How to Lower STI Transmission Risk With a Positive Partner

In the past decade or so, sex educators have sought to shift the way people think about sexually transmitted diseases. For starters, we don’t call them STDs anymore, we call them STIs, or, sexually transmitted infections. It’s a subtle shift meant to denote that these are conditions that can be passed from person to person, but not necessarily long-lasting or life-altering ones, which the word disease may connote. Further, calling them infections can help people see them as more akin to colds or flus — not necessarily fraught with the moral baggage they used to carry. For lots of people, and for many STIs, the process from infection to treatment to recovery can be a fairly straightforward medical process, not freighted with the burden of sexual shame and regret that STIs had long been associated with. RELATED: What to Do When You Have a Sexually Transmitted Infection As such, the stigma for people with infections has lessened significantly. And thankfully, they can go about their lives (romantic, sexual, or otherwise) without as much fear of judgment, rejection, and isolation. But what happens if you want to sleep with someone and find out they have an STI? Sexual health advice given to young people focuses around risk mitigation when you cannot be sure that a given sexual partner does not have a given infection. But what about when you’re sure that they do? Is it possible to have no-risk sex by taking the appropriate steps? In order to get a better handle on this question, AskMen spoke to a number of experts in the field. Here’s what they had to say: Having Sex With Someone With an STI While it may not be possible to be 100% confident that sex with an STI-positive partner won’t lead to transmission, to some degree, the same issue exists when having sex with someone whose STI status you don’t know (or who you believe to be STI-free). Many people who think they don’t have an STI are mistaken, and some people who do have one and know it may lie about it. Unless someone tells you they’re positive, sex is an exercise in trust; on the other hand, knowing someone has an STI removes that guessing game from the equation. RELATED: How to Tell a Partner You Have an STI So, if you decide to proceed, sex with someone who has an STI becomes a question of risk minimization and mitigation while also navigating the other basics when it comes to sex: desire, boundaries, consent, and comfort. “There are a lot of things you can do to reduce risk of transmission when one partner has an STI but the other does not,” says Dr. Justin Lehmiller, Lovehoney Scientific Advisor and Kinsey Institute Researcher. “Condoms can significantly lower the risk of transmitting most infections, but there are many other tools that can assist in further lowering risk.” While condoms are an important tool in the toolbox of preventing STI transmission, unfortunately wearing a condom alone won’t offer you 100% protection. “It's possible to have sex with someone with an STI without catching it, though there will always be a risk,” says Vicki, sexual wellness expert at Bodyjoys. “The most common preventatives are thick condoms or dental dams. However, some of the most contagious STIs such as herpes and syphilis can even be transmitted whilst wearing these, because they can be transmitted from skin-on-skin contact in the surrounding area not covered by the condom.” That reality is one of the reasons that sexual health experts don’t use the term “safe sex” anymore, but instead, “safer sex.” Unfortunately, “there is always a risk of contracting a STI if having sex with an infected partner,” says Rhiannon John, sexologist at Bedbible.com. “As there are many variables, it's always best practice to speak to your healthcare professional about your individual needs to protect yourself and your partner.” RELATED: Safer Sex Mistakes That Can Lead to STIs That being said, having sex with an STI-positive partner isn’t a completely unique form of risk-taking behavior. “It’s also worth noting that that risk is inherent to all activities and interactions,” says Jess O’Reilly, Ph.D, host of the Sex With Dr. Jess podcast. “When you eat, you could potentially come into contact with bacteria that can lead to infections. When you socialize, you could (and will) come into contact with viruses.” “In some cases, testing and treating for STIs is, in fact, simpler than dealing with colds and flus, but we treat STIs as unduly catastrophic due to sexual shame,” she adds. RELATED: What Is Sex Negativity and Why Is It a Harmful Concept? While the possibility of transmission may make things more complicated, it also means there’s room for more experimentation, rather than relying on traditional sexual scripts. “It takes a bit of strategy, honesty, and a little creativity in the bedroom,” says Emily May, an AASECT-certified sex therapist and writer for Private Sugar Club. “This is one of those topics I talk about all the time with clients who come to me worried about their sex life after contracting an STI.” Strategies for Minimizing Transmission Risk Explore Your Medical Options If the person you want to sleep with is able to, numerous medications may help reduce the transmissibility of their infection — and certain medical treatments could make you more immune to catching it. “If you have an STI, managing your infection may help reduce the risk of transmission, depending on your STI,” says John. “It’s always best to speak to your healthcare provider to assess your individual circumstances.” “Depending on the infection, you might also explore other tools like PrEP for HIV prevention, vaccines for hepatitis and HPV, or DoxyPep for preventing bacterial infections,” says Lehmiller. “For example, in the case of HIV, if the infection is effectively managed (i.e., viral load is suppressed to undetectable levels) and the HIV-negative partner is on PrEP, the risk of transmission is near zero.” “Likewise, if one partner has HPV but the other does not, the uninfected partner can lower their risk by getting the HPV vaccine,” he adds. “Further, if one partner has herpes, they can reduce risk of transmission by taking anti-viral medication and by avoiding sexual activity during outbreaks.” Talk About It “Having sex with a partner who has an STI is based on trust, more than usual,” says May. “It's up to them to explain the nature of their STI and full transparency of where and how it can be contracted. There's a lot more at stake, so it's important to educate yourself and not engage until you're fully informed and understand all of the risks involved.” Want to know more about this and other aspects of sexual health? Lehmiller recommends checking out Lovehoney’s STI Education guide. However, being prepared and aware of the risks involved doesn’t mean things can’t stay sexy. “Talk about your concerns, so that all parties involved feel equipped to reduce risk. And focus on pleasure,” says O’Reilly. “Chip away at sexual shame. The shame of STIs is often considered the most difficult symptom to treat.” Avoiding Unprotected Oral Lots of people see oral sex as a ‘lesser’ form of sex compared to vaginal or anal penetration, and following that thinking, they may imagine that it’s also less risky when it comes to STI transmission — but that’s not the case. “What you should not do is engage in [unprotected] oral sex, something many people think is safe but actually isn’t,” says licensed sexologist Sofie Roos. “Almost all STIs can transmit via oral sex.” Depending on the STI in question and its relative transmissibility, using a condom or a dental dam can significantly reduce the risk, however, possibly down to near-zero. On the flip side, however, some people may find that barrier protection methods impact the experience of oral sex more than penetrative sex — but that’s a question of personal preference. Get Tested “First, know your status by getting tested regularly and communicate about this with your partners,” says Lehmiller. If you have contracted an STI from a partner, catching it before symptoms start showing, via testing, is the best way to prevent further spread — as well as giving you a chance to treat it yourself before its effects worsen. “If an STI can be treated, consider taking meds to reduce viral load and outbreaks,” says O’Reilly. “If an STI can be cured (e.g. chlamydia, gonorrhea, syphilis, and trichomoniasis), you can take antibiotics.” Lower-Risk Alternatives to Penetrative Sex In some cases, someone’s STI status may mean that penetrative sex just doesn’t make sense for you, even factoring condom use and other preventative approaches. While that can be disappointing, it doesn’t mean that you can’t explore any kind of erotic connection in person. A number of options exist that either significantly lower or remove the danger of transmission entirely, largely in the realm of things that fall under the umbrella of non-penetrative sex, or outercourse. Hand Play “There are so many ways to keep things sexy without worrying about STI transmission,” says Emily May. “Manual stimulation, for example, is highly underrated.” “Using your hands reduces the risk of fluid exchange, which can reduce the risk of transmission of STIs that require fluids to enter the bloodstream for transmission,” says O’Reilly. Activities like vaginal fingering, anal fingering and handjobs can be a fun, lower-risk option in that case. “Non-penetrative sex can potentially reduce infection risk,” Lehmiller agrees. “However, it depends what you do with your hands. For example, if you touch your partner's genitals with your hands and then touch your own, you’re still creating opportunities for infections to spread.” Using medical gloves could be an option here, however — like a condom or dental dam for your hands. RELATED: Common Condom Mistakes “One couple I worked with got really into exploring touch in ways they hadn’t before,” says May. “Gloves and dental dams both allow you to stimulate your partner safely. It's a little underrated but versatile. These tools don’t just reduce risk; they can add some playful curiosity to your sex life.” This is a great approach “for STIs that are transmitted through bodily fluids like blood and semen,” says John. “STIs like gonorrhea are transmitted through unprotected vaginal, anal, or oral sex. So sexual practices outside of those, like manual stimulation, will greatly reduce the risk of transmission.” However, Roos says, “STIs that still can transmit via sexual stimulation that’s not involving penetration are herpes, syphilis, HPV and scabies.” Mutual Masturbation What about both of you pleasuring yourselves, rather than each other, simultaneously? “Mutual masturbation as an alternative can lower the risk of transmitting an STI in certain cases,” says Vicki. She notes that you can use sex toys in this case — but that sharing sex toys could lead to transmission, so you should each stick to your own. “For the truly risk-averse, mutual masturbation can be incredibly intimate,” May agrees. “Adding intense eye contact during that moment can crank up the connection like nothing else. Add in a little dirty talk, and you might not even miss the penetration.” Nipple Play Stimulating non-genital erogenous zones, like the nipples, neck and ears, is generally safe, says Roos. Here, too, this could be paired with dirty talk to help make the moment feel more erotic. RELATED: How to Play With Her Breasts Dry Humping “You might also decide to avoid certain activities that are higher risk,” says Lehmiller. “There are all kinds of ways to be sexual and intimate without penetration,” he says, including the infamous act of dry humping, or grinding your genitals against each other while still wearing clothes. While this is often associated with young or inexperienced lovers who aren’t yet ready for ‘full penetration,’ it can be an incredibly intimate and sexy form of foreplay as you build sexual tension without reaching a conclusion. Dry humping for a bit followed by a mutual masturbation session? Low risk, high reward. You Might Also Dig: The Best Proven At-Home STI Test KitsWhat Are Sexual Boundaries?Here’s What It’s Like to Take a Home STI Test