have said ‘my husband promised he wouldn’t put me at risk’.
The best person to look after your own health is you. It may be uncomfortable to realise but sometimes the male partner will find it very difficult to be completely truthful about his activities with his wife or partner. To avoid hurting her feelings or causing a scene, he may choose to be not completely honest. Safe Sex practices can protect you from contracting HIV and other STIs. ‘Safe Sex’ is any sexual activity which does not allow semen, vaginal fluids or blood to pass from an infected person into the body of another person. If you want to have sex, there are many sexual activities you and your partner can engage in that are safe and fun, which can reduce the risk of STI transmission.

'SAFE SEX'

‘Safe Sex’ includes…

Intercourse with a condom – Intercourse (or sex that involves penetration by your partner’s penis) is the main way that STIs, including HIV can be transmitted. Anal or vaginal intercourse without a condom can therefore represent a risk to your health. Without a condom for improved protection, infected semen or pre-cum may enter the bloodstream through the lining of your vagina or rectum. As the HIV virus occurs in pre-cum, withdrawing before ejaculation is not an effective protection. (See further information about male and female condoms, below.)

Receiving oral sex by using a dental dam. If your partner has bleeding, gum disease, ulcers or other infections in his mouth or throat there can be risk of contracting some STIS (such as Herpes). Bleeding may be caused by brushing teeth, flossing or eating sharp foods. If you are in any doubt you should use a dental dam for oral sex. A dental dam is a square piece of thin latex that is stretched across your vagina to prevent the exchange of bodily fluids. You can also make a dental dam out of a condom or latex glove.

Kissing – Saliva will not transmit HIV or most other STIs, so kissing is generally considered safe, provided that you and/or your partner has no bleeding, gum disease, ulcers or other infections in his mouth or throat.

Mutual masturbation – Touching and rubbing each other’s penis or vagina is considered safe, provided that there are no cuts or sores on your partner’s penis or hands. This does not include frottage.

Massage – All forms of sexual enjoyment with only skin contact, such as massage or body stroking, carry no risk of transmission of HIV or other STIs (possibly with the exception of pubic lice).

Use of sex toys – vibrators and other sex toys are considered safe provided they are used to penetrate only one person and do not come into contact with blood or semen. Objects used for penetration of more than one person should be used with a condom and washed thoroughly after each use.

Dressing up or role-playing as part of a fantasy is completely safe, provided it does not include any of the unsafe sex practices listed below.

Agreement – In the context of a trusting relationship in which both partners are completely honest, safe sex may involve having a clear, spoken agreement about sex within and outside the relationship that protects your sexual health. If you have any doubt at all about what your partner is telling you, don’t rely on the agreement alone. It is better to be safe and then you can relax.

'UNSAFE SEX'

‘Unsafe Sex’ includes:

Intercourse without a condom – Anal or vaginal intercourse without a condom represents a risk of transmission of HIV and other STIs.

Giving Oral Sex

Giving oral sex to your partner, provided he doesn’t ejaculate into your mouth, is considered to carry only a small risk. However any bleeding, gum disease, ulcers or other infections in your mouth or throat may increase the risk of contracting an STI, eg. Herpes in the mouth. Bleeding may be caused by brushing your teeth, flossing, recent dental work or eating sharp foods. If in doubt, insist your partner uses a condom.

USING CONDOMS

Male Condoms come in a variety of shapes, textures, flavours, colours and sizes to ensure sex is fun and safe. Experiment with different types to discover which ones you and your partner like best.

Keep a supply of condoms ready to ensure you always have one when you need it. Condoms can be bought in chemists and most supermarkets. Free condoms can be obtained from women’s health centres and sexual health clinics.

Become familiar with how to use condoms correctly. Read the instructions on the packet carefully, check the use-by date and be sure to use lubricant. Once you are both familiar with the use of condoms, you can play with them and have fun with their use. Ensure lubricants are water-based and recommended for use with condoms. Oil-based lubricants can damage the condom.

The Female condom has two rings to keep it in place. The ring at the closed end of the condom fits inside the vagina while the ring at the open end stays outside. These are available through Family Planning and can also be ordered over the internet.

IF YOU ARE PLANNING A FAMILY

If you and your male partner are planning to have children and there is a possibility he may be having sex outside your relationship, you need to consider how to conceive in a way which is not risking your health or the health of your child. This may include being assured that any sex he may be having is safe; having a full STI screen and discussions about no sex outside the relationship while attempting to achieve a pregnancy or another option may be to have your partner’s sperm tested and stored in a fertility clinic for insemination.

‘Safe sex has been a difficult subject to approach because I didn’t want my husband to think I don’t trust him. But because I suspect he’s not being completely honest with me, I know its important that when we have sex that it’s always safe sex.’ — Pauline, 15 year relationship

‘I realized it would be awkward for my boyfriend to suddenly suggest using condoms, so we agreed to use them all the time, just to be on the safe side. That way I don’t have to worry about the wart virus and any other STIs.’ — Rana, 6 month relationship

Getting Tested

If you have become aware that your male partner is attracted to, or is having sex with men, you will need to consider the possibility that he might have contracted a sexually transmitted infection and passed it on. This may be something that you have never needed to think about before, but now this has all changed.

Getting tested can also allow you to put your mind at rest with regard to the possibility of HIV and other sexually transmitted infections. It may also give you an opportunity to assess any of your partner’s behaviours which have put you at risk, and allow you to consider how to keep yourself safe from now on.

Women sometimes say they feel embarrassed and may even be angry they have to have be tested for sexually transmitted infections – especially if they believed their relationship was monogamous. But avoiding being tested doesn’t change your situation, it just means you’re potentially delaying treatment and putting your health further at risk.

Many STIs are easily treated and have good health outcomes the earlier treatment starts. If you test positive for HIV, early diagnosis will provide you with greater treatment options. The new drug combinations are effective in inhibiting HIV in the body and the earlier this can be done the better. Other sexually transmitted infections also have better health outcomes if treated early.

Sexual health clinics or your local GP will be able to give you a full sexual health screen. If you can, tell them you’ve been with a man who may have had unprotected homosexual activity. This will help them know the tests you may need.

Tests to ask to have included are:

  • HIV
  • Chlamydia
  • Gonorrhoea
  • Syphilis
  • Hepatitis
  • Non-Gonococcal Urethritis
  • Crabs/Pubic Lice
  • HPV
  • Trichomoniasis

It is also important to be up to date with your two yearly pap smears. Regular pap smears help detect early changes to the cervix caused by the Human Papilloma Virus (HPV).

Herpes and Genital Warts can be tested if you have symptoms.

For more information about sexually transmitted infections go to:
http://www.health.nsw.gov.au/sexualhealth/Pages/default.aspx

Contact Us if you’re wanting to talk. For some women getting tested can be a worrying time. If you have concerns we would like to answer any questions you may have and provide you with support.